Differentiating between rhinosinusitis and mastoiditis surgery from postmortem medical training: A study of two identified skulls and hospital records from early 20th century Coimbra, Portugal

Trepanations in non-adults of the 16th to 18th C. The osteological series of the Church of the Assumption of Valdepeñas (Ciudad Real, Spain)

OBJECTIVE

To investigate the presence of trepanations in an early Modern Age, skeletal collection documented in medical treatises but infrequently reported in osteological collections.

MATERIALS

Analyses were conducted on 387 non-adult crania from the ossuary in the church of the Assumption of Valdepeñas (16th - 18th C.), Ciudad Real, Spain.

METHODS

All complete or semi-complete crania of non-adults (aged 3-20 years) were macroscopically examined.

RESULTS

Trepanation was detected in two adolescents aged 14 and 20 years; no evidence of their survival was observed.

CONCLUSIONS

These findings suggest that trepanation was carried out in rural areas as Valdepeñas in the 16th-18th centuries, where the selection of instruments indicates knowledge of contemporaneous medical treatises.

SIGNIFICANCE

The present study provides new data on trepanation and how it was performed in adolescents during this period.

LIMITATIONS

Understanding the motive for these interventions is highly challenging in the absence of bone lesions, and their occurrence is likely underestimated due to the scant research in skeletal remains from the early Modern Age.

SUGGESTIONS FOR FUTURE RESEARCH

Further palaeopathological analyses of osteological collections from this period will provide more information about how this surgical technique was perfected.

Changes in mortality in a non-industrialized Portugal: Coimbra Municipal Cemetery records (1861-1914) and identified osteological collections

OBJECTIVE

To investigate if there were changes in mortality knowing that industrialization was a slow and late process in Portugal.

MATERIALS

The biographic information (1) of the individuals buried at the Coimbra Municipal Cemetery, considering three quinquennia: 1861-1865 (n = 1111, 18.3%), 1870-1974 (n = 2602, 42.7%), 1910-1914 (n = 2374, 39.0%), related to the periods before, during and at the end of the second industrialization and (2) of the Coimbra identified osteological collections (CIOC, N = 1796) composed of individuals who were born and died in the city.

METHODS

Excel databases with the biographic information were analyzed with SPSS.

RESULTS

Data from the cemetery show statistically significant differences between sexes and age-at-death mortalities. Non-adult mortality (higher in the age range from 1 to 7 years) has decreased over time which has increased mean age-at-death. The main adult occupations are domestic work (females) and craft activities (males). Child labor is common after the age of 14. The main causes of death (in both cemetery and CIOC records) were infections, respiratory diseases, heart disease, and malignant neoplasm. Among the communicable diseases, tuberculosis accounted for the highest number of deaths. The identified individuals have lesions compatible with tuberculosis and sinusitis while malignant neoplasms are more difficult to identify. The high prevalence of heart disease can overshadow other causes of death.

CONCLUSIONS

In the absence of industrialization, tuberculosis, heart disease, and malignant neoplasms increased over time, while respiratory diseases decreased.

SIGNIFICANCE

Mortality profile changed between 1861-1864 and 1910-1914 in Coimbra.

LIMITATIONS

The causes of death were studied, but not all diseases.

SUGGESTIONS FOR FURTHER RESEARCH

Study of other cemetery records for further comparison.

The Importance of Historical Medical Records Review in the Interpretation of Dry Bone Lesions on Identified Skeletal Remains: A Case Study of a Polymorbid Male (1895-1940)

ABSTRACT

The examination of documented skeletal remains provides an exceptional opportunity for biohistorical research to answer questions about an individual's life and death. Research in this area also makes it possible to assess the reliability of historical records from the period of interest, which is often the subject of discussion, especially in cases of historically known individuals. The remains of K.B.C. (1895-1940), a prominent local landowner and politician, were exhumed because of the repair of a family tomb in Jíloviště, Czech Republic. The aim of this study was to analyze pathological changes in his bones and to interpret these by comparing them with the results of a historical medical records review of private family and public archives regarding his diseases and death, thus verifying their credibility. Morphological and X-ray examinations of the bones revealed several serious pathological changes, whose presence fully corresponded to the studied documents. This showed the records' reliability, and it was thus possible to accurately interpret the lesions found. The results demonstrated the need for interdisciplinary collaboration in the analysis of such cases, including the assistance of the living descendants of the studied individuals, if possible.

Evidence of otitis media and mastoiditis in a Medieval Islamic skeleton from Spain and possible implications for ancient surgical treatment of the condition

OBJECTIVE

To evaluate lesions on a cranium from the Iberian Peninsula and assess its medico-historical and paleopathological significance.

MATERIALS

The skeletal remains of a juvenile individual found in a Medieval Islamic grave (10th -16th century) in Eastern Spain.

METHODS

Macroscopic examination of the left and right temporal bones, binocular microscopy, X-ray, and Scanning Electron Microscopy - Energy Dispersive X-ray Spectroscopy (SEM-EDS) were performed.

RESULTS

A sub-oval perforation superior to the right mastoid process and pathological changes on the right temporal bone were identified. SEM-EDS confirmed the presence of copper in the surrounding area of the perforation.

CONCLUSIONS

The observed pathological changes are most likely compatible with otitis media and subsequent mastoiditis. The sub-oval perforation could be interpreted either as an abscess or as evidence of a surgical procedure (mastoidectomy) or a combination of both; and the Cu traces may be the result of an associated object or, possibly, the application of a plaster with copper acetate used as medical treatment.

SIGNIFICANCE

This case contributes to the paleopathological record and the interpretation of similar cases, and also helps in the understanding of medical care and treatment in Medieval Islam.

LIMITATIONS

The lack of similar pre-modern cases of surgical intervention limits comparability to clinical cases. Suggestion for further research: Exploration into indicators of health care in past populations.