On some paleopathological examples of amputation and the implications for healthcare in 13th-17th century Lithuania.

OBJECTIVE: To explore care that was likely provided to an adult male amputee from medieval Lithuania, positioning analysis within what is known of contemporary amputation practices. MATERIALS: Three sets of skeletal remains with evidence for amputation, dating to between the 13th-17th centuries AD and recovered during different archaeological excavations in Vilnius, Lithuania. METHODS: Macroscopic inspection of lesions, with additional X-ray analysis of the main subject. The Index of Care was used to investigate possible caregiving. RESULTS: Two individuals experienced amputation of a single element, and the third experienced bilateral hand amputation. Only one individual displayed healing. Historic sources suggest use of amputation for punitive purposes during this period, and judicial punishment is proposed as the most likely reason for amputation in at least two cases. CONCLUSIONS: Evidence of long-term healing in one individual suggests receipt of care. This individual likely relied on family and/or community members for survival immediately following amputation, and subsequently for support in managing disability. SIGNIFICANCE: Successfully combining osteology with history in a framework for analyzing care provision in past Eastern European society, this study underlines the critical importance of context in undertaking bioarchaeology of care analyses. It also adds two examples of perimortem abscissions in this region to the paleopathological record. LIMITATIONS: Our approach relied on skeletal interpretation. Soft tissue was lost to decomposition and no relevant archaeological evidence was found in association with the remains. SUGGESTIONS FOR FURTHER RESEARCH: A review of skeletal collections may allow identification of overlooked cases of amputation (and care).

A possible case of paralysis in early modern Vilnius and the implications for social care.

OBJECTIVE: To present a case of possible paralysis from early modern Vilnius and to discuss the potential level of care that was provided in the society of that time. MATERIALS: A partially disturbed skeleton of a young female from a 16th-17th century Orthodox Christian cemetery. METHODS: Macroscopic, osteometric and X-ray examinations coupled with a literature review aimed at providing a differential diagnosis. RESULTS: The skeletal remains showed signs of disuse atrophy most probably due to a neurological disorder acquired in the woman's late teens. Differentials suggest that the observed limb atrophy was most likely a consequence of poliomyelitis. CONCLUSIONS: The case of a young female with paralysis presented in this paper could serve as an example of care provided by her household. SIGNIFICANCE: This study substantially contributes to further understanding of the nature and quality of care provided to disabled individuals in their households even in the absence of written sources. LIMITATIONS: There is a degree of diagnostic ambiguity due to the application of routine clinical criteria to paleopathological cases. SUGGESTIONS FOR FURTHER RESEARCH: The article makes several recommendations for future research, e.g., systematic investigation of possible cases of bone atrophy in a broader sociocultural context, as well as searching for evidence of gastrointestinal infections, especially poliomyelitis, supplemented by the application of biomolecular technologies.

Diet patterns in medieval to early modern (14th-early 20th c.) coastal communities in Lithuania.

Coastal residents are quite often expected to consume a significant amount of aquatic resources, though historical evidence often reveals a rather complex diet. To better understand the actual consumption and the distribution of various foods, stable isotope (δ13C and δ15N) analyses were employed to skeletal remains from three coastal communities, Palanga, Kretinga and Smelte, ranging in date from the medieval period to the early modern ages (14th-early 20th c.) near the Curonian Lagoon and the Baltic Sea in Lithuania. Animal bones from the region, covering the same time periods, were also analysed. Stable isotope results were compared with historical records. According to historical sources different types of diet were prevalent during that period of time: Medieval Prussian-Lithuanian peasant, Lithuanian fisherman, German urban, and religious-based. Elevated δ15N values for Smelte samples suggest a diet consisting of considerable amounts of freshwater fish protein, which is in contrast to historical sources. There were no significant differences in stable isotope values between males and females, while subadult δ15N values were significantly higher than adult ones, indicating that those children were breastfed for an extended period. Meanwhile, Palanga and Kretinga samples had isotope values suggesting a high reliance on terrestrial resources and a peasant type of diet.

A treponemal genome from an historic plague victim supports a recent emergence of yaws and its presence in 15th century Europe.

Developments in techniques for identification of pathogen DNA in archaeological samples can expand our resolution of disease detection. Our application of a non-targeted molecular screening tool for the parallel detection of pathogens in historical plague victims from post-medieval Lithuania revealed the presence of more than one active disease in one individual. In addition to Yersinia pestis, we detected and genomically characterized a septic infection of Treponema pallidum pertenue, a subtype of the treponemal disease family recognised as the cause of the tropical disease yaws. Our finding in northern Europe of a disease that is currently restricted to equatorial regions is interpreted within an historical framework of intercontinental trade and potential disease movements. Through this we offer an alternative hypothesis for the history and evolution of the treponemal diseases, and posit that yaws be considered an important contributor to the sudden epidemic of late 15th century Europe that is widely ascribed to syphilis.

A rare case of child abuse from early modern Lithuania.

The aim of this article was to describe the outcome of a probable case of physical abuse in the remains of a child dating from the 16th-18th centuries CE. The skeleton of a subadult was recovered during archaeological excavations carried out in the village of Uzubaliai, located in Alytus in southern Lithuania, and subsequently curated in the Faculty of Medicine at Vilnius University. The bones of this child were observed macroscopically and then submitted for radiological investigation. In order to speculate on the presence of abuse, features such as the presence, quantity, and type of injuries were considered. Stages of healing and the occurrence of additional nonspecific stress markers, such as linear enamel hypoplasia or Harris lines, were also recorded. The remains revealed the presence of lesions showing three stages of healing, including antemortem and perimortem fractures. Periosteal reactions were also observed on many of the bones. Traumas with high specificity for abuse, such as rib and scapular fractures, were assessed. Finally, endocranial new bone formation was also noted as a possible sign of neglect. The pattern of observed injuries showed evidence that was compatible with a case of physical abuse.

Four cases of beheading from 14th-17th century Lithuania.

ABSTRACT: Skeletal evidence of beheading in early modern Lithuania has been scarce, despite historical documentation indicating it as a popular practice. This study presents the first bioarchaeological cases of decapitation in early modern Lithuania, with four adult male individuals from the 14th-17th centuries A.D. that reveal evidence of perimortem lesions in the cervical and thoracic vertebrae. The osteological and radiological study of the affected bones suggests that the individuals might have been victims of episodes of interpersonal violence, rather than subjected to capital punishment.

Paleoimaging of a modern mummy from Lithuania (circa 19th-20th century).

An anthropogenic human mummy curated in the Museum of the History of Medicine, Vilnius University, was recently examined by means of computed tomography. Although the mummy lacked data regarding its specific context and historical information on its identity and chronology, the investigation focused on the embalming method adopted to preserve it. Some pathological alterations were also recorded. This research appears to suggest that this body was prepared for educational and/or scientific purposes rather than funerary purposes. Hence, the case could be categorized as a "medical mummy" prepared between the mid-19th and the mid-20th centuries.

Taphonomic considerations of a whipworm infection in a mummy from the Dominican Church of the Holy Spirit, Vilnius, Lithuania.

In the present study, the abdominal contents of 10 mummies from beneath the Dominican Church of the Holy Spirit in Vilnius, Lithuania, were examined for the presence of helminth parasites using standard archaeoparasitological techniques. Of the mummies examined, only one individual presented with evidence of parasitism. This individual was infected with both Trichuris trichiura and Ascaris lumbricoides (5,222 parasite eggs/gram). The conditions of many of the T. trichiura eggs suggest that a fortuitously embedded female whipworm decomposed within the individual's gut to release the eggs, as opposed to the eggs actually being passed by the adult helminth. This study highlights a taphonomic issue unique to mummies by demonstrating the differential preservation of parasite eggs existing in various stages of development. Whenever one is not dealing with parasite eggs that have already been passed by the host, as is the case when analyzing intestinal tissues, one must understand that some types of parasite eggs may not be fully formed. It is imperative, as demonstrated by our findings, that researchers have the knowledge to recognize under-developed intestinal helminth eggs in addition to fully formed intestinal helminth eggs from mummy source materials. Together, these findings demonstrate the persistence of these helminth parasites in Europe during the 18th and 19th centuries and represent the first archaeoparasitological evidence from mummies in Vilnius, Lithuania.