Age- and sex-related changes in vertebral trabecular bone architecture in Neolithic and Mediaeval populations from Poland.

This paper investigates trabecular bone ontogenetic changes in two different Polish populations, one prehistoric and the other historical. The studied populations are from the Brzesc Kujawski region in Kujawy (north-central Poland), one from the Neolithic Period (4500-4000 BC) and one from the Middle Ages (twelfth-sixteenth centuries AD), in total 62 vertebral specimens (32 males, 30 females). Eight morphometric parameters acquired from microCT scan images were analysed. Two-way ANOVA after Box-Cox transformation and multifactorial regression model were calculated. A significant decrease in percentage bone volume fraction (BV/TV; [%]) with age at death was observed in the studied sample; Tb.N (trabecular number) was also significantly decreased with age; trabecular separation (Tb.Sp) increased with advancing age; connectivity density (Conn.D) was negatively correlated with biological age and higher in the Neolithic population. These data are found to be compatible with data from the current biomedical literature, while no loss of horizontal trabeculae was recorded as would be expected based on modern osteoporosis.

The Reformation.

The most important text at the end of the Middle Ages was the Bible. It had been published in manuscript on parchment bound between wooden covers. The production of such a book was time consuming and expensive. Martin Luther's proclamation of 95 theses directed against the practice and authority of the Roman Catholic church led to a speedy opposition from the church. However, the modern availability of paper and printing together with the printing of images, resulted in a rapid distribution of the bible in German. The church authorities had banned the spreading of literacy outside the clergy, but the publishing of Luther's bible involved the use of techniques which could be applied to other disciplines, improving the quality of the information on which their activities was based. This included the practice of surgery.

Two surgical instruments.

The only instruments for opening the cranium considered in this chapter are drills, and in some cases facilitated with a special chisel called a lenticular. There were two kinds of trepan. The modiolus was the Latin name for a crown trepan which had a circular base with teeth which sawed a hole. Then there were the non-penetrating trepans which had a bit shaped to prevent unwanted penetration. They made small openings which could be joined by chisels to remove altogether larger areas of bone than were accessible to modioli. They were the favored instrument from the ancient world up to the Renaissance. At the beginning of the Renaissance, there was a move toward greater use of crown trepans and various methods were applied to stop them sinking too far inward. These included wings in the outer wall and changing the shape of the bit from cylindrical to conic. In time preferences returned to the cylindrical shape and larger diameters. There was also two instruments called lenticulars, the illustrations of which have been confused in the literature. It is now clear that the Roman instrument was shaped to cut the cranium and minimize the need for trepanation. The Renaissance instrument had a different shape and was used to smooth rough bone edges and excise spicules penetrating the meninges. They were simply two different instruments to which the same name was applied.

The meninges.

The dura was first described in ancient Egypt. Hippocrates insisted that it should be protected and not penetrated. Celsus proposed an association between clinical findings and meningeal damage. Galen proposed that the dura was attached only at the sutures, and he was the first to describe the pia in humans. In the Middle Ages, new interest in the management of meningeal injuries arose, with renewed interest in relating clinical changes to intracranial injuries. These associations were neither consistent nor accurate. The Renaissance brought little change. It was in the 18th century that it became clear that the indication for opening the cranium following trauma was to relieve pressure from hematomas. Moreover, the important clinical findings on which to base an indication for intervention were changes in the level of consciousness.

The pericranium.

The purpose of this chapter is to present how past surgeons have viewed the pericranium and how they have reacted to its appearances. In ancient times, the membrane was considered formed by the dura through the sutures and it retained a relationship with the dura via vessels in the sutures. It was considered advisable to strip it totally from any area to be examined for fissure fractures and also for any area to be trepanned, as pericranial injury was thought to lead to fever and inflammation. In the 18th century, a new idea arose that posttraumatic spontaneous separation of the pericranium from the bone was a reliable indicator of the development of intracranial suppuration. This idea was subsequently refuted. For over two millennia, the pericranium was considered to be an important membrane requiring the close attention of the surgeon. It is no longer required to receive more than minimal attention.

Evolution of understanding.

From the time of Hippocrates to the early 19th century, knowledge advanced but that was an uneven process. Anatomy was basically defined by Galen and remained cast in stone until the early 16th century. Neuroanatomy was described by Galen but had little practical value, as brain surgery was not possible. The anatomy of the cranium was known and was largely correct. Care was taken to avoid the frontal air sinuses and the venous sinuses and the temporal region. The role of the brain in consciousness was not understood. It was considered the seat of the soul but there was a lack of understanding that damage to it could induce clinical symptoms such as stupor or paralysis. These were variously attributed to injuries to the meninges or the bone. This error was finally corrected in the 18th century when the brain was identified as responsible for much of the clinical disturbance following cranial trauma. All awareness that post traumatic neurological deficit was contralateral was ignored until the late 18th century, although several authors noted it. Likewise, the presence of CSF had to wait until the 18th century until it was recognized. Fissures were treated with trepanation, because of a perceived risk of infection developing between the bone and the dura. Depressed fracture fragments were elevated, replaced, or removed according to the details of the injury. Finally, for centuries surgeons blocked patients ears to reduce the sound of drilling, despite the fact that such a blocking would amplify the noise.

A historical and palaeopathological perspective on cancer.

Cancer is often wrongly considered to be a modern disease in many popular medical venues. Cancers have been known to humanity since ancient times. In fact, its antiquity can be identified through the application of palaeopathological methodologies. The present perspective demonstrates by means of a historical and palaeopathological analysis how oncological manifestations were present long before the emergence of anatomically modern humans and addresses the epidemiological transition from ancient times to the contemporary world. The final section of the article examines breast cancer and its identification in ancient human remains.

Unravelling social status in the first medieval military order of the Iberian Peninsula using isotope analysis.

Medieval Iberia witnessed the complex negotiation of religious, social, and economic identities, including the formation of religious orders that played a major role in border disputes and conflicts. While archival records provide insights into the compositions of these orders, there have been few direct dietary or osteoarchaeological studies to date. Here, we analysed 25 individuals discovered at the Zorita de los Canes Castle church cemetery, Guadalajara, Spain, where members of one of the first religious orders, the Order of Calatrava knights, were buried between the 12th to 15th centuries CE. Stable carbon (δ13C) and nitrogen (δ15N) isotope analyses of bone collagen reveal dietary patterns typical of the Medieval social elite, with the Bayesian R model, 'Simmr' suggesting a diet rich in poultry and marine fish in this inland population. Social comparisons and statistical analyses further support the idea that the order predominantly comprised the lower nobility and urban elite in agreement with historical sources. Our study suggests that while the cemetery primarily served the order's elite, the presence of individuals with diverse dietary patterns may indicate complexities of temporal use or wider social interaction of the medieval military order.

How the German cockroach conquered the world.

DNA study implicates medieval warfare and colonial trade.

Human love: Physical and mental health from Avicenna's viewpoint.

Avicenna is one of the most eminent and influential Persian philosophers and scientists whose philosophical and medical works are of high significance all over the world. Using descriptive analysis, the present study aims to deal with philosophical, physiological, and psychological aspects of human love and lovesickness from his perspective. His anthropology stems from his philosophical contemplation and practical experience in medicine. According to the research results, Avicenna believes that the love of noble-minded and young for external beauty, as a branch of human love, leads to the perfection of moral virtues and spiritual tendencies. Virtual love for beautiful human forms, as a representation of divine names and attributes, is a means to reach absolute perfection and true love in the mystic journey. With respect to the medical and psychological aspects, Avicenna holds that lovesickness brings disease to the soul and body of a lover. Lustful and impious love has resulted from intermingling, recurrent, and obsessive perceptions of mental forms. Since it terminates proper and moderate reasoning and disturbs the mental balance of a lover, it would lead to spiritual, mental, and even physical impairment. After explaining the features and symptoms of lovesickness, Avicenna reviews its therapeutic treatments including spiritual and physical remedies. He concludes that physical condition and temperamental health are obedient to and under the control of the mind.

Inferring diet, disease and antibiotic resistance from ancient human oral microbiomes.

The interaction between a host and its microbiome is an area of intense study. For the human host, it is known that the various body-site-associated microbiomes impact heavily on health and disease states. For instance, the oral microbiome is a source of various pathogens and potential antibiotic resistance gene pools. The effect of historical changes to the human host and environment to the associated microbiome, however, has been less well explored. In this review, we characterize several historical and prehistoric events which are considered to have impacted the oral environment and therefore the bacterial communities residing within it. The link between evolutionary changes to the oral microbiota and the significant societal and behavioural changes occurring during the pre-Neolithic, Agricultural Revolution, Industrial Revolution and Antibiotic Era is outlined. While previous studies suggest the functional profile of these communities may have shifted over the centuries, there is currently a gap in knowledge that needs to be filled. Biomolecular archaeological evidence of innate antimicrobial resistance within the oral microbiome shows an increase in the abundance of antimicrobial resistance genes since the advent and widespread use of antibiotics in the modern era. Nevertheless, a lack of research into the prevalence and evolution of antimicrobial resistance within the oral microbiome throughout history hinders our ability to combat antimicrobial resistance in the modern era.

The Perception and Treatment of People about Abscesses in the Song Period: Focus on Hongmai Yijianzhi.

During the Song period, abscesses were a disease that could affect anyone regardless of their class. This study examines how people at that time explained the cause of abscesses and their efforts to treat them, focusing on the experiences of those who suffered from abscesses and their families. Previous research on disease history during the Song period primarily focused on ailments like colds and infectious diseases , or plagues prevalent in the southern regions of China. On the other hand, examining abscesses as a common everyday illness that could affect anyone and considering them from the perspective of patients' experiences has remained unexplored in previous studies. To reconstruct the experiences of Song period patients, this study analyzes over sixty anecdotes related to abscesses found in Yi Jian Zhi written by Hong Mai. These cases span across the mid to late 12th century, with a majority of the patients being from the literati () class or connected to the literati. These anecdotes exhibit two distinct trends. One focuses on narratives surrounding the onset of abscesses, attributing their cause primarily to the patients' lifestyle. When the cause of the abscesses was unknown, people metaphorically attributed its onset to perceived blasphemy against God, an act of killing, negligence in duties, or other wrongdoings. This trend is evident among the literati class in particular, where abscesses were often linked to factors such as excessive legal executions or exploitation, and even acts of killing people. Except for those cases, in explaining the cause of abscesses in commoners, there were instances caused by a pediculus infestation, while in case of literati, Dansha () poisoning was a common cause. It is interesting to note that the narrative tradition, prevalent in official history biographies, which attributes the onset of abscesses to worries and resentment, was not evident in written records such as Yi Jian Zhi. Furthermore, the detailed description of external similarities, portraying abscesses as traces of punishment from the underground realm, is a narrative characteristic that solidified such stereotypical perceptions. The literati's notion that they should alert people through these related anecdotes contributed to the spread of this perception. Another trend in these anecdotes was centered around narratives of abscess treatment, where the focus shifted primarily to seeking "doctors," unlike the metaphorical explanations of abscess onset causes and processes. When afflicted with abscesses, people generally sought out those renowned surgeons, known as Yang-yi , and those famous for treating abscesses. In local communities, individuals who had "received the divine secrets of abscesses," those possessing their own mysterious abscesses cures, and those famous for generations for treating abscesses by using stone acupuncture were active. Such information about them was shared within the local societies. Their treatment predominantly consisted of surgical procedures to lance abscesses and drain pus, which often led patients to endure significant pain during the treatment process. In many cases, such patients sought treatment from well-known local surgeons and abscess specialists who surgically treated them. The literati, who are said to have influenced the development of pulse-centered medical and academic medicine in China, also sought out surgeons for abscess treatment. Medical formularies compiled by the court as well as privately published ones rarely mentioned surgical methods utilizing tools. The fact that surgical techniques were utilized in local regions at that time indicates a disparity between the official medical practices documented in texts and the practical methods employed in local communities. An analysis of approximately sixty anecdotes related to abscesses shows that abscesses were characterized by unknown causes and excruciating pain. Their onset was often attributed to the patient's lifestyle and wrongdoings, and they were also perceived as punishment for one's wrongdoings. However, as it was a disease where treatment effects could be relatively easily observed through surgical procedures, there was a proactive utilization of the locally formed treatment environment, preferring surgical interventions over relying on religious powers. Contrary to the medical trends and methods outlined in medical literature, surgical treatments were prevalent as the chosen method of treatment among the population in local communities. It appears that the realities experienced, reasoned, and shared by people in the Song period regarding the perception and response to abscesses did not necessarily align with those of mainstream medical practices. Moreover, despite attributing the onset of abscesses to one's wrongdoing, there was a preference for seeking surgeons or Yang-yi over religious methods in their treatment, reflecting a characteristic of the local medical culture surrounding abscesses during the Song period.

Ancient Mycobacterium leprae genome reveals medieval English red squirrels as animal leprosy host.

Leprosy, one of the oldest recorded diseases in human history, remains prevalent in Asia, Africa, and South America, with over 200,000 cases every year.1,2 Although ancient DNA (aDNA) approaches on the major causative agent, Mycobacterium leprae, have elucidated the disease's evolutionary history,3,4,5 the role of animal hosts and interspecies transmission in the past remains unexplored. Research has uncovered relationships between medieval strains isolated from archaeological human remains and modern animal hosts such as the red squirrel in England.6,7 However, the time frame, distribution, and direction of transmissions remains unknown. Here, we studied 25 human and 12 squirrel samples from two archaeological sites in Winchester, a medieval English city well known for its leprosarium and connections to the fur trade. We reconstructed four medieval M. leprae genomes, including one from a red squirrel, at a 2.2-fold average coverage. Our analysis revealed a phylogenetic placement of all strains on branch 3 as well as a close relationship between the squirrel strain and one newly reconstructed medieval human strain. In particular, the medieval squirrel strain is more closely related to some medieval human strains from Winchester than to modern red squirrel strains from England, indicating a yet-undetected circulation of M. leprae in non-human hosts in the Middle Ages. Our study represents the first One Health approach for M. leprae in archaeology, which is centered around a medieval animal host strain, and highlights the future capability of such approaches to understand the disease's zoonotic past and current potential.

Network of large pedigrees reveals social practices of Avar communities.

From AD 567-568, at the onset of the Avar period, populations from the Eurasian Steppe settled in the Carpathian Basin for approximately 250 years1. Extensive sampling for archaeogenomics (424 individuals) and isotopes, combined with archaeological, anthropological and historical contextualization of four Avar-period cemeteries, allowed for a detailed description of the genomic structure of these communities and their kinship and social practices. We present a set of large pedigrees, reconstructed using ancient DNA, spanning nine generations and comprising around 300 individuals. We uncover a strict patrilineal kinship system, in which patrilocality and female exogamy were the norm and multiple reproductive partnering and levirate unions were common. The absence of consanguinity indicates that this society maintained a detailed memory of ancestry over generations. These kinship practices correspond with previous evidence from historical sources and anthropological research on Eurasian Steppe societies2. Network analyses of identity-by-descent DNA connections suggest that social cohesion between communities was maintained via female exogamy. Finally, despite the absence of major ancestry shifts, the level of resolution of our analyses allowed us to detect genetic discontinuity caused by the replacement of a community at one of the sites. This was paralleled with changes in the archaeological record and was probably a result of local political realignment.

Fragments of Alchemy from a Cairene Synagogue: Context, Codicology, and Contents of the Alchemical Corpus of the Cairo Genizah.

This article presents the results of a survey and a first assessment of the corpus of alchemical manuscripts retrieved from the Cairo Genizah, a storage room mainly intended for sacred writings that is attached to the Ben Ezra synagogue of Old Cairo. The alchemical manuscripts are described in their codicological and palaeographic features; their content is analysed in the context of the medieval production of alchemical texts in the surrounding Islamic world. The alchemical corpus of the Genizah represents a unique and widely unstudied source for our understanding of the relationship between Jews and alchemy in the medieval Mediterranean World.

An approach to the milestones of spine surgery in Persian traditional medicine.

BACKGROUND: The diagnosis and treatment of spine disorders have been challenging for thousands of years in different nations and medical schools. Despite this long history, there are many information gaps in this regard. The current research deals with the milestones and progress of spine surgery from ancient times until now, emphasizing the innovations of sages in the Persian traditional medicine era. METHODS: The present study is based on searching original and library documents, data from databases such as PubMed, Scopus, and Science Direct, and search engines such as Google Scholar. RESULTS: In Persian traditional medicine, Rhazes (865-925 AD) was the first sage who applied spine surgery based on the innovative knowledge of Galen (second century AD) and Paulus Aegineta (seventh century AD). Hally Abbas (tenth century AD), by suturing two separated bones during spine surgery, and Albucasis (936-1013 AD), by inventing, describing, and drawing the surgical instruments involved in surgeries in this area, and also using cauterization in the treatment of children's hunchback, were the innovators of new methods. CONCLUSION: The modern knowledge of spine surgery is based on intelligent experiences and prominent thoughts from thousands of years worldwide. However, sometimes, these key points have remained hidden. This issue necessitates investigating this science in different schools and territories for comparative studies, identifying the firsts in the prominent points of this field, preserving the identity of sages and nations, and preventing scientific plagiarism.

Ancient mitogenomes suggest complex maternal history of one of the oldest settlements of western India.

The ancient township of Vadnagar tells a story of a long chain of cultural diversity and exchange. Vadnagar has been continuously habituated and shows a presence of rich cultural amalgamation and continuous momentary sequences between the 2th century BCE and present-day. Seven cultural periods developed a complex and enriched settlement at Vadnagar in spatio-temporality. Although archaeological studies done on this oldest settlement suggested a rich cultural heritage, the genetic studies to pinpoint the genetic ancestry was lacking till date. In our current study we have for the first time reconstructed the complete mitogenomes of medieval individuals of the Vadnagar archaeological site in Gujarat. The study aimed to investigate the cosmopolitan nature of the present population as well as the migratory pattern and the inflow of different groups through trade, cultural and religious practices. Our analysis suggests heterogeneous nature of the medieval population of Vadnagar with presence of deeply rooted local ancestral components as well as central Asian genetic ancestry. This Central Asian component associated with mitochondrial haplotype U2e was not shared with any individual from India, but rather with individuals from the Bronze Age of Tajikistan and with an earlier age of coalescence. In summary, we propose that the medieval site of Vadnagar in western India was rich in cultural and genetic aspects, with both local and western Eurasian components.