A 'cold case' of care: Looking at old data from a new perspective in mummy research.

In 1973, analysis of the mummified remains of a young boy dated to 700AD and from the Late Nasca period (Peru) identified (i) chronic Pott's disease, leading to loss of lower body mobility, and (ii) acute miliary tuberculosis, affecting most organs and the immediate cause of death (Allison et al., 1973). This report was the first to establish, beyond dispute, the presence of tuberculosis in the Americas before the arrival of Europeans. Here, we revisit the 'Nasca Boy' from a bioarchaeology of care perspective. Contextualising the original study's results within what is known of contemporary lifeways, we apply the bioarchaeology of care methodology in considering the Nasca Boy's experience of living with tuberculosis; the type of care he required and how this may have evolved over a period of deteriorating health; and what such caregiving may suggest both about social organisation within his community and some of the more everyday aspects of Nasca existence. Up to now, the bioarchaeology of care approach has been employed almost exclusively with skeletal evidence; in this analysis of the Nasca Boy's remains, and in the accompanying wider-ranging discussion, we illustrate the potential of preserved soft tissue evidence to contribute to research into disability and care in the past. Although this report functions as a stand-alone case study, to obtain maximum benefit it should be read in conjunction with the Introduction to the special International Journal of Paleopathology issue on 'mummy studies and the bioarchaeology of care' (Nystrom and Tilley, 2018).

[Marcello Malpighi (1628-1694) and the Terms Miliary and Tubercle]. / Marcello Malpighi (1628­1694) und die Begriffe Miliar und Tuberkel.

Today Miliary Tuberculosis in Central Europe is a rare disease, quite often with resulting diagnostic uncertainty. The terms "miliary" and "tubercle" are outlined with their up to now accepted historical roots. An analysis of Marcello Malpighi's quite unknown post-mortem reports by the Italian author L. Munster reveals an earlier use of both terms than described till now.

Histologic diagnoses of tissues from two nineteenth century Habsburgs.

This study describes the histological alterations of the internal organs of Prince Joseph Habsburg (1776-1847) and his first wife, Alexandra Pavlovna Romanova (1783-1801). Both corpses were mummified and the internal organs were stored separately in rosemary oil, in metal vessels. Royal Prince Joseph Habsburg died on 13 January 1847. The microscopic study confirms focal subacute glomerulonephritis (type Berg) with IgA precipitate on the glomerular mesangium and Bowmann's capsule. To the best of this author's knowledge, this is the first case in the paleopathological literature in which the subacute IgA glomerulonephritis could be confirmed immunohistochemically. Gout (urate nephropathy), severe arteriosclerosis, prostate adenoma and purulent prostatitis could also be diagnosed. The Prince's first wife, Alexandra Pavlovna Romanova, died in childbirth at age 18 years, along with her newborn daughter. Histological examination of Alexandra's organs revealed severe fibrocaseous and miliary tuberculosis, with dissemination to the lymph nodes, liver and spleen.

Revisiting the death of Eleanor Roosevelt: was the diagnosis of tuberculosis missed?

Controversy has surrounded the death of Eleanor Roosevelt in 1962. There has been a persistent sense that doctors missed the diagnosis of miliary tuberculosis, thereby jeopardizing her life. This article, using Roosevelt's medical chart and other previously unreviewed documents, revisits her illness and death. What disease actually killed Eleanor Roosevelt? Did her physicians miss the diagnosis? These questions are of particular importance in light of the recent Institute of Medicine report estimating that almost 100,000 Americans die each year from medical mistakes. Why has the possibility of error clouded the care of Roosevelt for almost 40 years? What can Roosevelt's case reveal about ongoing efforts to reduce mistakes in clinical practice?