Enrique Gerszten

Diseases of the skull in pre-Columbian South American mummies.

OBJECTIVE The majority of paleopathological investigations focus on the study of the skull. This is because the skull is the most frequently preserved part of the human body recovered from archaeological excavations. From studying the skull, a variety of information can be obtained regarding the individual, such as sex, age, nutritional status, and other disease processes, if present. METHODS This study represents the examination of more than 700 human skulls recovered from archaeological excavations from the Andean region of southern Peru and northern Chile and dating back more than 8000 years. RESULTS A variety of skull abnormalities were encountered. The nonmetric variables of Huschkes foramina and palatine tori were common. Cranial deformation was observed in more than 85% of the cases. There were two cases of sagittal synostosis. Iron deficiency anemia resulting in porotic hyperostosis of the skull was evident in certain cultures. Exostoses of the external auditory canal resulting from chronic otitis was evident only among coastal populations. One skull demonstrated a periostitis consistent with Treponema infection. Trephination was encountered only in the skulls from Peru. Fifty-four cases of skull fractures were observed, half of which showed evidence of healing. Finally, only two cases of neoplastic skull lesions were encountered. CONCLUSION The study of the human skull alone provides a large amount of information regarding the health and diseases of ancient populations.

Intentional cranial deformation: a disappearing form of self-mutilation

Of the forms of human self-mutilation that have been recorded, few have been so widespread and long lasting as intentional cranial deformation. The earliest known record of the practice is from Iraq and dates back to 45,000 BC. The custom, which was practiced in many areas of the world, continued well into this century. Although tatooing, ear piercing, and circumcision are commonly practiced in our society, cranial deformation has almost completely disappeared from contemporary cultures, with the exception of isolated groups in Africa and South America. Intentional cranial deformation is intriguing for those who study the human cranium.

Diseases of the spine in South American mummies

OBJECTIVE The skulls and spinal columns of people from ancient civilizations, which frequently are found in a preserved state at archeological sites, can provide a large amount of information about these individuals’ physical condition through paleopathological investigation. METHODS This study represents the examination of more than 700 human remains dating back more than 8000 years that were recovered from archaeological excavations in the Andean region of southern Peru and northern Chile. RESULTS Examples of congenital malformations, degenerative processes, infectious diseases, neoplasias, and traumatic diseases were discovered. Congenital anomalies such as spina bifida occulta were relatively common in these populations. No cases of meningomyelocele were discovered. The most common pathological findings were degenerative changes of the vertebral bodies. Large cervical and lumbar osteophytes were identified in some remains. Several cases of cervical spondylosis were determined to be the result of an occupational disease resulting from carrying heavy loads on the back. These heavy loads were supported by wearing around the forehead a tumpline, known as a capacho. The most common infectious disease process in the spine was due to tuberculosis. The diagnosis was made by radiological and histopathological studies, and in several cases the organism Mycobacterium tuberculosis was identified in the soft tissues. Metastatic lesions on the vertebral bodies were identified in a single case. Examples of traumatic spinal injury were rare. Compression fractures were noted infrequently. CONCLUSION Diseases of the spinal column in the ancient inhabitants of the Andean region of South America were similar to those that affect the present-day population of that area.

Light and electron microscopic study of a rhabdomyoma arising in the floor of the mouth.

A rhabdomyoma occurring in the floor of the mouth of a 64‐year‐old woman was studied by the light and the electron microscopes. The extracardiac rhabdomyomas are rare lesions and appear to represent localized malformations of skeletal musculature. The lesional cells seem to be enzymatically active, but their histologic structure is deranged and distorted. Whether the cardiac and the extracardiac lesions represent similar conditions cannot be answered at this time.

Paleopathology in South American mummies: a review and new findings.

This article is a review of research and additional unpublished diseases that have been discovered and documented in naturally mummified remains recovered from South America. A new impetus in paleopathological studies was the work and discovery of a solution for rehydration of mummified tissues by Sir Marc Armand Ruffer in 1913. This solution allows the paleopathologist, after performing the autopsy, to process the tissues in a manner similar to current practices in pathology. In our studies, the most common diseases were infectious in nature, similar to the diseases that are most prominent today in the same regions.

Primary Left Ventricular Mural Endocarditis Diagnosed by Transesophageal Echocardiography

Primary left ventricular mural abscess was detected by transesophageal echocardiography and was confirmed at necropsy in a 44-year-old woman with Staphylococcus aureus bacteremia and cerebrovascular embolism. In two occasions, transthoracic echocardiography failed to show the mural abscess in this patient. Because of the aggressive nature of primary mural endocarditis, early use of transesophageal echocardiography is recommended in patients with Staphylococcal bacteremia and suspected endocarditis even in the absence of valvular abnormalities detectable by the transthoracic approach.

Light and electron microscopic study of a leiomyoblastoma of the duodenum

SummaryA case of leiomyoblastoma of the duodenum is presented with light and electron microscopic observations. This type of tumor is exceedingly rare in this location, and apparently was responsible for a series of bleeding episodes in the patient. Though the origin of the tumor may be in question from the light microscopic studies, the findings on the ultrastructural level support an origin from smooth muscle.

Paleopathology of cardiovascular diseases in South American mummies.

BACKGROUND Cardiovascular disease has emerged as the worlds leading cause of death in the last century. An epidemiological focus of this disease that extends not only beyond the developed world but also far back into antiquity asks new questions about associated risk factors. Ancient mummies found in the Atacama desert are well preserved and show signs of cardiovascular disease as early as 1000B.C. in Peru and Chile. METHOD AND RESULTS Gross and histopathological examination of specimens shows atherosclerosis, cardiomegaly, endocarditis, and myocardial fibrosis. CONCLUSION In comparison to other ancient populations, less atherosclerosis has been noted in South American mummies. The chewing of coca leaves, a habitual cultural practice unique to the region, supports evidence of reduced cardiovascular risk among ancient people living in South America.

Paleopathology of Spleens in South American Mummies

This study analyzed 19 naturally mummified pre-Columbian individuals excavated from desert regions of southern Peru and northern Chile. In the majority of autopsies of mummies, the spleen cannot be identified due to rapid autolysis and decomposition; therefore, our aim was to identify, in the cases in which the spleen was found, any normal and abnormal structures from mummified spleen tissues. The research consisted of gross and microscopic examinations of the spleen. Pathological features were identified, but no evidence of specific diseases was determined.