Skeletal metastatic carcinomas from the Roman period (1st to 5th Century AD) in Hungary

OBJECTIVES

According to paleopathological records, tumors have a great antiquity. The prevalence of cancer in ancient populations might have differed from that in modern humans because of substantial differences in environmental factors, life expectancy and the availability of treatment. This study presents 3 cases of probable skeletal metastatic carcinoma from the Roman period (1st-5th century AD) in Hungary, showing the development of bone metastases of cancer without chemo- and radiotherapy.

METHODS

All skeletons were subjected to a careful macroscopic investigation, which was extended by radiological, stereo- and scanning electron microscopic analyses.

RESULTS

In 1 case, the mixed nature and localization of the lesions, as well as the sex and age of the individual, suggested breast cancer as the primary focus. In the other 2 cases, based on the mostly osteoblastic nature and the localization of the lesions as well as on the sex and age of the individuals, the most probable diagnostic option is prostate carcinoma with skeletal metastases.

CONCLUSIONS

In view of the scarcity of cancer metastases that have been diagnosed in archeological specimens in general, identification of all examples of cancer in antiquity represents an important contribution both to paleopathology and to modern medicine.

[The establishment of the hospital-system in the Byzantine Empire]

Byzantine hospitals developed out of Christian institutions for the poor and homeless. Philanthropy provided the initial impulse to create hospices (xenons) and to expand these institutions into specialized medical centers (iatreons or nosokomeions). However the Byzantine nosocomeions resemble more closely modern hospitals than they do any of the institutions of Greek-Roman antiquity or any of the houses of charity in the Latin West during the Middle Ages. Since the 4th century the Byzantine hospitals have stressed the central position of the nosocomeion in Byzantine society at the intersection of state, ecclesiastical and professional interest. In the great cities and in the capital, more than hundred hospitals worked in the East-Roman Empire. The Byzantine hospital rules guaranted patients private beds, required physicians to wash their hands after each examination and arranged the physical plant to keep all the sick warm. The Byzantine hospitals had separate sections (in modern terms: surgery-trauma surgery, internal medicine, ophthalmology, etc.) and at the beginning of the sixth century a separate institution for women. From the sixth century at least, bathing facilities normally adjoined Byzantine nosocomeia. By the twelfth century Byzantine hospitals also set aside a room or perhaps a separate building to treat outpatients. In addition to the main dormitories the surgery, baths and outpatient clinic, the large parts of hospitals also had separate rooms (or adjoining buildings) for library, for lecture hall, for administrative functions and record keeping for storage and for other services.

[Magical and religious healing in Byzantium]

Religious and magical ways of healing have been known and practiced since the very beginning of human history. In the present article, the Byzantine philosophical, cultural, historical and "methodological" aspects of this way of healing are discussed. The article outlines the development of magic healing in Byzantium from the 4th to the 15th century. During this period magical therapy included the cult of patron saints--listed by the author--and pleading for divine intervention as well. The activity of "anargyroi" and the use of magical objects and amulets is also discussed in detail. Exorcism was also a part of religious therapy both against psychical and somatical diseases. In early Christianity, and especially in Byzantium the devil or other demons were also supposed to cause various somatical or psychical illnesses by "intrusion" or "internalisation," i.e. by possession or obsession of their victims.

[Dental care, dental diseases and dentistry in antiquity]

Numerous written relicts, belletristic works (poems of Martial, Juvenal, Ovid etc.) indicate that oral hygiene and its tools (toothbrush, toothpick, use of tooth pastes and tooth-powder) were used long before our times. Already ancient people started to remove, file, dye and inlay teeth. The teeth were dyed red, green or black in Egypt, red or brown (with henna or betel) in India, white by Romans. The teeth decoration has a long but forgotten history. The most skillful and artistic work was done by the Maya's between 900 BC and 1500 AD. The modification of contours (more than fifty forms) of the incisors were practiced also in Mesoamerica. Dentistry was surely practiced in ancient Egypt, India, China, Greece and Rome, while odontology and especially suitable dental appliances arose only by Etruscan. Dental prosthesis, including bridges and simple retention bands were invented by the Etruscans 2500 years ago. These Etruscan bridges were worn mostly by females, suggesting that cosmetics was the principal dental concern. Some,--if not all--of the Roman and other prostheses have been purely ornamental. Orthodontic appliances are also Etruscan invention. The holes caused by caries were filled with garlic, incense, caraway seed in Egypt, with wood or lead in Rome, and with "silver-paste" (amalgam) in ancient China. The toothache was cured with poppy-tee, or hashish and nightshade plants (Solanaceae) in Egypt, Greece, Roman Empire while with coca (Erythroxylon coca) in South-America.