Trepanations in the ancient Greek colony of Akanthos: Skull surgery in the light of Hippocratic medicine

OBJECTIVE

The study presents seven new cases of trepanations on four individuals from the ancient Greek colony of Akanthos (5th - 1st c. BC) and juxtaposes the paleopathological observations with the Hippocratic treatises.

MATERIALS

A meta-analysis of 42 published trepanations on 27 individuals from Greece.

METHODS

Trepanations from Akanthos were observed macroscopically, stereoscopically and by computer tomography. The meta-analysis considers the demographic, geographical and temporal distribution, the techniques, associated pathology, and survival rate.

RESULTS

Trepanations were observed on four females in Akanthos. Three trepanations were performed with scraping and four with drilling. Two individuals exhibited significant signs of healing, and two survived shortly after the operation. In two cases, trepanation was practiced for treating cranial injuries. In Greek antiquity trepanation was performed predominantly in males, principally as a surgical treatment of cranial injuries. The survival rate was 62.9 %. Scraping was the oldest, most frequent and successful technique.

CONCLUSIONS

Trepanation performed systematically in Greece since the Bronze Age (ca. 2,000 BC). Hippocrates who rationally conceived medicine, codified the pre-existing empirical knowledge. The trepanations from Akanthos show technical similarities but also discrepancies from the Hippocratic recommendations, confirming the mental and technical readiness of the ancient surgeon.

SIGNIFICANCE

The synchronous to Hippocrates trepanations from Akanthos, provide the opportunity to compare physical evidence with the written sources.

LIMITATIONS

The frequency of trepanations is affected by the representativeness and the state of the skeletal preservation.

SUGGESTIONS FOR FUTURE RESEARCH

Trepanations published in previous decades, need to be reassessed with new imaging modalities. A standard recording methodology is fundamental for data comparison.

Oral conditions of the pre-Hispanic mummies of Gran Canaria (Canary Islands, Spain)

OBJECTIVE

To analyse the oral conditions of pre-Hispanic mummies from Gran Canaria (5th-11th centuries AD), comparing the results with published data from the non-mummified population.

MATERIALS

440 teeth and 764 alveoli of 30 adult mummies.

METHODS

Macroscopic examination of pathological and non-pathological features of the oral cavity, using standardized criteria.

RESULTS

The mummies reveal frequent dental caries (11.8%), especially affecting molars (27.6%), a high prevalence of calculus (66.3%) and periodontal disease (34.9%). The average wear is characterized by extensive dentine exposure. Periapical lesions (10.6%) and antemortem tooth loss (AMTL) (15.9%) are common. A high percentage of individuals exhibit linear enamel hypoplasia (LEH) (84%). Except for periodontitis, the data indicate the absence of significant statistical differences between the mummies and the skeletonized sample.

CONCLUSIONS

The profile of the dental pathologies of the mummies indicates a carbohydrate-rich diet that contained abrasive grit from the stone querns used to grind cereals. Comparison of the oral conditions of mummified and skeletonized remains shows no differences in access to food resources, reinforcing the recent rejection of the traditional interpretation of the mummies as the pre-eminent status group of Canarian society.

SIGNIFICANCE

This is the first study to delve into the oral conditions of pre-Hispanic mummified remains from Gran Canaria. The results have implications for the framing of research questions based on the social status of these mummies.

LIMITATION

The preserved sample of mummified remains of ancient Canarians is small.

SUGGESTION FOR FURTHER RESEARCH

Comparative analysis from a diachronic perspective would improve understanding of the historical development of ancient Canarians.

Prevalence of cranial trauma in Eurasian Upper Paleolithic humans

OBJECTIVES

This study characterizes patterns of cranial trauma prevalence in a large sample of Upper Paleolithic (UP) fossil specimens (40,000-10,000 BP).

MATERIALS AND METHODS

Our sample comprised 234 individual crania (specimens), representing 1,285 cranial bones (skeletal elements), from 101 Eurasian UP sites. We used generalized linear mixed models (GLMMs) to assess trauma prevalence in relation to age-at-death, sex, anatomical distribution, and between pre- and post-Last Glacial Maximum (LGM) samples, while accounting for skeletal preservation.

RESULTS

Models predicted a mean cranial trauma prevalence of 0.07 (95% CI 0.003-0.19) at the level of skeletal elements, and of 0.26 (95% CI 0.08-0.48) at the level of specimens, each when 76-100% complete. Trauma prevalence increased with skeletal preservation. Across specimen and skeletal element datasets, trauma prevalence tended to be higher for males, and was consistently higher in the old age group. We found no time-specific trauma prevalence patterns for the two sexes or age cohorts when comparing samples from before and after the LGM. Samples showed higher trauma prevalence in the vault than in the face, with vault remains being affected predominantly in males.

DISCUSSION

Cranial trauma prevalence in UP humans falls within the variation described for Mesolithic and Neolithic samples. According to our current dataset, UP males and females were exposed to slightly different injury risks and trauma distributions, potentially due to different activities or behaviors, yet both sexes exhibit more trauma among the old. Environmental stressors associated with climatic changes of the LGM are not reflected in cranial trauma prevalence. To analyze trauma in incomplete skeletal remains we propose GLMMs as an informative alternative to crude frequency calculations.

Mitogenomes illuminate the origin and migration patterns of the indigenous people of the Canary Islands

The Canary Islands’ indigenous people have been the subject of substantial archaeological, anthropological, linguistic and genetic research pointing to a most probable North African Berber source. However, neither agreement about the exact point of origin nor a model for the indigenous colonization of the islands has been established. To shed light on these questions, we analyzed 48 ancient mitogenomes from 25 archaeological sites from the seven main islands. Most lineages observed in the ancient samples have a Mediterranean distribution, and belong to lineages associated with the Neolithic expansion in the Near East and Europe (T2c, J2a, X3a…). This phylogeographic analysis of Canarian ancient mitogenomes, the first of its kind, shows that some lineages are restricted to Central North Africa (H1cf, J2a2d and T2c1d3), while others have a wider distribution, including both West and Central North Africa, and, in some cases, Europe and the Near East (U6a1a1, U6a7a1, U6b, X3a, U6c1). In addition, we identify four new Canarian-specific lineages (H1e1a9, H4a1e, J2a2d1a and L3b1a12) whose coalescence dates correlate with the estimated time for the colonization of the islands (1^st millennia CE). Additionally, we observe an asymmetrical distribution of mtDNA haplogroups in the ancient population, with certain haplogroups appearing more frequently in the islands closer to the continent. This reinforces results based on modern mtDNA and Y-chromosome data, and archaeological evidence suggesting the existence of two distinct migrations. Comparisons between insular populations show that some populations had high genetic diversity, while others were probably affected by genetic drift and/or bottlenecks. In spite of observing interinsular differences in the survival of indigenous lineages, modern populations, with the sole exception of La Gomera, are homogenous across the islands, supporting the theory of extensive human mobility after the European conquest.

Aggressive or funerary cannibalism? Skull-cup and human bone manipulation in Cueva de El Toro (Early Neolithic, southern Iberia)

OBJECTIVE

We analyze the processing sequence involved in the manufacture of a skull-cup and the manipulation of human bones from the Early Neolithic of Cueva de El Toro (Málaga, Spain).

MATERIALS AND METHODS

The Early Neolithic material studied includes human remains found in two separate assemblages. Assemblage A consists of one skull-cup, a non-manipulated adult human mandible, and four ceramic vessels. Assemblage B contains manipulated and non-manipulated human remains that appeared mingled with domestic waste. Using a taphonomic approach, we evaluate the skull-cup processing and the anthropogenic alteration of human bones.

RESULTS

The skull-cup was processed by careful paring away of skin, fragmentation of the facial skeleton and base of the skull, and controlled percussion of the edges of the calotte to achieve a regular shape. It was later boiled for some time in a container that caused pot polish in a specific area. The other human bones appeared scattered throughout the living area, mixed with other remains of domestic activity. Some of these bones show cut marks, percussion damage for marrow extraction, and tooth/chewing marks.

DISCUSSION

Evidence from Cueva de El Toro suggests that cannibalism was conducted in the domestic sphere, likely following ritualized practices where the skull-cup could have played a part. Interpretation of this evidence suggests two hypotheses: (a) aggressive cannibalism relates to extreme inter-group violence; and (b) funerary cannibalism is a facet of multi-stage burial practices. Similar evidence has been found in other Neolithic sites of this region and suggests that cannibalism and skull-cups were elements widespread in these communities. These practices may be linked to significant transformations associated with the end of the Early Neolithic in southern Iberia.