Mudslide and/or animal attack are more plausible causes and circumstances of death for AL 288 ('Lucy'): A forensic anthropology analysis

Why paleomedicine is useful for medical education

What is the place of medico-historical cases in the professional practice of the disciplinary field of medicine and biology? How can these patients from the past be used for teaching and continuing medical education? How to justify their place in biomedical publications? In this article, we explain all the legitimacy of paleomedicine, and the need to intensify such research in the form of a well-individualised branch of paleopathology and the history of medicine.

[Lucy's fatal childbirth? About materno-foetal mortality in the ancient times]

OBJECTIVES

Skeletal remains of pregnant woman whit fetus still in the pelvic region are scarce in the archaeological record. We aimed to review the different cases of maternal and fetal death in the ancient times.

METHODS

A review of literature using Medline database and Google about mortality during pregnancy in Prehistory, Antiquity and middle age. The following key words were used: ancient times; paleopathology; immature fetus; medieval; pregnancy; mummies; Antiquity; maternal mortality.

RESULTS

Thirty articles were found and we added one personal unpublished case. There were 64 female skeletons with mainly infectious abnormalities (10 dental abscesses and 2 pneumoniae) followed by traumatic lesions (2 frontal fractures and 1 femur luxation). There were 48 fetal remains and 3 twins. We noted 8 obstructed labors (3 breech presentations, 4 transverse lies and one possible shoulder dystocia).

CONCLUSIONS

The fact that there were only few cases of maternal deaths with fetal remains raises the questions of the cause of death and the relationship between death and obstetric disorders. Beside the underestimation of these archaecological cases, the reasons of both fetal and maternal death must be looking for among several diseases or anomalies of both or of one of them, related with poor environmental conditions (such as malnutrition and high morbidity from infections) and lack of care the mother and fetus need.

Reply to: Charlier et al. 2018. Mudslide and/or animal attack are more plausible causes and circumstances of death for AL 288 ('Lucy'): a forensic anthropology analysis. Medico-Legal Journal 86(3) 139-142, 2018

The Pliocene hominin fossil 'Lucy' (A.L. 288-1, Australopithecus afarensis) was discovered in the Afar region of Ethiopia in 1974 and dates to 3.18 million years in age. In Kappelman et al.,¹ we presented the results of a detailed investigation of the skeleton that for the first time identified and described unusual bone-into-bone compressive fractures at several of the major long bone joints. Using multiple criteria, we concluded that these fractures are more likely to be perimortem than postmortem in nature. We next evaluated a number of possible mechanisms that could have produced these fractures and, on the basis of all of the evidence, hypothesised that a fall from considerable height, likely out of a tree, with its resulting vertical deceleration event, most closely matched the pattern of fractures preserved in the skeleton and was also the probable cause of death. Charlier et al. disagree with our approach and hypothesis, and instead present what they consider to be better evidence supporting two of the other possible mechanisms for breakage that we also investigated, a mudslide/flood, or an animal attack. We here show that the evidence presented by Charlier et al. is incorrectly interpreted, and that these two alternative hypotheses are less likely to be responsible for the fractures.