This New Field Of Medicine Is Like House - With A Time Machine

di Galassi Francesco

Storia della Medicina

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Long before there was a field of bioarchaeology — the study of human skeletons from archaeological sites — there was an interest in palaeopathology. More than a century ago, physicians and anthropologists pored over Egyptian mummies and peered into microscopes at bones to look for evidence of diseases that affected ancient people. Originally a field that was interested in the individual “patient,” palaeopathology grew to take a population-wide approach, with goals of understanding demography and epidemiology. And now, recent advances in molecular biology have dramatically expanded the amount of information we can learn from skeletons and mummies.

In light of 21st advances in medical knowledge, one physician is applying his training to better understand diseases of the past through text. Dubbed palaeopathography (from ancient + disease + writing), this new subfield of medical history seeks to comb through histories, novels, and even artwork to solve diagnostic mysteries.  The result is basically what you’d expect if House, M.D. had a time machine: fascinating differential diagnoses about the health of world leaders, artists and writers.

Working at the cutting edge of palaeopathography is Dr. Francesco Galassi. Italian by birth, Galassi completed medical school at the University of Bologna, did a neuroanatomy internship at the Utrecht Medical Center in the Netherlands, and also completed an internship at Oxford. A polymath and polyglot, Galassi has published over two dozen articles in the past three years on topics related to palaeopathography. I recently had the chance to meet Galassi, who works at the Institute of Evolutionary Medicine at the University of Zurich, and ask him a few questions about this new subfield of medical history and his vision for its future.

Kristina Killgrove: You first trained as a medical doctor. How did you get interested in studying diseases of famous people from history?

Francesco Galassi: Ever since I was a child I’ve been fascinated by history, ancient languages and science. Even as a medical student I would spend long hours researching the history of medicine and anatomy. After my colleague Dr. Ashrafian and I published an article on the medical history of Julius Caesar, I had the fabulous opportunity to start working full time for Prof. Frank Rühli in palaeopathology, a discipline which perfectly allows me to cultivate both my historical and medical passions.

Killgrove: Speaking of ancient diseases, which ancient patient or case that you’ve studied has had the most interesting condition, or the most difficult to figure out?

Galassi: Caesar certainly ranks first since the complexity of his medical condition is by no means inferior to that of his political and military figure. However, it’s been equally fascinating to discover how famous literary works, such as the c. 1800 BC novel Sinuhe or Giovanni Boccaccio’s Decameron could contain descriptions of such physiological phenomena as the fight-or-flight response or medical matters such as sudden cardiac death with such great precision and clarity hundreds of years before science succeeded in providing a fully persuasive explanation.

Killgrove: I often get asked which famous person I would dig up and study, if I could choose anyone. So if you could go back in time, whose doctor would you be, and why?

Galassi:  To put it bluntly — I would be Alexander the Great’s physician in Babylon in June 323 BC. Although the diagnostic and therapeutic strategies of the day might still have not helped to cure his mysterious fatal illness, that could have potentially been a history-changing event. When I consider, however, the tragic fate of Glaucias, the physician assisting Alexander’s friend Hephaistion, well… one is not really sure about still wanting to be in the Macedonian’s medical staff!

Killgrove: Oh no, what happened to poor Glaucias?

Galassi: Plutarch tells us that Hephaistion fell ill with fever and, as soon as his physician Glaucias had left him alone to go to the theatre, he ate a boiled fowl and drank a huge cooler of wine. This caused Hephaistion to fall ill again and die. Then Alexander, furious about his friend’s death, had Glaucias crucified.

Killgrove: That would certainly not be an ideal job.  So let me ask you, what do you see as the big challenges in the field of palaeopathography today that you hope will be solved (or studied) in the next decade?

Galassi: Palaeopathography is a unique opportunity for palaeopathology, since it allows the investigation of symptoms and signs of diseases, vital for medicine, yet unavailable when only studying ancient bones or mummies. This is especially viable with famous historical figures about whom plenty of information of all sorts has been preserved, which cannot be said of the ordinary men and women of old, neglected by history. Paleopathography should, nonetheless, be used reasonably, favoring a descriptive and cautious approach, which complements – but does not substitute for – hard biological evidence. We don’t want to “biologize” history.

The biggest challenge and goal in the future will be to compile an epidemiology of ancient diseases and their evolution throughout history, at the same time establishing a new discipline, palaeo-semiotics. The reconstruction of the clinical manifestations of diseases in the past will thereby greatly enrich traditional osteological analysis and mummy research.

Killgrove: Palaeo-semiotics? Can you explain that term a bit more?

Galassi: Semiotics or symptomatology is the medical branch that studies the signs and symptoms of diseases as they manifest in the patient. If we want to discover if diseases evolved and took a different shape throughout history, we certainly have to focus on the hard evidence found in mortal remains — bony or mummified bodies — yet we cannot forget about semiotics, which play so great a role in clinical medicine.

Killgrove: I see, so you’re interested studying patients’ reported symptoms, not only today but in the past.

Galassi: Exactly. We need to ask questions like, Were the symptoms and signs of certain diseases in the past exactly the same as we see them today in the clinical setting? In order to find that out, we need to reexamine historical documentation and the biographies of historical figures, which contain information of vital medical relevance. Just like prehistoric insects are found to have been embedded in amber, biomedical facts can be found in the biographical accounts of ancient figures.

 

Killgrove: That’s fascinating, and a great analogy to use. Between palaeopathography, the rise in our ability to study ancient pathogens using DNA analysis, and an increase in palaeopathology studies within bioarchaeology, I imagine we will see more of these interdisciplinary studies in the near future!


Articolo inserito il 21 ottobre 2016 e letto 490 volte

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