PALEOPATHOLOGY OF A NOBLEMAN FROM POPOLI (ITALY)

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Luca Ventura*, Gerald Conlogue**, Ronald Beckett**,
Antonio Calabrese°, Raimondo Quaresima°°, Gino Fornaciari^

* Department of Pathology, City Hospital of L’Aquila, Italy.
** Bioanthropology Research Institute, Quinnipiac University, Hamden, Connecticut, U.S.A.
° Department of Radiology, City Hospital of Popoli, Italy.
°° Department of Chemistry, Faculty of Engineering, University of L’Aquila, Italy.
^ Division of Paleopathology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Italy.

Abstract
The paleopathology of a mummified nobleman from a crypt under the Church of the Holy Trinity in Popoli (Italy) is described. X-ray in the crypt with Polaroid film disclosed an artifact, which helped date the individual at the time of death to be the early 1800’s.  Initial paleopathologic data were obtained using Polaroid x-ray and videoendoscopy.  Data was confirmed with CT scanning.  Tissue biopsies were taken from the thoracic diaphragm and left kidney with histologic, buy diazepam online, and x-ray diffraction studies conducted.  Paleopathologic findings include poor dentition, pulmonary pathology with diaphragmatic involvement, acetabular arthritis, and a kidney stone, removed for analysis using radiographic localization and endoscopic guided extraction.The paleopathology of a mummified nobleman from a crypt under the Church of the Holy Trinity in Popoli (Italy) is described. X-ray in the crypt with Polaroid film disclosed an artifact, which helped date the individual at the time of death to be the early 1800 ’s.  Initial paleopathologic data were obtained using Polaroid x-ray and videoendoscopy.  Data was confirmed with CT scanning.  Tissue biopsies were taken from the thoracic diaphragm and left kidney with histologic, microscopic, and x-ray diffraction studies conducted.  Paleopathologic findings include poor dentition, pulmonary pathology with diaphragmatic involvement, acetabular arthritis, and a kidney stone, removed for analysis using radiographic localization and endoscopic guided extraction.The paleopathology of a mummified nobleman from a crypt under the Church of the Holy Trinity in Popoli (Italy) is described. X-ray in the crypt with Polaroid film disclosed an artifact, which helped date the individual at the time of death to be the early 1800’s.  Initial paleopathologic data were obtained using Polaroid x-ray and videoendoscopy.  Data was confirmed with CT scanning.  Tissue biopsies were taken from the thoracic diaphragm and left kidney with histologic, microscopic, and x-ray diffraction studies conducted.  Paleopathologic findings include poor dentition, pulmonary pathology with diaphragmatic involvement, acetabular arthritis, and a kidney stone, removed for analysis using radiographic localization and endoscopic guided extraction.

Introduction
The Church of the Holy Trinity in Popoli dates back to the Renaissance era. During recent renovations the floor boards were removed from a side room just off the altar. Once removed, access to a crypt below the room was revealed. The crypt held several bodies in varied states of preservation with most of the individuals skeletonized. One individual within the crypt was found to be a well preserved mummy. He was still in a wooden coffin that was in poor condition. While the crypt is still being examined it appears to be holding the remains of eight to twelve individuals. The research team was brought together through the efforts of the National Geographic Channel and Engel Brothers Media from New York City. The project was featured as an episode in a 13 part television series called “The Mummy Road Show”. The mummy under investigation was located directly below the crypt opening. The coffin lid was pulled slightly back from the head end and once removed, revealed a well preserved individual covered in dust. Visual examination suggested that the mummy was male and well dressed. It was initially thought that he may have been a priest since he was buried in the church and the clothes seemed to be similar to that which a priest might wear. After cleaning, the burial close proved to be of fine linen with floral print covering the entire jacket altering our hypothesis regarding the vocation of the individual. The fine clothes and burial location suggested someone of high social status, holding an important role in the church. Mummification was likely due to the dry cool environment in the crypt supported by burial during the dry season in Popoli, located in central Italy, east of Rome.

Materials and Methods
Initial nondestructive analysis was conducted in the crypt in order to preserve the context of any remaining tissue. Videoendoscopy was used prior to portable x-ray in order to ascertain if internal organs and soft tissue were present and to obtain biopsies of any internal target organs. Videoendoscopy was successful in identifying organ and soft tissue remains in the thoracic region and biopsy of the right thoracic hemidiaphragm was taken. Portable x-ray was then conducted in the crypt using a researcher constructed frame to hold the x-ray tube. The crypt ceiling was arched with about 110 cm clearance at its peak. In order to eliminate the need for wet film processing, Polaroid instant photographic film was used. X-ray efforts were successful in collecting images of the mummy from the head to the pelvic region. It was determined that further examination would require removing the mummy from the crypt. The mummy was wrapped in plastic wrap in order to secure it and minimize any movement. Subsequent x-rays identified pathologies and artifacts. A renal stone was detected in the left kidney, confirmed with CT scan, and  localized using Polaroid x-rays with spinal needles inserted at the approximate location of the stone. One needle was introduced anteriorly with the other being introduced from the left lateral aspect. The localizing x-rays provided a guide for excision of the stone under videoendoscopic guidance. Artifact localization was also accomplished via x-ray. Thoracic tissue was successfully rehydrated. Histology studies were conducted on the right thoracic tissue biopsy using Hematoxylin-eosin and Masson’s trichrome stain. The renal stone was examined stereomicroscopically and composition determined by x-ray diffraction.

Results
The study revealed considerable data regarding the approximate age in antiquity, sex, age at time of death, dentition, biomechanical stress, pulmonary pathology, and renal pathology of this individual.
Burial - X-ray survey of the individual in the crypt using Polaroid photographic film demonstrated a metallic artifact within the clothes at about left lateral waist level. The initial anterior-posterior view was supplemented with lateral projection to help localize the artifact.  Videoendoscope was introduced along the left lateral side of the mummy among the folds of the clothes and found a small pouch, which was removed and x-ray determined that the pouch did hold the metallic artifact. Initial impression based on radiographic appearance was that the artifact was a coin. The pouch was carefully opened and the metallic artifact was in fact a medallion with the impression of a woman and an inscription that identified the figure as Saint Philomena. People adopted Saint Philomena as their patron saint between the years of 1802 and 1810, which suggests that this burial occurred during that time span. Additional items found in the pouch included an intricately folded piece of paper with an inscription, which indicated that within the folds of the paper was a piece of the shirt of Saint Philomena. Additional items included were what appeared to be a religious artifacts and papers that were too delicate to examine at the time of this study.
Sex - Determination of sex was made using visual inspection, and x-ray analysis. Lateral x-ray of the head revealed a prominent brow ridge and mandible. X-ray of the pelvis revealed male characteristics.
Age at time of death - Age at time of death was estimated to be 35 to 40 years. Estimate was made using dentition assessment and the presence of minor sclerosis at the superior aspect of the acetabulum bilaterally.
Dentition - Lateral x-ray of the head revealed poor dental status with caries present as well as evidence of gum disease.
Biomechanical stress - Bilateral sclerosis at the superior aspect of the acetabulum was present.
Fractures - Old multiple rib fractures were present bilaterally.
Pulmonary pathology - Endoscopic biopsy from the right thoracic region revealed fibrous tissue with calcification, fibromuscular tissue, fungal spores attached to the fibrous tissue, and presence of parasites. The presence of muscle bundles in the sample indicates that this is likely diaphragm muscle. The presence of calcifications in the tissue is suggestive, but inconclusive for tuberculosis. The presence of fungal spores and hyphae is common in mummified remains. The parasite likely represents a post mortem contamination.
Renal stone - Extracted under endoscopic guidance the stone measured 22x16x15mm. The external surface shows a central core with small spherical nodules. The cut surface, observed with the stereomicroscope at 7x magnification, shows a central nucleus composed of sharp-edged crystals and various concentric laminations, pale and dark brown in color. The x-ray diffraction analysis on the surface revealed calcium oxalate monohydrate (whewellite) 90% and calcium phosphate (hydroxylapatite) 10%. The peak distribution was almost the same in a modern kidney stone tested as a control. No trace of uric acid could be found.

Discussion
The mummy provided valuable information regarding the life and times in early 1800’s Italy. The non-destructive analysis coupled with selective biopsy revealed considerable data demonstrating the life and state of health at the time of death of this individual. Artifact analysis suggests that this individual held some significant status with in the Church of the Holy Trinity. The study demonstrates the flexibility of on site non-destructive analysis, using this data to target specific tissues or artifacts for additional study, which serves to preserve the individual for future research. The individual was middle-aged, had dental, pulmonary and renal pathologies. The remains exhibited old healed bilateral rib fractures. There were no major arthritic changes suggesting a life free from extensive labor. The artifacts found with the remains suggest that the individual was important to the church community and he or his survivors wanted to assure his safe journey to the afterlife by including important religious icons relevant to the times.

References
Fornaciari G, Ventura L, Conlogue G, Beckett R, Engel L, Bucher A. Paleopathology of a nobleman from Popoli, Italy. 29th Annual Meeting of the Paleopathology Association, Buffalo (USA), april 9-10, 2002.
Ventura L, Leocata P, Beckett R, Conlogue G, Sindici G, Calabrese A, Di Giandomenico V, Fornaciari G. The natural mummies of Popoli. A new site in the inner Abruzzo region (Central Italy). Antropologia Portuguesa 2002; 19: 151-160.
Ventura L, Leocata P, Sindici G, Diana M, Ventura T. Paleopathologic map of the inner Abruzzo region (Italy). Advances in Clinical Pathology, 2001; 5: 19-20.
Ventura L, Leocata P, Mancinelli D, Miranda G, Ventura T. Paleopathological studies in the inner Abruzzo region (Central Italy). Antropologia Portuguesa 2002; 19: 145-150.


Articolo inserito il 01 febbraio 2006 e letto 8893 volte

 
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