How Paleopathology Reveals Unspoken Secrets Of The Past

Treponemal diseases are infectious diseases such as yaws, bejel, and syphilis caused by the bacterium, Treponema pallidum. Due to its potential for bone damage, it marries both anthropology and pathology in a subfield known as paleopathology. This subject focuses on the pathological conditions, traces of medical issues, on ancient remains. While major paleopathological changes for syphilis rarely occur in the early stages of the disease, unique skeletal anomalies have been observed in severely progressed cases. These skeletal changes allow forensic anthropologists to identify cases of syphilis, which has proven to be an important asset in determining the medical history of syphilis. What scientists did not know was that it would not only shed light on the highly debated origin of the disease but also on dark societal secrets.

“What scientists did not know was that it would not only shed light on the highly debated origin of the disease but also on dark societal secrets.”

Two hypotheses about the origins of acquired syphilis have long been debated in the field of forensic anthropology and paleopathology (Rothschild & Rothschild 1995). The first theory is one that has been long accepted; that syphilis first showed up in the Native American populations in the New World (the modern Americas) and was carried over to the Old World (Europe) through Christopher Columbus’ journey. With novel emerging evidence, however, this theory is slowly losing merit. Studies such as Lopez et al. (2016) describe data that show evidence of treponemal diseases in Europe way before the famous journey of Christopher Colombus even took place.

A fifteenth century image of the very early treatment of syphilis in Vienna, Austria (Byard 2019). Syphilis is a bacterial infection that is spread by sexual contact. It starts as a painless sore, typically on your genitals, rectum or mouth, and then progresses to the rest of the body in a deadly fashion.

The documentary, Secrets of the Dead: The Syphilis Enigma, discusses the first major study that challenged the Columbus theory of syphilis origin. When skeletal remains from an English monastery in Hull were uncovered, scholars were surprised to discover that the bone anomalies were characteristic of an advanced stage of syphilis. Apart from the fact that this sexually-transmitted disease was found in a once extremely religious place, what stood out was the fact that there were rarely any cases of syphilis in Europe that were so dated. More precisely, carbon-dating placed the bones between 1300 and 1420 AD; at least 70 years before Columbus journeyed to America! Other evidence such as the dendrochronology (the carbon-dating version of wood and tree bark) of the wooden coffins also contributed to this discovery. These findings led to the second theory of syphilis origin; that it was present in Europe first and was just unrecognized because of other deadly diseases at the time and because bone changes occurred only in late-stage syphilis. 

Christopher Columbus, as he first arrives in the New World, is received by the inhabitants and honored with the bestowing of many gifts, 1594 (Theodor de Bry’s America). Did Columbus carry syphilis from the Americas to Europe? Or has the disease always been in Europe? Courtesy of Special Collections, University of Houston Libraries.

One of the clearest indications of syphilis came from a particular specimen as described in the video, labeled as skeleton 1216. The skull of 1216 displayed dents or holes in the surface of the bone known as poshmark legions or caries sicca. This, along with a hole in the palatine bone (roof of the mouth) are characteristic of syphilis according to the presenters in the video. Additionally, destructive lesions and bone formation areas (“saber shin”) particularly in the lower limb bones corroborate the idea that the individual with these remains had syphilis. These features were described and explained by bioarchaeologist and paleopathologist Dr. Charlotte Roberts who first identified this new theory about the origin of syphilis.

Skeletal evidence of syphilis in skeleton 1216. A: caries sicca lesions on the skull; B: holes on the roof of the mouth (palatine bone); C: new bone formation and lesions on limb bones. (Roberts et al. 2013)

The anthropological data that is described in the documentary is evidence that can potentially rewrite medical history as we know it. Apart from the obvious question of the origins of disease, societal practices and general way of life in the past can be answered by studies such as this one. For instance, this study touched upon the potential promiscuity in the form of prostitution in port areas where syphilis, a sexually-transmitted disease, was identified. In fact,  the archeological dig at the supposedly religious place at Hull revealed rods that looked they were for whipping. This combined with the presence of a sexually-transmitted disease paints this historical site in a completely new light. Going back to the medical perspective, the lesions and other marks on the skeletal remains of syphilis victims can provide an indication of how severe the symptoms were and how much some people would have suffered at that time. 

The infamous Hull monastery in the late 18th century. What secrets did these conclaves hide?

Anthropological studies such as this one can not only help interpret the past but can also direct the future. This study showed key evidence to pinpoint the origins of certain diseases. This is important because it can help current biomedical scientists understand the potential of some pathogens to mutate and survive in different environments and populations. For instance, what are the third-stage syphilis identifiers in skeletal remains, and can this be used to monitor cases in populations? The answer to this question lies in paleopathological studies such as the one discussed here and can aid in the epidemiology of treponemal diseases through improved surveillance and containment strategies. Even syphilis vaccine development could benefit from this study; future research could observe the rate at which, and under what conditions, the syphilis pathogen mutates in different environments, which could impact the way syphilis immunization is done. Sometimes you have to look into the past, to see a better future.

Where do you stand in this debate of syphilis origin – did Columbus carry it with him from America to Europe or did it exist in Europe long before Columbus ever set foot in America? What are some other interesting insights we could gain about history from similar studies? Let us know your thoughts in the comments below!


References

Byard, R. W. (2019). Classical syphilitic lesions from the museum. Forensic Science, Medicine and Pathology, 15(2), 309-313.

Lopez, B., Lopez-Garcia, J. M., Costilla, S., Garcia-Vazquez, E., Dopico, E., & Pardinas, A. F. (2017). Treponemal disease in the Old World? Integrated palaeopathological assessment of a 9th–11th century skeleton from north-central Spain. Anthropological Science, 170515.

Roberts, C. A., Millard, A. R., Nowell, G. M., Gröcke, D. R., Macpherson, C. G., Pearson, D. G., & Evans, D. H. (2013). Isotopic tracing of the impact of mobility on infectious disease: The origin of people with treponematosis buried in hull, England, in the late medieval period. American Journal of Physical Anthropology, 150(2), 273-285.

Rothschild, B. M., & Rothschild, C. (1995). Treponemal disease revisited: Skeletal discriminators for Yaws, Bejel, and venereal syphilis. Clinical Infectious Diseases, 20(5), 1402-1408.

Salt C. Secrets of the Dead. UK: Thirteen/WNET: PBS; 2002. The Syphilis Enigma. 60 min.

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