This study aims to place trepanation in a medieval therapeutic context by addressing its medical use in neurological disorders and by testing the existence of particular dietary care for the sick. MaterialsSix cases of trepanation found at the St. Cosme priory (La Riche, France) dated from the 12th-15th centuries. MethodsNeurological health was explored by geometric morphometrics by comparing the six cases to 68 skulls and 67 endocraniums belonging to individuals from the same period and geographical area. Trepanned diet was investigated by carbon and nitrogen isotopes and compared to 49 individuals from the same site. ResultsThe study of shapes suggests a possible pathological state for four subjects. The diet of the trepanned is not different from the rest of the population. ConclusionsThe treatment of neurological disorders emerges as the main therapeutic motivation in the corpus, contrary to the reports from the ancient surgical treatises. A specific diet for the sick is not highlighted. SignificanceGeometric morphometrics is rarely used in paleopathology and the results suggest a potential of this type of analysis in the identification of pathological cases. The results on therapeutic motivations and diet do not fit the descriptions from ancient medical sources. LimitationsThe study of forms did not lead to definitive diagnosis. The isotopic study does not allow us to appreciate all the aspects of the diet. Suggestions for Further ResearchA geometric morphometric study of the skulls and endocraniums of individuals with a known neurological condition would allow a better appreciation of the link between shapes and pathologies.

To identify the pathology causing the severe facial dysmorphia of a medieval individual from the site of Rigny (Indre-et-Loire, France) and to evaluate its functional repercussions on the subject's hearing and social life. MaterialsOne individual from Rigny for the osteological study, 69 individuals from the region for the Ct-Scan study and 48 individuals from the site for the isotopic analysis. MethodsMacroscopic analysis was performed using standard osteological methods. Consequences of pathology on hearing were assessed by CT-scan. Dietary behaviour was analysed by stable carbon and nitrogen isotope analysis of bone collagen. ResultsThe individual is a woman who was over 50 years of age at the time of her death with a severe form of Treacher-Collins syndrome that resulted in deafness. No osteological signs of maltreatment were observed and there is no evidence that this individual's diet was different from that of the rest of the community. ConclusionsAll information testifies to the full integration of this individual into the village population. SignificanceThis study is the first archaeological description of Treacher Collins syndrome. It shows the ability of the paleopathological approach to help identify the attitudes of societies for which written sources are most often lacking. LimitationsIn the absence of palaeogenomic analysis it is not possible to identify the origin of this case. Suggestions for further researchIncrease the paleopathological semiology by CT-scan in order to specify the consequences of pathologies and integrate isotopic analyses to enrich discussion about perceptions of disease.

The social and cultural changes that occurred between the medieval and modern periods in urban contexts are well documented; however, those in rural contexts are less well understood. This research aims to bridge this gap by analysing changes in dietary practices and oral health conditions between the medieval and modern eras, and by identifying their relationship with the social status of individuals buried at the rural site of the church of Saint-Pierre and Saint-Paul in Joué-lès-Tours (Indre-et-Loire, France). The objectives of this study are to jointly analyse the isotopic data concerning the diet of 37 individuals and the osteological and archaeological data, and to tie these results in with local historical and archaeozoological data. While the burial practices identified between the thirteenth and eighteenth centuries suggest social distinctions between groups of individuals, the study of diet (δ 13 C and δ 15 N) and the state of oral health point to a homogeneous social group characterized by the preferential consumption of pig meat, poultry and freshwater resources, and a degraded state of health. The available parochial registers and regional archaeozoological knowledge tend to confirm this hypothesis. This study confirms the relevance of the isotopic tool, which supplies dietary information to reinforce the archaeo-anthropological framework of interpretation, and also provides a critical examination of some of the criteria used to discuss the social composition of a set.