3D reappraisal of trepanations at St. Cosme priory between the 12th and the 15th centuries, France

Abstract

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.

The changing shape of palaeopathology: The contribution of skeletal shape analyses to investigations of pathological conditions

“…Artificial cranial modification often comes first to mind when referencing this topic. While we did not identify any articles on cranial modification that linked sufficiently with palaeopathological themes, we expect this area has potential for future exploration, perhaps through methods such as those used by Bédécarrats et al (2021) to examine cranial shape and trephination. Their conclusions touched on the potential to investigate palaeoneuropathy through shape‐based analyses, which may also hold promise for cranial modification studies (Section 3.1.3).…”

“…Similarly, trepanations as therapeutic medical interventions in medieval France have also been investigated using shape analyses (Bédécarrats et al, 2021). Skulls and endocrania of individuals with and without trepanations were scanned and compared using 3D GM.…”

“…Skulls and endocrania of individuals with and without trepanations were scanned and compared using 3D GM. Individuals with trephinations typically fell within normal ranges of shape variation, however, patterns in the distribution of the trephined skull shapes combined with the presence of synostoses in some trephined skulls suggested possible links between premature suture closure and the subsequent trephinations (Bédécarrats et al, 2021). The integration of these quantitative shape analyses, although not conclusive, demonstrates how shape may provide opportunities to further investigate therapeutic interventions and palaeoneuropathy in archaeological contexts.…”

“…In addition, other research has been designed with the group‐level in mind, aiming to uncover patterns in sociocultural experiences (e.g., Martin et al, 1987), injury or illness repercussions and responses (e.g., Gilmour et al, 2019; Mansukoski & Sparacello, 2018), trends in therapeutic interventions (e.g., Bédécarrats et al, 2021), or even consequences of cultural practices (e.g., Zhao et al, 2020). Early on, Martin et al (1987) tackled socially informed questions, clarifying historical documents and censuses using skeletal shape to illuminate important trends in social inequalities in the post‐reformation south, namely that the diet and health among African Americans was substandard.…”

“…Describe pathological conditions and support/refute diagnoses (e.g., Berezina & Buzhilova, 2021;Berner et al, 2021;Colombo et al, 2018;Darton et al, 2015;DeSilva & Papakyrikos, 2011;Gunz et al, 2004;Hershkovitz et al, 1997;Milella et al, 2015;Rmoutilová et al, 2020;Slon et al, 2013;Thompson, 2014;Trinkaus, 2018;Vairamuthu & Pfeiffer, 2018;Viciano et al, 2017;Zhao et al, 2020) 2. Understand how specific traits and shape characteristics predispose individuals to pathological conditions (e.g., Bédécarrats et al, 2021;Calce et al, 2018;Mansukoski & Sparacello, 2018;Mays, 2006;Plomp et al, 2012;Plomp et al, 2019;Plomp et al, 2020;Plomp, Viðarsd ottir, Weston, et al, 2015;Shepstone, 2001;Shepstone et al, 1999;Ward et al, 2010;Weiss, 2005) 3. Identify and interpret adaptations and alterations in functional anatomy in response to pathological conditions (e.g., Berner et al, 2021;Churchill & Formicola, 1997;Gilmour et al, 2019;Lazenby & Pfeiffer, 1993;Licata et al, 2019;Micarelli et al, 2018;Roberts et al, 2004;Sparacello et al, 2016;Thompson, 2014;Trinkaus, 2018;Viciano et al, 2017;...…”