Craniofacial Trauma by Falling Roof-Tiles in Antiquity. Evidence From Nonmedical Sources

Abstract

N onmedical sources (literary works, fine arts, material culture, myths, and tale) can provide unexpected information on craniofacial pathologies in ancient times. [1][2][3] These sources indicated that the medicine in the Greek Archaic period (8th-6th century BC) reached a high knowledge of the anatomy of the head and neck, including head and facial trauma. In the Homeric poems, as well known, we can find the first descriptions of lesions affecting the neurocranial region, mostly with a fatal outcome. 4 Even authors of the Classical and Hellenistic period, such as Plato and Plutarch, reported cases of head and neck injuries, in the battlefields, also affecting figures such as the kings Cyrus and Alexander the Great.Cranial injuries could also occur outside the war scenarios and by an accidental cause, especially in an urban context due to the presence of buildings with roofing systems not adequately fixed to the structures. Tiles as roof covering elements were mainly developed in Greco-Roman world. Originally, the ancient Aegean peoples used thatch roofs with overhanging eaves, supported by dried clay bricks; once that these people began to use brick walls, the buildings were strong enough to support heavier materials at the roof level. Furthermore, as the first settlements were transformed into real urban nuclei, the risk of thatched roofs feeding uncontrollable fires increased. Therefore, between 700 and 650 BC, the Greeks introduced roof tiles obtained from a mixture of baked clay, which guaranteed, among other things, even less flammability and few and simple maintenance interventions.The new roofing system was further developed by the pre-Roman civilizations of Italy and then by the Romans who spread it to Mediterranean Europe, North Africa, and the Near East. This type of roof was based on the tegula, a plain flat tile, which was laid flat upon the roof, and the imbrex, a semicylindrical roofing tile, like a half-pipe, laid over the joints between the tegulae.The lack of maintenance and climatic events made the new roofing system a potential danger for citizens, since the tiles are blunt objects of a certain weight. The fall of a clay tile could cause scalp or facial and intracranial injuries and, in the worst cases, skull fractures. The fatality of the tiles falling is well highlighted by a Roman roof tile fragment with part of an amusing yet profound graffito: ''''Watch me. I am destined to fall to the ground!''''