Trauma in the city of Kerma: ancient versus modern injury patterns

Abstract

Injuries, whether accidental or intentional, have incapacitated humans and their primordial ancestors throughout time, although the injury mechanisms have become increasingly more technologically sophisticated. Interpretation of injury aetiology among past peoples is challenging, and often impossible, however, clinical research from developing countries provides a useful analogy with which to evaluate trauma or health patterns of an ancient society. This paper presents a systematic analysis of cranial and postcranial skeletal trauma among 223 adults who were excavated by George Reisner in 1923 from the city of Kerma (1750-1550 BC), Egypt's ancient nemesis in the struggle for control of the Nile River trade route. A total of 156 injuries (fractures, dislocations and muscle pulls among the skull, long bones, extremities and torso) were observed among 88 individuals, 48 of whom had one injury only. The skull was the most frequently traumatized element (11.2%) followed by the ulna (8.3%); 2.4% (48/2029) long bones were fractured. The modal distribution of the Kerma fractures was compared to the fracture distributions of two samples from India and Nigeria where falls were the most common cause of injury. Some characteristics of the three injury patterns were shared: males suffered the greatest frequency of injury, the economically active people (25 to 50 years of age) presented the most injuries among adults, and a small proportion of the victims had more than one major injury. However, the Kerma distribution of the fractured bones varied dramatically from the clinical injury distributions: the ulna and skull were among the least frequently injured bones in the modern samples, while the radius, humerus and lower leg were the most commonly traumatized elements among the modern people, but rare among the ancients. The configuration of the ulna and skull injuries at Kerma was characteristic of those associated with blunt force trauma in other clinical assessments and the absence of these specific lesions from the modern samples where accident was the primary injury mechanism presents a persuasive argument for interpersonal violence among the ancient Kerma people.

Skeletal and dental indicators of health in the late mediaeval (12–15th century) population from Nin, southern Croatia

“…Long bone fractures recorded in the series are typical of those usually related to accidents (e.g. Djurić et al, 2006;Judd, 2004;Russell et al, 2001) such as fractures of radius, tibia, and fibula. The hypothesis of the relatively low risk of deliberate violence in late medieval Nin is further supported by the complete absence of perimortem trauma and trauma inflicted by sharp-edged weapons.…”

Does human sexual dimorphism influence fracture frequency, types and distribution?

“…Where sex is a biological reality, gender is a social construction [Grauer & Stuart-Macadam 1998], and in this study gender seems to influence the distribution of fractures in the sample [Judd 2004]. In addition, the results indicate a selection for gender equality in Odense where there was low human sexual dimorphism.…”

“…A similar method was used by Judd [2002aJudd [ , 2004 when examining the skeletal remains from the Nubian site Kerma.…”

In vitro strain in human metacarpal bones during striking: testing the pugilism hypothesis of hominin hand evolution

“…Modern assault injuries resulting from fist strikes show a distinctive distribution of skeletal injuries with high rates of trauma to the face (Walker, 1997(Walker, , 2001Carrier and Morgan, 2015). Facial skeletal trauma consistent with injury due to fist fighting has been observed in many samples of prehistoric skeletal remains (Owens, 2007;Cohen et al, 2012;Judd, 2004;Jurmain, 2001;Jurmain et al, 2009;Andrushko and Torres, 2011;Lessa and Mendonça de Souza, 2004;Standen and Arriaza, 2000;Scott and Buckley, 2014;Walker, 1997;Webb, 2009). Additionally, evidence consistent with facial skeletal trauma due to fist fighting also exists in the fossil record of Australopithecus (Dart, 1948;Roper, 1969) and early Homo (Wu et al, 2011;Pérez et al, 1997;Curnoe and Brink, 2010).…”