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葡萄牙北部(费拉达圣玛丽亚的特拉万卡)出土的首例男性(公元 17-19 世纪)麻风病疑似证据。

The first probable evidence of leprosy in a male individual (17th-19th century AD) unearthed in Northern Portugal (Travanca, Santa Maria da Feira).

机构信息

University of Coimbra, Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, Calçada Martim De Freitas, 3000-456, Coimbra, Portugal.

University of Coimbra, Research Centre for Anthropology and Health (CIAS), Department of Life Sciences, Calçada Martim De Freitas, 3000-456, Coimbra, Portugal.

出版信息

Int J Paleopathol. 2021 Mar;32:80-86. doi: 10.1016/j.ijpp.2020.12.001. Epub 2021 Jan 19.

DOI:10.1016/j.ijpp.2020.12.001
PMID:33482498
Abstract

OBJECTIVE

This study describes the first evidence of a probable paleopathological case of leprosy from northern Portugal.

MATERIALS

An adult male, skeleton 403, exhumed from the Christian cemetery associated with the church dedicated to Saint Mamede (Travanca, Santa Maria da Feira), dated from the 17th-19th century AD.

METHODS

Standard bioarchaeological methods were used for sex and age-at-death determinations, and leprosy-related bone lesions were identified through macroscopic analysis guided by paleopathological diagnostic criteria.

RESULTS

The macroscopic observation revealed probable leprosy-related skeletal lesions, namely tenuous rhinomaxillary changes, bilateral proliferative periosteal reactions on the tibiae and fibulae, as well as concentric atrophy, acro-osteolysis and ankyloses of foot bones.

CONCLUSIONS

Skeleton 403 represents a probable case of leprosy according to the nature and distribution pattern of bony lesions observed.

SIGNIFICANCE

This finding fills an important gap in the history of leprosy in Portugal. Although historical sources show that the majority of leprosaria were located in the northern part of the country, suggesting that leprosy was more prevalent in this area of Portugal in the past, no paleopathological evidence of this disease was reported for this region to date. Furthermore, the inhumation of a leprosy sufferer in a 17th-19th century AD Christian parish cemetery is deeply imbued with social meaning.

SUGGESTION FOR FUTURE RESEARCH

The future detailed study of the remaining skeletons unearthed from the cemetery of the Church of São Mamede will hopefully reveal further osteological evidence of leprosy in addition to the application of ancient DNA analysis to confirm the presence of the pathogen of this disease. Also, further documentary research is needed in order to expand appreciation of the epidemiological and social impact of leprosy in the 17th-19th century AD Portugal.

摘要

目的

本研究描述了葡萄牙北部首例疑似麻风病的古病理学案例。

材料

从与圣马梅德教堂(特雷万卡,圣玛丽亚达费拉)相关的基督教公墓中挖掘出的成年男性骨架 403,其年代可追溯至公元 17 至 19 世纪。

方法

采用标准的生物考古学方法确定性别和死亡年龄,并通过宏观分析结合麻风病相关的骨骼病变诊断标准来识别与麻风病相关的骨骼病变。

结果

宏观观察显示可能存在与麻风病相关的骨骼病变,包括鼻上颌骨的疏松变化、胫骨和腓骨的双侧增生性骨膜反应,以及足部骨骼的同心萎缩、肢端骨溶解和关节强直。

结论

根据观察到的骨骼病变的性质和分布模式,骨架 403 代表了一例可能的麻风病病例。

意义

这一发现填补了葡萄牙麻风病史研究的一个重要空白。尽管历史资料表明,大多数麻风病院都位于该国北部,这表明过去葡萄牙北部地区的麻风病更为普遍,但迄今为止,该地区尚未报告有关这种疾病的古病理学证据。此外,在 17 至 19 世纪基督教教区公墓中埋葬一名麻风病患者,具有深刻的社会意义。

未来研究建议

对从圣马梅德教堂公墓中挖掘出的其余骨骼进行详细研究,有望除了应用古 DNA 分析来确认这种疾病病原体的存在之外,还能揭示更多的麻风病骨骼证据。此外,还需要进一步的文献研究,以扩大对 17 至 19 世纪葡萄牙麻风病的流行病学和社会影响的认识。

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