Hackett C J
Virchows Arch A Pathol Anat Histol. 1975 Oct 30;368(3):229-41. doi: 10.1007/BF00432525.
Diagnostic criteria of syphilis and some other diseases are proposed from a study of 424 crania and calvariae and 250 long bones in 22 medical museums in Europe. Yaws bone lesions in Uganda and changes in Australian aboriginal bones also contributed to the establishment of these criteria. Any deductions about disease in the past or isolated populations must depend upon acceptable diagnostic criteria; post mortem damage must be recognised. In crania and calvariae the sequence of changes of Virchow's caries sicca, and in long bones nodes/expansions with superficial cavitation are sound indicators of syphilis, and of yaws and treponarid in relevant geographical areas. Attention is called to the cause of sequestra in European calvariae labelled syphilis, the absence of sequestra due to haematogenous pyogenic osteomyelitis in Australian and other aboriginal bones and possibly in Europe before the Middle Ages. The number of bones with diagnostic criteria needed to demonstrate the endemicity of a particular infection in a past community is discussed. There is also need for an extensive application of diagnostic criteria of syphilis to pre-Columbian or pre-European bones everywhere. The uncertain future of old dry diseased bones in medical museums, and the need for reference centres to provide sound advice and guidance in palaeopathology are stressed.
通过对欧洲22家医学博物馆的424块颅骨和头盖骨以及250根长骨的研究，提出了梅毒及其他一些疾病的诊断标准。乌干达的雅司病骨病变以及澳大利亚原住民骨骼的变化也为这些标准的制定提供了依据。对过去或孤立人群中疾病的任何推断都必须依赖于可接受的诊断标准；必须认识到死后损伤。在颅骨和头盖骨中，维尔肖干性龋齿的变化顺序，以及在长骨中出现的伴有表面空洞的结节/膨大，是梅毒、雅司病和在相关地理区域的密螺旋体病的可靠指标。需要注意的是，在欧洲被标记为梅毒的头盖骨中死骨的成因，在澳大利亚和其他原住民骨骼中以及可能在中世纪以前的欧洲，由于血源性化脓性骨髓炎导致的死骨不存在。讨论了在过去的社区中证明特定感染的地方性流行所需的具有诊断标准的骨骼数量。还需要将梅毒诊断标准广泛应用于各地的前哥伦布时期或前欧洲时期的骨骼。强调了医学博物馆中陈旧干燥患病骨骼不确定的未来，以及古病理学参考中心提供可靠建议和指导的必要性。
