Paleopathology is the study of disease by using mummified and skeletal remains, documents, early books, paintings, sculptures, and coprolites. Earlier investigators such as Esper and Cuvier focused on non-human specimens, but later ones expanded their interests to humans. They studied the ancient Egyptians and found evidence of osteoarthritis, tuberculosis, leprosy, and smallpox, as well as of injuries and fractures. In their studies they used microscopy, X-rays, and CT scans, as well as more recent and sophisticated techniques such as carbon dating and DNA and isotopic analysis.

Some of the greats of paleopathology were as follows:

Johann Friedrich Esper (1732–1781) was born in Berlin, studied medicine at the University of Halle, and practiced in Berlin and Magdeburg. As a physician, he was particularly interested in medicinal plants and wrote several books about them. He studied geology, entomology, and even ornithology, and he published one of the first comprehensive studies of birds in Germany. He was also interested in fossils and their significance in the history of science. He may be thought of as the first paleopathologist. In 1774 he correctly identified the presence of an osteosarcoma in a bear. Highly regarded during his lifetime, he was elected to the Berlin Academy of Sciences.

Georges Cuvier (1769–1832) was an early French paleopathologist. He expanded the Linnaean classification of animals into groups and showed that many species had become extinguished by catastrophic events such as floods. He studied ancient bones and determined they belonged to prehistoric animals such as the mastodon, Megatherium, or Pterodactylus. He thought that reptiles rather than mammals first dominated the world, rejected evolution theories as such, but believed that new species first appeared and eventually were destroyed. He died in Paris during a cholera epidemic.

Sir Marc Armand Ruffer (1859–1917) may well have put modern paleopathology on the map through an article published posthumously in 1920 on the pathology of ancient Egyptian teeth. He was the son of a Swiss banker, born in Lyons and educated in Germany, France, and England. After working for some time on rabies under Louis Pasteur, he became in 1891 the first director of the future Lister Institute. He developed a diphtheria antitoxin, but he contracted clinical diphtheria with its severe paralytic complications and had to resign his position. To regain his health, he went in 1896 to Cairo, where he was appointed professor of bacteriology. He studied the normal and abnormal histology of Egyptian mummies, essentially founding the discipline of human paleopathology. (See a more extensive article on Ruffer in this section.¹)

Grafton Elliot Smith (1871–1937) was born in Australia and graduated in medicine from the University of Sydney in 1895. After studying and working in Cambridge and at the British Museum, he secured in 1900 an appointment at the Cairo School of Medicine. There he acted as advisor to the archaeological survey of Nubia (now southern Egypt and northern Sudan), an effort made urgent by the construction of the Aswan Low Dam, which threatened to flood important archeological sites. In this endeavor, he was assisted first by Frederic Wood Jones and later by Douglas Erith Derry. He studied thousands of human remains and obtained much valuable information about them. Later he became professor of anatomy at Manchester (1909–1919), at University College London (1919–1937), and also took an interest in the neurology of shell shock during World War I. He believed that humans originated from Europe, not Africa or Asia, and spread from there to Egypt. He viewed Egypt as the ultimate source of civilization. Even agriculture, he maintained, originated in Egypt and only later spread to Mesopotamia.

Frederic Wood Jones (1879–1954) was born and grew up in London, studied medicine at the London Hospital School of Medicine, and later qualified as a surgeon. In 1907 he went to Cairo to assist Grafton Elliot Smith in the archaeological survey of Nubia and examined the human relics of thousands of desert specimens. He taught at medical schools in London and Manchester and became professor of anatomy at the Royal Free School of Medicine (1915) and at the University of Adelaide (1920). In 1926 he helped found the Anthropological Society of South Australia and was appalled by the conditions under which the detribalized native peoples were forced to exist and by the public’s indifference to their plight. From 1932–33, he acted as temporary director of anatomy at the Peiping Union Medical College, and in 1938 was appointed to the chair of anatomy in Manchester. Though heavily influenced by Charles Darwin, he became a Lamarckian evolutionist and believed that certain acquired traits could be inherited. He was a forceful teacher and wrote scientific books in vivid prose.

Douglas Erith Derry (1874–1961) graduated in medicine from Edinburgh University in 1903. After teaching and conducting research in anatomy, he went to Cairo as assistant professor of anatomy. In 1909 he joined the archaeological survey of Nubia, then returned to England as curator and lecturer in anatomy and anthropology at University College, London. In 1919 he went again to Cairo, as professor of anatomy at the Government Medical School. He spent a winter at the archaeological excavations at Gebel Moya, south of Khartoum, and following the discovery of Tutankhamun’s tomb at Luxor in 1923 he took a leading share in examining the human and other remains. He was the first anatomist to examine the mummy of the Tutankhamun.

Derry made significant contributions to human anatomy, and his findings on the human skull provided the basis for the study of human evolution. His influence on the medical profession in Egypt was profound. As professor of anatomy, he devoted himself to the growth of the school of medicine, was injured during a revolver attack by a student, and in 1952 was “brusquely evicted” from his chair on political grounds.

Samuel George Shattock (born Samuel George Betty in 1852 in London) was educated in Bath and in 1875 won the Liston Gold Medal at University College Hospital as the medical student who wrote the best report on surgical cases in the hospital. He worked in surgical pathology, became museum curator at University College Hospital, then at St Thomas’s Hospital (1884) where he also became lecturer and later professor of pathology. He taught surgical pathology using museum specimens and was a pioneer of palaeopathology.

In 1905 he exhibited a prehistoric and predynastic collection of urinary calculi found in Egypt. In 1909 as president of the Pathological Section of the Royal Society of Medicine, he exhibited microscopic sections of the aorta of the mummy of the Pharaoh Merneptah. As Hunterian Professor of Surgery and Pathology from 1909–1911, he was active in developing the study of pathology and also of the new science of bacteriology. Like his great model John Hunter, he insisted that morbid anatomy should be advanced not only by study but also by experimentation.

Arthur C. Aufderheide (1922–2013) received his degrees from the University of Wisconsin-Madison in 1943 and the University of Chicago in 1952. He became professor at the University of Minnesota in Duluth and spent most of his active life there. His major contribution was his work on mummies. Referred to as “the mummy doctor,” he believed mummies could provide valuable insights into understanding the spread of diseases and used X-rays and CT scans to examine their internal structure. He studied mummies from many different locations and times, from ancient Egypt, Peru, Italy, and the Aleutian Islands, finding cases of tuberculosis, leprosy, malaria, leishmaniasis, and parasitic infections. He worked to discover if any of the Medici in Florence died from malaria, and also found that the ancient Romans had ten times more lead in their bones than modern humans. He advocated using anthropology in public health activities to prevent the spread of diseases. He also worked in Brazil on Chagas disease, helping to identify the insect vectors transmitting it, and developed strategies for controlling its spread. (From a more extensive article on Aufderheide in this section.²)

Modern developments

In recent times, a new generation of paleopathologists has expanded its reach into new, unexplored areas. It has studied the bone lesions of thalassemia, rare cancers such as rhinopharyngioma and their relation to the Epstein-Barr virus, along with Down syndrome, extensive lice infestations, lung damage from inhalation of fumes from oil lamps, hospital gangrene during the Civil War from staphylococcal or streptococcal infections, syphilis affecting long bones, leprosy in northern Europe, spondylolisthesis or fractures of lower vertebrae from mechanical stress, and coccidiomycosis in the Native American peoples of southern Arizona.³

Paleopathology has even extended its range to studying the illness, injury, and deformity of fossilized eggs. Fossil records have revealed several conditions afflicting eggs, such as eggshells of excessive thickness or multiple layers, which cause the embryo to suffocate. Eggshells may be too thin and collapse, and they may be wrinkled, bulged, ridged, or have unusual shapes caused by convulsions and contractions of the uterus. Their study in the context of disease is in the tradition of the early work of Johann Esper and Georges Cuvier.

References

1. Dunea, George. “Marc Ruffer, founder of paleopathology.” Hektoen International, Anthropology, Winter 2023. https://hekint.org/2023/01/12/marc-ruffer-founder-of-paleopathology/.
2. Dunea, George. “More on Arthur Aufderheide, the mummy doctor (1922–2013).” Hektoen International, Anthropology, Winter 2023. https://hekint.org/2023/01/12/more-on-arthur-aufderheide-the-mummy-doctor-1922-2013/.
3. Buikstra, Jane, and Charlotte Roberts, editors. The Global History of Paleopathology: Pioneers and Prospects. Oxford UP, 2012.
4. Read more on these notable figures of paleopathology in the Australian Dictionary of Biography, Plarr’s Lives of the Fellows, and on Wikipedia.