Assassination of Elisabeth, Empress of Austria, Queen of Hungary, on 10 September 1898: further additions and minor annotations.

Very recently, a comprehensive re-evaluation of the medical facts and observations surrounding the death of Empress Elisabeth "Sisi" of Austria (1837-1898) was published. The Empress was assassinated in Geneva by the anarchist Luigi Luccheni or Lucheni (1873-1910). In parallel to this recent publication, our study group came across an almost unknown letter from Dr. Golay, who was one of the examining doctors of Empress Elisabeth. In this publication we add relevant additions based on this letter and provide further insights regarding the attempts at resuscitation.

First-time complete visualization of a preserved meningeal artery in the mummy of Nakht-ta-Netjeret (ca. 950 BC).

The preservation of the meningeal artery in ancient mummified bodies, particularly in anthropogenic Egyptian mummies, is a highly controversial topic in neuroscience and anthropological research. A recent (2015) debate between Wade and Isidro, based on the interpretation of the meningeal grooves and cast in a skull from the necropolis of Kom al-Ahmar Sharuna (Egypt), highlighted both the necessity of having clear radiological descriptions of this anatomical structure and of assessing large collections of mummified crania. Here, we present for the first time an instance of extremely well-preserved middle meningeal artery in the mummy of the ancient Egyptian dignitary Nakht-ta-Netjeret (ca. 950 BC), still inside the meninx, using paleo-radiological techniques. We finally link this find with experimental data from the neurological literature on the methodology of excerebration implemented by ancient Egyptian embalmers.

The Gladiator's Tears: Epiphora From Ancient Rome.

This article examines the clinical presentation of epiphora in Ancient Rome through the historico-medical analysis of the literary evidence provided by the verses by the poet Juvenal in his Satire VI. A gladiator's ophthalmological problem is interpreted as epiphora caused by traumatic injuries to the craniofacial region, compatible with those described in the palaeopathological literature. This analysis also focuses on the history of epiphora in antiquity and its treatment.

Egyptian Canopic Jars at the Crossroad of Medicine and Archaeology: Overview of 100 Years of Research and Future Scientific Expectations.

Ancient Egyptian human remains have been of interest in the fields of both medical and Egyptological research for decades. However, canopic jar holders for internal organs (liver, lungs, stomach, intestines) of Egyptian mummies appear to be but a very occasional source of data for such investigations. The few medical approaches focusing on the content of these jars are summarized and listed according to pathogens and diseases to give a structured overview of this field of study. An extensive search of the literature has been conducted from different bibliographic databases with a total of n = 26 studies found. The majority of diseases found consisted of infectious diseases and internal medicine conditions such as schistosomiasis or emphysema. These are just 2 examples of many that, instead of primarily affecting bone, muscle or skin, specifically target internal organs. Hence, a better understanding of the evolution of diseases that still affect mankind could be gained. In conclusion, this reassessment shows that canopic jars represent a highly underestimated source for histological, radiological and ancient DNA examination of Ancient Egyptian remains and should, thus, be more and more brought back into the focus of retrospective medical research.

St. Catherine of Siena (1347-1380 AD): one of the earliest historic cases of altered gustatory perception in anorexia mirabilis.

St. Catherine of Siena suffered from an extreme form of holy fasting, a condition classified as anorexia mirabilis (also known as inedia prodigiosa). Historical and medical scholarships alike have drawn a comparison between this primaeval type of anorexia with a relatively common form of eating disorder among young women in the modern world, anorexia nervosa. St. Catherine's condition was characterised by a disgust for sweet taste, a condition also described in anorexia nervosa, and characterised by specific neurophysiological changes in the brain. St. Catherine's case may be considered one of the oldest veritable descriptions of altered gustation (dysgeusia). Moreover, a more compelling neurophysiological similarity between anorexia mirabilis and anorexia nervosa may be proposed.

Body height of mummified pharaohs supports historical suggestions of sibling marriages.

Body height is an important factor in reconstructing health conditions and it serves as an indicator of socio-economic status. Researchers rely on ancient data to analyze evolutionary aspects of human health and its interrelation with environmental influences. This study presents body height estimates from all periods of ancient Egyptian history and compares the general population with the existing mummies of the members of royal families. A sample of 259 adult Egyptian mummies originating from various collections and published sources with body lengths (long bone measures or/and overall measurements, CT data) were analyzed, and royal mummies were scored with respect to the level of consanguinity. Male royals were taller than males in the general ancient Egyptian population, while female royals were shorter than females in the general population. The body height variation of the royals is significantly reduced when compared with a pool of non-royal mummies. This provides evidence for inbreeding resulting from consanguineous marriages. However, there appears to be no correlation between the level of inbreeding and individual body height. The random sample of general population does not show signs of inbreeding. Due to the present lack of larger, technically and ethically challenging genetic studies, the selected non-invasive approach of body height is the most reliable indicator of sibling marriages of pharaohs based on direct physical evidence.

Kaspar Hauser, the Child of Europe: Are smallpox vaccination scars the clue to a 2-century-old mystery?

We have explored the 19th century mystery of the identity of Kaspar Hauser, the so-called Child of Europe, from the perspective of the smallpox vaccination. We have highlighted the improbability that he was secretly inoculated based on the vaccination policies and methodologies applied at the time. This consideration allows for a reflection on the whole case and the importance of vaccination scars in ascertaining immunization against one of humanity's deadliest killers, especially given the recent monkeypox outbreak.

A critical assessment of proposed outbreaks of plague and other epidemic diseases in Ancient Egypt.

The current coronavirus disease 2019 (COVID-19) pandemic has reminded us of past epidemics. Pharaonic Egypt has often been associated with epidemics and disasters through the 10 plagues in the Bible. The aim of this study was to examine which epidemics and serious diseases can be effectively proven for Ancient Egypt through mummies and historical source texts. The biblical plagues cannot be proven because there is no agreement on the dating of the Exodus, or the Exodus is a conglomeration of memories of different events. Other diseases such as malaria and schistosomiasis have been proven for Ancient Egypt, while polio and smallpox are still uncertain. There are indications of a bubonic disease from the time of the middle 18th Dynasty, but its exact nature cannot be determined from source texts or mummies, as they are too vague.

Autopsing history: The mummy of Charlemagne (c. 747 - 814 AD), father of Europe.

In this article, a complete history of Charlemagne's mortal remains is outlined, including the first publication reporting on the most recent tomb opening in 1988. Besides exclusive bioarchaeological details - namely that his body was indeed mummified - a full clinical interpretation of the Emperor's final illnesses and death is given: a likely combination of osteoarthritis, gout and a recurrent fever caused by an infectious disease.

Radiological findings in ancient Egyptian canopic jars: comparing three standard clinical imaging modalities (x-rays, CT and MRI).

BACKGROUND: The aim of our study was to evaluate the potential and the limitations of standard clinical imaging modalities for the examination of ancient Egyptian canopic jars and the mummified visceral organs (putatively) contained within them. METHODS: A series of four ancient Egyptian canopic jars was imaged comparing the three standard clinical imaging modalities: x-rays, computed tomography (CT) and magnetic resonance imaging (MRI). Additionally, imaging-data-based volumetric calculations were performed for quantitative assessment of the jar contents. RESULTS: The image contrast of the x-ray images was limited by the thickness and high density of the calcite mineral constituting the examined jars. CT scans showed few artefacts and revealed hyperdense structures of organ-specific morphology, surrounded by a hypodense homogeneous material. The image quality of MRI scans was limited by the low amount of water present in the desiccated jar contents. Nevertheless, areas of pronounced signal intensity coincided well with hyperdense structures previously identified on CT scans. CT-based volumetric calculations revealed holding capacities of the jars of 626-1319 cm3 and content volumes of 206-1035 cm3. CONCLUSIONS: CT is the modality of choice for non-invasive examination of ancient Egyptian canopic jars. However, despite its limitations, x-ray imaging will often remain the only practicable method for on-site investigations. Overall, the presented radiological findings are more compatible with contained small organ fragments rather than entire mummified organs, as originally expected, with consequent implications for envisioned future sampling for chemical and genetic analysis.

Palaeopathology of the earlobe crease (Frank's sign): New insights from Renaissance art.

Several studies have associated the earlobe crease sign, discovered by Sanders T. Frank in 1973, with cardiovascular pathology, yet very few studies have focused on the antiquity of this trait, with the most ancient one thought to date back to the Roman Emperor Hadrian (76-138CE). This article presents two more cases from the Italian Renaissance in the works of the artist Andrea Mantegna (1431-1506) and examines them in a multidisciplinary fashion.

The sudden death of Alaric I (c. 370-410AD), the vanquisher of Rome: A tale of malaria and lacking immunity.

BACKGROUND: Alaric I (c. 370-410AD), King of the Visigoths, sacked Rome for the second time in over eight centuries of history. Historians suggest that malaria, probably contracted either in Rome or in the Pontine Marshes, was responsible for his sudden death in Cosenza (Calabria) in the autumn of 410AD, where he was allegedly buried in the River Busento. In this article, we aim to examine this hypothesis through a full pathographic reassessment of the most likely cause of Alaric's demise. METHODS: To achieve this, we resorted to a dual philological-medical approach: clinical likelihood and malaria seasonality coupled with primary historical sources (mainly Jordanes' work De origine actibusque Getarum) and the reconstruction of the itineraries followed by Alaric and his army after the sack of Rome. RESULTS: Sudden death is caused by several factors. The possibility that Alaric died of a cardiovascular disease was discarded since no description of potentially pathological signs emerged from the available sources. Given his lack of semi-immunity, falciparum malaria was considered as the most likely cause of his demise. It took him over two months to reach the coasts of Calabria during the peak of malaria's transmission (summer-autumn). During the march, Alaric did not suffer from recurrent fevers or other ailments, which would have been reported by historians. CONCLUSION: The scenario emerging from this multidisciplinary reanalysis allows us to hypothesise that Plasmodium falciparum malaria, contracted during his journey through Calabria, was the most likely candidate responsible for Alaric's unexpected demise.