Between the Living and the Dead: Trauma Medicine and Forensic Medicine in the Mid-Qing

This paper analyzes the influence of forensic medicine on therapeutic medicine through a case study of Qian Xiuchang and Hu Tingguang, two Chinese doctors who specialized in treating traumatic injuries. During the early nineteenth century, both men compiled medical treatises that sought to improve on a scholarly model of “rectifying bones” articulated in 1742 by the Imperially-Compiled Golden Mirror of the Medical Lineage. Both texts also incorporated information from forensic medicine, including official inquest diagrams and checklists promulgated by the Qing government. I show that they drew on these forensic materials to help address two interlinked medical issues: understanding the effects of injury on different parts of the body, and clarifying the location and form of the body’s bones. Overall, I suggest that the exchange of ideas between the realm of therapeutic medicine and forensic medicine was an important epistemological strategy that doctors and officials alike employed to improve their knowledge of the material body.     

Clay‐shoveler's fracture: an uncommon diagnosis in palaeopathology

An archaeological case of clay‐shoveler's fracture was observed in an adult male exhumed from a Roman necropolis dated to the 1st–3rd century AD and located in the city of Barcelona, Spain. Clay‐shoveler's fracture is a breakage of a lower cervical or upper thoracic spinous process as a result of mechanical stress. Different mechanisms have been related to this injury, generally in labour‐related contexts. This paper reviews the literature concerning this uncommon finding, focusing especially on its mechanism and on activity‐related lesions. Copyright © 2006 John Wiley & Sons, Ltd.     

Trauma in the Crusader period city of Caesarea: a major port in the medieval eastern Mediterranean

Caesarea is the first fortified city to undergo palaeopathological analysis of its Crusader period inhabitants. This study of the 12th and 13th century population aims to determine the major types of trauma present, whether from weapon injuries or accidents. Since the Crusades were known for the significant number of battles and raids that took place, weapon injuries were expected to be common. Thirteen cases of trauma are described and a highly unexpected pattern has come to light. These cases do not include one single example of weapon‐related trauma. Every fracture is of a type expected from accidents or interpersonal violence without weapons. Possible explanations include the location of the city deep within Frankish territory and the robust city walls giving effective protection to the inhabitants, and also that the population were involved in activities that left them prone to accidents but not weapon injuries. The other important finding from this study was that the cases of lower limb long bone spiral fractures had healed in a near‐anatomical alignment. This is not what we would expect, as a proportion of these injuries would normally have been unstable and tend to heal poorly aligned. The good position could have resulted from surgeons' use of splints to immobilise the bones while they healed. This suggestion is supported by laws of the kingdom of Jerusalem, which stated that surgeons were to be punished if they allowed such fractures to heal at an angle. Copyright © 2006 John Wiley & Sons, Ltd.     

Dental trauma and antemortem tooth loss in prehistoric Canary Islanders: prevalence and contributing factors

Differential diagnosis of the aetiology of antemortem tooth loss (AMTL) may yield important insights regarding patterns of behaviour in prehistoric peoples. Variation in the consistency of food due to its toughness and to food preparation methods is a primary factor in AMTL, with dental wear or caries a significant precipitating factor. Nutritional deficiency diseases, dental ablation for aesthetic or ritual reasons, and traumatic injury may also contribute to the frequency of AMTL. Systematic observations of dental pathology were conducted on crania and mandibles at the Museo Arqueologico de Tenerife. Observations of AMTL revealed elevated frequencies and remarkable aspects of tooth crown evulsion. This report documents a 9.0% overall rate of AMTL among the ancient inhabitants of the island of Tenerife in the Canary Archipelago. Sex‐specific tooth count rates of AMTL are 9.8% for males and 8.1% for females, and maxillary AMTL rates (10.2%) are higher than mandibular tooth loss rates (7.8%) Dental trauma makes a small but noticeable contribution to tooth loss among the Guanches, especially among males. In several cases of tooth crown evulsion, the dental root was retained in the alveolus, without periapical infection, and alveolar bone was in the initial stages of sequestering the dental root. In Tenerife, antemortem loss of maxillary anterior teeth is consistent with two potential causal factors: (a) accidental falls while traversing volcanic terrain; and (b) interpersonal combat, including traditional wrestling, stick‐fighting and ritual combat. Steep‐walled valleys (barrancos) and lava fields (malpaís) required agile locomotion and occasional vaulting with the aid of a wooden staff. Accidental falls involving facial injury may have contributed to AMTL. Traditional conflict resolution involved competitive wrestling (lucha canaria), stick‐fighting (juego del palo), and ritualised contests involving manual combat. These activities made a small but recognisable impact on anterior dental trauma and tooth loss. Inter‐personal behaviours of such intensity leave their mark on skeletal and dental remains, thereby providing insight into the lives and cultural traditions of the ancient Guanches. Copyright © 2006 John Wiley & Sons, Ltd.     

Trepanation in the Chachapoya region of northern Perú

This paper discusses trepanation frequency data from the Chachapoya region of the northern highlands of Perú. New data from three skeletal samples are presented: Kuelap, Laguna Huayabamba, and Los Pinchudos, as well as isolated crania housed at the Chachapoya Museo Instituto Nacional de Cultura. The vast majority of the trepanations are circular in shape, except for one individual exhibiting as many as three roughly square trepanations. Evidence for healing is prevalent, with examples of both associated periosteal reaction of nearby outer table bone, as well as for healing of the insult itself. Only one case demonstrates a clear association between a traumatic injury and a trepanation event. The purpose or function of the remaining cases of trepanation, however, remains elusive. Copyright © 2006 John Wiley & Sons, Ltd.     

Lysis at the anterior vertebral body margin: evidence for brucellar spondylitis?

Recently, palaeopathologists have begun to diagnose brucellosis in skeletal remains from minor lytic lesions located on the anterior margins of one or some few vertebral bodies, taking these lesions to represent brucellar epiphysitis. However, review of the literature indicates that these lesions have been sporadically noted for some time by palaeopathologists and various different interpretations have been placed upon them. In view of this, a study of these vertebral marginal lesions (VML) was undertaken in a large series of archaeological skeletons from England, with the aim of characterising their morphology and frequency and shedding light upon their causes. In the study material, VML were found only in the lumbar spine, where they occurred with a prevalence of approximately 4%. It was argued that VML are consistent with two principal alternative diagnoses: brucellosis and traumatic anterior disc herniation. Differentiating these possibilities for the VML in the study material was difficult, but the balance of the evidence seemed to favour traumatic anterior disc herniation as the more likely cause. It is concluded that VML should not be used to identify the presence of brucellosis in skeletal remains unless there is further evidence, in the form of additional skeletal lesions or biomolecular evidence for residual brucella bacterial DNA, to support such a diagnosis. Copyright © 2007 John Wiley & Sons, Ltd.     

La Greffe Générale: the voice of French facially injured soldiers

Like the combatants on the frontline, the wounded soldiers of the First World War wrote and published newspapers during the sometimes lengthy periods of time they spent in hospital. La Greffe Générale is the journal written by and for facially injured combatants treated at the Val-de-Grâce military hospital in Paris. Throughout the eight issues released between December 1917 and July 1918, the voices of these men can be heard. While the surgeons’ perspective prevails in most remaining documents to do with French maxillofacial wards, La Greffe Générale gives an insight into the experiences of injury and treatment from the point of view of the wounded and convalescent combatants. The specific challenges faced by facially injured men are reflected in their writings, as this article shows. At the same time, their newspaper is in itself an attempt to respond to some of these issues. Ultimately, the patients’ publication reveals how gueules cassées, as French disfigured veterans came to be known, tried to collectively cope with their changed lives. The ethos reflected in, and fuelled by, La Greffe Générale played, this article argues, a significant part in the later constitution of the facially disfigured men’s organisation, the Association des Gueules Cassées.     

Gorgobad: reflections on a German-Australian family biography

This article continues the focus on German-Australian militarised modernities through the Second World War to the present day. It draws on the author’s own family history, beginning with the memories evoked by her grandparents’ house in northern Sydney, built between 1950 and 1953. Named ‘Gorgobad’, Persian for ‘place of the wolves’, it resonates with a family history that involves German colonial investments in post-First World War Iran, the global geopolitical upheavals of the Second World War, which drew her family into separate histories of refuge, British imprisonment and deportation and, finally, building a new home in Australia. The essay asks pertinent questions about the entanglement of hegemonic racialised orders in Europe with the very racialised orders of the grounds on which Gorgobad was built.