The historical origins of the vegetative state: Received wisdom and the utility of the text

The persistent vegetative state (PVS) is one of the most iconic and misunderstood phrases in clinical neuroscience. Coined as a diagnostic category by Scottish neurosurgeon Bryan Jennett and American neurologist Fred Plum in 1972, the phrase “vegetative” first appeared in Aristotle’s treatise On the Soul (circa mid-fourth century BCE). Aristotle influenced neuroscientists of the nineteenth and early-twentieth centuries, Xavier Bichat and Walter Timme, and informed their conceptions of the vegetative nervous system. Plum credits Bichat and Timme in his use of the phrase, thus putting the ancient and modern in dialogue. In addition to exploring Aristotle’s definition of the “vegetative” in the original Greek, we put Aristotle in conversation with his contemporaries—Plato and the Hippocratics—to better apprehend theories of mind and consciousness in antiquity. Utilizing the discipline of reception studies in classics scholarship, we demonstrate the importance of etymology and historical origin when considering modern medical nosology.     

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.     

Work intensifications,injuries and legal exclusions for paid domestic workers in Montréal,Québec

There is increasing research on the intensification of work in the post-1980s time period. The focus on flexibility in management practices has resulted in more tasks being offloaded onto workers who must then adjust their time-use to accommodate the greater workload. Studies of work intensification are not new to manufacturing production and there is increasing attention to unpaid domestic labour and service sectors. One industry, however, that has been neglected by these studies is paid domestic work where employers are individuals or families. Drawing on the traditions of feminist political economy and geography, I argue that the socio-spatial specificity of paid domestic work contributes an emphasis on workplace injury and labour law exclusion to intensification of work paradigms. Based on qualitative interviews conducted in Montréal, Québec from 2013 to 2015, I show how paid domestic workers intertwine narratives about work intensification and workplace injury yet remain excluded from the Act respecting occupational health and safety and the Workers’ Compensation Act in Québec. Migrant women caregivers are disproportionately impacted by these exclusions and I show how the Filipino Women’s Organization in Québec (PINAY) is at the forefront of challenging these exclusions. In conclusion, I propose an approach that combines feminist geography and political economy to consider how time-squeezes impacting individual or household employers may be intensifying the workloads of their paid domestic workers and how labour law structurally excludes workers along the social dimensions of gender, race and citizenship.     

Injuries to the skeleton due to prolonged activity in hand-to-hand combat

Two complete skeletons from the Hamman-Todd collection of the Cleveland Museum of Natural History (CMNH) show a suite of pathological lesions that suggest the individuals had been involved in boxing or other hand-to-hand combat. These lesions were studied and compared with medical and autopsy records. The aims of the research were to estimate the accumulated damage to the bones over time, to characterize the different types of the damage, and to establish criteria for hand-to-hand combat or violence for archaeological material. Our inspections showed that besides the muscle markings developed and the numerous healed fractures that are expected when someone is involved in such activities, other types of lesion are present that are helpful for a proper differential diagnosis. These are: degenerative changes at the lesser tuberosity of the humerus; focal necrotic changes/bone growth on the trochlea of the humerus; necrotic changes on the distal head of the ulna; bony patches on upper limb bones only; secondary centres of ossification failing to fuse (mainly in vertebrae and acromion); a huge conoid tubercle on the clavicle; bony spurs on the distal articular head of the metacarpals; necrotic changes on the femoral head next to the fovea and on the roof of the acetabulum; and a developed bony ridge for the attachment of the iliotrochanteric ligament. Finally, we propose a set of criteria that will help to identify people in archaeological material who were involved in hand-to-hand combat.     

Approaches to violent death: a case study from early medieval Cambridge

This paper examines one of a number of weapon‐injury victims from the cemetery at Church End in Cherry Hinton, Cambridge (Hertfordshire Archaeological Trust/Archaeological Solutions site HAT358), which was in use from the late Anglo‐Saxon period until after the Norman Conquest. Drawing on precedents set by forensic studies, palaeopathology and more traditional spatial cemetery analysis, assertions are made about the nature of the attack and its context. Copyright © 2006 John Wiley & Sons, Ltd.     

Injuries on a skull from the Ancient Bronze Age (Ballabio,Lecco, Italy): a natural or an anthropic origin?

This paper discusses the results of the analysis of a female skull from a collective burial dated to the Ancient Bronze Age in Italy (Ballabio, LC). A virtual restoration and 3D reconstruction was also produced from the digitalized skull to complete the damaged parts and to recreate the facial appearance of this young adult female from the Bronze Age. The skull shows clear evidence of post-mortem modifications, as some series of scraping marks on the external cranial vault cross the parietal bones longitudinally. The contemporaneous presence of taphonomic linear marks on the skull and periostitis on the frontal bone, as well as the provenance of the specimen from a secondary burial (a typical funerary habit documented in Italy during the Copper Age and Ancient Bronze Age), makes it difficult to interpret the case (scalping, surgery, or ritual practice linked to secondary burial). The advanced methods used to analyse the skull surface allowed us to discriminate intentional marks from modifications due to other taphonomic processes and to determine the timing of their formation (peri- or post-mortem). The possibility that the scraping marks are related to a ritual practice, conducted during the individual's life (with specific symbolic or social value) or after death or at the moment of secondary burial, is discussed.     

Face to Face with Phineas Gage

We present here a reproduction of a daguerreotype of Phineas Gage that came into our possession more than 30 years ago. It is, as far as we know, the only image of this famous patient. We describe how we identified the subject in the image, describe how daguerreotypes are made and set out our comparisons of the image with the Phineas Gage life mask and tamping iron held in the Warren Anatomical Museum, Francis A. Countway Library of Medicine.     

Multiple Injury and Health in Past Societies: An Analysis of Concepts and Approaches,and Insights from a Multi‐Period Study

Earlier clinical and bioarchaeological studies found that injury recidivists were most likely to be young adult males. Since then, the clinical meaning of the injury recidivist has expanded to include all individuals with multiple injuries, and other aspects of health have been considered. Our study sought to apply these advances to paleopathology and place multiple injuries in a wider context by investigating: the age and sex distribution of those with single and multiple fractures, and if people with multiple injuries had poorer general health. The sample of 213 males and 190 females (≥18 years old) from six populations in England, Siberia, and Sudan ranged in date from the 3rd century BC to the mid‐19th century AD. Health variables included cribra orbitalia, porotic hyperostosis, periostitis, Schmorl's nodes, enamel hypoplasias, dental caries, and periodontitis. Ante‐mortem injuries were: fractures (0/1/≥2), myositis ossificans, dental trauma, and sharp‐force injuries. The data were analysed using chi‐square and hierarchical loglinear analyses (P = 0.05). No significant three‐way association between age, sex, and injury was found. There was no difference between the sexes when individuals with single versus multiple injuries were compared. There were significant differences in the age‐distribution of people with 0 and 1/≥2 fractures. Males and those 26–35 years old were most likely to have fractures and multiple injuries. Porotic hyperostosis was significantly associated with fractures. There was no significant relationship between general poor health and multiple injuries. Copyright © 2016 John Wiley & Sons, Ltd.     

Peri mortem cranial injuries from a medieval grave in Saint Peter's Cathedral,Bologna, Italy

In 1999, renovation work in the 16^th century crypt in Saint Peter's Cathedral, Bologna (Italy), uncovered a capuchin‐type grave probably from the Early Middle Ages, containing commingled bones belonging to several individuals. A study of the osteoarchaeological material by the Laboratory of Bioarchaeology and Forensic Osteology of the University of Bologna identified two skulls of young males, both presenting signs of direct traumatic lesions produced peri mortem: one on the frontal, the other on the left parietal. The aim of the present study was to examine the lesions in relation to possible aetiological factors. Copyright © 2007 John Wiley & Sons, Ltd.     

Patterns of Cranial Trauma in a Prehistoric Population from Central California

Evidence of cranial trauma was investigated in a skeletal sample from the site CA-Ala-329 located on the eastern side of San Francisco Bay, Central California. The sample included 365 crania, including 134 adult males, 104 adult females, 22 adults of indeterminate sex and 105 subadults. Evidence of cranio-facial fracture was found in eight individuals, one of whom is an adolescent. Thus, the frequency in adult crania of traumatic injury is 7/260 (2.7 per cent). Of the seven individuals of known sex displaying such cranial trauma, all are male. The injuries are generally suggestive of some form of interpersonal aggression, with five healed vault fractures, one lesion with an embedded obsidian fragment (a probable projectile point) and two healed facial fractures. Further clear evidence of interpersonal aggression has been previously determined in this sample and has been reported at even higher levels elsewhere in California. © 1997 by John Wiley & Sons, Ltd.