Archives and Skeletons: an interdisciplinary approach to the study of paleopathology of tuberculosis

Abstract

Tuberculosis (TB) may be an acute or chronic infection of bone and/or soft tissues. Nevertheless, human skeletons only registered a small percentage of those cases. This work aims to explore data from morbidity and mortality of individuals who contracted or died of TB after Koch bacillus discovery and before the development of antibiotics, using this information to interpret the scarcity of evidences detectable by paleopathological studies. To fulfil these goals, the Coimbra University Hospital and Coimbra Municipality Cemetery records from 1919-1928 were analyzed. As expected, pulmonary TB was the most common form of the diseases, both at hospital admission (43.7%, n=904) and as cause of death of the individuals inhumed, especially after the age of 10 years. In children under 10 years, meningeal TB was the more common form. Pott’s diseases represented only 4.7% (n=98) of the hospital admission due to TB and 0.7% (n=8) of the TB deaths at the cemetery. However, in paleopathology the macroscopic evidence of TB comes mainly from Pott’s disease. Documented skeletons shows that new bone on visceral surfaces of ribs can occurs in other diseases besides pulmonary TB but its presence can be also use as an indicative of possible TB infection.