Adding insult to injury: opportunistic treponemal disease in a scalping survivor

Abstract

Although the taking of scalps is arguably a perimortem trophy-taking behaviour, cases of scalping survival are occasionally reported in the historical documents of the American Colonial Period and the 19 th century westward expansion. Survival cases are also detected in pre-Columbian bioarchaeological contexts. Although scalp avulsion injuries can heal without complication, often the process is compromised by secondary osteomyelitis, usually attributable to environmentally ever-present Staphylococcal or Streptococcal bacteria. A scalping survivor case from the late prehistoric (AD 1200-1600) Hampton site (40RH41) of East Tennessee unusually displays infectious sequelae in the area denuded by scalp avulsion which are pathognomonic for treponemal disease (caries sicca, stellate scarring). This infection is probably a reflection of the easy opportunity afforded by the large size of the wound bed, poor post-trauma hygiene, and direct inoculation of the diploë by a ubiquitous Treponema.

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

“…The presence of a bony reaction on the frontal bone in association with scratches agrees with the hypothesis of scalping with survival of the individual for a certain period, allowing the inflammatory reaction of the pericranium: the skull surface, deprived of its pericranium, dries and becomes necrotic, after which new inflammatory granulation tissue replaces the necrotic tissue (Hamperl, 1967;Ortner, 2003;Smith, 2008).However, a few days would be necessary to produce such a bony reaction (Jacobi et al, 1996;Buchan, 2006;Toyne, 2011),while the scraping marks show no evidence of healing (e.g. bone proliferation, etc.…”

“…Bloodletting is an ancient practice, used even today in many traditional societies, based on the idea that "bad blood" can cause the disease and that its removal promotes healing. For this reason, cuts, nicks and scraping to cause bleeding have been performed to treat infections, as well as some other diseases (Stewart, 1956;Mays, 2005;Buchan, 2006;Smith, 2008).…”

Variation in large ectocranial lesions from pre-Columbian Kuelap, Peru

“…Several diagnoses are not accepted. If a particular diagnosis is relevant to a (Ortner, 2003;Klaus and Ortner, 2014;Powell and Cook, 2005;Smith, 2008;Standen and Arriaza, 2000) No cases Disease (chronic) Disease deficiency scurvy or anemia Increased vault thickness, variable porosity and coelescing of porosity of the outer table; usually observed on parietal bosses (Blom et al, 2005;Ortner, 2003;Ortner and Ericksen, 1997;Walker et al, 2009) No cases Bone tumors. Osteoblastomas.…”

“…Paleopathological studies of cranial lesions are well documented for many regions of the world (Domett and Buckley, 2012;Lewis, 2004;Shang and Trinkaus, 2008;Smith, 2008;Stewart, 1950). The most common pathology, cranial trauma, is identified as healed and unhealed fractures of the vault and facial bones, and is typically used as a proxy for interpersonal violence.…”

Possible cases of scalping from pre‐hispanic highland Peru

“…Nor is the morphology of the lesion consistent with advanced porotic hyperostosis of the vault StuartMacadam, 1992), carcinogenic destruction (Gregg et al, 1982;Ortner, 2003), or treponemal disease (Powell & Cook, 2005;Smith, 2008). The observed skeletal manifestations of osteitis likely resulted from an infection that spread from adjacent soft tissue or was the result of direct inoculation from trauma or surgery (Lane et al, 2006).…”