Objective

This paper aims to contribute to the definition of ancient rare diseases in skeletons displaying pathologies associated with paralysis. It uses a new suite of methods, which can be applied to challenging cases of possible paralysis in archaeologically-derived human skeletal material, specifically applied to the identification of poliomyelitis.

Materials

An adult male skeleton from Roman Halbturn, Austria.

Methods

Morphological and entheseal change analyses, CT scans, X-rays, cross-section morphology, and histology, alongside modern clinical, as well as historic, literature were used to discuss paralyses.

Results

The results suggest a diagnosis of poliomyelitis; now considered a rare disease, but perhaps ubiquitous in antiquity, thus complicating the definition of ‘rare disease’.

Conclusions

The integrated methodological procedures employed for this case constitutes a replicable and thorough approach to diagnosis, and explores the nature of ancient rare diseases. Due to the socio-environmental aspects of poliomyelitis transmission, it is likely that polio was likely not rare in the past. Therefore, the definition of ‘rare diseases in the past’ must include rarely occurring rarely diagnosed diseases due to biases and challenges within the archaeological and environmental record.

Significance

The developed suite of methods has not been applied to establish a diagnosis of polio in the past.

Limitations

The individual considered in this study is fairly well-preserved; thus, this set of analyses may not be applicable to all remains where preservation is poor or highly fragmentary, and the discussion of rare diseases requires relatively secure diagnoses and context.

Suggestions for further research

Large collections and series of skeletal human remains are recommended to develop definitive conclusions.

中文翻译：

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古代罕见病的挑战性定义和诊断方法：以脊髓灰质炎为例

客观的

本文旨在为显示与瘫痪相关的病理的骨骼中古代罕见疾病的定义做出贡献。它使用了一套新的方法，可应用于考古学衍生的人类骨骼材料中可能出现瘫痪的具有挑战性的案例，特别适用于脊髓灰质炎的鉴定。

材料

一具来自奥地利罗马哈布特恩的成年男性骨骼。

方法

形态学和附着点变化分析、CT 扫描、X 射线、横截面形态学和组织学，以及现代临床和历史文献被用来讨论瘫痪。

结果

结果提示脊髓灰质炎的诊断；现在被认为是一种罕见的疾病，但可能在古代无处不在，从而使“罕见疾病”的定义变得复杂。

结论

该病例采用的综合方法程序构成了一种可复制和彻底的诊断方法，并探索了古代罕见病的本质。由于脊髓灰质炎传播的社会环境因素，脊髓灰质炎在过去很可能并不罕见。因此，“过去的罕见疾病”的定义必须包括由于考古和环境记录中的偏见和挑战而很少发生的罕见疾病。

意义

开发的一套方法过去并未用于确定脊髓灰质炎的诊断。

限制

本研究中考虑的个人保存得相当完好；因此，这组分析可能不适用于保存较差或高度零碎的所有遗骸，并且对罕见疾病的讨论需要相对安全的诊断和背景。

进一步研究的建议

建议收集大量的人类骨骼遗骸以得出明确的结论。