Rich table but short life: Diffuse idiopathic skeletal hyperostosis in Danish astronomer Tycho Brahe (1546-1601) and its possible consequences

Abstract

The exhumation of Danish astronomer Tycho Brahe (1546-1601) was performed in 2010 to verify speculative views on the cause of his death. Previous analyses of skeletal and hair remains recovered from his grave refuted the presumption that he died from poisoning. These studies also outlined the possibility that he actually died from an acute illness, echoing the rather vague and inaccurate testimony of some historical records. We performed a detailed paleopathological analysis of Tycho Brahe's skeletal remains, along with a reconstruction of his diet based on carbon and nitrogen stable isotopes analysis and an estimate of his physical status (relative body fat) based on medullar and cortical dimensions of the femoral shaft. The astronomer's remains exhibit bone changes indicative of diffuse idiopathic skeletal hyperostosis (DISH). The study further allows us to classify him as obese (100% reliability according to our decision tree designed from Danish males), and points out his rich diet (high input of animal protein and/or marine resources) and high social status. Comorbidities of DISH and obesity are reviewed, and their influence on health status is discussed. We further consider some conditions associated with metabolic syndrome as possible causes of Tycho Brahe's final symptoms (urinary retention, renal failure and coma), including diabetes, alcoholic ketoacidosis and benign prostatic hypertrophy. Although a definite and specific diagnosis cannot be established, our study points to today's civilization diseases often associated with DISH and metabolic syndrome as the possible cause of death of Tycho Brahe.

Fig 1. The skeletal remains of Tycho Brahe (Photo Marek Jantač).

Fig 2. Anterior view of the thoracic spine (T2–T12).

A flowing ossification is present along the right side of the vertebrae. Also note the left sided bony bridge that leads to fusion of T3 and T4. Scale: 2 cm (Photo Marek Jantač).

Fig 3. Radiograph of the T2–T12 thoracic vertebrae (norma lateralis).

Note the ossification at the site of the anterior longitudinal ligament that coats the vertebral bodies.

Fig 4

The right innominate (a) and close-up view of its sacroiliac region (b). The pictures show the broken bony bridge (arrow) that connected the hip bone to the sacrum. Scale: 2 cm (Photo Marek Jantač).

Fig 5

Macroscopic (a) and radiologic (b) aspects of the right calcaneus (medial view). Note the presence of the enthesophyte at the insertion of the triceps sural muscle (white arrows) and the heel spur on the plantar surface (grey arrows). Scale: 2 cm (Photo Marek Jantač).

Fig 6. δ¹³C and δ¹⁵N values in Tycho Brahe and his wife, compared with isotopic datasets from medieval and post-medieval Europe.

Isotopic values used for comparative purpose are for faunal and human remains from late medieval Denmark [–46], early modern Belgium [47], 18^th–20^th centuries Copenhagen [48], and early modern Prague [49,82]. Detailed view at human data is provided on the right. As domesticated fauna, the mean values of the main consumed domesticated species (cattle, sheep/goat, pig) were used.

Fig 7. Decision tree to distinguish normal and obese categories based on body fat (BF)% data.

Tycho Brahe’s classification path is identified by a plain red line. All data are adjusted according to maximum femoral length.