A Case of Syphilis with High Bone Arsenic Concentration from Early Modern Cemetery (Wroclaw, Poland)

Abstract

Venereal syphilis is a sexually transmitted disease caused by Treponema pallidum - Gram-negative, slowly growing bacteria. The spread of the disease in the Old World was due to increased birth rate, urban population growth, migration and lack of knowledge concerning the epidemiology. In the past, the treatment was mainly symptomatic and included application of mercury compounds. The goal of the study was to present the case of advanced venereal syphilis found in early modern (16th-18thc) graveyard localized in Wroclaw, Poland. The object of the study is a cranium of a male whose age at death has been estimated to be over 55. In order to observe the morphological and paleopathological characteristics of the examined material, anthropometrics, computed tomography, spectrometry and microscopic methods were incorporated. Microscopic analysis revealed the presence of the extensive inflammatory lesions. Analyses indicate tertiary stage of venereal syphilis as the most probable cause of the observed lesions. Concentration of arsenic (16.17±0.58 μg/g) in examined bone samples was about hundred times bigger than average arsenic concentration in bones reported in other studies. Advanced stage of observed lesions along with high arsenic level may suggest long-lasting palliative care and usage of arsenic compound in therapeutic treatment of this chronic disease.

Keywords: bioarchaeology; mercury; paleopathology; syphilis; treponematoses.

Fig. 1

A: Wroclaw City/Poland B: Former Cemetery of our Saviour (Czysty Square/present)

Fig. 2

Profile presenting normalized values of differences between some measurements of the skull from grave no. 2000 and mean values of the assessment of male skulls from Czysty Square in Wroclaw. The anthropometric parameters do not differ significantly (differences do not exceed 1.96 S.D.) as compared to average values of measurements of male skulls from Czysty Square in Wroclaw, which suggest that the skull belonged to the male individual.

Fig. 3

The skull 2000. A: Frontal view. B: Highly damaged frontal bone. C: Fracture in the right zygomaticomaxillary suture. D: Cross-horizontal-section of the skull in CT. Arrow and square indicate the inflammation on the base of the skull (anterior and middle cranial fossa) E: CT image of the right side of the skull. In the base of the vault lucencies are visible. F: CT image of the front of the skull. All damages and lesions of the skull have been thoroughly described in the results section. Scale bar=1cm.

Fig. 4

Histological microsections. A, C: Stained with H&E, light microscopy. B, D, E, F: Unstained, autofluorescence. There are areas of bone covered by several layers of bone lamellae and rough areas presenting osteolysis (orange arrows). Moreover, there is no trace of osteogenesis which should follow resorption. E,F: Diverse autofluorescence of different areas of bone matrix. Proper, blue (white arrow) and untypical, light-yellow (yellow arrow).

Fig. 5

Back-scattered electron images of the bone from the Czysty Square: a - general view of the bone structure showing various generations of apatite, b- minute sulphide mineralization in the bone structure (surrounded by red line), c- a grain of sphalerite - ZnS (white) occurring between various kinds of apatite.

Fig. 6

Representative EDS analysis of sulphide (sphalerite - ZnS) grains occurring within the bone showing the peaks of the Zn and S. Cps/eV – count per second electron‐volt, keV: kilo‐electron‐volt.