Paleopathology in Bone Material from the Anthropology Laboratory of the University of Granada

Abstract

The Field Guide “Paleopathology Collection at the University of Granada” includes one of the most important collections of human bone remains that present anomalies or specific characteristics that can be used to determine the existence of diseases, accidents or malformations in each subject’s life, as well as the probable cause of death. The collection consists of several thousand skeletons or parts of them. It is located at the Faculty of Medicine of the University of Granada and has been created and managed by Professor Miguel C. Botella López, founder and director of the Anthropology Laboratory of the University of Granada, between 1971 and 2024. Professor Botella is the author of the diagnoses made for each specimen from different geographical areas of Spain in a time period ranging from the Neolithic to the present day. The collection is of special interest to students and professionals in medicine, archaeology, criminology or law.

1. Genesis and History

The Field Guide “Paleopathology Collection at the University of Granada” presents an important collection of human remains located in Tower A of the Faculty of Medicine of the University of Granada, within the Anthropology Laboratory. The origin of this collection dates back to the 1970s, when Professor Botella founded, together with other colleagues—Professor Miguel Guirao Pérez (human anatomy) and Professor Manuel García Sánchez (anthropology)—the Physical Anthropology Laboratory at the Faculty of Medicine of Granada. Thus, skeletons with different pathologies began to be incorporated, coming from old collections of the University itself, as well as from his own professional activity in the field of archaeology or physical anthropology. From 1975 to 2024, Professor Botella directed the Laboratory, which, several decades after its creation, was integrated into the Department of Legal Medicine, Toxicology and Physical Anthropology of the University of Granada. Today it is listed as a Unique Laboratory of that University. Over the decades, new materials have been added to this collection, which have been identified and diagnosed by Professor Botella and his colleagues in the department, and which today constitute one of the most important collections in the world. The collection comprises more than 5000 human skeletons of adult individuals spanning the Neolithic period, that is, from about 6000 years ago to the present day without interruption. Seventy-five percent of the collection is made up of individuals from the Bronze Age, Chalcolithic, Roman, and Mediaeval periods. The remaining 25% corresponds to periods after the Middle Ages and modern times. The entire collection was intentionally selected from the population of the Mediterranean region (southern Spain). This was performed deliberately to offer a view of human variability within a specific population. Therefore, it is a first-rate collection for studying pathologies over time. Of the 5000 preserved skeletons, only a small portion is incomplete because only the portion considered representative of the pathology was preserved. Logically, the only pathologies that can be observed in skeletons are chronic pathological processes since acute ones resolve (in one sense or another) quickly without leaving any trace in the bone because not enough time has passed. For example, pneumonia—a very common cause of death—cannot yet be detected in human skeletal material. However, degenerative processes, such as osteoarthritis, arthritis, etc., can. Similarly, although acute infectious processes do not manifest in the skeleton, chronic infectious processes, such as tuberculosis, syphilis, leprosy, etc., do. For this guide, the clearest and most representative elements of the collection were selected, although the most preserved remains contain some pathological processes, especially traumatic, infectious, and degenerative processes. Metabolic processes, tumours, etc., are much less represented in the collection, as is the case in any current human population. The data collection process includes all the information that a skeletal set can provide. Pathologies are among the most important aspects of collection.

The collection is constructed to allow for the study of human evolution in all its parameters and also serves to establish guidelines for, for example, estimating sex and age, etc., or new methods of anthropological research. In most cases, the complete skeleton is preserved. A significant proportion of these pieces correspond to individuals who died during the 19th century. In these cases, the pathological findings are supported by in vivo diagnoses using available diagnostic tools. The remains were preserved because the physician considered them representative of a specific type of pathology. Obviously, in the case of the oldest remains, in vivo diagnoses are not available. Because no diagnosis is available, only pieces with a precise and unquestionable diagnosis are included in these cases.

In 2018, the laboratory and the collection were moved to the new headquarters of the Faculty of Medicine, located on the Health Campus of the aforementioned university, where part of the collection displayed in showcases in the Anthropology Laboratory, which is the one presented in this Field Guide, can be visited upon request. The laboratory is also open without restriction to interested researchers and students.

In addition to the collection presented in this guide, the University of Granada has a collection of 500 skeletons of children with known sex, age, and cause of death.

2. Field Guide Structure

The Field Guide is structured in six parts, corresponding to different types of pathologies or causes of modification of the bone structure, thus facilitating its use by the reader: The first part presents pathologies related to congenital diseases, developmental disorders and manipulations; the second part shows the vestiges of different infectious diseases, with truly striking examples; the third deals with traumas that present different causes and degrees of consolidation; the fourth part is dedicated to joint and degenerative diseases and their traces in different bones; the fifth part collects different cases of neoplasias, abnormal masses of tissue originating from various causes; and finally, the sixth part exhibits other pathologies that cannot be classified in the previous sections. The bibliographic references used for the preparation of this Field Guide should be cited as follows: Aufderheide and Rodríguez-Martín, 1998 [1]; Barnes, 2012 [2]; Buikstra, 2019 [3]; Grauer, 2023 [4]; Mann and Winter, 2023 [5]; Ortner, 2003 [6]; Waldron, 2020 [7].

3. Images

A sequence of images is included that show some of the pieces that can be seen in the University of Granada collection, arranged according to the sequence indicated above. All images were taken by Prof. Botella and are part of the publication “Paleopathology in the collection of the Laboratory of the University of Granada”, Botella et al., 2025 [8].

First, examples of congenital diseases, developmental disorders and manipulations are shown. Figure 1a shows a complete spina bifida of an individual who lived in the 20th century. Figure 1b shows two skulls, one hydrocephalic (top of the photograph) and another microcephalic (bottom of the photograph). Figure 2a shows a scaphocephalic skull, and Figure 2b shows an acrocephalic or turricephalic skull. Finally, Figure 3a,b show surgical trepanations with survival.

Secondly, images of infectious diseases are presented, showing the effects they can have on human bones. Figure 4a shows osteomyelitis resulting from an open fracture that has healed, and Figure 4b shows the effects of poliomyelitis on the femur. Figure 5a shows a coin-shaped perforation in the palate due to leprosy, and Figure 5b shows a leper’s skull with alterations in the nose and dental arch. Figure 6a shows syphilitic gummas in tertiary syphilis, and Figure 6b shows a severe deformity of the spine due to Pott’s disease or vertebral tuberculosis. Finally, other effects of tuberculosis on bones are shown in this section: Figure 7a shows the destruction of the acetabulum and the head of the femur, and Figure 7b shows tuberculous caverns in the femur.

Thirdly, different traumas are shown. We can see in Figure 8a the effect of a healed fracture on the skull, while Figure 8b shows the impact of a bullet also on a skull. Figure 9a shows a healed trauma to the frontal bone of a skull, and Figure 9b shows a fracture of the neck and upper third of the femur healed with Ender needles. Finally, Figure 10a presents a poorly consolidated femur fracture, and Figure 10b, a consolidated pubic fracture.

Fourthly, the collection includes joint and degenerative diseases. Figure 11a presents an ankylosis of the axis and atlas due to dislocation, and Figure 11b an osteoarthritis resulting from a tibial plateau fracture with joint mice (corpus liberum). Figure 12a shows osteoarthritis of the hip, and Figure 12b shows articular osteophytes in osteoarthritis in the distal end of the femur. To finish this part, Figure 13a shows osteophytes, disc disease and osteoarthritis in lumbar vertebrae, and Figure 13b shows disc herniations.

Fifth, the effects of different neoplasms or tumours on bones are shown. Figure 14a shows a benign tumour in the anterior fossa of the skull up to the orbit, and Figure 14b shows the effects of an osteosarcoma in a young individual. In Figure 15a an osteosarcoma can be seen, and in Figure 15b, a meningosarcoma. Finally, Figure 16a shows a metastasis from breast cancer, and Figure 16b shows a metastasis from prostate cancer.

Finally, a section is included on other pathologies. In Figure 17a a cribra orbitalia can be seen, and in Figure 17b, a cribra femoralis. To conclude this field guide, Figure 18a shows dental enamel hypoplasia, and Figure 18b shows a large urinary bladder stone.

4. Conclusions

This field guide is a sample of the most important collection in Spain and Europe for studying the populations of the southern Mediterranean region of Spain from the Neolithic to the present day. This section presents a selection of materials that can be used as guides for studying the most common pathologies observed in the skeleton. The enormous variability of disease manifestations in living organisms must be taken into account, with those occurring in bones representing only a fraction of the total.