CASE 1 OF PALEOPATHOLOGY CASE REVIEWS

Huari Gallery Mummy

Image Directory:
1 Rescuing mummies
2 Huari gallery mummy
3 Radiograph of tooth in lung
4 Third molar
5 Dried exudate of pneumonia
6 Normal lung
7 Atelectasis
8 Electron micrograph of  Ancylostoma duodenale
9 Hookworm attachment site
10 Remains of Trichinella spiralis
11 Bentonite flocculation test

Rescuing mummies Personnel from the Museum of Ica rescued 22 undisturbed mummies 22 kilometers from the ocean near Nazca, Peru in November 1960. Three of the mummies had external wool shirts with a condor design. The bundles all had false heads. Robbers had removed all ceramics and other items that they could sell.
Huari gallery mummy This was one of the mummies rescued from a Huari burial on the Hacienda Montegrande. It was in a gallery burial which was opened by grave robbers. The gallery represents a house with adobe walls that are built "soga" style - ends of the bricks face out. A single door was in the wall. The roof had 21 beams and a mat ceiling covered with leaves and a layer of mud.
Radiograph of tooth in lung The mummy was a middle aged man belonging to the Huari culture. He died between 890-950 AD based on Carbon 14 dating. He had a series of medical problems the first of which was revealed when a whole body radiograph was taken. A tooth was seen in his lungs with evidence of pneumonia.
Third molar On autopsy the tooth was found to be a third molar from the left maxilla, lodged in the left bronchus which leads to the left superior lobe of the lung.
Dried exudate of pneumonia It was covered with a dried exudate that was associated with the pneumonia distal to the obstructed bronchus and could only be dislodged by cutting open the bronchus. Histological sections revealed the pneumonic area with the alveoli filled with dried pus.
Normal lung For comparison, here is a normal lung.
Atelectasis Histological sections also revealed areas of atelectasis deeper in the lung. Atelectasis is an area of collapsed alveoli which originated from the area of lung tissue served by the obstructed bronchus. It was necessary for the man to be in a supine position for the tooth to have lodged in this bronchus.

It was noted at autopsy that there was blood in the intestines. He had eaten a meal consisting of corn, beans, an unknown vegetable, as well as "charqui" (dried meat) that was still in his stomach. The "charqui" had been crushed in a stone mortar which is still the method used to prepare this food today in Peru. Particles of silica (from sand in the stone mortar grinding) were numerous in the stomach contents. Often common today, the charqui was old. It had tunnels with insects in the meat fragments, but these were not associated with the man's own tissues.

Samples of small intestine, colon (with a bit of formed feces) along with other organs, the diaphragm, and some striated muscle from his calf were collected. The origin of blood in the small intestine was further investigated by a graduate student. He injected samples of the fecal material from this mummy, and four others into 10 different rabbits. He took weekly blood samples to test for the formation of antibodies against a number of different pathogenic bacteria over a period of 28 days. This mummy was the only one with a significant rise in titer to Salmonella sp., from a pre-inoculation concentration of 1:20 to a final of 1:680.

A repeat study in depth confirmed this screening operation and showed that this organism belonged to Salmonella Group D, a group that contains the agent of typhoid fever. All the rabbits had a significant rise for the ubiquitous E. coli. Thus, it is very possible that he was prostrated with the clinical problems of this disease when he aspirated the tooth.

Electron micrograph of  ancylostoma duodenale He had, in addition to these medical problems, two incidental ones of a less serious nature. Two parasites were found. Ancylostoma duodenale was found in the ileum. This is a scanning electron micrograph of  Ancylostoma duodenale in the ileum.
Hookworm attachment site This is one of the hookworm attachment sites.
Remains of trichinella spiralis Sections of tissue revealed calcified areas in his diaphragm that contained the remains of Trichinella spiralis.
Bentonite flocculation test They were identified using the bentonite flocculation test.

This individual was a most interesting case. The initial radiological diagnosis of aspiration pneumonia was possibly initiated during the course of a systemic Salmonellosis such as Typhoid Fever. His health was further jeopardized by the presence of two helminthic infestations, hookworm and trichinosis.

While investigating his course, a modern patient died after a 14 day hospitalization from a similar aspiration pneumonia. The etiology of an aspiration pneumonia can be established by a simple X-ray.

References:
Allison, M.J., Pezzia, A., Hasegawa, L., and Gerszten, E.: A Case of Hookworm Infestation in a Pre-Columbian American. - Amer. J. Phy. Anthrop., 41:103-105, 1974.

Allison, M.J., Pezzia, A., Gerszten, E., Giffler, R.F., and Mendoza, D.: Aspiration Pneumonia Due to Teeth - A Report of Two Cases 950 A.D. and 1973 AD, South-Med. J., 67:479-483, 1974.

Sawicki, V.A*., Allison, M.J., Dalton, H.P., and Pezzia, A.: Presence of Salmonella Antigens in Feces from a Peruvian Mummy: Bull. N.Y. Acad. Med., September, 1976, Vol. 52:805-813.

*Graduate Student

Updated March 7, 2006