23692
Accession Number
30630
Author
Bequeker, Jan; Fabry, Guy; Vanopdenbosch, Ludo
Author Affiliation
University Hospital, Department of Rheumatology; University Hospital, Department of Orthopedics; University Hospital, Department of Neurology
Title Of Article Chaper
Hieronymus Bosch (1450-1516): Paleopathology of the Medieval Disabled and its Relation to the Bone and Joint Decade 2000-2010
Title Of Journal Book
IMAJ
Volume
3
Pages
864-871
Collation
8 p. : ills.
Reference Bibliography
Includes bibliographic references
Language Of Text
English
Literature Type
Serial
Literature Level
Analytic
Abstract
Background: At the start of the Bone and Joint Decade 2000-2010, a paleopathologic study of the physically disabled may yield information and insight on the prevalence of crippling disorders and attitudes towards the afflicted in the past as compared to today. Objective: To analyze The procession of the Cripples, a representative drawing of 31 disabled individuals by Hieronymus Bosch in 1500. Methods: Three specialists – a rheumatologist, an orthopedic surgeon and a neurologist – analyzed each case by problem-solving means and clinical reasoning in order to formulate a consensus on the most likely diagnosis. Results: This iconographic study of cripples in the sixteenth century reveals that the most common crippling disorder was not a neural form of leprosy, but rather that other disorders were also prevalent, such as congenital malformation, dry gangrene due to ergotism, post-traumatic amputations, infectious diseases (Pott’s, syphilis), and even simulators. The drawings show characteristic coping patterns and different kinds of crutches and aids. Conclusion: A correct clinical diagnosis can be reached through the collaboration of a rheumatologist, an orthopedist and a neurologist. The Bone and Joint Decade Project, calling for attention and education with respect to musculoskeletal disorders, should reduce the impact and burden of crippling diseases worldwide through early clinical diagnosis and appropriate treatment.
Keywords
bone; paleopathology; medieval; disabled; joint; medical; archaeology
pub_id
23692