In an unassuming cemetery in Estremoz, southern Portugal, archaeologists found over 100 burials dating to the 13th to 15th centuries AD. One middle-aged man, however, had a hole in his head and clear evidence of disease in his left foot. Their diagnosis? A foot fungus that has never been seen in Medieval Europe before.
The skeleton in question was studied by biological anthropologists Ana Curto and Teresa Fernandes, who report their findings in the latest issue of the International Journal of Paleopathology. The man’s left heel and ankle bones were fused together, and the heel bone also has a worm-eaten appearance, with round holes found throughout. All five of the metatarsals in his left midfoot show evidence of destruction and irregular healing. His left lower leg also seems to have been compromised by the same disease. Curiously, the right foot is totally normal.
Based on these ancient “symptoms,” Curto and Fernandes attempted a differential diagnosis, excluding some diseases and finally settling on one. They first ruled out diseases present since birth, narrowing their focus to diseases that can be acquired during life. The pattern of bone lesions doesn’t match well with leprosy or cancer, both of which also involve destruction of bone. Tuberculosis and osteomyelitis (infection of the bone marrow) also don’t match well, but the anthropologists could not definitively exclude those causes.
