Matskási István (szerk.): A Magyar Természettudományi Múzeum évkönyve 81. (Budapest 1989)

Ferencz, M. ; Józsa, L.: Fistulography: a new method in palaeopathological examinations

sequester of irregular form took shape within the abscess (Plate II). The macroscopic and the radiological analysis indicated that the young man of medium stature must have suffer ed this transverse fracture of his tibia at least 1-2 years before his death. Presumably the fracture was a trauma of first degree openess (not more than 1 cm

2 skin injury caused by the sliding of the fractured end). The fractured limb was secured as necessary and the injured man could ease it of burden for the time required. The open wound led to infection resulting in the bone's purulent inflammation and necrosis, in the forming of a sequester and in fistular osteomyelitis. In spite of the septic complication the fracture was healing with proper stability in a satisfactory position but the infectious process did not terminate and the injured man had an active fistula to the end of his life. Though the fracture was healing no restitua ad integrum took place. There was no abnormality indicating nutritional troubles (rachitis, scorbute, Harrisline) on the bone. Arthrosis did not develop yet as it could also be determined from the articular endings. This fact also made it probable that the injured man died within 1-3 years after the fracture and so there was not enough time for arthrosis to develop as a result of abnormal biomechanics brought about by axial déviances. As a more far ranging conclusion we may state that the people of the given period (llth-12th c.) possessed the knowledge of securing fractures and perhaps of follow up treatment too. This way fractures could be healed and the injured person could take full use of their limbs until the end of their lives. However, contemporary medicine was helpless when faced with septic complications. CONCLUSIONS The examination methods of macroscopic palaeopathology cannot be sufficient for the scientific recognition of the diseases of historical times and for the determination of their relative frequencies. The X-ray analysis of bone material tripled the number of clinical patterns and conditions that can be recognized (PAP & JÓZSA 1988). Therefore we consider it necessary to carry out X-ray examination of all bones suitably preserved. Skeletal abnormalities with no marked macroscopic characteristics mostly found detailed and correct diagnosis in X-ray analysis (LAX et al. 1982). This way new data can be obtained in cases where even the image of the sawn-up bone suplied no information (REGÖLY-MÉREI 1962). Our experience led us to the conclusion that traditional X-ray illumination or photography is far from being satisfactory in a good number of cases. Therefore we tried to apply some X-ray techniques - previously used only for living subjects - for palaeopathologic material as well. (We adapted these procedures for the object's special demands.) As far as we know, fistulography was not yet applied in palaeopathology. We managed to adapt this decades-old examination method of living bodies for the special needs of palaeopathology and this way we found a method to establish accurate diagnosis without ruining the findings. We hope that this present briefly introduced case demonstrated the place and the possibilities of fistulography in palaeopathology.