Amazing Things We’ve Learned From 800 Ancient Skull Surgeries

The practice of trepanation was surprisingly successful and was seen more often during the Inca heyday due to the weapons used in war.

Some 2,000 years ago, a Peruvian surgeon picked up a simple tool and began to scrape a hole in the skull of a living human being. Before the surgery was over, much of the patient’s fractured upper skull had been removed without the aid of modern anesthesia or sterile techniques. The patient, almost incredibly, survived.

The ghoulish operation is only one example of trepanation, an ancient medical practice that has been freshly examined in Holes in the Head: The Art and Archaeology of Trepanation in Ancient Peru, a new book by physical anthropologist John Verano of Tulane University and five collaborators.

Thousands of years ago, surgeons trepanned patients in early Europe and the South Pacific, and trepanation was still being practiced in East Africa as recently as the 1990s. But the procedure reached its apex in Peru between the 14th and 16th centuries A.D.—at least judging by the number of trepanned skulls found in the region and the high survival rates conveyed by signs of healing in the bone.

Verano spoke with National Geographic about his views on the art and science of trepanning, based on decades of study and more than 800 trepanned skulls.

How common was trepanation in ancient Peru?

It was surprisingly widespread. In its heyday, it basically covered what was the territory of the Inca Empire, which was at that time the largest empire in the world geographically. [Trepanation] was not just something here and there. It was all over. [Peru] has more skulls with trepanations than everywhere else in the world combined.

Why was trepanation so prevalent in Peru?

The weapons they used in war were primarily sling stones and bashing clubs, things that would cause fractures to the head, whereas in many other parts of the world, the weapons were bows and arrows or swords or spears. Those things don't cause the frequency of head wounds that bashing weapons and sling stones do.

Why did Peruvian surgeons turn to such a dramatic procedure?

It probably started as a very simple thing—cleaning the scalp after a blow to the head and doing some simple things like picking out broken pieces of bone, which would be dead. They learned early on that this was a treatment that could save lives. We have overwhelming evidence that trepanation was not done to increase consciousness or as a purely ritual activity but is linked to patients with severe head injury, [especially] skull fracture.

Were you surprised by the survival rate of Peruvian trepanations?

I didn’t realize when I began that the Inca rates would be so high, that they would push over 70 percent. The very earliest trepanations [were] from Paracas, from the south coast of Peru. [There was] only about 40 percent survival, but when you looked at the size of the holes they put in the head—and I still don’t know why they opened such huge windows into the skull—there are a fair number that survived. I’ve been able to put to rest the idea that Paracas was some odd, irrational experiment by shamans.

Why were the Peruvian practitioners so successful compared to Western attempts?

[In the West,] doctors would just rinse [surgical tools] off in water and wipe them down and use them in another patient. Also, surgery was done in hospitals. That’s where many people get infections even under the best circumstances today. In Peru they didn’t have hospitals. People were probably operated on in open-air situations and probably with tools that were not used over and over again. So the risk of infection was probably a lot lower.

Wouldn’t such surgery have been hideously painful?

There are a lot of nerves in your scalp. If you tried taking a knife or a razor blade to your scalp, it would hurt, but you could grit your teeth and deal with that. But the bone itself has very few nerves. So if a doctor told you, “We’re going to scrape through your skull and it’s not going to hurt,” he or she would be telling you the truth.

Can modern medicine learn anything from the ancients?

We won’t gain anything in terms of surgical technique, because tools have changed a lot. In part, my goal [in writing the book] is to educate people. We can put aside any idea that trepanation was a primitive, backward practice. It’s important to understand how things were done back then and some of the amazing feats in terms of high survival rates.
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Reference:

Watson, Traci. 2016. “Amazing Things We’ve Learned From 800 Ancient Skull Surgeries”. National Geographic News. Posted: June 30, 2016. Available online: http://news.nationalgeographic.com/2016/06/what-is-trepanation-skull-surgery-peru-inca-archaeology-science/

From genes to latrines—Vikings and their worms provide clues to emphysema

In a paper published today in Scientific Reports a group of researchers led by LSTM have found that the key to an inherited deficiency, predisposing people to emphysema and other lung conditions, could lie in their Viking roots.

Archaeological excavations of Viking latrine pits in Denmark have revealed that these populations suffered massive worm infestations http://sciencenordic.com/dna-study-vikings-were-plagued-intestinal-parasites. The way that their genes developed to protect their vital organs from disease caused by worms has become the inherited trait which can now lead to lung disease in smokers.

Chronic obstructive pulmonary disease (COPD) and emphysema affect over 300 million people, or nearly 5% of the global population. The only inherited risk factor is alpha-1-antitrypsin (A1AT) deficiency, and this risk is compounded if individuals smoke tobacco.

A1AT protects the lungs and liver from enzymes called proteases that are produced by cells of the immune system, but also by parasitic worms. In the absence of A1AT these proteases can break down lung tissue leading to COPD and emphysema. Deficiency of A1AT is genetically determined and is due to deviants of A1AT that are surprisingly common, particularly in Scandinavia, where they evolved in Viking populations more than two thousand years ago. Why these disease-causing deviants of A1AT are so common in human populations today has long been a mystery.

LSTM's Professor Richard Pleass is senior author on the paper. He said: "Vikings would have eaten contaminated food and parasites would have migrated to various organs, including lungs and liver, where the proteases they released would cause disease."

In this latest paper the authors show that these deviant forms of A1AT bind an antibody called immunoglobulin E (IgE) that evolved to protect people from worms. The binding of A1AT to IgE prevents the antibody molecule from being broken down by such proteases.

"Thus these deviant forms of A1AT would have protected Viking populations, who neither smoked tobacco nor lived long lives, from worms." Continued Professor Pleass, "it is only in the last century that modern medicine has allowed human populations to be treated for disease causing worms. Consequently these deviant forms of A1AT, that once protected people from parasites, are now at liberty to cause emphysema and COPD."
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Reference:

Phys.org. 2016. “From genes to latrines—Vikings and their worms provide clues to emphysema”. Phys.org. Posted: February 4, 2016. Available online: http://phys.org/news/2016-02-genes-latrinesvikings-worms-clues-emphysema.html

Prosthetic Leg with Hoofed Foot Discovered in Ancient Chinese Tomb

The 2,200-year-old remains of a man with a deformed knee attached to a prosthetic leg tipped with a horse hoof have been discovered in a tomb in an ancient cemetery near Turpan, China.

The tomb holds the man and a younger woman, who may or may not have known the male occupant, scientists say.  

"The excavators soon came to find that the left leg of the male occupant is deformed, with the patella, femur and tibia [fused] together and fixed at 80 [degrees]," archaeologists wrote in a paper published recently in the journal Chinese Archaeology.

The fused knee would have made it hard for the man to walk or ride horses without the prosthetic leg, the researchers found. The man couldn't straighten his left leg out so the prosthetic leg, when attached, allowed the left leg to touch the floor when walking. The horse hoof at the bottom of the prosthetic leg acted like a foot.

The prosthetic leg was "made of poplar wood; it has seven holes along the two sides with leather tapes for attaching it to the deformed leg," the archaeologists wrote. "The lower part of the prosthetic leg is rendered into a cylindrical shape, wrapped with a scrapped ox horn and tipped with a horsehoof, which is meant to augment its adhesion and abrasion."

"The severe wear of the top implies that it has been in use for a long time," they added.

Radiocarbon dating indicates that the tomb in Turpan (also spelled Turfan) dates back around 2,200 years. The only other known prosthetic leg in the world that dates to that time is part of a bronze leg found in Capua, Italy. That leg was destroyed in a bombing raid during World War II. Prosthetic toes, dating to earlier times, have been found in Egypt.

Who used it?

Two other studies, published in the journals Bridging Eurasia and Quaternary International, provide more details about the man who used the hoofed leg. Researchers estimate that the man was about 5 feet 7 inches (1.7 meters) tall, and between 50 and 65 years old when he died.

What caused the odd fusion of his left knee joint? "Different causes, like inflammation in or around the joint, rheumatism or trauma, might have resulted in this pathological change," archaeologists wrote in the journal Bridging Eurasia.

Researchers found evidence that the man was infected with tuberculosis at some point in his life. They think that inflammation from the infection may have resulted in a bony growth that allowed his knee to fuse together. "The smooth surface of the bones affected by the ankyloses [joint fusion] suggests the active inflammatory process stopped years before death," the researchers wrote in Bridging Eurasia.

The man appears to have been a person of modest means, as he was buried with nonluxurious items: ceramic cups and a jar, a wooden plate and wooden bows, the archaeologists found. Sometime after he died, his tomb was reopened, and the body of a 20-year-old woman was put in, disturbing the man's bones. What relationship the man and woman had (if any) is unknown. The tomb was one of 30 that archaeologists excavated in the cemetery. 

Gushi people

Based on the results of the radiocarbon dating, "the occupants of the cemetery might have belonged to the Gushi [also spelled Jushi] population," archaeologists wrote in the Chinese Archaeology article. Little is known about these people. Ancient Chinese texts suggest that the Gushi had a small state. "As recorded in the Xiyu zhuan (the Account of the Western Regions) of the Hanshu (Book of Han, by Ban Gu), during the middle of the Western Han, there lived in the Turfan Basin the Gushi population, who constitutes one of the 'Thirty-six States of the Western Regions' of the Qin and Han Dynasties," the archaeologists wrote.

The Gushi state was conquered by China's Han Dynasty during a military campaign in the first century B.C., according to ancient records. "Given that the study of the Gushi culture is yet at its nascent stage, the [cemetery] provides valuable new materials," the archaeologists wrote.

Excavations at the cemetery were conducted between 2007 and 2008 by scientists at the Academia Turfanica, a research institute. A paper reporting their findings was published in 2013, in Chinese, in the journal Kaogu. That paper was recently translated and published in the journal Chinese Archaeology.

The papers reporting the study of the man's skeleton were published in 2014 in the journal Bridging Eurasia and in 2013 in the journal Quaternary International.
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Reference:

Jarus, Owen. 2016. “Prosthetic Leg with Hoofed Foot Discovered in Ancient Chinese Tomb”. Live Science. Posted: January 11, 2016. Available online: http://www.livescience.com/53321-ancient-prosthetic-leg-with-hoofed-foot-discovered.html

Oldest case of leukemia discovered—prehistoric female skeleton shows signs of this cancer

Scientists of the Senckenberg Center for Human Evolution and Paleoenvironment and the University of Tübingen have discovered what may well be the oldest known case of Leukemia. By means of high-resolution computer tomography they were able to detect indications of the cancer in an approximately 7000 year old skeleton of a woman who died between 30 and 40 years of age. Any other, similar pathologies could be ruled out.

Life in the Neolithic Age was not easy: The farming work was exhausting, and medical care was more than inadequate from the present point of view. These harsh conditions left their mark on the people's health – infectious diseases, deficiency symptoms and degenerative changes were commonplace. "However, except alveolar inflammation and dental caries, the 'individual G61,' a female skeleton from the Neolithic graveyard of Stuttgart-Mühlhausen, was not affected by any of these diseases," says Dr. Heike Scherf of the Senckenberg Center for Human Evolution and Paleoenvironment at the University of Tübingen.  

Together with her colleagues, the researcher found indications of leukemia on the skeleton of a woman, who was between 30 and 40 years of age at the time of death. "We examined several bones of the skeleton with our high-resolution computed tomography system, and we found an unusual loosening of the interior bone tissue – the cancellous bone – in the upper right humerus and the sternum," adds Scherf.

In adults, the ends of the humeri and the sternum, as well as the vertebrae, ribs, skull, pelvis and the ends of the femurs contain hematopoietic (blood-forming) stem cells. In these locations, leukemia – colloquially known as blood cancer – can occur.

The team of scientists working with the paleoanthropologist Scherf compared the humerus of the 7000 year old "patient" with humeri of 11 individuals from the same site in southern Germany, where they were excavated between 1982 and 1993.

"None of the other specimens showed this significant pattern," explains Scherf, and she adds, "Even though they come from the same site and belong to the same age group."

Other diseases that cause similar symptoms were refuted by the scientist from Tübingen: "The biological age and the restriction of the findings to the humerus and sternum counter-indicate osteoporosis. Hyperparathyroidism, a hyperfunction of the parathyroid gland, can be ruled out because typical characteristics for this pathology, which manifest in other parts of the skeleton, such as the skull and the finger bones were not found." According to Scherf, the results therefore strongly indicate a case of leukemia in 'individuum G61.' This would be the oldest evidence of leukemia to date. "However, we cannot determine whether the woman actually died from the disease," summarizes Scherf.
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Reference:

Phys.org. 2015. “Oldest case of leukemia discovered—prehistoric female skeleton shows signs of this cancer”. Phys.org. Posted: August 31, 2015. Available online: http://phys.org/news/2015-08-oldest-case-leukemia-discoveredprehistoric-female.html

The Six Weirdest Ancient Roman Ideas About The Human Body

Given our 21st century understanding of medicine, in which scientists can grow or 3D print new organs, the ancient Romans may seem fantastically clueless about human anatomy and disease. But until Anders Vesalius revolutionized the study of anatomy in the 16th century, Western medicine was dominated by the thoughts of Greek physicians like Hippocrates and Galen, whose work was amplified by Roman historians such as Pliny the Elder.

Pliny notoriously perished in the eruption of Mt. Vesuvius in 79 AD, but not before he completed a 37-book (ten-volume) encyclopedia of ancient knowledge known as Historia Naturalis, or Natural History.  Book VII of Pliny’s history focuses on anthropology and human physiology.  Many of the bits of knowledge he collected, though, are… less than accurate.  Following are some of the weirdest things that Pliny (and, by extension, many people over the next millennium) believed about the human body.

Height.  Human stature is known to vary significantly, with thecurrent tallest man in the world coming in at 8’3″ and the shortest at 19″. Pliny’s report of the shortest man in Rome could be right, but his claims about the tallest Romans stretch the truth:

In the reign of the deified Augustus, there was a couple called Pusio and Secundilla who were half a [Roman] foot taller [approx. 9'10" tall] and their bodies were preserved as curiosities in the Sallustian gardens. In the reign of the same emperor, the smallest man was a dwarf called Conopas, who was two [Roman] feet and a palm [approx. 26" tall] in height. — Pliny, Natural History, 7.75 [trans. M. Beagon]

Handedness. Anthropological studies show that about 10% of the human population is left-handed, although the exact reason for lateralization, or handedness, is not entirely clear.  Pliny seems to have noticed this, but gets confused:

It has also been observed that the right side of the body is the stronger, but sometimes both sides are equally strong and in some people the left hand predominates, although this is never the case with women. — Pliny, Natural History, 7.77 [trans. M. Beagon]

Birth. Without a clear understanding of sperm and eggs, not to mention an inability to see the developing fetus through ultrasound like we can, Pliny has some odd thoughts about pregnancy and childbirth. Still, we can see aspects of this in old wives’ tales that persist today:

Girls are born more quickly than boys, just as they grow old more quickly. Boys move often in the womb and are generally carried on the right side, while girls are carried on the left. — Pliny, Natural History, 7.37 [trans. M. Beagon]

Death. I’m not sure how many dead bodies Pliny saw floating in rivers, but apparently enough that he felt he could comment that:

Male corpses float on their backs but female corpses float on their faces as though nature were preserving their modesty even in death. — Pliny, Natural History, 7.77 [trans. M. Beagon]

Disease. The Romans mostly subscribed to a miasma-type theory about disease: bad humors, bad air, and other sorts of things were blamed for sicknesses before the modern understanding of germ theory took hold in the 19th century. Worse than that, though, were the cures for disease, which often included lead (Pb):

The same substance [lead] is also employed in preparations for the eyes, cases of prolapse of those organs more particularly; also for filling up the cavities left by ulcers, and for removing growths and fissures of the anus, as well as hemorrhoidal and wart-like tumors. — Pliny, Natural History, 34.50 [trans. J. Bostock]

Women’s Health. The Romans’ understanding of gynecology was spectacularly poor. So your final quote is one of my all-time favorites; Pliny here talks about ’that time of the month’.  Forget such cliches as “being on the rag” when you can use “blunting the edge of steel” instead:

It would indeed be a difficult matter to find anything which is productive of more marvelous effects than the menstrual discharge. On the approach of a woman in this state, must will become sour, seeds which are touched by her become sterile, grafts wither away, garden plants are parched up, and the fruit will fall from the tree beneath which she sits. Her very look, even, will dim the brightness of mirrors, blunt the edge of steel, and take away the polish from ivory. A swarm of bees, if looked upon by her, will die immediately; brass and iron will instantly become rusty, and emit an offensive odor; while dogs which may have tasted of the matter so discharged are seized with madness, and their bite is venomous and incurable. — Pliny, Natural History, 7.13 [trans. J. Bostock]

While the ancient Romans knew quite a lot about the human body, their understanding of disease and of internal anatomy were limited. For more interesting quotes and commentary on this, I recommend Audrey Cruse’s book Roman Medicine, which deals with archaeological evidence like surgeon’s tools and anatomical votives and some bioarchaeological studies in addition to surveying the historical record.
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Reference:

Killgrove, Kristina. 2015. “The Six Weirdest Ancient Roman Ideas About The Human Body”. Forbes. Posted: July 22, 2015. Available online: http://www.forbes.com/sites/kristinakillgrove/2015/07/22/the-six-weirdest-ancient-roman-ideas-about-the-human-body/

Scientists recreate ancient Siberian brain surgery techniques for first time

Experts undertake pioneering tests on skulls to finally understand how doctors carried out remarkable operations more than 2,300 years ago.

More details about the remarkable brain surgery techniques carried out by the earliest Siberians 2,300 years ago have been revealed by scientists.

Neurosurgeons have been working with anthropologists and archaeologists over the past year following the discovery of holes in the skulls of three ancient sets of remains in the Altai Mountains.

Evidence at the time suggested they were examples of trepanation – the oldest form of neurosurgery – with speculation it showed the early nomads had learned the skilful technique from the medical centres of the ancient world, or had uncovered it at the same time as prominent doctors in Greece and the Middle East.

Now, following a series of tests to recreate the ancient surgery, expert have uncovered more about the method and finally concluded how the early doctors carried out their work.

Among the findings made by the Institute of Archaeology and Ethnography, at the Siberian Branch of the Russian Academy of Science, were that the surgeons were highly skilful with the operations carried out with only one primitive tool scraping at the skull.

In addition, it was clear that the ancient doctors adhered to the strict Hippocratic Corpus, the landmark declaration of medical ethics set down 5,000km away in Greece in 500BC.

Prominent Novosibirsk neurosurgeon Aleksei Krivoshapkin, who was asked to examine the skulls, said: 'Honestly, I am amazed. We suspect now that in the time of Hippocrates, Altai people could do a very fine diagnosis and carry out skilful trepanations and fantastic brain surgery.'

The skulls, belonging to two men and a woman, were found in the Altai Mountains and date back about 2,300 to 2,500 years ago.

Analysis last year showed one of the males, who was aged between 40 and 45, had suffered a head trauma and had developed a blood clot that likely left him suffering headaches, nausea, sickness and movement problems.

It was surmised that the trepanation would have been carried out to remove the haematoma, with evidence of later bone growth indicating the man survived the surgery and lived for years afterwards.

The second man had no visible traces of trauma but instead was suspected of having a congenital skull deformation that the ancient surgeon wanted to fix.

In both cases, a relatively small hole was made in the skull allowing surgeons to access the brain at an area where damage to joints and the membrane would have been minimised.

And while the actual technique and the implements used may have varied from those recommended in Ancient Greece, it was clear the care for the patient and the location of the hole showed a similar ethnical consideration.

In order to study the procedure in detail, a team of experts have spent the past year examining the skulls and carrying out a series of tests to recreate the 2,000 year old surgery.

The remains were first analysed under a microscope at the Institute of Archaeology and Ethnography to find any markings that indicated the way the surgeons operated.

No trace of the way the doctors removed the skin was found, and given the good preservation of the skull surface it is assumed this was carried out with high precision.

It was found the trepanation was conducted in two stages. First, a sharp cutting tool removed the surface layer of bone carefully without perforating the skull itself. Then, with short and frequent movements a hole was cut into the skull.

Professor Krivoshapkin said: 'All three trepanations were performed by scraping. From the traces on the surface of the studied skulls, you can see the sequence of actions of the surgeons during the operations.

'It is clearly seen that the ancient surgeons were very exact and confident in their moves, with no traces of unintentionally chips, which are quite natural when cutting bone.'

Archaeologists have not yet uncovered any dedicated medical tools but in almost all graves from this epoch - regardless of social status - bronze knives were found.

The examination of the skulls showed that only one tool was used and it is suspected it could also be a bronze knife.

Professor Krivoshapkin tried testing a typical Tagar blade from the region, taken from the Minusinsk museum, on a skull but it was found to be unsuitable surgery.

A replica of a bronze knife from the time was then made using modern elements by archaeologist Andrei Borodovsky, a doctor of historical sciences at the Institute.

He said: 'I chose a brass alloy of copper, tin, and zinc after the failure with the Tagarsky knife, which turned to be too soft for such surgery. The blade just twirled. Our modern copy of brass alloy performed very well.

'I think it is important to remember that here in the 5th Century BC Altai was a big centre for bone cutting production. People here were very skilful in making different objects from animal bone.

'Working with the animal bones, they understood the main principles of working with such material and later it helped them to make such complicated surgeries.'

The final stage of the research was to recreate the surgical procedure using a modern-day skull. Copying the same techniques believed to have been used by the Altai surgeons, it took Professor Krivoshapkin 28 minutes to perform the technique.

While he said it 'required considerable effort', the hole in the skull was found to mirror those found in the ancient patients.

The last remaining unanswered question for the scientists, however, is what anaesthetic or painkiller the doctors used. Some speculate cannabis, but it may never be known.
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Reference:

Liesowska, Anna & Derek Lambie. 2015. “Scientists recreate ancient Siberian brain surgery techniques for first time”. The Siberian Times. Posted: January 29, 2015. Available online: http://siberiantimes.com/science/casestudy/features/f0054-scientists-recreate-ancient-siberian-brain-surgery-techniques-for-first-time/

Tuberculosis found in 7000 year old bodies

Tuberculosis was present in Europe as early as 7000 years ago, according to new research published in the open-access journal PLOS ONE.

Muriel Masson and colleagues at the University of Szeged examined 71 individuals for their skeletal palaeopathology from a late Neolithic Tisza culture population of the 7000-year-old site of Hódmezővásárhely-Gorzsa in southern Hungary.

A disease called Hypertrophic Pulmonary Osteopathy (HPO) is characterized by symmetrical new bone formations on the long bones caused by periostitis. Most recently in the Middle East, the skeletal remains of a 12-month old infant recovered from the underwater Neolithic site of Atlit-Yam, Israel, dated to 9250-8160 BP, were described as showing evidence of HOA, in addition to Mycobacterium tuberculosis aDNA and mycolic cell wall biomarkers.[1].

Numerous cases of infections and metabolic diseases HPO is however a rare find in the archaeological record. The oldest documented cases in Europe include a Merovingian skeleton from the site of Les Rues des Vignes (Nord, France) dated AD500 to 700.

The researchers here found numerous cases of infections and metabolic diseases, and some skeletons showed signs of HPO which offered the potential of isolating tuberculosis. They focused on one skeleton in particular to verify this hypothesis, and analysed the ancient DNA and lipids from the bones to do so. Both tests confirmed the presence of the bacterial complex associated with tuberculosis.

This is one of the earliest known cases of HPO and tuberculosis to date, and helps shed new light on this European community in prehistoric times.

Masson concludes, “This is a crucial find from a fantastic site. It is not only the earliest occurrence of fully-developed HPO on an adult skeleton to date, but also clearly establishes the presence of Tuberculosis in Europe 7000 years ago.”
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References:

Past Horizons. 2013. “Tuberculosis found in 7000 year old bodies”. Past Horizons. Posted: October 31, 2013. Available online: http://www.pasthorizonspr.com/index.php/archives/10/2013/tuburculosis-found-in-7000-year-old-body

hat is Qigong?

Qigong (pronounced chee-gong) is an exercise and healing technique developed in China more than 4,000 years ago. Certain slow movements seen in qigong look similar to t'ai chi. One could argue that t'ai chi developed from qigong. Yet the practices are very different.

T'ai chi originated as a form of exercise and martial arts only a few hundred years ago. Qigong has little in the form of such movement based on self-defense. In contrast, qigong has a far deeper spiritual or paranormal base that many today would describe as pseudoscience, with various characteristics — touch healing, distance healing, levitation — that clearly violate known laws of physics.

Similarly, whereas numerous studies have shown the health benefits of t'ai chi for balance, flexibility, stamina, mental health, pain management, Parkinson's disease and certain chronic diseases, qigong has not produced similarly strong and positive results.

Qigong is not without merit in terms of improving health, however. At a very basic level, it does have aspects of exercise. Many people in China and in the Western world find qigong exercises to be rejuvenating, not unlike transcendental meditation.

Qigong also is seen to be more useful and legitimate than falun gong, an adulteration of t'ai chi and qigong largely considered utterly useless yet nonetheless practiced by many Westerners.

Qigong vs. t'ai chi

There's no competition between practitioners of qigong and t'ai chi. They are simply two different things. The first difference is in the name; the word "chi," which can be confusing.

The "qi" in qigong is indeed the "chi" or energy flow often discussed in Chinese medicine. Qigong means energy cultivation, or harvesting the chi to your benefit, revealing its healing arts roots. The "chi" in t'ai chi sounds similar to qi to Western ears, but it means "extreme." The full name, t'ai chi ch'uan, means something similar to "grand, extreme fist," revealing its martial arts roots.

Most t'ai chi movements, as slow as they may seem, are associated with fast and powerful martial arts movements. The qigong movements are instead associated with cultivating the chi energy flow.

At the risk of generalizing, qigong movements tend to be circular and, in a distant way, correspond to acupuncture and its intent to release and move chi. Yet quite similar to t'ai chi, qigong movements also entail focused breathing and concentration.

One of the most basic forms of qigong is Baduanjin qigong with eight movements, often called the Eight Pieces of Brocade, or Fabric. Translations vary. The movements are: Pressing the Heavens With Two Hands, Drawing the Bowstring and Letting the Arrows Fly, Separating Heaven and Earth, Wise Owl Gazes Backward, Punching With Angry Gaze, Bouncing on the Toes, Big Bear Turns From Side to Side, and Touching the Toes Then Bending Backwards.

Exercise vs. healing

A Westerner's experience with qigong may be these eight movements only, and thus one may think that qigong is a poetic form of t'ai chi, often accompanied by New Age music. But the river runs deeper. Unlike t'ai chi, the world of qigong includes masters who view themselves as healers. Some of these healers not only teach the movements and meditative properties of qigong to their patients, but they also attempt to transmit their energy to the recipient.

Qi or chi, as stated, is the unquantifiable energy or life force within all living things, according to certain Chinese philosophy. In this view, all disease emanates from an imbalance of this energy. The role of the qigong healer is to adjust or unblock the chi and enable the healing process. This is not entirely unlike the role of an acupuncturist.

A qigong healer may go about adjusting a patient's chi by placing his hands on or over the patient, which is also called touch healing (or reiki) and distance healing, respectively. The Internet is full of anecdotes of healing all sorts of ailments in this fashion, including doing so over the telephone with a patient. Qigong healers have claimed to cure cancer and quadriplegia paralysis.

Scientific support of qigong

Unlike with t'ai chi, there is a dearth of high-quality studies showing the healing benefits of qigong, either as an exercise or as a paranormal force. There is less controversy about the exercise aspect, however, when limited to gentle movements and relaxation.

One of the largest studies involving qigong — a review of 66 studies totaling 6,410 participants — was published in 2010 in the American Journal of Health Promotion, but the researchers unfortunately combined qigong and t'ai chi. Nevertheless, the researchers found various positive results from these exercises when lumped together in improving bone health and balance.

Perhaps as expected for a meditative exercise, a 2007 study published in Journal of Hypertension found that qigong exercise had a mildly positive effect in lowering blood pressure. A 2007 study published in the Journal of Alternative and Complementary Medicine found that qigong exercise as a mildly positive effect in controlling diabetes. And a 2010 study published in the British Journal of Sports Medicine found that qigong exercise helped in improving sleeping patterns.

A 2007 study published in Acta Oncologica, however, found that qigong exercise wasn't effective in prolonging the life of cancer patients.

Of course, there is no evidence that qigong healers can indeed heal by touch or via a distant, paranormal force, as practitioners of falun gong claim.
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References:

Wanjek, Chris. 2013. “What is Qigong?”. Live Science. Posted: July 16, 2013. Available online: http://www.livescience.com/38192-qigong.html

Ancient Shipwreck Reveals 2,000-Year-Old Eye Medicine

Ancient gray disks loaded with zinc and beeswax found aboard a shipwreck more than 2,000 years old may have been used as medicine for the eyes, researchers say.

These new findings shed light on the development of medicine over the centuries, scientists added.

Scientists analyzed six flat gray tablets approximately 1.6 inches (4 centimeters) in diameter and 0.4 inches (1 cm) thick that were found in a round tin box aboard the so-called Relitto del Pozzino shipwreck, which was discovered about 60 feet (18 meters) underwater in 1974 on the seabed of the Baratti Gulf off the coast of Tuscany. The hull, only 50 to 60 feet (15 to 18 m) long and about 10 feet (3 m) wide, dated back to about 140 B.C.

The Roman shipwreck lay near the remains of the Etruscan city of Populonia, which at the time the ship foundered was a key port along sea trade routes between the west and east across the Mediterranean Sea. A number of artifacts were unearthed during the excavation, including wine jars, an inkwell, tin and bronze jugs, stacks of Syrian-Palestinian glass bowls and Ephesian lamps.

"Such objects suggest that the ship, or at least a great part of its cargo, came from the east, probably the Greek coasts or islands," the researchers wrote in a study detailed online Jan. 7 in the journal the Proceedings of the National Academy of Sciences.

The cargo also included medical equipment, such as an iron probe and a bronze vessel that may have been used for bloodletting or for applying hot air to soothe aches. These findings suggest a physician was traveling by sea with his professional equipment, the researchers said.

To learn more about these potentially medicinal tablets, researchers investigated the chemical, mineralogical and botanical composition of fragments of a broken tablet.

"In archaeology, the discovery of ancient medicines is very rare, as is knowledge of their chemical composition," the researchers wrote. "The data revealed extraordinary information on the composition of the tablets and on their possible therapeutic use."

The disks were about 80 percent inorganic, with zinc making up about 75 percent of the inorganic components. Zinc compounds have been known since ancient times to serve as medicines, with the ancient Roman naturalist Pliny the Elder writing that they could help treat the eyes and skin.

The tablets also contained starch, pine resin, beeswax and a mix of plant- and animal-derived fats, perhaps including olive oil. Starch was a known ingredient of Roman cosmetics, olive oil was used for perfumes and medicines, and pine resin may have kept the oil from going rancid and fought microbes due to its antiseptic properties.

Pollen grains were numerous, with about 1,400 grains per gram seen in the tablets. These came from olive, wheat and many other plants, such as stinging nettles and alder trees. However, about 60 percent of this pollen came from plants that are pollinated by insects such as bees, suggesting they may inadvertently have hitched along in a bee product such as beeswax instead of getting intentionally added to the medicine.

Linen fibers were seen, which may have helped keep the tablets from crumbling. Charcoal was detected as well, which may be residue from other ingredients or was potentially added intentionally.

Intriguingly, the Latin word for eyewash, "collyrium," derives from a Greek word meaning "small round loaves." This fact highlights the notion that these small round tablets are linked with eye health.

"This study provided valuable information on ancient medical and pharmaceutical practices and on the development of pharmacology and medicine over the centuries," the researchers said. "In addition, given the current focus on natural compounds, our data could lead to new investigations and research for therapeutic care."
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References:

Choi, Charles. 2013. “Ancient Shipwreck Reveals 2,000-Year-Old Eye Medicine”. Live Science. Posted: January 8, 2013. Available online: http://www.livescience.com/26062-ancient-shipwreck-eye-medicine.html

Ancient Saharan head cases

Desert-society healers appear to have operated on skulls 2,000 years ago



Talk about getting inside others’ heads. Skulls of three men from North Africa’s ancient Garamantian civilization, which flourished in the Sahara Desert from 3,100 to 1,400 years ago, contain holes and indentations that were made intentionally to treat wounds or for other medical reasons, say anthropologist Efthymia Nikita of the University of Cambridge in England and her colleagues.

Signs of renewed bone growth around the rims of these cranial openings indicate that the men, who lived roughly 2,000 years ago, survived the surgical procedure, the researchers report in a paper published online August 9 in the International Journal of Osteoarchaeology.

Given the evidence of widespread trade networks in North Africa several thousand years ago, “the knowledge of cranial surgical techniques must have been among the cultural traits that spread among populations,” Nikita says.

Previously excavated North African sites contain the earliest evidence of scraping, cutting or drilling pieces of bone out of people’s skulls, a practice known as trepanation. Skull surgery occurred as early as 13,000 years ago in what’s now Morocco. Ancient Egyptians performed the technique starting around 4,000 years ago, as did pre-Inca groups living in South America 1,000 years ago (SN Online: 4/25/08). Some modern North African populations have used trepanation to treat headaches following injuries or disease.

Nikita’s team examined skeletal remains excavated by other researchers since the 1950s at village sites near the ancient Garamantian capital of Garama in what’s now southwestern Libya. Three adult male skulls contained dime- to quarter-sized holes inside hollowed-out areas, as well as scraped-out depressions.

Analysis of this damage rules out disease, bone-chewing animals, accidental falls or intentional blows as causes, the scientists say. Careful placement of fracture-free holes away from sensitive cranial sutures argues against torture or violence as a cause. Reasons for performing trepanation in these ancient cultures remain unclear, although one Saharan skull contains fractures inflicted by a weapon of some kind that may have instigated such cranial surgery.
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References:

Bower, Bruce. 2011. "Ancient Saharan head cases ". Science News. Posted: August 17, 2011. Available online: http://www.sciencenews.org/view/generic/id/333452/title/Ancient_Saharan_head_cases

From Arabick Roots to the Arab spring

The Arabick Roots exhibition at the Royal Society helps to correct the 'clash of civilisations' view of the history of science

Alkali, algebra, algorithm, alembic. Spotted the pattern? It's no coincidence that many scientific words in English contain the Arabic definite article. In recent years, historians and scientists such as Jim al-Khalili have done a fantastic job of shedding some light on the Arabic origins of modern science (Arabic here referring to all cultures that made use of the script, rather than just the Arab people).

In particular it's the "golden age" of Arabic science, between the 8th and 13th centuries, that gets all the press. So while the Vikings were romping around northern Europe, the 8th century Persian mathematician al-Khwārizmī was developing solutions to quadratic equations. While Alfred the Great was busy fending off those Vikings, the Arab polymath al-Kindi was introducing Indian numerals into mathematics, and the Persian physician al-Razi was conducting a study into the differences between measles and smallpox.

That's algebra, smallpox and numbers, all sorted by the end of the 9th century. The Arabic contribution to science is certainly impressive, but what happened next? Did the west's scientific revolution just kick in, allowing Europeans to pick up where Arabic science left off: a neat end to one scientific culture, and the beginning of another? After a public tour of the Royal Society's latest exhibition, Arabick Roots, I can report that the answer is a resounding "no".

This was something our guide, curator Dr Rim Turkmani, was keen to get across. Arabic science did not abruptly stop. The exhibition gives us a flavour of how, just as we hit the 17th and 18th centuries, European and Arabic thought started to intermingle. There was certainly a good deal of translation, but in many cases the Royal Society had direct contact with Arabic scholars.

Dr Turkmani showed us the Royal Society Charter Book, a great tome of vellum containing the signature of every Fellow, and there, signed in Arabic, were the names of the first three Arab Fellows of the Royal Society.

Our guide led us down a grand marbled staircase to a cabinet entitled 'From inoculation to vaccination'. Ahh, vaccination. We know the story: noting that milkmaids rarely suffered from smallpox, Edward Jenner reasoned that cowpox could be used to vaccinate against the disease. For this he is championed as the 'Father of Immunology'. But almost 70 years earlier, one of the first Arab Fellows, Cassem Aga, was teaching the Royal Society about the inoculation techniques practised in Tripoli. Dr Turkmani explained how, in the letter on display, Aga expressed his bafflement: how could Europeans be unaware that a mild dose of the smallpox virus could prevent a healthy individual contracting the disease? "Cassem Aga couldn't remember a time before inoculation," said our guide. "It had been going on in the Arab world before anyone could remember."

This was exactly what I had been hoping for: the chance to cut our heroic western scientists down to size. Forget Jenner, it was Arabic science that saved us from smallpox! But when I ventured this opinion Dr Turkmani corrected me: "I want to combat the idea of a clash of civilisations," she said. Which is a much more positive message than my attempt at point scoring. Jenner's contribution was extremely important, as cowpox is a much safer vaccine, she said, but it was Arabic scholars who set the ball rolling.

As we continued, it became clear that neither Arabic nor European science acted in isolation. Dr Turkmani pointed out a sheet of paper covered in circles, right-angled triangles and parallel lines. We were looking at Alhazen's problem, a real trigonometric nightmare. Set by the 10th-century Iraqi polymath Ibn al-Haytham, the challenge is this: given points A and B exterior to a circle, find a point C on the circle such that the angle ACB is bisected by the diameter through C.

Got it yet? Don't fret. An algebraic solution was only discovered in 1997 by Oxford mathematician Peter Neumann. al-Haytham had completed a geometric proof and in the 900 years between, various Arabic and European scholars contributed suggestions. The medley of points and planes you can see at the exhibition is Christiaan Huygens's 1673 attempt.

As the tour wrapped up, I asked Dr Turkmani about Arabic science today. She was to the point: "The Arab Spring has demonstrated the people's desire to be free to pursue knowledge." She cited increased scientific activity in Egypt since the fall of Mubarak. Ultimately, she said, "there is one civilisation: we all contribute."

And so it strikes me that, while Arabick Roots does not have an agenda, it does have a message. Arabic science isn't something alien, confined to a "golden age" in the past. From smallpox to Alhazen's problem, it has kept contributing: a continuous part of a global scientific culture that has never gone away.

For more information on Arabic science check out this site:
History Science Technology

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References:

Poskett, James. 2011. "From Arabick Roots to the Arab spring". Guardian. Posted: July 25, 2011. Available online: http://www.guardian.co.uk/science/blog/2011/jul/25/arabick-roots-arab-spring

Plants found in ancient pills offer medicinal insight

DNA extracted from 2,000-year-old plants recovered from an Italian shipwreck could offer scientists the key to new medicines.

Carrots, parsley and wild onions were among the samples preserved in clay pills on board the merchant trading vessel that sank around 120 BC. It's believed the plants were used by doctors to treat intestinal disorders among the ship's crew.

Such remedies are described in ancient Greek texts, but this is the first time the medicines themselves have been discovered.

"Medicinal plants have been identified before, but not a compound medicine, so this is really something new," says Alain Touwaide, director of the Institute for the Preservation of Medical Traditions, which has the world's largest digital database of medical manuscripts.

Prof Touwaide is working with scientists at the Smithsonian's Natural History Museum, who carried out the DNA analysis. They discovered traces of carrot, parsley, alfalfa, celery, wild onion, radish, yarrow and hibiscus contained in the ancient pills.

The pills, which researchers believe were diluted with vinegar or water to make them easier to ingest, were preserved inside tin boxes and were the size of coins.

"I was always wondering if the texts were only theoretical notions without practical application," he says. "Now we know they were applied."

'Written evidence'

In May, Prof Touwaide's conclusions, based on the DNA findings and his own study of medicinal texts, will be formally presented to an international gathering of archaeologists, historians of medicines and other experts in Rome.

"What is remarkable is that we have written evidence [from the ancient Greeks] of what plants were used for which disorders," says Alisa Machalek, a science writer for the National Institutes of Health, one of the world's leading research centres.

"This research is interesting, especially for medical historians, because it confirms that what we eat affects our bodies."

Prof Touwaide hopes his research will help to develop modern treatments.

"We extract the information from these texts so that scientists can see if they can make shortcuts to pharmacological discoveries," he says.

"We re-purpose ancient medical information and jump from the past to the future."

For instance, the Roman statesman Cato recommended eating broccoli to stay healthy and Prof Touwaide has found references to the Greek physician Galen using it in the 2nd Century AD to treat intestinal cancer.

Prof Touwaide says modern research is now under way to isolate a compound found in broccoli that may be a source for the treatment of cancer today.

"This is a huge field in chemistry and pharmaceutical science," says Ms Machalek.

"Native Americans chewed on willow bark to relieve pain - now we pop open a bottle and chew on aspirin which contains similar compounds. Taxol, a cancer medicine, is derived from the bark of the Pacific Yew."

Early Greek writings

To understand the significance of the plants contained in the 2,000-year-old pills, Prof Touwaide studied a number of medical works, including the Hippocratic Collection.

The collection is one of the earliest sets of Greek writings still in existence and is attributed to Hippocrates, considered to be the founder of Western medicine.

He cross-referenced those findings with other works, such as the Encyclopaedia of Natural Substances, written in the 1st Century AD by Dioscorides.

Dioscorides noted that "the large onion is sharper than the round onion. All onions are pungent and apt to cause flatulence. They stimulate the appetite. They are thirst making. They cleanse the bowel."

"They are good for opening outlets for various secretions as well as haemorrhoids, and they are used as suppositories, pilled and dipped in olive oil," Dioscorides wrote.

A significant percentage of commercial medicines are derived from natural sources, but the active compound has been isolated, concentrated, standardised and packaged into measured doses.

The shift toward synthetic chemical medicines occurred in the 20th Century, but according to Mark Blumenthal, the founder and executive director of the American Botanical Council, there is renewed interest in the medicinal benefits of natural foods - including those found in the pills.

"A lot of ancient plants have modern functions," he says.

"There's a lot of marketing going on for so-called functional foods - foods with high levels of antioxidants, for improving the cardiovascular system or reducing the risk of cancer.

"Hibiscus tea is growing in popularity and research shows that it lowers blood pressure. Garlic and to some degree onions, continue to have cardiovascular benefits and reduce the build-up of plaque."

But Prof Touwaide says the traditional cures based on plants and minerals are in danger of being forgotten.

He says part of the problem is that too few people now study classical Greek, Latin or Arabic and there are not enough experts to interpret the original texts.

Prof Touwaide is proficient in 12 languages and has spent years collecting his library of 15,000 books on plants and their uses.

He believes such ancient knowledge should become protected by Unesco as part of the world's heritage.
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References:

O'Brien, Jane. 2011. "Plants found in ancient pills offer medicinal insight". BBC News. Posted: April 27, 2011. Available online: http://www.bbc.co.uk/news/world-us-canada-13190376

Ship wreck reveals ancient secrets of medicine

It has been more than 2,000 years since a Roman merchant ship foundered off the west coast of the Italian peninsula and almost 40 years since the wreck was discovered. Now, the DNA trapped in medicines found aboard the ship is yielding secrets of health care in the ancient world.

Samples from two tablets analyzed at the Smithsonian's Center for Conservation and Evolutionary Genetics reveal a dried concoction of about a dozen medicinal herbs, including celery, alfalfa and wild onion, bound together with clay and zinc.

The tablets may have been used externally to treat skin conditions or dissolved in water or wine and taken for intestinal ailments such as dysentery, speculates Alain Touwaide, historian of sciences in the Department of Botany at the Smithsonian's National Museum of Natural History.

The DNA tests confirm that medicines written about in ancient texts were actually used, said Touwaide, who with his wife and research partner, Emanuela Appetiti, obtained the tablets from the Italian Department of Antiquities in 2004.

Archaeologists have found older artifacts in Egypt and China, vessels for wines that contained herbal additives. Touwaide, however, says the shipwreck tablets are the first remains of ancient pharma-ceuticals to be found and also the first to be successfully analyzed with advanced DNA sequencing techniques. Preserved inside small tin boxes, the tablets are gray-green solid disks about an inch across and one-third of an inch thick.

"Extracting the DNA and sequencing it was not an easy task," Touwaide said. The analyses were conducted intermittently over four years, the last in October, by Smithsonian geneticist Robert Fleischer, who said that the results are preliminary and that more testing is in the works.

"I didn't expect it to work at all," said Fleischer. "They're very old. I had assumed everything had degraded, but they were in pretty remarkable condition. You could still see plant fibers."

The ingredients also include radish or cabbage, wild carrot or a relative, yarrow, jack bean and a hibiscus species. Fleischer found smaller genetic traces that may be a carrot relative named angelica, as well as willow, aster, the common bean and nasturtium.

A tramp freighter?

The ship was about 50 feet long, dates to around 130 B.C. and went down in the Gulf of Baratti off the coast of Tuscany. It was discovered in 1974 by members of the Italian Experimental Center for Underwater Archaelogy, but its contents were not surveyed and excavated until the 1980s. Touwaide and Appetiti received the tablet fragments under an agreement between the Smithsonian and the Archaelogical Department of Tuscany.

Divers retrieved several tin containers, 136 vials made of boxwood, a locker and medical tools. The large number of vials suggests that the medicines were being shipped rather than being used by the ship's doctor. "It might be both," said Touwaide. "There might have been a physician on board; there might have been a medical cargo."

Among the recovered objects are glass from Syria, a Cypriot pitcher and lamps from Asia Minor, suggesting the vessel may have been a tramp freighter plying the ports of the entire Mediterranean.

That may be a false assumption, according to Cemal Pulak, vice president of Texas A&M University's Institute of Nautical Archaeology, who said the items might have been stored in a port and placed on the ship all at once, or salvaged from another wreck. Pulak, who is not involved with the Tuscan wreck, has excavated and studied eastern Mediterranean shipwrecks that date to the Bronze Age.
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References:

Higgins, Adrian. 2011. "Ship wreck reveals ancient secrets of medicine". Washington Post. Posted: February 1, 2011. Available online: http://www.washingtonpost.com/wp-dyn/content/article/2011/02/01/AR2011020100169.html?wprss=rss_nation/science

Ancient Medical Kit Held Veggie Pills

A Roman ship that wrecked nearly 2,000 years ago contained a chest stocked with surgical tools and green pills.

Advanced DNA analysis of 2,000-year-old tablets has revealed that vegetable pills may have been part of an ancient travel medical kit, according to a new study.

The kit was recovered from a shipwreck found some 200 meters (656 feet) from one of the most beautiful beaches in Tuscany. The wreck is estimated to date back to 140-120 B.C. and was partly excavated in the 1980s and 1990s by a team of the Archeological Superintendency of Tuscany.

"It wasn't an easy task. The wreck is covered by marine plants and their roots. This makes it hard to excavate it. But our efforts paid off, since we discovered a unique, heterogeneous cargo," underwater archaeologist Enrico Ciabatti told Discovery News.

Made from pinewood, oak and walnut tree, the ship, named "Relitto del Pozzino" after the beach near where it was found, carried ceramic vases (amphoras) for wine from Rhodos; glass cups from the Syro-Palestinian area; ceramics possibly from Athens and Pergamon; a pitcher in Cypriot style; and lamps from Asia minor.

"The cargo made it possible to trace the ship's itinerary. We think that the Roman ship sank because of a mistral storm on its way back from the Eastern Mediterranean Sea after visiting the Syro-Palestinian area, Cyprus and Delos," Ciabatti said.

But the most interesting part of the cargo was a sort of medical chest possibly belonging to a physician on board the ship.

Within the kit, the archaeologists found a bleeding cup, a surgery hook and a mortar. They also recovered 136 drug vials made of boxwood and several tin containers carrying circular, flat green tablets -- each about three centimeters wide and half a centimeter thick. Because they were sealed, the pills were completely dry even though they had been laying on the sea floor for millennia.

"We obtained some samples in 2004, but only recently a next generation sequencing technology has allowed us to identify their ingredients," Alain Touwaide, an international authority on medicinal plants of antiquity at the Smithsonian Institution and the Institute for the Preservation of Medical Traditions in Washington , D.C., told Discovery News.

Geneticist Robert Fleischer of the Smithsonian's National Zoological Park, who presented the findings last week at the Fourth International Symposium on Biomolecular Archaeology in Copenhagen, Denmark, was able to analyze DNA fragments in two of the pills.

After comparing the sequences to the GenBank genetic database maintained by the US National Institutes of Health, he identified many plants typical of a vegetable garden, including carrot, radish, parsley, celery, wild onion and cabbage. Alfalfa, yarrow and the more exotic hibiscus were also part of the mix.

"The plants match those described in ancient texts such as those by the ancient Greek physicians Dioscorides and Galen. However, more work has to be done since we do not have the complete sequence for each plant, but only fragments which could belong to other species as well," Touwaide said.

The researchers have divided the plants in three groups: the more likely, the uncertain and the improbable ones.

"On the basis of the ancient texts, all the plants included in the first group, that of the likely ones, have a common property, which is the treatment of intestinal disorders," Touwaide said.

One hypothesis is the pills were dissolved in water or wine to make a liquid medicine that was ingested. The sailors could have used the pills as a vitamin supplement during the long voyages.

Touwaide stressed that for now that's only hypothesis and has yet to be confirmed. But he added, "Preliminary analysis of these tablets seems to confirm that the ancient doctors used common plants for their treatments."

According to Gianna Giachi, chemist director at the Archeological Superintendency of Tuscany, the research is extremely important.

"For the first time, the new technology has allowed a full investigation of these pills and their use. Personally, I believe they were not ingested, but melted a bit and applied on the skin. We hope to publish the final results by next year," Giachi told Discovery News.

Part of the ship's recovered cargo, including the tin containers and the cylindrical vials of boxwood, is on now display at the Archaeological Museum in Piombino.

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References:

Lorenzi, Rossella. 2010. "Ancient Medical Kit Held Veggie Pills". Discovery News. Posted: September 14, 2010. Available online: http://news.discovery.com/archaeology/roman-ship-medical-kit.html