Acute or chronic diseases of the upper and lower respiratory tracts have always affected people’s everyday lives – in the past and today. They include colds, influenza, tonsillitis, sinusitis, bronchitis and chronic bronchitis, pleurisy, pneumonia, asthma and lung cancer. Virus-related diseases such as Covid-19 have been emerging sporadically for millennia. Environmental factors, as well as working and living conditions in settlements play a role in their development and spread. Air pollution and poor air quality support the emergence of respiratory diseases.
Infectious diseases spread by breathing in particles that an infected person coughs or sneezes, by touching body fluids directly or surfaces contaminated with saliva, blood, sweat or secretions. Fever, cough, breathlessness, sore throat, fatigue, chest pain while breathing or coughing, as well as muscular pain and headache may accompany respiratory diseases.
Most of these symptoms primarily affect soft tissues, but after persisting for some months, they manifest as discrete changes on the bone surface of skeletal remains. These traces can be investigated in the skeletal remains from archaeological contexts. Most common signs of respiratory diseases are found at the nasal floor and cavity (rhinitis), the paranasal sinuses (sinusitis) and the ribs (pleurisy). Especially pleurisy, the inflammation of the pleura that separate the lungs from the chest wall, leaves traces on bones due to the direct contact of the tissue with the ribs. Normal bone surfaces appear smooth, whereas porosities, vessel imprints, or plate-like new bone formations indicate pathological changes. We can differentiate active and healed lesions, but there are also mixed examples (see figure).
Medical treatment is available for many respiratory diseases today. However, not all people have access to necessary medicines. First historical reports of flu epidemics date back to Ancient Greece, but outbreaks of flu and other viral diseases can probably be assumed for much earlier times. Without understanding the underlying causes, the diseases were difficult to treat. Left untreated, some were life-threatening or deadly, especially for undernourished people or individuals with a weakened immune system.
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