The dead teach the living. — Motto of the Paleopathology Association9
Imagine a single tooth, buried for millions of years, revealing not just the diet of our ancient ancestors but the very story of human evolution.
In August 2025, a team of scientists announced the discovery of 13 such teeth in Ethiopia, providing startling evidence that two different human ancestor species, Australopithecus and Homo, coexisted in the same place at the same time between 2.6 and 2.8 million years ago4 . This breakthrough, pieced together from fragmentary dental clues, exemplifies the fascinating work of paleopathology—the science of studying ancient diseases and health conditions.
This field has evolved far beyond its origins as a medical curiosity. Today, paleopathology stands at the intersection of cutting-edge technology and profound historical inquiry, offering unprecedented insights into how disease shaped, and was shaped by, human behavior, environment, and culture over millennia7 . From identifying cancer in Egyptian mummies to tracing the evolution of tuberculosis, this discipline transforms silent bones and preserved tissues into vibrant narratives of our past.
Paleopathology is formally defined as the study of ancient diseases in humans and animals recovered from archaeological contexts9 . It is a cornerstone of bioarchaeology, integrating a biocultural approach to reconstruct past lived experiences.
Initially dominated by medically trained doctors who applied their diagnostic skills to mummies and skeletonized remains2 , it has expanded into a rigorously scientific discipline. Modern paleopathology has moved from "speculation-based musings" to a "scientifically-validated approach" for recognizing disease in the archaeological, zoological, and paleontological record3 .
A fundamental shift in paleopathology has been the adoption of the biocultural approach, which posits that biology and culture are inextricably intertwined2 . Disease is no longer viewed merely as a biological response but as a complex interplay of variables including age, biological sex, gender, nutritional status, and social and physical environments.
The past 50 years have witnessed tremendous scientific strides within paleopathology, driven largely by technological innovation2 .
The modern paleopathologist wields an array of sophisticated tools that allow for non-invasive examination of both the macro and microstructure of ancient remains.
| Tool/Technology | Primary Function | Application Example |
|---|---|---|
| Computed Tomography (CT/Micro-CT) | Provides high-resolution 3D imaging of internal structures without destruction | Differentiating between types of bone lesions; visualizing soft tissue in mummies2 |
| Ancient DNA (aDNA) Analysis | Extracts and sequences genetic material from ancient remains | Identifying pathogens like Yersinia pestis (plague) and Mycobacterium tuberculosis2 |
| Stable Isotope Analysis | Analyzes chemical signatures in organic tissues | Reconstructing diet, mobility, and physiological stress during childhood2 |
| Paleo-immunohistochemistry | Detects ancient immune responses or pathogen proteins | Identifying specific pathogens like Plasmodium (malaria) in dental pulp7 |
| Scanning Electron Microscopy | Provides extreme magnification of surface details | Studying microscopic wear patterns on teeth or bone histology3 |
These technologies have led to groundbreaking discoveries. For instance, the adoption of CT scanning has provided new insights into the diagnosis of cancer, tuberculosis, and atherosclerosis in ancient remains2 . Meanwhile, the successful extraction of pathogenic ancient DNA has revolutionized our understanding of the evolution and spread of diseases like the Black Death and leprosy2 .
One of the most significant emerging frameworks is ONE Paleopathology, a holistic, interdisciplinary approach that examines health from a deep-time perspective5 . It expands on the "ONE Health" model, integrating human, animal, and environmental health data to address contemporary public health concerns.
Studying diseases in ancient animal remains to understand environmental health conditions that also affected human populations.
Examining how historical climate shifts influenced the spread of infectious diseases such as the Black Death5 .
Tracing how diseases like tuberculosis and leprosy have moved between humans and animals over millennia5 .
This approach acknowledges a truth long recognized in Indigenous knowledge systems: the health of humans, animals, and ecosystems is fundamentally interconnected5 .
A landmark study, published in a 2025 research topic, exemplifies the power of modern paleopathological methods7 . The investigation sought to confirm the presence of malaria in medieval Corsica and understand its impact on the population.
The research team, led by Boualam et al., analyzed dental pulp from individuals buried at the site of Mariana (9th–13th centuries CE) using a multi-pronged diagnostic strategy7 :
Teeth were carefully extracted from skeletal remains excavated from the cemetery.
The dental pulp, known to be a rich source of pathogens due to its protected environment, was removed from the pulp chamber.
The pulp was subjected to three independent analytical techniques:
The study provided one of the most robust microbiological documentations of malaria in a European archaeological context7 . The results were groundbreaking:
| Aspect of Finding | Detail | Significance |
|---|---|---|
| Pathogen Identified | Plasmodium falciparum, the most virulent malaria species | Confirmed the presence of a deadly strain in medieval Europe. |
| Historical Confirmation | Evidence dated to 9th-13th centuries CE | Anchored historical records of "bad air" (mal'aria) with biomedical proof. |
| Methodological Validation | Dental pulp successfully used as a substrate | Opened new avenues for detecting blood-borne pathogens in ancient remains. |
This research did more than just identify a disease; it confirmed the long-held endemicity of malaria in Corsica long before modern records began. It also validated a powerful methodological approach, opening the door for similar studies of ancient intraerythrocytic pathogens worldwide7 .
The Corsican malaria study highlights the reliance on specialized reagents and materials. The following table details key solutions and tools fundamental to advanced paleopathological research.
| Reagent/Material | Function | Application in the Featured Experiment |
|---|---|---|
| DNA Extraction Kits | Isolate ancient DNA from mineralized or preserved tissues | Extracting pathogen DNA from the dental pulp of medieval skeletons. |
| Protein-Specific Antibodies | Bind to unique protein markers from ancient pathogens | Used in immunohistochemistry to detect Plasmodium proteins. |
| PCR Reagents | Amplify tiny amounts of ancient DNA for sequencing | Amplifying pathogen DNA for metagenomic sequencing. |
| Immunochromatographic Strips | Provide rapid, visual detection of specific antigens | Used as a quick, confirmatory test for the presence of malaria. |
| Lysis Buffers | Break down cell membranes to release cellular content | Breaking open calcified dental pulp to release biomolecules. |
As the field looks forward, several key themes are shaping its trajectory. The Paleopathology Association's 50th anniversary in 2024–2025 has prompted reflection on the "next 50 years," focusing on greater integration and ethical rigor9 .
There is a growing imperative to address the ethical dimensions of working with human remains. This includes the need for clear guidelines on destructive analyses (like aDNA and isotope studies) and collaboration with descendant communities2 .
A 2025 survey revealed a significant gap in training and confidence between human osteologists and zooarchaeologists when analyzing pathological lesions8 . Addressing this through integrated training is crucial for the development of a unified ONE Paleopathology approach.
Integrating skeletal data with historical archives can recenter personhood in paleopathological narratives. One study reinterpreted a shoulder dislocation in a woman from the Huntington Anatomical Collection through almshouse and death records, weaving a story that connected her injury to gender, industrial labor, and trans-Atlantic immigration.
Paleopathology has matured into a discipline that does far more than catalogue ancient diseases. It investigates the human condition itself—our fears, interventions, failures, and astonishing capacity for resilience7 .
By bridging past and present, it offers invaluable perspectives for tackling modern health challenges, from zoonotic spillover to the health impacts of climate change5 .
As we continue to develop more refined tools and more collaborative frameworks, the bones of our ancestors and the animals that lived alongside them will continue to whisper their stories. In listening, we not only honor the dead but equip the living with the deep-time wisdom needed to build a healthier future.