Meningeal inflammation (Serpens endocrania) and intrathoracic chronic disease in 1st century A.D. Roman Palestine (Qumran): From paleopathology to clinical practice.

INTRODUCTION: Characterized by serpentine vascular impressions on the endocranial surface, Serpens endocrania is closely associated with chronic respiratory diseases, particularly tuberculosis. MATERIAL/METHOD: Located on the Dead Sea shores, the archaeological site of Qumran is classically associated with the Essenes, a Jewish religious community (1st century B.C. to 68 CE). Among 1200 burials, excavations in the cemetery uncovered the remains of 52 individuals. RESULTS: Among these 52 remains, we report seven cases of Serpens endocrania (i.e. 13.46% of the small sample), which is higher than that detected in other studies of ancient populations. DISCUSSION: We discuss the possible causes of such an unusually high proportion in ancient skeletal populations: exposure to infections (tuberculosis, and/or environmental factors). We propose silicosis (and/or silico-tuberculosis) as a possible differential diagnosis, taking into consideration the desert environment and, more specifically, prolonged inhalation of quartz/silica dust particles inducing chronic pulmonary inflammation and promoting additional infections.