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INSIGHT: Report of Radiological-Forensic Findings on the Iceman
Journal of Archaeological Science (2002) 29, 323–326 doi:10.1006/jasc.2002.0824, available online at http://www.idealibrary.com on
INSIGHT: Report of Radiological-Forensic Findings on the Iceman P. Gostner and E. Egarter Vigl* Department of Radiology and *Department of Pathology, General Hospital, Bolzano, Italy (Received 27 September 2001, revised manuscript accepted 2 January 2002) Ten years after the discovery of the Iceman in the Alps on the Italian–Austrian border a foreign body in the form of an arrowhead was discovered in the left shoulder region of the mummy. X-rays of the thorax using a digital radiography system provided sufficient evidence to identify its shape and size. Computer tomography (CT) provided further information on the position of the arrowhead, direction of the shot and its impact on the surrounding soft tissue and bones. This additional evidence of a fresh entry wound would further prove the cause of death as resulting from the arrowhead shot. 2002 Elsevier Science Ltd. All rights reserved. Keywords: ICEMAN, ARROWHEAD, CAUSE OF DEATH.
Archaeological Museum of Bolzano. The following X-rays were made: an X-ray of the thorax in the anterior-posterior direction, as well as three different projections of the right and left half thorax (KV 46, mAs 25, 110 cm focus distance). A digital CR-system with phosphorus plates 3542 cm was used (BaSrFBR:Eu Supp.: P.E.T, 3543 cm format, 17922176 pixel resolution). Preservation work on the mummy had already been carried out four months previously at the Department of Pathology of the Hospital of Bolzano. A computer tomography (CT) was also routinely performed on the entire mummy at the Department of Radiology and data were stored. The CT-examination was performed on state of the art equipment which also enabled a 3D reconstruction of the thorax.
Introduction n September 1991 the mummified corpse of a man was discovered in the Alps, at a height of 3210 metres. His age was said to be over 5000 years old (Figure 1). Following a difficult recovery operation the mummy was brought to the Institute of Forensic Medicine at the University of Innsbruck (Austria) and then on to the Institute of Anatomy for further preservation some days later. The simulation of a glacial environment was chosen as the method of natural preservation. Examinations by various international highly-specialized research teams over the next few years have provided valuable scientific information. Because the mummy and his belongings were preserved in ice, the researchers were able to recreate a detailed picture of a human being and his surroundings during the neolithic period (Fleckinger & Steiner, 1999; Goedecker-Ciolek, 1993; Seidler et al., 1992; Spindler, 1999). One of the remaining mysteries was the cause of death. Recent X-ray examination of potential fresh fractures at the ribs carried out almost 10 years after the mummy’s discovery have contributed substantially to the clarification of the cause of death.
I
Results The bone thorax appeared moderately deformed. Fresh fractures which would have been incurred at the time of death or directly prior to death were not visible. A well-healed fracture on the seventh and eighth left rib and a bone defect on the fifth and sixth left rib caused by biopsy was found. Remarkable findings were however visible in the left shoulder area. By the upper restriction of the second rib a shadow of an arrowshaped structure was visible, with a longitudinal diameter of 21 mm and a width of 17 mm, which was clearly not a part of the skeleton. Analysis of the form and density of the foreign body led to the conclusion of its identification as a stone arrowhead dating from the neolithic period (Figure 2).
Materials and Methods On 27 June 2001 mobile X-ray apparatus was used to investigate the mummy under preservation in the Addresses for correspondence: Paul Gostner MD, Department of Radiology, General Hospital, L. Bo¨hlerstr. 5, I 39100 Bolzano, Italy. E-mail: [email protected] Eduard Egarter Vigl MD, Department of Pathology, General Hospital, L. Bo¨hlerstr. 5, I 39100 Bolzano, Italy. E-mail: [email protected]
323 0305–4403/02/$-see front matter
2002 Elsevier Science Ltd. All rights reserved.
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P. Gostner and E. Egarter Vigl
Figure 3. CT-scan of thorax showing the foreign body in the soft tissue of the left shoulder.
Figure 1. Glacial mummy with an ‘‘unnatural’’ position of the left arm.
Figure 4. 3D reconstruction of the arrowhead in the left shoulder (black arrow), bone defect in the left shoulderblade (white arrow).
Figure 2. Left half thorax with arrowhead above the second rib.
Owing to these somewhat surprising X-ray results additional CT sectional images and 3D reconstructions were made of both shoulder regions. This illustrated the exact topographical location of the arrowhead and its relation to the surrounding anatomical structures. The arrowhead was also visible in the soft tissue of the left shoulder, in the area of the large shoulder vessels,
and approximately 16 mm from the pleura parietalis. The arrowhead density was relatively high (2200 HE), compared to the mummy’s compact bone structure (1400 HE). Furthermore, the soft tissue of the left shoulder was found to be denser than that on the opposite side (Figure 3). The 3D reconstruction of the thorax also showed a 2 cm, oval-shaped hole with even borders, located in the fossa infraspinata of the left scapula. Directly under it a second hole, only a few millimeters wide as seen (Figure 4). These bone changes could only be localized in retrospect on the axial CT sectional images. The right shoulder blade was normal. Following the results of the radiology the body surface of the Iceman was once again examined; the aim being to find a skin injury, which could in shape and size be the arrow’s point of entry. In order to do so the mummy was transferred from the preservation cell to the laboratory cell and warmed up to +8C; under artificial Neon-Truelight illumination it was examined with the naked eye and with a 10 magnifying glass. Attention was drawn mainly to the front and back of the left shoulder and to the
Report of Radiological-Forensic Findings on the Iceman 325
Figure 5. Location of the entry wound, dorsal side of the left shoulder.
armpit, where according to the arrowheads position on the X-ray images an injury, if any, might be found. After approximately 20 min the mummy’s surface was free of ice so that thorough examination of the skin was possible. Directly under the spina scapulae approximately in the centre of a little depression there was a small skin defect. By means of a magnifying glass the upper edge going across could be seen as sharp and slightly jagged like a cut. The lower edge which is semi-circle in shape and showing downwards borders the little depression which has a dark slightly reddish brown bottom (Figure 5). After another 10 min the skin and the tissue under the skin had thawed sufficiently for a probe 1·5 mm in diameter to be introduced into the injury. This could be carried out to a depth of 2 cm without force where it was then blocked by hard tissue—either leftover ice or the shoulder blade. The probe was showing medial and slightly downwards. Attempts at forced induction and a blind search for the hole in the shoulder blade seen in the CT was abandoned. A further skin defect was observed at the top of the shoulder blade area. This was somewhat larger than that in the centre of the shoulder blade, showing white in colour and the skin was scaled. Detailed analysis of this point showed no detectable signs of either any significant injury, nor stab wound. This superficial injury was therefore ruled out as being the point of entry of the arrowhead.
Discussion The foreign body in the form of an arrowhead was well recognizable and as such diagnosable in the left shoulder region on the digital X-rays. Because an X-ray is a projection picture, the arrowhead’s actual size most probably exceeds the measurements taken from the X-ray. In fact, the computer tomography showed that
the arrowhead had an actual length of 27 mm and a width of 18 mm and also gave a measurement of its location. It is positioned in the soft tissue between the second rib and the shoulder blade according to the probable course of the large armpit vessels. It was also noted that the soft tissue surrounding the arrowhead was denser than that of the right shoulder. This finding may be attributed to a hematoma resulting from the shot injury, but radiologically an accompanying inflammation cannot be excluded. The question could be answered once and for all if the board in charge were to give the go-ahead to the execution of the biopsy or the removal of the arrowhead, both of which have already been proposed. Since such interventions not only interfere with the integrity of the mummy, but also threaten its preservation with each thawing process, non invasive methods, such as the evaluation of radiographies, will be among the methods of choice in future. The arrowhead points upwards from left to right from the back. This means the marksman must have shot from a low-lying position facing the back lefthand side of the man. Whether the defect in the left scapula was connected with the arrow injury remains unknown. But it is probable, due to the position of the hole and orientation in relation to the arrowhead. A sure proof could only be demonstrated by exploring the shot tunnel with a probe after thawing out the mummy. The second little hole close to the big one probably is caused by chipping. Due to its barbs it is improbable that the arrowhead changed its position markedly when the man tried to extract it. An exact CT study of the thorax with 3D reconstructions showed complete interior wall of the left thoracic cavity without any evidence of pleuric effusion so that any injury of the lung or pleura can be excluded. The discovery of the arrowhead in the mummy’s body in accordance with pathological investigations which found a fresh skin wound and tunnel in the left shoulder region confirm the popular opinion that a disaster occurred prior to the mummy’s death (Ambach et al., 1991, 1992; Ambach, 1993; Bahn & Everett, 1993; Bahn, 1995; Spindler, 1994, 1999; zur Nedden et al., 1994). It is now proven that the Iceman did not die a natural death, nor due to exhaustion or frostbite alone. A new hypothesis can be drawn, that he was shot on purpose with an arrow and because the injury was not fatal, he managed to escape. Both, the location of the corpse and the position of the mummy’s equipment would lead to the conclusion that the fleeing man sank down behind a round boulder in a condition of total exhaustion (Bahn & Everett, 1993). Whether the cold at such heights also contributed to his death is likely but remains a hypothesis. The injured part of the body was the left-hand side, and not the right-hand side as previously assumed. Therefore, discussion regarding the position and posture of the corpse may well not be over. It is plausible that the position of the mummy upon discovery corresponds with his dying
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position. Because the man suffered the injury at the back of his left shoulder, his stomach position and the unnatural position of his left arm in front of his face is understandable (Bahn & Everett, 1993). Due to this novel discovery the image of the ice man has been completely transformed. Although many questions and details have still to be clarified it is clear that the man died a violent death. The cause of the argument prior to the Iceman’s death will never be clarified. On the interval between injury and death further analyses, i.e. soft tissue biopsies of the left shoulder area, could give more detailed information. Also, would the special shape of the arrowhead found in the Iceman’s body, if compared with the different arrowheads found in the northern or southern region of the Alps, give some indication where the archer came from?
References Ambach, E., Tribitsch, W. & Henn, R. (1991). Fatal accidents on glaciers: forensic, criminological and glaciological conclusions. Journal of Forensic Sciences 36, 1469–1473. Ambach, W., Ambach, E., Tributsch, W., Henn, R. & Unterdorfer, H. (1992). Corpses released from glacier ice: glaciological and forensic aspects. Journal of Wilderness Medicine 3, 372–376.
Ambach, E. (1993). Paradoxical undressing in fatal hypothermia (Homo tirolensis). Lancet 341, 1285. Bahn, P. & Everett, K. (1993). Iceman in the cold light of day. Nature 362, 11–12. Bahn, P. G. (1995). ‘‘Last days of the iceman.’’ Review of The Man in the Ice, by K. Spindler. Archaeology 48, 66–70. Fleckinger, A. & Steiner, H. (1999). Faszination Jungsteinzeit—Der Mann aus dem Eis. Bolzano, Vienna, and South Tyrol Museum of Archaeology, Folio Verlag. Goedecker-Ciolek, R. (1993). Zur Herstellungstechnik von Kleidung und Ausru¨stungsgegensta¨nden. In Die Gletschermumie vom Ende der Steinzeit aus den O } ztaler Alpen. Mainz: Ro¨mischGermanisches Zentralmuseum, 108. Seidler, H., Bernhard, W. B., Teschler-Nicola, M., Platzer, W., zur Nedden, D., Henn, R., Oberhauser, A. & Siovold, T. (1992). Some anthropological aspects of the prehistoric Tyrolean Ice Man. Science 258, 455–457. Spindler, K. (1994). The Iceman’s last weeks. Nuclear Instruments and methods in Physics Research B 92, 274–281. Spindler, K. (1999). Der Mann im Eis: Neue sensationelle Erkenntnisse u¨ber die Mumie aus den O } tztaler Alpen. Munich: C. Bertelsmann. zur Nedden, D., Wicke, K., Knapp, R., Seidler, H., Wilfing, H., Weber, G., Spindler, K., Murphy, W. A. Jr & Platzer, W. (1994). New findings on the Tyrolean Ice Man: archaeological and CT-body analysis suggest personal disaster before death. Journal of Archaeological Science 21, 809–817.
INSIGHT: Report of Radiological-Forensic Findings on the Iceman P. Gostner and E. Egarter Vigl* Department of Radiology and *Department of Pathology, General Hospital, Bolzano, Italy (Received 27 September 2001, revised manuscript accepted 2 January 2002) Ten years after the discovery of the Iceman in the Alps on the Italian–Austrian border a foreign body in the form of an arrowhead was discovered in the left shoulder region of the mummy. X-rays of the thorax using a digital radiography system provided sufficient evidence to identify its shape and size. Computer tomography (CT) provided further information on the position of the arrowhead, direction of the shot and its impact on the surrounding soft tissue and bones. This additional evidence of a fresh entry wound would further prove the cause of death as resulting from the arrowhead shot. 2002 Elsevier Science Ltd. All rights reserved. Keywords: ICEMAN, ARROWHEAD, CAUSE OF DEATH.
Archaeological Museum of Bolzano. The following X-rays were made: an X-ray of the thorax in the anterior-posterior direction, as well as three different projections of the right and left half thorax (KV 46, mAs 25, 110 cm focus distance). A digital CR-system with phosphorus plates 3542 cm was used (BaSrFBR:Eu Supp.: P.E.T, 3543 cm format, 17922176 pixel resolution). Preservation work on the mummy had already been carried out four months previously at the Department of Pathology of the Hospital of Bolzano. A computer tomography (CT) was also routinely performed on the entire mummy at the Department of Radiology and data were stored. The CT-examination was performed on state of the art equipment which also enabled a 3D reconstruction of the thorax.
Introduction n September 1991 the mummified corpse of a man was discovered in the Alps, at a height of 3210 metres. His age was said to be over 5000 years old (Figure 1). Following a difficult recovery operation the mummy was brought to the Institute of Forensic Medicine at the University of Innsbruck (Austria) and then on to the Institute of Anatomy for further preservation some days later. The simulation of a glacial environment was chosen as the method of natural preservation. Examinations by various international highly-specialized research teams over the next few years have provided valuable scientific information. Because the mummy and his belongings were preserved in ice, the researchers were able to recreate a detailed picture of a human being and his surroundings during the neolithic period (Fleckinger & Steiner, 1999; Goedecker-Ciolek, 1993; Seidler et al., 1992; Spindler, 1999). One of the remaining mysteries was the cause of death. Recent X-ray examination of potential fresh fractures at the ribs carried out almost 10 years after the mummy’s discovery have contributed substantially to the clarification of the cause of death.
I
Results The bone thorax appeared moderately deformed. Fresh fractures which would have been incurred at the time of death or directly prior to death were not visible. A well-healed fracture on the seventh and eighth left rib and a bone defect on the fifth and sixth left rib caused by biopsy was found. Remarkable findings were however visible in the left shoulder area. By the upper restriction of the second rib a shadow of an arrowshaped structure was visible, with a longitudinal diameter of 21 mm and a width of 17 mm, which was clearly not a part of the skeleton. Analysis of the form and density of the foreign body led to the conclusion of its identification as a stone arrowhead dating from the neolithic period (Figure 2).
Materials and Methods On 27 June 2001 mobile X-ray apparatus was used to investigate the mummy under preservation in the Addresses for correspondence: Paul Gostner MD, Department of Radiology, General Hospital, L. Bo¨hlerstr. 5, I 39100 Bolzano, Italy. E-mail: [email protected] Eduard Egarter Vigl MD, Department of Pathology, General Hospital, L. Bo¨hlerstr. 5, I 39100 Bolzano, Italy. E-mail: [email protected]
323 0305–4403/02/$-see front matter
2002 Elsevier Science Ltd. All rights reserved.
324
P. Gostner and E. Egarter Vigl
Figure 3. CT-scan of thorax showing the foreign body in the soft tissue of the left shoulder.
Figure 1. Glacial mummy with an ‘‘unnatural’’ position of the left arm.
Figure 4. 3D reconstruction of the arrowhead in the left shoulder (black arrow), bone defect in the left shoulderblade (white arrow).
Figure 2. Left half thorax with arrowhead above the second rib.
Owing to these somewhat surprising X-ray results additional CT sectional images and 3D reconstructions were made of both shoulder regions. This illustrated the exact topographical location of the arrowhead and its relation to the surrounding anatomical structures. The arrowhead was also visible in the soft tissue of the left shoulder, in the area of the large shoulder vessels,
and approximately 16 mm from the pleura parietalis. The arrowhead density was relatively high (2200 HE), compared to the mummy’s compact bone structure (1400 HE). Furthermore, the soft tissue of the left shoulder was found to be denser than that on the opposite side (Figure 3). The 3D reconstruction of the thorax also showed a 2 cm, oval-shaped hole with even borders, located in the fossa infraspinata of the left scapula. Directly under it a second hole, only a few millimeters wide as seen (Figure 4). These bone changes could only be localized in retrospect on the axial CT sectional images. The right shoulder blade was normal. Following the results of the radiology the body surface of the Iceman was once again examined; the aim being to find a skin injury, which could in shape and size be the arrow’s point of entry. In order to do so the mummy was transferred from the preservation cell to the laboratory cell and warmed up to +8C; under artificial Neon-Truelight illumination it was examined with the naked eye and with a 10 magnifying glass. Attention was drawn mainly to the front and back of the left shoulder and to the
Report of Radiological-Forensic Findings on the Iceman 325
Figure 5. Location of the entry wound, dorsal side of the left shoulder.
armpit, where according to the arrowheads position on the X-ray images an injury, if any, might be found. After approximately 20 min the mummy’s surface was free of ice so that thorough examination of the skin was possible. Directly under the spina scapulae approximately in the centre of a little depression there was a small skin defect. By means of a magnifying glass the upper edge going across could be seen as sharp and slightly jagged like a cut. The lower edge which is semi-circle in shape and showing downwards borders the little depression which has a dark slightly reddish brown bottom (Figure 5). After another 10 min the skin and the tissue under the skin had thawed sufficiently for a probe 1·5 mm in diameter to be introduced into the injury. This could be carried out to a depth of 2 cm without force where it was then blocked by hard tissue—either leftover ice or the shoulder blade. The probe was showing medial and slightly downwards. Attempts at forced induction and a blind search for the hole in the shoulder blade seen in the CT was abandoned. A further skin defect was observed at the top of the shoulder blade area. This was somewhat larger than that in the centre of the shoulder blade, showing white in colour and the skin was scaled. Detailed analysis of this point showed no detectable signs of either any significant injury, nor stab wound. This superficial injury was therefore ruled out as being the point of entry of the arrowhead.
Discussion The foreign body in the form of an arrowhead was well recognizable and as such diagnosable in the left shoulder region on the digital X-rays. Because an X-ray is a projection picture, the arrowhead’s actual size most probably exceeds the measurements taken from the X-ray. In fact, the computer tomography showed that
the arrowhead had an actual length of 27 mm and a width of 18 mm and also gave a measurement of its location. It is positioned in the soft tissue between the second rib and the shoulder blade according to the probable course of the large armpit vessels. It was also noted that the soft tissue surrounding the arrowhead was denser than that of the right shoulder. This finding may be attributed to a hematoma resulting from the shot injury, but radiologically an accompanying inflammation cannot be excluded. The question could be answered once and for all if the board in charge were to give the go-ahead to the execution of the biopsy or the removal of the arrowhead, both of which have already been proposed. Since such interventions not only interfere with the integrity of the mummy, but also threaten its preservation with each thawing process, non invasive methods, such as the evaluation of radiographies, will be among the methods of choice in future. The arrowhead points upwards from left to right from the back. This means the marksman must have shot from a low-lying position facing the back lefthand side of the man. Whether the defect in the left scapula was connected with the arrow injury remains unknown. But it is probable, due to the position of the hole and orientation in relation to the arrowhead. A sure proof could only be demonstrated by exploring the shot tunnel with a probe after thawing out the mummy. The second little hole close to the big one probably is caused by chipping. Due to its barbs it is improbable that the arrowhead changed its position markedly when the man tried to extract it. An exact CT study of the thorax with 3D reconstructions showed complete interior wall of the left thoracic cavity without any evidence of pleuric effusion so that any injury of the lung or pleura can be excluded. The discovery of the arrowhead in the mummy’s body in accordance with pathological investigations which found a fresh skin wound and tunnel in the left shoulder region confirm the popular opinion that a disaster occurred prior to the mummy’s death (Ambach et al., 1991, 1992; Ambach, 1993; Bahn & Everett, 1993; Bahn, 1995; Spindler, 1994, 1999; zur Nedden et al., 1994). It is now proven that the Iceman did not die a natural death, nor due to exhaustion or frostbite alone. A new hypothesis can be drawn, that he was shot on purpose with an arrow and because the injury was not fatal, he managed to escape. Both, the location of the corpse and the position of the mummy’s equipment would lead to the conclusion that the fleeing man sank down behind a round boulder in a condition of total exhaustion (Bahn & Everett, 1993). Whether the cold at such heights also contributed to his death is likely but remains a hypothesis. The injured part of the body was the left-hand side, and not the right-hand side as previously assumed. Therefore, discussion regarding the position and posture of the corpse may well not be over. It is plausible that the position of the mummy upon discovery corresponds with his dying
326
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position. Because the man suffered the injury at the back of his left shoulder, his stomach position and the unnatural position of his left arm in front of his face is understandable (Bahn & Everett, 1993). Due to this novel discovery the image of the ice man has been completely transformed. Although many questions and details have still to be clarified it is clear that the man died a violent death. The cause of the argument prior to the Iceman’s death will never be clarified. On the interval between injury and death further analyses, i.e. soft tissue biopsies of the left shoulder area, could give more detailed information. Also, would the special shape of the arrowhead found in the Iceman’s body, if compared with the different arrowheads found in the northern or southern region of the Alps, give some indication where the archer came from?
References Ambach, E., Tribitsch, W. & Henn, R. (1991). Fatal accidents on glaciers: forensic, criminological and glaciological conclusions. Journal of Forensic Sciences 36, 1469–1473. Ambach, W., Ambach, E., Tributsch, W., Henn, R. & Unterdorfer, H. (1992). Corpses released from glacier ice: glaciological and forensic aspects. Journal of Wilderness Medicine 3, 372–376.
Ambach, E. (1993). Paradoxical undressing in fatal hypothermia (Homo tirolensis). Lancet 341, 1285. Bahn, P. & Everett, K. (1993). Iceman in the cold light of day. Nature 362, 11–12. Bahn, P. G. (1995). ‘‘Last days of the iceman.’’ Review of The Man in the Ice, by K. Spindler. Archaeology 48, 66–70. Fleckinger, A. & Steiner, H. (1999). Faszination Jungsteinzeit—Der Mann aus dem Eis. Bolzano, Vienna, and South Tyrol Museum of Archaeology, Folio Verlag. Goedecker-Ciolek, R. (1993). Zur Herstellungstechnik von Kleidung und Ausru¨stungsgegensta¨nden. In Die Gletschermumie vom Ende der Steinzeit aus den O } ztaler Alpen. Mainz: Ro¨mischGermanisches Zentralmuseum, 108. Seidler, H., Bernhard, W. B., Teschler-Nicola, M., Platzer, W., zur Nedden, D., Henn, R., Oberhauser, A. & Siovold, T. (1992). Some anthropological aspects of the prehistoric Tyrolean Ice Man. Science 258, 455–457. Spindler, K. (1994). The Iceman’s last weeks. Nuclear Instruments and methods in Physics Research B 92, 274–281. Spindler, K. (1999). Der Mann im Eis: Neue sensationelle Erkenntnisse u¨ber die Mumie aus den O } tztaler Alpen. Munich: C. Bertelsmann. zur Nedden, D., Wicke, K., Knapp, R., Seidler, H., Wilfing, H., Weber, G., Spindler, K., Murphy, W. A. Jr & Platzer, W. (1994). New findings on the Tyrolean Ice Man: archaeological and CT-body analysis suggest personal disaster before death. Journal of Archaeological Science 21, 809–817.