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Oldest case of Down’s syndrome from medieval France

• by Colin Barras

The oldest confirmed case of Down’s syndrome has been found: the skeleton of a child who died 1500 years ago in early medieval France. According to the archaeologists, the way the child was buried hints that Down’s syndrome was not necessarily stigmatised in the Middle Ages.

Down’s syndrome is a genetic disorder that delays a person’s growth and causes intellectual disability. People with Down’s syndrome have three copies of chromosome 21, rather than the usual two. It was described in the 19th century, but has probably existed throughout human history. However there are few cases of Down’s syndrome in the archaeological record.

The new example comes from a 5th- and 6th-century necropolis near a church in Chalon-sur-Saône in eastern France. Excavations there have uncovered the remains of 94 people, including the skeleton of a young child with a short and broad skull, a flattened skull base and thin cranial bones. These features are common in people with Down’s syndrome, says Maïté Rivollat at the University of Bordeaux in France, who has studied the skeleton with her colleagues.

"I think the paper makes a convincing case for a diagnosis of Down’s syndrome," says John Starbuck at Indiana University in Indianapolis. He has just analysed a 1500-year-old figurine from the Mexican Tolteca culture that he says depicts someone with Down’s syndrome.

Treated well?

Rivollat’s team has studied the way the child with Down’s syndrome was buried, which hasn’t been possible with other ancient cases of the condition. The child was placed on its back in the tomb, in an east-west orientation with the head at the westward end – in common with all of the dead at the necropolis.

According to Rivollat, this suggests the child was treated no differently in death from other members of the community. That in turn hints that they were not stigmatised while alive.

A similar argument was put forward in a 2011 study that described the 1500-year-old burial in Israel of a man with dwarfism (International Journal of Osteoarchaeology, DOI: 10.1002/oa.1285). The body was buried in a similar manner to others at the site, and archaeologists took that as indicating that the man was treated as a normal member of society.

Starbuck is not convinced by this argument. “It can be very difficult to extrapolate cultural values and behaviour from burials or skeletal remains,” he says.

Journal reference: International Journal of Paleopathology, DOI: 10.1016/j.ijpp.2014.05.004