Unveiling ancient chronic calcific arterial disease: radiological and histological insights from two Sicilian natural mummies of the 18th-19th centuries

The issue of atherosclerosis in antiquity has sparked significant debate, as it remains one of the most prevalent diseases in Western populations nowadays. This paper investigates two mummies preserved in the Santa Maria della Grazia church of Comiso (Sicily) with evidence of atherosclerosis. The chapel contains 50 male mummies dressed in Capuchin attire dated to the 18th-19th centuries. The mummification process occurred naturally, aided by microclimatic conditions and procedures that facilitated the draining of the fluids. We studied two mummies, a friar who died in 1742 at the approximate age of fifty, and a farmer, aged around thirty, who probably died in the early 19th century. Autopsy revealed severe calcification of the distal portion of the abdominal aorta, iliac and femoral arteries. Samples were obtained through preexisting fissures in the bodies and underwent radiological, histological, and immunohistochemical examination. The analyses confirmed a severe atherosclerosis with calcified plaques. These cases are of considerable relevance for the exceptional macroscopic and histological preservation of the vessels, which is rare in paleopathology; furthermore, the presence of atherosclerosis in non-elderly adults in this historical period, when the patterns of the diet and lifestyle were different from today, contributes to demonstrating that this disease is not only related to modernity. The mummies are no longer accessible, so it is impossible to obtain additional samples. Future paleonutritional and molecular investigations on the samples already collected could elucidate whether in these two individuals the pathology was solely related to dietary habits or was influenced by genetic predisposition.