300-Year-Old Medical Prosthesis Helped 18th-Century Man From Poland Live With Cleft Palate

The use of prostheses for cosmetics, biological function, and psycho-spiritual sense has been evident since ancient times. The earliest proof of prosthetics comes from a 3,000-year-old mummy discovered in Egypt.

Centuries-Old Medical Prosthesis

Just recently, researchers discovered a prosthetic device in a crypt in the St. Francis of Assisi church in Krakow, Poland, during an archaeological excavation from 2017 to 2018. It lies between the jaws of a man with a cleft palate, as confirmed by the physical examination and a computed tomography scan of his remains.

Without access to modern surgery, the 18th-century man found another way to deal with his medical condition. He wore a prosthetic of wool and precious metals that fit into his nasal cavity.

Known as a palatal obturator, the exceptional device measures 1.2 inches long and weighs around 0.2 ounces (5.5 grams). According to anthropologist Anna Spinek from the Hirzfeld Institute of Immunology and Experimental Therapy in Poland, this could be the first such discovery in Poland and Europe. No such medical devices exist in institutional and private collections in Poland and other countries.

When experts removed the prosthesis from the remains, they noticed that a fiber pad bore specks, which were unintentionally removed during the conservation process. To determine the composition of the medical device, the researchers analyzed it under a scanning electron microscope and with energy-dispersive X-ray spectroscopy. They found the device comprised a woolen pad sewn to a metallic plate. According to archaeologists, it is likely that the wool pad was covered with a thin sheet of copper and gold to block secretions that can leak into the fabric, thus preventing infections.

It isn't easy to examine how well the obturator fitted or how tight a seal it offered. However, modern-day patients who struggle with similar health conditions describe the use of a prosthesis as improving speech and increasing comfort when eating.

Dealing With Orofacial Clefts

Our mouth has a bony part called the hard palate, which separates the oral and nasal cavities. The hard palate's primary function is to prevent substances in the mouth from entering the nasal cavity. It also helps a person swallow, breathe, and talk.

Orofacial cleft happens when the hard palate, or the roof of the mouth, does not close entirely during gestation. This condition, which includes cleft palate and cleft lip, has been known historically and has a global prevalence of 1 in 1,000 to 1,500 births in modern times.

Greek orator Demosthenes is reported to have had a cleft palate and is believed to have used pebbles to fill the gap. Meanwhile, several works in the 16th century suggest using combinations of wool, cotton, sponges, gold, silver, and wax to fix the orofacial cleft. These rare devices were custom-made by dentists and were crafted from precious metals. Because of this, only those from the wealthiest social classes can afford the prosthesis. Individuals born with cleft palate can get surgery to correct their condition.