July 23, 2011

Famed Farinelli's Flawed Frontalis

In 2006, archaeologists exhumed the remains of the legendary 18th century castrato, Carlo Maria Broschi, better known as Farinelli.  As a boy, Farinelli showed talent as an opera singer and, when their father died young, his elder brother Riccardo made the decision to have Farinelli castrated, an illegal operation at the time, in order to preserve his voice.  Farinelli became quite famous by the 1720s and sang daily until his death at the age of 78.  An analysis of the bones has just been published in the Journal of Anatomy by Belcastro, Fornaciari, and Mariotti, with the most salient finding being that Farinelli's castration led to hormonal changes that likely caused him to develop internal frontal hyperostosis (or hyperostosis frontalis interna, depending on what side of the Atlantic you're from), a thickening of the frontal bone in the cranial vault that is found almost exclusively in postmenopausal women.

Farinelli's bones, circled
(credit: Belcastro et al., Fig. 1)
Crush fraction of an L vert
(credit: Belcastro et al., Fig. 5)
Farinelli's bones were eventually moved to the grave of his great-niece, Maria Carlotta Pisani, and placed at her feet (see photo).  The bones were unfortunately not at all well-preserved.  Belcastro and colleagues could only estimate sex based on the narrow sciatic notch and the absence of a preauricular sulcus. In terms of age, they found evidence of fused cranial sutures, porosity of the auricular surface, trabecular thinning, degenerative changes in the vertebrae, and a compression fracture of one of the lumbar vertebrae, all pointing to an advanced age for this individual.  Interestingly, they noticed incomplete obliteration of the epiphyseal lines on the medial border of the left scapula and the left iliac crest.  While epiphyseal lines can persist into adulthood, they almost never persist past about 35 years old.  Based on the length of the right ulna, they estimate his stature at 6'3".  Of the 14 teeth that could be properly examined, there was evidence of caries in two, leading them to conclude he had good oral hygiene.

Thickening of Farinelli's frontal bone
(credit: Belcastro et al., Fig. 8)
When Belcastro and colleagues reconstructed some of the cranial fragments, they discovered extreme thickening of the vault (see photo), up to 21mm at the thickest.  As the area around the sagittal sulcus was unaffected, the authors conclude that the thickening is internal frontal hyperostosis rather than Paget's, acromegaly, fibrous dysplasia, or meningioma.  The etiology of IFH is not actually very clear, but the fact that it's found almost exclusively in post-menopausal women and men with hormonal disturbances (e.g., Klinefelter's syndrome) points to a problem with the body's hormonal balance.  Belcastro and colleagues succinctly review the clinical literature on IFH in men and conclude that Farinelli's IFH is most likely related to his castration.  Interestingly, castration can also explain his height (due to delayed epiphyseal fusion) and the finding of unfused epiphyses in his skeleton.

It's no secret that I am not a fan of digging up famous dead Italians, but in this case, Belcastro and colleagues have published the only osteological analysis of a castrato or eunuch.  Granted, the identification of this skeleton with Farinelli is not 100% clear because of the condition of the remains, but it's reasonable to assume that they did indeed find the man.

Portrait of Farinelli
(credit: Wikimedia commons)
The question remains, though, what effect IFH would have had on Farinelli's life, or on the lives of the numerous women who are also affected by this condition?  The clinical literature suggests that IFH is basically asymptomatic - because the disease has such a slow progression, over the span of decades, even the most severe cases of cranial thickening are assumed to pose no problem for the individual, whose brain can compensate little by little to the change in skull shape.  A short New Scientist piece, though, quotes Israel Hershkovitz as claiming that IFH is linked to "behavioral disorders, headaches, and neurological diseases like Alzheimer's."  Because of this quote, New Scientist ran with the headline "Lack of testes gave castrato superstar headaches."  Belcastro and colleagues, of course, didn't say anything about headaches, but apparently New Scientist thinks that discovering osteological evidence of a hormonal imbalance in the skeleton of a castrato isn't interesting enough for their readers.

I'll have to look into the claim that IFH does produce symptoms like headaches, though, as I'm quite interested in the pathology.  IFH is often not noticed in a bioarchaeological population unless the skulls are broken in just the right places.  Bioarchaeologists don't tend to have enough money to xray or CT hundreds of individuals as we collect data, so I suspect that we miss quite a few ancient cases of this condition.  I looked at a couple hundred skeletons from Imperial Rome and found one case of IFH (below), and I looked at a couple dozen skeletons from Gabii and found another case.

IFH in an Imperial Roman woman in her early 40s
(credit: Killgrove 2010)
A project that I would like to undertake in the future deals with understanding the lives of post-menopausal women in Rome.  These women were often seen as second-class citizens, even more so than women in general, because they were past their reproductive prime.  Looking at the prevalence of IFH within Imperial Roman cemeteries will help me understand post-menopausal women better, but it would be quite interesting for another reason: if Belcastro and colleagues are right that castration in men can lead to IFH, then it might be possible to find skeletons of eunuchs from Rome.  Anyway, I'll have to find a serious amount of funding first so that I can scan all the skulls.

Since I'm gearing up to teach a palaeopathology class in the fall, I'm thinking of making internal frontal hyperostosis a topic of an assignment, to see what the students can find out about the pathology.  I'm particularly interested in whether anyone's looked at a large population for frequency of IFH, or if the reported cases from archaeological sites are just individuals whose skulls happened to be broken in just the right way.

UPDATE (7/25/11) - Past Horizons is carrying this essay, which I modified slightly for them, so do click through.

UPDATE (9/1/11) - Rossella Lorenzi wrote up this story for Discovery News.  A French news site also has a summary of the piece.


MG Belcastro, G Fornaciari, & V Mariotti (2011). Hyperostosis frontalis interna (HFI) and castration: the case of the famous singer Farinelli (1705-1782). Journal of Anatomy PMID: 21740437.

K Killgrove (2010).  Migration and mobility in Imperial Rome.  PhD Dissertation, University of North Carolina at Chapel Hill.


Fins said...

Is it plausible to give them the benefit of the doubt and assume they chose Farinelli not because he was famous but because he offered the chance to study the skeleton of a known castrato? Or am I too optimistic?

Jan Helldén said...

Thanks for another great post. One of the beauties about bioarchaeology is that it gives us the oppurtunity to study the lives of the ordinary people so rarely mentioned in the written sources. Like you I think that the whole idea of digging up the remains of famous persons like Mona Lisa, Cervantes et al. just to find out how they really looked like is rather uninteresting. In this case though Fins could have a point: Normally we wouldn't know that the skeleton is that of a castrato, but in the case of Farinelli we know that for sure. Wether this is the motive driving the present study is - I think - rather doubtful.

The idea of studying the lives of post-menopausal women in Rome sounds quite interesting. How large a matirial will there be to work on, i.e. what was the avarage age for women in classical Rome? How many did survive to experience a post-menopausal life? One thing I would be curious to know is, whether osteoporosis was as common then as it is today?

Kristina Killgrove said...

I also suspect that someone just wanted to dig up Farinelli. If I were in the same situation - if some archaeologists had dug up a famous person - I'd certainly do my job and find out all I could from the skeleton. It's nice to see that the osteologists found something interesting in this case, but I don't think that should be a reason to dig up every famous dead person.

There is a lot of material for studying older women in Rome. Average life expectancy was only in the 30s, but for anyone who survived the critical period of infancy, life expectancy was into the 50s and 60s. I've found numerous skeletons who can be confidently dated to that age range, and several that were likely older at death. It's difficult, though, to tell age-at-death with a high degree of certainty after about 50 or 60 years of age. Still, I suspect that Roman women were going through menopause in their 40s, so there should be plenty of post-menopausal women in skeletal collections in Rome.

I would like to follow up on the osteoporosis angle (as well as HFI frequencies). It's been done at Isola Sacra by Helen Cho (PhD diss, 2002), so I would look at women from Rome itself, or find another way of approaching the Isola Sacra material (or both).

But I don't know whether osteoporosis would be more or less common then - the Romans didn't know as much as we do about age-related bone loss and how to prevent it. Many of them were also active well into old age, whereas we Americans are not, and they may not have suffered from as much osteoporosis. I think it's a project worth doing, and I have a colleague who wants to look at burials and inscriptions to see status from those lines of evidence. Stay tuned! Hopefully some day soon I'll announce a new research project here! :)

thesebonesofmine said...

I have fibrous dysplasia, so to me its its rather interesting you mention it as a (probably not likely) possible cause to the IFH in this individual. I've never heard of this before, so thank you for the information! Having just read Waldron's Palaeopathology (2009), he doesn't mention IFH as a possible indicator of fibrous dsyplasia in archaeological material (if only we could x ray all bones!). Do you know where I can read the Journal of Anatomy article online? Interesting article & well articulated, thanks!

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