Over the past few years, bioarchaeological research in combination with genetic as well as contextual evidence has been challenging the misconception that cardiovascular diseases (CVDs) are a problem of modern life and living conditions (Thompson et al., 2013; Binder & Roberts, 2014; and chapters in this volume). However, the evidence for CVDs in the past has so far been largely confined to mummified human remains. The preservation of their soft tissues maintains the pathological evidence linked to CVD, including calcifications, in its original location within the blood vessels in which they developed.

Atherosclerosis, a disease with a multifactorial aetiology, is characterised by the accumulation and hardening of fatty materials in the arterial blood vessels that may cause obstruction (stenosis) of the lumen. Today, it is one of the most common diseases of the developed countries, and every year thousands of people die of the complications associated with atherosclerosis (Herrington et al., 2016). Indeed, the severe consequences include myocardial infarction (heart attack), stroke (cerebrovascular accident or CVA) and chronic kidney failure (Yusuf & McKee, 2014).

The Pathologic–Anatomical Collection in Vienna, Austria, now housed in the Narrenturm (‘Lunatic Tower’, a mental health asylum built in the eighteenth century), offers a valuable reference collection for identifying calcified human tissue from archaeological contexts. This can be achieved through comparison of potential calcifications with documented pathological body parts that were collected from hospital patients for a teaching collection, mainly from the end of the eighteenth century until the mid-twentieth century.

In past human populations, atherosclerosis has been identified in mummies from different regions of the world, and from a range of chronological periods (for extensive reviews see Chapters 3 and 4). This current study from Sweden aims to contribute to the limited evidence for atherosclerosis associated with human skeletal remains by presenting examples of atherosclerosis in another part of the body. We describe two well-preserved cemeteries in Åhus and Skänninge (1237―1536 CE) in present-day Sweden where several individuals with atherosclerosis of the internal carotid artery were discovered.

Chapter 3 focusses on the temple of Hera at Foce del Sele north of the Greek colony of Poseidonia-Paestum in southern Italy. New archaeometric analysis on the metopes from the Hera sanctuary near the mouth of the river Sele has made it possible to propose a new reconstruction of the oldest Hera temple on the site, which belongs to the first generation of Doric stone temples. The study of the architectural elements confirms the decorative nature of the first Doric friezes. Moreover, by analyzing the mythological subjects on the frieze and comparing them with other early Doric temples in Selinous, Delphi, and Athens, it can be shown that the tendency to choose Panhellenic themes over local traditions is a general feature of early Doric temples. Because of the detachment of the imagery from local traditions, the Doric temple is described as a “non-place” according to the definition of the French anthropologist Marc Augé. Conceiving temples as standardized “non-places” that could be set up in any given local environment was crucial to the agendas of Greek elites, who needed to reorganize agricultural and urban landscapes to regulate population pressure and social tensions – both in the colonies and in homeland Greece.

The concluding chapter contextualizes the study of ancient Doric architecture against the backdrop of European colonialism and modern globalization. The evolutionary explanation of the Doric temple can be seen as part of a broader tendency in the West of naturalizing and normalizing Greek/Western culture as world culture by tracing it back to universal principles. The critique of the evolutionary narrative makes it possible to appreciate the disruptive and innovative character of the Doric order as part of a historical shift in the wielding of religious and political power and in the relation between Greek communities and the landscapes they inhabited. Population growth, social change, and political innovation led to urbanization, colonization, and land reclamation on an unprecedented scale. These processes challenged the traditional religious system, which was based on an intrinsic relation between the divinities and the natural features of the landscape. The Doric temple can be seen as a response to this situation: by redefining the sacred space, “inhabited” by the gods, it also redefined what was outside the sacred precinct, the “profane” land that was subject to new forms of exploitation, land distribution, and colonization.

The Papyrus Ebers, written in ancient Egypt in c. 1550 BCE, provides the earliest known historic medical description of cardiovascular diseases (CVDs), likely attesting to the widespread occurrence of these conditions (Nunn, 1996: 85–7). However, evidence to prove that they were indeed a frequent health problem in antiquity remains scarce and confined to mummified remains despite the multitude of human remains discovered and analysed since the beginning of archaeological exploration of the Nile Valley (Davies & Walker, 1993; Binder 2019).

In the past, architectural change in Archaic Greece was often explained as a somehow natural, coherent evolution from “primitive” wooden structures to sophisticated stone temples. Following the ancient writer Vitruvius, modern authors have attempted to demonstrate that the architectural orders, in particular the Doric, can be traced back to functional necessities typical of wooden buildings. While this explanation of the Doric order has long been questioned, few attempts have been made to explore alternative explanations. The chapter lays out a methodology to analyze architectural change by asking how the experience of sacred spaces and landscapes changed and who were the social groups interested in promoting such change. The chapter highlights the kinetic and multisensorial dimension of the experience of space and architecture, as stressed also by authors from other fields. Further, a survey of recent contributions to the study of the Doric and Ionic orders suggests that they emerged suddenly in the early sixth century BC, rather than evolving slowly over centuries. The emergence of the Doric order went hand in hand with the emergence of architectural sculpture on pediments and friezes. By looking at a series of case studies the book aims to shed light on the relation between the various transformation processes.

This chapter aims to outline current knowledge concerning the genetic background of cardiovascular disease (CVD) and its study in ancient human remains. This is demonstrated by the application of a palaeogenetic analysis to the mummy of the Tyrolean Iceman, who presented with both arterial calcifications and a strong genetic predisposition for heart disease. Further discussion highlights how the study of ancient humans can provide new insights into the genetic background of CVD and its intersection with risk factors related to lifestyle.

The first two involve blockage of blood vessels to the heart and brain, usually due to fat build-up, leading to heart attacks and strokes, respectively, but blood clots (emboli) and bleeding from a blood vessel can also cause a stroke. Fat globules may also be released into the bloodstream following severe injuries to bones. They are caused by disruption of fat cells in fractured bones (especially the femur and pelvis), and can also cause blockage of the vessels (Rothberg & Makarewich, 2019). CVDs further include rheumatic heart disease, where the heart muscle and valves are damaged by streptococcal bacteria in rheumatic fever; heart malformation at birth (congenital heart disease; and deep vein thrombosis, which leads to blood clots usually being released from the leg veins into the bloodstream causing blockage of a pulmonary artery, known as an embolism (World Health Organization, 2019).

Following the century-old landmark work by bacteriologist and experimental pathologist Sir Marc Armand Ruffer, who demonstrated the presence of atherosclerosis during autopsies of multiple Egyptian mummies (Ruffer, 1911), an international multidisciplinary group of physicians and scientists (the Horus Team, named for the Egyptian deity; Finch, 2011.) formed to evaluate the existence, extent and aetiology of atherosclerosis in ancient peoples. The Horus Team first described atherosclerotic calcifications on computed tomography (CT) scans in 2009 (Allam et al., 2009).

In February 2010, I was crouching down in a subterranean tomb chamber at the archaeological site of Amara West in modern Sudan, excavating the human skeletal remains of people that had lived some 3000 years ago. Suddenly, I came across fragile tubular objects made of a whitish substance arranged almost like a string of beads parallel to the femur of a middle-aged woman (Figure 1.1). The unassuming little tubes were carefully collected, wrapped in scraps of acid-free tissue paper, packed in cardboard boxes used for Sudanese matches and labelled ‘calcified arteries?’. Together with the excavated skeletal remains, they were later – courtesy of the National Corporation for Antiquities and Museums of Sudan – shipped to the British Museum in London for further scientific analysis within the framework of my PhD research at Durham University under the supervision of Charlotte A. Roberts, the co-editor with myself of this book.