Chronic Disease and Disability in an 18th-Century Portuguese Nun: An Integrative Multisource Approach

This study presents an integrative approach to chronic disease and disability in a Portuguese nun who died in 1779. The aim is to interpret her condition by combining osteopathological and burial context evidence with written sources. It offers a concise example of how bringing these sources together can enhance pathological interpretation and support the reconstruction of soft tissue disease, disability, and the lived experience of disease in past populations. This older woman was exhumed from the Convent of Jesus in Setúbal, Portugal. Her atypical burial position, also noted in the convent chronicles, indicates the remains likely belong to Michaela Archangela do Ceo. Osteopathological analysis revealed several changes, including atheromas, while the burial showed a crouched position, presumably related to stroke sequelae. The chronicles describe lifelong frailty and disease, followed in later life by a stroke with right-sided hemiplegia, pressure ulcers, and myiasis. Apart from the atheromas, which may be associated with the stroke, the skeletal changes show no correspondence with the signs reported in the account. The chronicles further document the attentive care she received, reflecting communal support within the convent, and the religious meaning of suffering. In conclusion, this case demonstrates the value of integrating multiple sources to interpret pathological conditions and the lived experience of disease, while emphasizing the relevance of soft tissue disease that leaves no skeletal trace. It also illustrates the careful application of retrospective diagnosis as an interpretive tool for historical documentation. Altogether, it highlights key methodological considerations for interpreting disease in osteoarchaeological contexts.