]>EXG5145S0531-5565(98)00048-510.1016/S0531-5565(98)00048-5Elsevier Science Inc.Fig. 1(A) Discovery site of the Ice Man from the Hauslabjoch in the Ötztaler Alps, September 19, 1991. (B) Preservation unit containing the Ice Man. (C) Face of the Ice Man. Note the high degree of dental abrasion and the diastema between the upper central incisors. (D) Three-dimensional polyacrylic model of the osseous skull (stereolithographic reconstruction). (E) Set of tattoos (vertical lines) in the lumbar region. (F) CT-plane of the thorax showing the lungs and heart for computer assisted endoscopic navigation, investigation, and sample withdrawal. (G) Endoscopic inspection of the lower middle mediastinum. The heart (covered by pericardium) and left lung can be seen. The coronary vessels are also visible. (H) Endoscopic view of the surface of the left lung covered by the pleura. Anthracotic (coal-like) pigment is clearly visible in the lung tissue. (I) Osteon method for determining the age at death of the Ice Man.Original Articles“‘Man from the HauslabjochOthmarGabera*othmar.gaber@uibk.ac.atKunzelKarl-HeinzKünzelaaInstitute für Anatomie, Universitas Leopoldino-Franciscea Oenipontana, Müllerstasse 59, A-6010 Innsbruck, Austria*Correspondence to: O. Gaber; Fax +43-512-507-3061Abstract—On September 19, 1991, at an altitude of 3,200 m (10,498 feet), the remains of a well-preserved, freeze-dried mummified body of a 3,000 bc, Late Stone Age man, was found on the Austrian–Italian border. Studies conducted at the University of Innsbruck have revealed that these are the remains of a 45–46-year-old male, 45 kg (99 lbs) (living weight) and 160 cm (5 feet, 2 inches) tall. Morphometric, pathophysiologic, paleobotanical, photogrammetric, anthropological, computer tomographic, and other studies have been conducted to determine the living conditions and possible causes of death of this Late Stone Age man.KeywordsHauslabjochTyrolmorphometrypathophysiologypaleobotanyphotogrammetryanthropologycomputer tomographyIntroductionOn September 19, 1991, a body emerging from the surrounding ice was observed by two German mountain hikers at an altitude of 3,200 m (10,498 feet), within a glacier area at the border between Austria (Tyrol) and Italy (South Tyrol) (Fig. 1A).  After reporting the find, it was quickly realized that these remains were not of some unfortunate contemporary climber, but that of an individual of far greater antiquity. Within a week of the discovery, the news was known worldwide.InvestigationThe find consisted of a fairly well-preserved, freeze-dried, mummified body of a man who also carried with him a number of implements. Dating (14C) of both soft tissues and bone revealed that the individual was approximately 5,300 years old, i.e., from 3,000 bc or the Late Stone Age.To preserve the remains and allow for thorough preservation and investigation, the corpse was transferred to the Institute for Forensic Medicine, Institute for Anatomy at the University of Innsbruck in Austria.Since his discovery, the “Ice Man” has been stored within a specially constructed cooling and conservation system (maintained at −6°C, with a relative humidity of 98%). These parameters are constantly monitored by electronic sensing and warning devices. Anatomical scientists have been in charge of the “Ice Man” since he was placed in this glacier-like environment (Fig. 1B) (Gaber et al., 1990).Sixty-four scientific teams in the fields of archaeology and natural sciences (e.g., botanists, glacerologists, geologists, metallurgists, and physicians) have compiled data to determine the conditions under which the “Ice Man” lived and eventually died.A few facts regarding this Late Stone Age Man: Names: Ice Man; Man from the Hauslabjoch; Man from the Tisenjoch; Similaun Man; Homo tirolensis; Frozen Fritz, or “Ötzi.”Sex: Male.Body height: 160 cm (5 feet, 2 inches).Body weight: 13.3 kg (29.3 lbs) [living weight: 45 kg (99 lbs)].Age: 45–46 years.Historical age: 5,300 years (determined by modern dating [14C] techniques).Genetic ancestry: European (DNA determined from bone and muscle fragments).Special features: high degree of dental abrasion, lack of wisdom teeth, diastema between upper central incisors (Fig. 1C), lack of the 12 set of ribs, rib fracture on left side (healed), rib fracture on the right (recent injury), deep lesion in the left hip, gluteal–femoral region, and tattoos (stripes and crosses) at strategic locations on the body.Nationality: unfortunately, no passport was found with the Man from the Hauslabjoch, but if he was alive today he would be considered Italian. Based upon resurvey of the border between Austria and Italy (Bolzano Province), the site of the discovery was determined to lie 92.56 m (303.7 feet) within Italy. By contractural agreement, all initial investigations were conducted in Innsbruck.Items that the ice man carriedAround the Ice Man were found many objects that were transferred to the Römisch-Germanisches Zentralmuseum in Mainz for preservation and restoration. The items consisted of: 14 arrows—partly feathered and equipped with flint heads; a leather pouch containing objects of flint, sinew, bone, and pitch that appear as some sort of “repair kit;” a flint stone dagger made up of an oakwood handle covered by a braided material; an ax with a blade of nearly pure copper; pierced stone beads to which were attached a number of leather straps; a birch-bark container; two lumps of tree fungi with a leather strap; a backpack frame made of hazelwood; and clothing—footwear leggings, leather loin cloth, bear skin cap, and grass wrapping material.FindingsAnthropological and paleobotanical findingsUpon further investigation, the conditions under which the Ice Man lived were reconstructed. Although his origin and destination are forever lost in history, we have learned a great deal about his living conditions.The anthropological data and the parallel skeletal finds from other Neolithic graves led us to assign the Ice Man to the so-called “Remedello group,” which had settled at the southern part of the Lake Garda region in Northern Italy. Moreover, the paleobotanical investigations, based upon different types of grasses, and remains of grain and pollen all support the theory that the Ice Man’s origin was south of the Alps. Additional support of this theory is that the flints that he carried could have been found or mined from the Trentino region of Italy.Computer-tomographic numerical dataThese data have allowed us to reconstruct the skull three dimensionally, and a plastic model was produced using stereolithography. Once completed, further anthropological measurements and other anatomical investigations could be conducted without transferring the Ice Man from the cooling unit (Fig. 1D) (Künzel et al., 1992; Zur Nedden and Wicke, 1992).PhotogrammetryThis geographical screening method has been used to achieve a reconstruction of the Ice Man’s body surface. Within days of the discovery, some dark-gray alterations of the skin were observed (Fig. 1E) (Sjovold et al., 1995; Van D Velden et al., 1995). Other markings became visible, these consisted of stripes and crosses. Further inspection revealed more cutaneous markings or “tattoos” on both calves.Infrared photographyThis technique allowed additional visualization of the tattoos. The newly discovered tattoos, not visible to the unaided eye, revealed 57 stripes arranged in 16 groups, and in addition, one large and small cross-like marking. These tattoos were localized in certain regions where, due to physical stress, degenerative changes occur that cause chronic pain. Upon further x-ray investigation, discrete bone damage beneath these skin areas was observed.Because of its biomechanical, static, and dynamic functions, the lumbar region of the spine carries the greatest structural weight of the axial skeleton. Manifestations of joint and skeletal stress, with resulting symptoms and signs, are well known to be found in muscle origins and in inserts as well as in the ligaments apparatus and in the vertebral joints. Hence, the markings previously described appear to be localized above these sensitive areas.The position of the tattoos in both lower legs is striking because the marks project towards the functionally important muscle–tendon–ligament structures. The above markings, on both the lumbar spine and lower legs, appear to reflect the results of strain, probably due to moving on rough ground, and would identify areas where pain would originate. Another example of such a marking is the positioning of a large cross on the medial side of the right knee where the marking projects exactly to the medial capsular ligament structures and the medial meniscus, another well-known site of pain resulting from chronic stress.Hence, the tattoos could have been either a form of medical treatment (e.g., acupuncture) or could have been the result of a religious or tribal ceremony. However, the findings above lead us to hypothesize that these markings or tattoos denoted areas of pain due to overuse.Bacteriological evaluationThese studies detected 20 eggs of the parasite (Trichirus trichiura, or whip worm) in the small intestine (Aspöck et al., 1996). The colon also contained a large amount of quartz-like sand, signifying the eating of milled grains. This abrasive material also helps explain the high abrasions found on the Ice Man’s dentition.EndoscopyComputerized tomography is the basis for drawing specimens from intracorporeal regions (Fig. 1F). However, in contrast to living material, and through the process of mummification, all internal organs of the Ice Man had dried out and become much smaller, so newer methods were required for accurate sampling. Hence, a new device to enable minimal invasive endoscopical sampling was developed. This newer technique was a computer-supported “virtual reality,” so exact placement on specific organs could be obtained (Gunkel et al., 1997).The endoscopic precision probes were composed of pure titanium, which prevents any tissue contamination of trace elements that might be detected in future experiments (Mersdorf and Tessadri, 1995).As of this writing, samples have been obtained from the upper respiratory passage, the lungs, liver, spleen, rib, cartilage, as well as bone, muscle, and tissue from the diaphragm, intercostal muscles, brain, and peripheral nerves. These 100 specimens were transferred to 80 team for further investigation. These samples are to be tested for histopathology, DNA testing and determination, parasitology, and trace elements (Fig. 1G and H) (Hess et al., in press, Platzer et al., in press).Recent discoveriesThe age of the Ice Man had been considered to be between 25 and 35 years at the time of his death. However, we used two different methods of age determination based on the physiological changes in the development and transformation of bone tissue during aging. By screening a thin section, the number and the areas claimed by secondary osteons and osteon fragments were recorded, and the definitive age was determined by regression analysis and micromorphological methods. Applying macromorphological methods, we used spongious structure and its changes during aging, at the proximal ends of the humerus and femur. Combination of these two methods yielded results that now age the Ice Man to 45 to 46 years (Fig. 1I) (Gaber, 1998)(Hess et al., 1989)ConclusionThe Ice Man provides a unique view into the past, and new techniques are allowing us to reconstruct the life of an individual in the Late Stone Age. 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