 Good afternoon everyone, so we will now examine the question of the relationship of medieval royal society to disease through a French case today. The case that will interest us comes from the churchyard of Notre-Dame-de-Renis. This former parish is located in the région Saint and more precisely in the department of Andrelois, 30 km southwest of the city of Tour. This site is located at the bottom of a small valley that is perpendicular to the flood plain 1.2 km away from the Andrel river and 2 km away from the Loire river. The excavation around the church of Rigny was carried under the supervision of Elisabeth Zadorario and Henri Galignier from 1996 to 1999. It has led to a better understanding of the formation process of a rural parish centre and it has also allowed the study of the population buried in the parish centre and the evolution of funeral practices from medieval to contemporary times. 1,738 graves have been excavated, they were dated from the middle of the 8th century to 1865, which is the year in which the parish centre was transferred. The study of the parish registers for the period from 1670 to 1792 and of the serial registers from 1793 to 1856 show a mainly forming village but also oriented to red craft and trade. Thus, 13% of the ideal male population to bury in Rigny, whose profession is well documented, is composed of merchants and only 8% of notables, against more than 40% of daily workers. Among the 1,738 burials excavated in the parish centre, the term of the individual 1,437 is that of a person buried between the 12th and the 5th century, probably in a burial shrewd. His head held upright by two stones. This kind of arrangement to hold the visis head is generally interpreted as a sign of difference to God and in Rigny, this type of burial with cephalic arrangement is mainly used in the oldest burial phases but at least longer during the Middle Ages. This individual was identified as a woman at least 50 years old at the time of her death. Her hapanicular skeleton, well represented, show only legion related to senescence as osteoarthritis, antisopathy or schmoles not. However, the scale of this individual has a mandible of facial dizastasis with bilateral and symmetrical hypoplasia of zygomatic bones. The lower margins of the orbits are incomplete and infra-orbitals foramen are absent. The mandible and more particularly its branches are also hypoplastic. Its body has a concavity on the underside and the gaudial angles appear more open than normal. The condylar cervix is short and temporal bones are also marked by the incomplete zygomatic arches and the atresia of the external acoustic miages. These osteological features are characteristic of trichocline syndrome, a craniofacial congenital condition which is particularly rare in the contemporary population. To acknowledge it is the first time that it is identified in the archaeological records. The trichocline syndrome is also known as franciscatis valoncline syndrome or mandible facial dizastasis. It is an autosomal dominant disorder of craniofacial development. No other it occurs with a frequency of approximately 1 in 50,000 live births. Mutation in TCOF1 and in a smaller subset of trichocline syndrome patients in PLR1D and PLR1C are held responsible for the resulting phenotype. Nevertheless, in some trichocline syndrome patients, no mutations within the three genes are detected. The condition is autosomal dominant disorder with a variable degree of penetrance and expressions. Between 50% and 60% of gays have no family history and there are mutations de novo. So far over 120 mutations have been identified. However, combined analysis of these variant and clinical features has not demonstrated a clear relationship between genotype and phenotype. There is no gender predilection and mutations can be spliced, nonsense or deletion variants. Craniofacial deformities consist mostly of defect in the periorbital regions and hypoplasia of the mandible and zygoma, macrosia and middle layer deformities. The range of presentation is wide, from mild case with no functional deficits and minimal deformities to severe case in which death may occur in the perinatal period as a result of airway compromise. The facial appearance is characteristic, abnormalities are bilateral and usually symmetric but not always. The hypoplastic mala bones make the nose appear more prominent and the nasal roots width is increased but the nose is usually of normal size and the face is narrow. Downward sloping palpebral fissures, deep breast cheekbones, mouth from pinet, wrist and chin and large down tongue mouths are characteristic. The facial profile in TCS in dramatical convex due to the pronounced retrognacea. Patients have no associated developmental delay or neurological disorder but often face social challenges through life because of their physical appearance. Bilateral conductive death net is common in mandible facial dialysis with a red dot atrasia of the external auditory mirrors. This deafness is due to the right range of deformity of the ocicular chain associated with a characteristic reduction in the size of the middle hair cavity. The preliminary is essentially normal. In the case of this individual, in the addition to the consequences of this syndrome in the individual's physical appearance, repercussion on his hearing could be suspected. Therefore, an analysis of his hearing system was conducted by CT scan. The skull was acquired by CT scan at the CIR platform of the INBAS in Travelle-de-Brain. In order to facilitate the three-dimensional comprehension of the internal anatomy, a protocol of segmentation and 3D reconstruction was implemented using the TMS software. Segmentation is the operation consisting of selecting on the slices the tissues of interest and it is particularly useful for the visualization of cavities as illustrated on this example of an undercast. For the case study, the ear is a focus area. The internal ear can be easily studied by CT scan as shown on this slide. It is composed of the external acoustic meadows separated from the tamponic cavity by the tamponies membrane. The cavity contains the ossicles and the step S is connected to the OCO slab around by the oval window. When a sound wave penetrates the external acoustic meadows, the tamponies membrane vibrates and puts the ossicles in motion. This motion is transmitted to the cochlea by the step S at the oval window. And this referential obtained from an astrophlect buried in a parish cemetery from Touraine. We can see the internal ear here and also the external acoustic meadows and the tamponic cavity and they are connected because the tamponies membrane disappeared during the decomposition. And now if we look at the case of two checkerings, we can see the susc labyrinth ear, which is normal, but the external meadows is not connected to the cochlea and present a severe atrophy. It has a diameter of one millimeter whereas in the referral check we are about around one centimeter. Thus, the subject present as a severe hypoplasia of the middle ear associated with the absence of the tamponic cavity and the lack of the oval window. The rest of the cochlea and semi-secular canals are normal. This dysplasia can be part of the picture-coloured syndrome. This syndrome can include an hypoplastic middle ear, but the OCO slab around is normal. Other observations led to a diagnostic of bilateral congenital conductive deafness. Deafness in medieval society is recognized as a disease as shown on this illustration from the treatise after the Physicallie et des Siorgières by John Arden, an English servant from the 14th century. And as a disease, it can be treated by medication. Deafness is also recognized as a source for mutism, as explained in the treatise Dear Love Between a Lord and a Clerk by John Trevisa. Since the time that the tower of Babel was built, men have spoken with diverse tongues in such a way that diverse men are alien to another and do not understand other speech. Commandment of speech is by hearing, so always he who is deaf is always mute, for he cannot hear speech to learn. A more personal take on deafness is given by the writings of Teresa de Catagena, a medieval nun who suffered from progressive deafness. And I quote, When I look at my suffering in worldly terms, it seems very painful and anguished. When I turn my thought from these concerns, drawing it into my breast and I see the solitude that my suffering imposes, separating me from worldly transactions, I call it a kind of solitude, a blessed solitude, a solitude that isolates me from dangerous things and surrounds me with short blessings, a solitude that removes me from things harmful and dangerous to my body and soul. So the first part of this excerpt unlights the social and psychological burden associated to deafness, but with the association of deafness with isolation, anguish and pain, but the second part is about the acceptance of this empowerment and its benefit in a religious life. In fact, religious institutions seems more able to integrate deaf people in their communities. They see the development of same languages and lectures for the deaf during the 16th and 17th century. For the rural context, we do not have text about the perception of deafness, but it is likely that communication impediment may have had an impact on the integration of the community. In the medieval period, food was a powerful marker of social identity. It also actively contributes to the health of individuals, according to the hypocrites theory of humans, because it helps to maintain a balanced mood. This argument motivated the integration of 48 individuals from many, including the individual with Trichocline syndrome, into the study of the diet of medieval populations into a human. This ongoing study, a part of my thesis, aimed at the comparison of the diet of six populations, including five from the city of Tour and its surrounding. The isotopic ratios of human collagen are compared to several types of animal protein, aquatic and terrestrial food environment, potentially consumed by an archaeological data. Food isotopic variability was estimated from 98 medieval animals from Tour, Mayer and Chambord sites. These animals come from both aquatic and terrestrial environments. They are divided into eight groups based on environmental, biological and domestication criteria. Among the aquatic group, the first is composed of freshwater animals, the second of anadromous and catadromous species, and the third of marine animals. Among the terrestrial group, the first is composed of wild herbivores, the second of domestic herbivores, the third of domestic omnivores, the fourth of carnivore and human commensals, and the last of migratory birds. The isotopic signatures of these different groups are quite distinct. When a heavy carbon enrichment of one per mil and one of four per mil of heavy nitrogen is applied to this different group, the expected range of value are obtained for theoretical, exclusive consumption of this resource of this group. When we compare this range of value with the isotopic ratios of carbon and nitrogen if human and rainy, and the different seeds in Tour, we see a difference in the resource consumed between the city and the countryside. The city populations are derived based mainly on meat from domestic omnivores, pig and poultry, with a variable proportion of aquatic resources, probably freshwater. The population of the rainy community as a diet is mainly omitted from domestic herbivores, bovine and caphrine, with a variable proportion of aquatic resources, probably freshwater. The individual with Trichocline syndrome has a central isotopic signature within the rainy isotope variability. Thus, not shamed in the diet of this individual compared to the rest of the community, is perceptible. This result does not arg in favor of the food arrangement in a care perspective, but it is no more consistent with an individual excluded from his community. The similarity of eating beer views and integration into the community of the faithful through the funeral practices from rigid individual benefitted, as well at his age, at death and the absence of any signs of mistreatment are consistent with a form of care by the community for this individual with a nativical face and suffering from thisness and therefore probably mutism. In this case, in addition to the fact that it is the first to be described in the archaeological registers of this type of pathology, also raises the question of archaeological perception of care in a rural context. As I have actually noticed in the publication of our thesis, there are two entreative ways to approach care in an archaeological record. First of all, by estimator of care, like surgery, and we will see some examples in the next presentation. This is compatible with its survival without care. For the case presented, this woman suffer from a physical dysplasia, deafness and mutism. This pathological condition must have an impact on the subject social and integration and psychological state. The rest of the skeleton does not show signs of abuses and both the isotopic analysis and funeral practices leads to an integration All those signs support the hypothesis of the social stigma of the teacher calling syndrome, a counterbalance by a benevolent attitude of contemporaries. Despite the lack of direct evidence of care, we can assume that in this rural community this subject receives the form of care. Thank you for your attention.