Did Children in Medieval and Post‐medieval Poland Suffer from Scurvy? Examination of the Skeletal Evidence

Late‐medieval and post‐medieval writings report that scurvy was a widespread condition in medieval and early historical Poland. Archaeological and historical data indicate that the diet of children was based on foods poor in vitamin C and contained small amounts of raw plant products. Also, historians emphasise that in medieval and post‐medieval Poland, there were seasonal fluctuations in food availability, frequently accompanied by poor harvests. Both resulted in long periods of poor nutrition, which affected children most severely. The aim of this study was to investigate skeletal manifestations of scurvy in subadult remains from medieval and post‐medieval Poland. Following standards described by Ortner and colleagues, anatomical sites pathognomonic of scurvy in subadults (<17 years) were assessed for abnormal porosity and hypertrophic bone among skeletons excavated from three sites: Ostrów Lednicki (dated to the 11th–14th centuries AD), Cedynia (10th–14th centuries AD) and Słaboszewo (14th–17th centuries AD). In total, 3.6% of all examined children were found to bear traces of vitamin C deficiency. The prevalence of scorbutic lesions was 4.5% for Cedynia, 2.6% for Ostrów Lednicki and 3.6% for Słaboszewo. The majority of affected children were less than 7 years of age. Scurvy was likely more widespread in the living populations than it appears from the calculation of skeletal markers, because some individuals might have recovered or died before obvious traces became apparent. Also, in some children, scurvy might not have reached an advanced stage, identifiable in the skeletal material. The prevalence of scurvy reflects not only dietary patterns but also food storage and preparation techniques adopted in the Polish territories during the Middle Ages, which contributed to low intakes of vitamin C. Copyright © 2015 John Wiley & Sons, Ltd.     

The effect of growth on stable nitrogen isotope ratios in subadult bone collagen

Stable nitrogen isotopes have been used to reconstruct infant feeding practices as nursing infants have elevated δ¹⁵N ratios compared with their mothers. However, infancy is also a time of rapid growth, which may alter nitrogen isotope diet‐to‐tissue spacing. Several studies have documented a decrease in δ¹⁵N during growth in tissues with relatively fast accretion rates. This study investigates the effect that the growth of long bones, via collagen accretion, has on δ¹⁵N ratios. Long bones from individuals aged seven to nineteen years were obtained from a protohistoric ossuary in Ontario, Canada. Analysis of juveniles and adolescents permitted the examination of growth in a group who were not also nursing. It is concluded that a nitrogen isotope growth effect is not detectable in bone collagen from juveniles and adolescents, because: (1) δ¹⁵N ratios are not significantly different among the epiphyses, metaphyses and diaphysis of a growing long bone; (2) δ¹⁵N ratios are not significantly different between faster‐growing versus slower‐growing metaphyses; and (3) δ¹⁵N ratios are not significantly different between bones (or areas of a bone) that are still undergoing growth, versus bones that have ceased growing. The relatively slow speed of collagen accretion may explain why a growth effect is not manifested. Ultimately this research lends support to the use of nitrogen isotopes from bone collagen for infant feeding reconstructions. Copyright © 2009 John Wiley & Sons, Ltd.     

The ‘schemes’ of Piero de' Pazzi and the conflict with the Medici (1461–2)

This article opens up an important but overlooked chapter in the political and diplomatic history of Florence, as well as that of fifteenth-century Franco-Italian relations more broadly. In late 1461, the city of Florence elected ambassadors to go to France to congratulate King Louis XI on his accession to the throne. Intended as a purely ceremonial mission, the Florentine diplomat Piero de' Pazzi ignored his commission and pursued policies that explicitly promoted French interests in Italy. By doing so, Piero sought to improve the standing of his own family, both domestically and abroad, at the expense of the Medici regime in Florence and the anti-French Italian League that the Medici supported. This article offers for the first time a full investigation of a surprisingly early example of tensions between the Medici and the Pazzi, tensions that famously erupted in the Pazzi Conspiracy of 1478.     

Rickets and child abuse: the case of a two year old girl from the 4th century in Lisieux (Normandy)

The burial of a child of two years of age from the 4^th century site of Lisieux‐Michelet (Calvados, France) was examined for bone hyperplasia and a variety of mechanical deformations recognized in association with skeletal trauma. Results of DNA analysis of bone using the PCR method identified this child as female. Microscopic features of the teeth (interglobular dentine) and a sample taken from the tibia conclusively determined that this child suffered from vitamin D‐resistant rickets and possibly X‐linked hypophosphataemic rickets as its most common form of occurrence. In addition, evidence for child abuse is suspected based on the presence of cranial and tooth fractures and the appearance of successive plaque‐like endocranial (meningeal) appositions. This is the first palaeopathological report of child abuse in antiquity. Copyright © 2002 John Wiley & Sons, Ltd.     

Reconstruction of Socioeconomic Status in the Medieval (14th–15th Century) Population of Grevenmacher (Luxembourg) Based on Growth,Development and Diet

Numerous historical sources describe many aspects of the estate‐based society in medieval times; the detection of socioeconomic status within populations through skeletal remains is a topic of growing interest in anthropological studies. In medieval times, it was common for members of high social rank to be buried within or next to a church. This was certainly the case in Grevenmacher (Luxembourg), where remains of a church building and an adjacent cemetery from the 13th until the beginning of the 15th century were subjected to archaeological and anthropological analysis. By integrating archaeological and anthropological elements, as well as stable isotope analysis, we documented osteological manifestations as indicators of diet differentials in two subsamples (first group consists out of 56 individuals, second one out of 184 individuals) from the medieval cemetery of Grevenmacher. We could distinguish two subsamples that we assumed as different in their socioeconomic status with regards to the burials' position in the cemetery and burial characteristics. Differences in osteological traits such as bone length, stature and body mass indicated differences in diet between sample groups. To substantiate these outcomes, stable isotopic analysis (δ¹³C, δ¹⁵N) were made; the results displayed a clear separation between the sample groups on the basis of their diet. Therefore, we were able to confirm certain individuals in the medieval population of Grevenmacher in relationship to their socioeconomic status. Copyright © 2017 John Wiley & Sons, Ltd.     

Skeletal manifestations of vitamin D deficiency osteomalacia in documented historical collections

The frequency with which changes related to vitamin D deficiency are recorded in juvenile bone from archaeological contexts makes it clear that conditions conducive to such deficiency were fairly widespread at a number of points in the past. Although changes will take longer to be manifest in the adult skeleton than in juveniles, and may not be as obvious, the scarcity of reported cases suggests that it is likely that cases of osteomalacia are being overlooked in archaeological human bone. Vitamin D is probably better described as a hormone, rather than a vitamin, and the production of vitamin D within the body following exposure to sunlight allows adequate mineralisation of bone to take place. Lack of exposure to sunlight, which can be caused by a range of factors, is probably one of the main causes of vitamin D deficiency. The result of such a deficiency is a general weakening of the skeleton. The range of skeletal changes recorded across different bones of the skeleton in two documented historical pathology collections (the Galler collection, Basel, and the collection of the Federal Museum for Pathological Anatomy, Vienna), are discussed for scapulae, vertebrae, ribs, sterna, pelves and femora. The likelihood of each feature being preserved in archaeological skeletal material is considered. Although the changes associated with osteomalacia may lead to fragmentation of the skeleton, the presence of characteristic changes on bones from across the skeleton should make the condition identifiable using macroscopic examination, even where the skeleton is not well preserved. The identification of cases of osteomalacia in archaeological skeletal material is potentially significant because of the socio‐cultural information that can be implied from diagnosis of the condition. Copyright © 2005 John Wiley & Sons, Ltd.     

Adult scurvy in skeletal remains of late 19th century mineworkers in Kimberley,South Africa

Throughout history, scurvy has been a well‐known disease which develops due to restricted resources of fresh fruit and vegetables. The condition results from an extended limited intake of vitamin C. Although skeletal lesions associated with infantile scurvy have been well described by many authors, very little literature is available on adult scurvy and the resulting skeletal lesions. The purpose of this study was to investigate the skeletal remains of a 19th century mining population from Kimberley, South Africa, for any skeletal lesions that may be indicative of adult scurvy. Scurvy was well documented as being extremely prevalent in this population. The skeletal remains of 107 individuals, presumed to have died around 1898, were studied. The majority of these individuals were males between 19 and 45 years of age. It is likely that most individuals were migrant workers at the diamond mines. All bones were visually assessed for macroscopic indications of pathological bone alterations associated with healed scurvy. Bone samples were also taken from ambiguous lesions in order to perform histological investigations. Lesions indicative of possible healed adult scurvy were observed in 16 individuals. These lesions included bilateral ossified haematomas, osteoperiostitic bone changes and periodontal disease. Histological investigation confirmed the presence of ossified haematomas on the anterior tibiae of some individuals. Hospital records and historical documents describing the incidence of scurvy in the local hospitals and the daily diet of the black mine workers supported these findings. Copyright © 2009 John Wiley & Sons, Ltd.     

Controlling the Waters of Granducal Florence: A New Look at Stefano Bonsignori's View of the City (1584)

ABSTRACT

A striking feature of Stefano Bonsignori's Nova pulcherrimae civitatis Florentiae topographia accuratissime delineata, printed in 1584, is the pre-eminence of the Arno River and the detailed depiction of a variety of often quite minor water-related structures. This large (nine-sheet) map was dedicated to Francesco I de' Medici, Granduke of Florence. Contemporary initiatives and legislation as well as works of art and literature reveal that water management had been an important aspect of the policies of Francesco's father, Cosimo I, whose achievements had transformed the city's landscape and whose efforts earned the Medici ruler the title of Granduke of Tuscany in 1569. Bonsignori's portrayal of urban structures was created as a celebration of Cosimo's architectural legacy, and the depiction of the Arno, with its embankments and riverside structures, along with some of the city's fountains and wells, acknowledged granducal ambition to control its waters.     

Rural Rickets: Vitamin D Deficiency in a Post‐Medieval Farming Community from the Netherlands

Rickets is caused by vitamin D deficiency as a result of limited exposure to sunlight and inadequate diet. In the 19^th century, rickets was endemic in most northern European cities. In post‐Medieval Netherlands, rickets is documented in low frequencies in a few urban samples, but has not been studied in contemporaneous rural populations. Beemster is a rural farming community in the Netherlands that was established in the 17^th century upon drained land, with the Middenbeemster cemetery in use until 1866 AD. Ninety‐five individuals from the ages of 32 weeks in utero to 15 years were examined for rickets in order to understand factors that can cause vitamin D deficiency in rural, non‐industrialized populations. To identify rickets in the Beemster sample, ten features were scored, with bending deformities of the lower limb and one other feature, or at least three non‐bending features, having to be present in order for diagnosis. Nine individuals (9.5%) had evidence of rickets—a high prevalence, especially for a rural community where ample sunlight was available. The two and three year old Beemster infants were most heavily affected with an age‐specific prevalence of 30.4%. Two three‐month‐old infants also had rickets. Some of the affected may have developed rickets secondarily, as a result of a different illness, but cultural practices including prolonged swaddling, occlusive clothing, and keeping the young indoors, are suggested to have contributed to this high rickets prevalence. Dietary variables including poor weaning foods and common episodes of malnutrition may have also contributed to vitamin D deficiency. This study demonstrates the value of careful analysis of pathological conditions in subadults and highlights that rickets was not only a disease of cities, but affected populations that would appear to have been at low risk, because of maladaptive cultural practices. Copyright © 2013 John Wiley & Sons, Ltd.     

Carbon Isotope Variability in the Bone Collagen of Red Kangaroos (Macropus rufus) is Age Dependent: Implications for Palaeodietary Studies

Isotopic assessment of bone collagen is often used as an environmental tracer in both contemporary and palaeoenvironmental studies. However, variability in the isotopic composition of this tissue remains poorly understood for naturally occurring and wild populations of animals. In this study the stable carbon isotope composition of both diet and bone collagen was assessed for a population of red kangaroos (Macropus rufus). Animals sampled ranged in age from approximately 10 months to 15 years. The diet of this population, estimated from faeces collected in the field, varied from predominantly C₄grasses in late summer (δ¹³C⋍−16·5‰) to mostly C₃herbage in late winter (δ¹³C⋍−22·5‰), with a long-term average δ¹³C of between −19 and −20‰. Bone collagen was enriched in¹³C by 3 to 4‰ in older animals relative to pouch young. Isotopic analysis of hair, used to assess more recent diet in individuals, indicated that diet selection was similar in all animals that had been weaned. We suggest that the most likely explanation for the age-dependent relationship in the δ¹³C of bone collagen occurs because milk (the only source of nutrition in suckling kangaroos) is not fractionated in the same manner as plant-derived carbon during its assimilation into skeletal tissue. If this is the case, then such a relationship should be most predominant in mammals that have low birth weights (relative to the adult mother) and gain significant weight from milk. Whatever the precise mechanism(s) for the observed fractionation, bone collagen of kangaroos seems to retain an isotopic memory of the carbon laid down prior to weaning, which takes several years to be diluted and replaced with carbon derived from an “adult” herbaceous diet. These results have implications for palaeoecological research where fossil skeletal tissue is used as dietary or environmental tracers particularly if the relative age of the animals sampled is unknown.     

The effect of parity status on δN: looking for the “pregnancy effect” in 18th and 19th century London

This study examined the effect of parity status on δ¹⁵N using the well-characterised 18th and 19th century skeletal collection from the crypt of Christ Church, Spitalfields, London. We tested whether the cumulative effect of multiple pregnancies and breastfeeding could significantly reduce female δ¹⁵N values compared to males. The results from stable isotope analysis of 92 adult ribs show that the population of Spitalfields had relatively little variation in diet, compared to contemporary urban populations, and had abundant animal and marine protein. We were able to rule out any effect attributable to socio-economic status, date or age at death on the stable isotope ratios. There were no significant differences in δ¹⁵N due to parity status, nor were there any differences between males and females. Models of collagen turnover rates in ribs suggest that the effect of δ¹⁵N depletion due to pregnancy would be undetectable except in ideal circumstances, where bone of the optimal turnover period was sampled, and in cases where multi-parous individuals died shortly after parturition.     

Scurvy in adults and youngsters: the Dutch experience. A review of the history and pathology of a disregarded disease

Prior to the Dutch maritime expansion of the 17th and 18th centuries, scurvy was known in the Low Countries as an endemic disease. From the end of the 16th century the disease started to draw much more attention due to increasing long sea journeys of sailors. Already in the Dutch medical literature of the 16th century, a strong relation was expressed between the prolonged taking of foodstuffs of poor quality and the risk of contracting scurvy. Although from that time, many Dutch physicians recommended oranges, scurvy grass and brook‐lime, it took 200 years before inadequate therapy on the fleet was replaced by systematic prevention. Why did the old time effective recommendations for the therapy of scurvy stay inadequate for mariners? To understand, maritime and medical history were unfolded and evaluated with respect to palaeopathological findings reported for 39 cases of active scurvy and one case of healed scurvy. The palaeopathology of scurvy in adults and still growing youngsters was investigated from the remains of 50 Dutch whalers who had been buried during the 17th and 18th centuries on an island of the Spitsbergen Archipelago. Conforming the clinical literature, the original haematomas from scurvy were found as a black staining at the tips of dental roots. In the weight‐bearing bones of the lower extremities large black stains were positioned bilaterally around endofractures of the metaphyses, bilaterally on joint surfaces and bilaterally at epiphyseal discs of youngsters. In the non‐weight‐bearing bones they were often found unilaterally, such as at insertions of muscles. Immunoenzymatic staining of microscopic sections proved that the black stains were from remnants of denatured haemoglobin. No microscopic bone repair activities had happened. In a case of healed scurvy it could even be demonstrated how many times the recovery process had taken place from the layers of appositional bone which had replaced the original subperiosteal haematomas. Copyright © 2004 John Wiley & Sons, Ltd.     

An Osteobiography of a 19th‐Century Dog from Toronto,Canada

A 19^th‐century dog burial uncovered from a historical homelot in Toronto, Canada, provided a unique opportunity to reconstruct the individual's osteobiography. Of particular interest are the dog's very large size and a suite of skeletal pathologies. Recovery of a nearly complete skeleton combined with the use of X‐rays and micro‐computed tomography (micro‐CT) allowed for a discriminating differential diagnoses. Stable isotope analyses were applied to investigate questions of diet. Results reveal an individual who suffered greatly from disease towards the end of his life and hint at its owners attitudes towards dogs. The interdisciplinary approach applied to this case study highlights the potential information obtainable from pet burials. We argue that better analyses and reporting of pet burials will help address research questions targeting broader themes related to human–animal relationships. Copyright © 2015 John Wiley & Sons, Ltd.     

Residual rickets or osteomalacia: a case dating from the 16–18th centuries from Krosno Odrzańskie,Poland

A skeleton from a 16–18^th century burial site in Krosno Odrzańskie, Poland, was examined using classical morphological, metric and macroscopic palaeopathological observations, as well as radiography and tomography of the skull and long bones. A wide variety of the observed bone deformations probably occurred as a consequence of past rickets and/or osteomalacia, whose primary cause may also have been chronic renal failure. Preservation of the bones enables a discussion of the cause of such pathological changes. The subject under study appears to be a very interesting example of an individual whose skeleton shows advanced pathological alterations associated with the subject's vitamin D deficiency, overall health conditions and relatively long lifespan. Copyright © 2008 John Wiley & Sons, Ltd.     

Preliminary evidence for medieval Polish diet from carbon and nitrogen stable isotopes

In this pilot study, stable carbon and nitrogen isotopes from bone collagen and apatite of skeletons from the 11th and 12th century cemetery in Giecz, Poland are interpreted. Isotope values from a small number of fish and animal bones from the same archaeological site are also examined. The goal of this research is to provide preliminary evidence of diet for a group of medieval Polish peasants, with particular emphasis on sex-based differences in diet. Results of isotope analyses suggest diet of this early medieval population was omnivorous and terrestrial-based. Fish bones sampled exhibit low δ¹³C ratios, and in half of the cases are significantly enriched in ¹⁵N, indicating they are freshwater species. Human bones do not reflect these signatures, suggesting freshwater fish were not a significant source of dietary protein at Giecz. The ¹³C_coll from some human bones is enriched beyond what might be expected from an exclusively C₃ diet. Associated mammal bones do not exhibit similarly elevated δ¹³C_coll ratios, suggesting enrichment among humans is not due to consumption of animals foddered on C₄ plants. Two possible sources of ¹³C_coll enrichment are marine fish in diet and direct consumption of a C₄ plant, such as millet. The δ¹³C values obtained from bone apatite of a small subset of humans suggest that millet contributes to ¹³C_coll enrichment, although at least three individuals may have also consumed small amounts of marine fish. Sex-based differences in δ¹⁵N ratios indicate that men consumed relatively more animal products (meat or dairy) than did women. There is also a correlation between δ¹³C_coll and δ¹⁵N values in skeletons of men that is absent in women. These carbon and nitrogen isotope data are the first reported for any Polish population and contribute to a more complete picture of dietary adaptation and social organization in medieval Europe.     

A Simple(R) Model to Predict the Source of Dietary Carbon in Individual Consumers

Quantitative individual human diet reconstruction using isotopic data and a Bayesian approach typically requires the inclusion of several model parameters, such as individual isotopic data, isotopic and macronutrient composition of food groups, diet‐to‐tissue isotopic offsets and dietary routing. In an archaeological context, sparse data may hamper a widespread application of such models. However, simpler models may be proposed to address specific archaeological questions. As a consequence of the intake of marine foods, individuals from the first century ad Roman site of Herculaneum showed well‐defined bone collagen radiocarbon age offsets from the expected terrestrial value. Taking as reference these radiocarbon offsets and using as model input stable isotope data (δ¹³C and δ¹⁵N), the performance of two Bayesian mixing model instances (routed and concentration‐dependent model versus non‐routed and concentration‐independent) was compared to predict the carbon contribution of marine foods to bone collagen. Predictions generated by both models were in good agreement with observed values. The model with higher complexity showed only a slightly better performance in terms of accuracy and precision. This demonstrates that under similar circumstances, a simple Bayesian approach can be applied to quantify the carbon contribution of marine foods to human bone collagen.     

Dedicated Followers of Fashion? Bioarchaeological Perspectives on Socio‐Economic Status,Inequality, and Health in Urban Children from the Industrial Revolution (18th–19th C), England

The 18th and 19th centuries in England were characterised by a period of increasing industrialisation of its urban centres. It was also one of widening social and health inequalities between the rich and the poor. Childhood is well‐documented as being a stage in the life course during which the body is particularly sensitive to adverse socio‐economic environments. This study therefore aims to examine the relationship between health and wealth through a comprehensive skeletal analysis of a sample of 403 children (0–17 years), of varying socio‐economic status, from four cemetery sites in London (c.1712–1854). Measurements of long bone diaphyseal length, cortical thickness, vertebral neural canal size, and the prevalence of a range of pathological indicators of health stress were recorded from the Chelsea Old Church (high status), St Benet Sherehog (middle status), Bow Baptist (middle status), and Cross Bones (low status) skeletal collections. Children from the low status Cross Bones site demonstrated deficient growth values, as expected. However, those from the high status site of Chelsea Old Church also demonstrated poor growth values during infancy. Fashionable child‐care practices (e.g. the use of artificial infant feeds and keeping children indoors) may have contributed to poor infant health amongst high status groups. However, differing health risks in the lower status group revealed the existence of substantial health inequality in London at this time. © 2016 The Authors International Journal of Osteoarchaeology Published by John Wiley & Sons Ltd.     

Testing the human factor: radiocarbon dating the first peoples of the South Pacific

Archaeologists have long debated the origins and mode of dispersal of the immediate predecessors of all Polynesians and many populations in Island Melanesia. Such debates are inextricably linked to a chronological framework provided, in part, by radiocarbon dates. Human remains have the greatest potential for providing answers to many questions pertinent to these debates. Unfortunately, bone is one of the most complicated materials to date reliably because of bone degradation, sample pre-treatment and diet. This is of particular concern in the Pacific where humidity contributes to the rapid decay of bone protein, and a combination of marine, reef, C₄, C₃ and freshwater foods complicate the interpretation of ¹⁴C determinations. Independent advances in bone pre-treatment, isotope multivariate modelling and radiocarbon calibration techniques provide us, for the first time, with the tools to obtain reliable calibrated ages for Pacific burials. Here we present research that combines these techniques, enabling us to re-evaluate the age of burials from key archaeological sites in the Pacific.     

A Large‐Scale Palaeopathological Study of Hip Fractures from Post‐Medieval Urban England

Hip fractures have high incidence rates in many current groups and are associated with high morbidity, mortality, and considerable expenditure. Although hip fractures associated with significant traumatic events can occur at any age, many hip fractures occur in older adults. To date, few hip fractures have been reported from archaeological skeletal material, and a number of hypotheses have been suggested for this. This research presents a comprehensive assessment of hip fractures in archaeological bone; 1597 adult (18+ years) skeletons from eight urban post‐medieval sites from England dating from the 18^th and 19^th centuries were recorded, and contemporary medical texts reviewed. This adult sample included 834 males and 652 females as well as 11 persons of undetermined sex. Ways of classifying and describing fractures in the clinical literature were reviewed and a methodology applicable to paleopathology determined. Of this sample, 15 (0.94%) had fractures in the femoral neck or intertrochanteric area: nine males, four females, and two individuals of undetermined sex. The numbers of fractures in males were interesting and most likely represent examples of accidental trauma as well as osteoporosis‐related fractures, the latter receiving growing awareness in recent clinical literature. Overall there was an age‐related trend with more individuals aged 50+ years with fractures than in other age categories. Underlying osteoporosis was potentially a complicating factor in five individuals and was likely associated with a vitamin D deficiency osteomalacia and a metastatic neoplastic condition in a further two cases. Fractures occurring close to the time of death and healed fractures were observed, indicating that the risk of mortality following this trauma was not consistent across this 18^th and 19^th century sample. Skeletal and historical evidence presented in this study indicate that the impact of hip fracture injuries varied, with survival likely linked to the fracture type. Copyright © 2016 John Wiley & Sons, Ltd.