Leprosy at the Lazaretto on St Eustatius,Netherlands Antilles

Leprosaria established in the Americas during the Colonial period bear many similarities with those found in medieval Europe. They are comparable in terms of isolation, the objectification of leprosy sufferers and their association with religious charities. The Lazaretto on St Eustatius was operated from 1866 to 1923. The site was investigated to recover palaeopathological evidence of leprosy at a leprosarium in the Americas. Five burials were excavated; three individuals showed evidence of bone modifications consistent with those caused by leprosy, including aspects of ‘rhinomaxillary syndrome’ and the bilaterally symmetrical post‐cranial changes that have been described in leprosy examples from medieval Europe. An exceptional find was the presence of potentially leprous bone changes to the hyoid, thyroid and 3^rd–6^th cervical vertebrae. Copyright © 2007 John Wiley & Sons, Ltd.     

Possible cases of leprosy and tuberculosis in medieval Sigtuna,Sweden

In Sigtuna, Sweden, a medieval cemetery, including 227 skeletons, was analysed in 2006. On the outskirts of the churchyard, six skeletons with bone changes indicating systemic inflammatory disease were observed. Two out of three individuals with well‐preserved facial bone regions displayed signs of rhinomaxillary remodelling. Four of the afflicted exhibit severe bilateral alterations of the lower legs and phalanges of the feet and concentric atrophy of the metatarsals. In addition, one of the individuals exhibited a kyphosis in the lumbar vertebrae. In a discussion about alternative diagnoses, lepromatous leprosy and tuberculosis were identified as the causes of the destructive lesions in two individuals. Though the skeletal changes of the lower legs and feet in four cases demonstrate a close resemblance to secondary lesions of leprosy, the disease could not be confirmed. The skeletal changes of the last individual were unspecific and the possible causes several, rendering diagnosis difficult. The burial locations imply that the afflicted persons belonged to a lower social stratum. Due to the significantly higher frequency of pathological changes in the cemetery compared to other cemeteries in the town, the individuals could be regarded as fellow sufferers among others with various medical conditions. The bioarchaeological identification of systemic infectious diseases of a group of individuals of this size is unique to north of Scania in Sweden, where only a few cases of leprosy and tuberculosis have previously been diagnosed. The significance of the present study is emphasised by the interconnection between the afflicted, the archaeological context and the knowledge of the medieval society in Sigtuna. Copyright © 2010 John Wiley & Sons, Ltd.     

A scapula deformity in two burials from medieval England

A scapula malformation is described in two burials from the site of the late medieval Dominican friary at Ipswich, UK. The changes appear most consistent with primary scapular neck dysplasia. One of the burials also showed clear signs of leprosy. The burials are of lay benefactors of the friary. The Ipswich Dominican friary had no known function as a leprosy hospital. Finding of burials of lepers other than in burial grounds of leprosaria is highly unusual for medieval England. Scapular neck dysplasia has a strong genetic component in its aetiology. This, coupled with its rarity, suggests a close genetic link between the two burials. The findings suggest that in this case, family ties with the friary overrode the normal medieval custom of interring lepers in leprosy hospitals. This illustrates that even rare skeletal variants may convey useful biocultural information about past populations. Copyright © 2008 John Wiley & Sons, Ltd.     

Slipped proximal femoral epiphysis in a priest from the medieval period

During the course of a routine analysis of a cemetery burial population associated with the medieval hospital of St Giles, Brough, North Yorkshire, the partially excavated burial (No. 1423) of a priest, as identified through the associated chalice and paten dating to the medieval period, was observed to exhibit osseous changes commensurate with those of an untreated slipped proximal femoral epiphysis. Secondary osseous changes were noted that may indicate habitual positional behaviour subsequent to the injury.     

The Structure of the Timber Kitchen at Weoley Castle,Birmingham

A CEMETERY uncovered during roadworks at High Wycombe in ig86 confirmed the location of the medieval hospital of St Margaret. Examination of the skeletal remains suggests that several of the individuals excavated had suffered from leprosy.     

THE MEDIEVAL URBAN CHURCHYARD AS A MEETING PLACE: A CASE STUDY OF FUNCTION AND ORGANISATION OF THE CHURCHYARD OF ST. CLEMENS IN COPENHAGEN

The article presents the results of a study based on activity analysis of a medieval churchyard of St. Clemens in the urban setting of Copenhagen. The churchyard was in function from the 11^th to 16^th century revealing changes in layout and burial rites over time. A glimpse of the symbolic life of the medieval Copenhageners is also exposed and analysed. Moreover, the study of the churchyard reveals activities of a more secular nature and presents some of the activities that must have been part of everyday life in the medieval town. Thus, the churchyard has not only been an arena for meetings between the living and the dead but also a location for experiencing the urban life burgeoning outside the churchyard. For comparison, a recently discovered contemporaneous churchyard at Rådhuspladsen is also discussed.     

Stable isotope analysis of a medieval skeletal sample indicative of systemic disease from Sigtuna Sweden

In Sigtuna, Sweden, several medieval cemeteries have been excavated, from which approximately 800 skeletons have been excavated and analysed. Archaeological finds and anthropological analyses have exposed social differences between the cemeteries. Stable isotope analyses have shown that the inhabitants of the town consumed a mixed diet. Significant differences in dietary patterns between the cemeteries may be related to social stratification.In the outskirts of a churchyard excavated in 2006, bone changes showing systemic inflammatory disease indicative of leprosy were observed in six individuals. The burial location suggests that the affected belonged to a lower social stratum. Bone samples were taken from these six individuals, 19 other human skeletons and five animals from the same cemetery for analysis of the stable isotope composition of carbon (C), nitrogen (N) and sulphur (S).The results showed no significant differences in δ¹³C and δ¹⁵N values between the groups, i.e. the seemingly healthy humans and the humans affected by severe inflammatory disease appear to have had similar diets. Nor was a significant difference observed in δ³⁴S data between the six affected individuals and the rest of the sample, implying that no difference in origins could be observed between the two groups studied. However, a comparison between the present study and the previous analysis resulted in significant differences in carbon values.Based on the results obtained in this investigation it is suggested that if a dietary difference existed between people in the outskirts of a cemetery (for example those suffering from leprosy) and people buried in higher ranked regions, it was not a difference in food source but rather in other parameters. Instead dietary differences and possibly social variations are demonstrated between cemeteries. The results from the present study highlight the hierarchical arrangements of social classes in the early medieval society.     

Leprosy in a skeleton from the 7th century necropolis of Vicenne‐Campochiaro (Molise,Italy)

Analysis of the skeleton from tomb 144 of the early medieval necropolis of Vicenne‐Campochiaro in Central Italy revealed several features indicative of leprosy. The skeleton belongs to a male estimated to be between 20 and 25 years of age at death. The distal halves of the 1st and 2nd left metatarsals present acro‐osteolysis and both legs show severe subperiosteal bone reaction. The facial skeleton shows changes compatible with a chronic inflammatory process, possibly due to an infectious disease. The anatomical distribution of the lesions and their association with other skeletal lesions seems to be compatible with a near‐lepromatous form of leprosy. A differential diagnosis is made, and the skeletal traits pathognomonic of leprosy are discussed. Copyright © 2005 John Wiley & Sons, Ltd.     

Pre-Columbian treponematosis in medieval Britain

There has been much debate regarding the origins of treponemal disease and, in particular, acquired syphilis. Greater numbers of skeletons with apparently diagnostic bone lesions in the New World than in the Old have given rise to the postulate, particularly advanced by American workers, that the disease originated there prior to AD 1492 and was carried back to the Old World by Columbus's sailors. This paper presents evidence for the presence of treponemal disease in medieval Norwich prior to AD 1492, however. The dating of the site is good and the skeleton concerned comes from a well-sealed context. Others in the group have similar lesions and there are four individuals with evidence of leprosy. All were buried in a communal cemetery. The individual has widespread, bilateral, florid periostitis, especially of the tibiae and fibulae, and the radiographic changes support the diagnosis of treponemal disease. Differential diagnosis and geographical situation suggest that this skeleton displays evidence of syphillis.     

Cranial trauma and treatment: a case study from the medieval cemetery of St. Mary Spital,London

Excavation of the cemetery of the medieval priory of St. Mary‐without‐Bishopsgate, Spitalfields, London from 1998–2001, recovered the remains of over 10,000 individuals. Following initial assessment, skeleton 19893 was found to have suffered three cranial injuries caused by a sharp edged implement. The remains were those of a middle aged adult male of around 172.4 cm in stature, truncated at the hips by a later feature. The remaining elements were well preserved. The cranial injuries were well healed, suggestive of some degree of post‐traumatic care. Evidence of possible surgery was also found. Soft tissue complications would undoubtedly have followed the assault. Battle related trauma was considered, together with evidence of treatment. Whilst the demographic profile of the individual fitted a plausible one for a professional fighter of the medieval period, no firm evidence of occupation could be provided. The case study indicates both the ability of medieval people to survive major trauma and the wealth of information full analysis of the Spitalfields assemblage will provide the osteological community. Copyright © 2004 John Wiley & Sons, Ltd.     

Paleopathological and Molecular Study on Two Cases of Ancient Childhood Leprosy from the Roman and Byzantine Empires

This study is based on the paleaopathology of leprosy on human skeletal remains and the detection of ancient Mycobacterium leprae DNA. Two cases of childhood leprosy were recognized. The first case was in a Roman necropolis at Martellona (Rome, Central Italy), dated to the 2nd to 3rd centuries ce . The skeleton of a child aged 4–5 years, from tomb 162, is the youngest individual in Italy from this time period, with the clear rhino‐maxillary syndrome and other bony changes indicative of leprosy. The second case from a burial at Kovuklukaya, in the Sinop region of Northern Turkey, was from the 8th to the 10th centuries, during the Byzantine era. The endocranium of a 4–5‐month‐old infant with new bone formation—an indication of chronic inflammation—was positive for M. leprae DNA. Infant and childhood leprosy is uncommon today, and there is a scarcity of information in the osteoarchaeological literature of leprosy in the past, especially in children. The significance of these cases is that it adds to an understanding of the history of the disease in the former Roman Empire. It is hoped that over time sufficient data can be obtained to understand the epidemiological dynamics and clinical evolution of leprosy from the ancient period until today. Copyright © 2012 John Wiley & Sons, Ltd.     

Some miscellaneous ancient fleece remains

Wool fibre measurements are described from four unconnected remains: (1) some possibly Iron Age sheepskin from Germany that appeared to have a hairy fleece type; (2) the cloth from the Quernmore burial, Lancashire (dated 1300 years BP), one yarn of which was of hairy medium type, and the other true medium; (3) some sheepskin from Saxon Durham which had wool of true medium type, and (4) some wool of medieval date from Baynard's Castle, London, which was of true fine type.     

Two cases of leprosy from Žatec (Bohemia), dated to the turn of the 12th century and confirmed by DNA analysis for Mycobacterium leprae

The leprosy known today primarily from tropical areas was a relatively common disease in European Middle Ages. This article describes two skeletons bearing palaeopathological indications of leprosy from a cemetery at ?atec in North-West Bohemia (Czech Republic). The archaeological context clearly shows that these individuals were buried prior to the second decade of the 12th century, and most probably in the second half of 11th century. This rules out the possibility that these individuals might have contracted the disease in connection with the Crusades, in which a Bohemian contingent under Prince Vladislav II participated from 1141 to 1142. Molecular genetic methods were applied to detect specific DNA fragments of the causative agent of leprosy, Mycobacterium leprae. The nasal concha of one individual yielded DNA that could be directly sequenced after isolation and amplification. The vertebral body of the second individual, on the other hand, did not provide DNA of sufficient quality for direct sequencing and only weak amplification was detectable. The morphological and genetic analyses both indicate that leprosy existed prior to the Crusades in medieval Bohemia, albeit that its prevalence was probably not as great as in northern or western Europe.     

A case of treponematosis from pre‐Columbian Chaco Canyon,New Mexico

Although numerous cases of treponemal infection have been identified in prehispanic New World skeletal remains, none has been reported from Chaco Canyon, New Mexico. Chaco Canyon was the epicentre of a broad culture system that spanned the Four Corners region of the pre‐Columbian Southwestern United States. A burial recovered from the central Great House of Chaco Canyon, Pueblo Bonito, exhibits lesions indicative of treponematosis. However, the pathological condition of this individual has heretofore been only tentatively diagnosed because the skeleton was collected from a commingled context and distributed across four separate catalogue numbers. Now reassociated, these remains exhibit a pattern of pathological changes strongly indicative of treponemal disease. This case not only adds to the growing body of literature on the clinical expression and geographic distribution of pre‐Columbian treponematosis, but also demonstrates the utility of painstaking reassociation of commingled human remains. Copyright © 2009 John Wiley & Sons, Ltd.     

Periostitis and osteolysis in a medieval skeleton from South‐West Hungary: (Leprosy,treponematosis, tuberculosis or hypertrophic osteoarthropathy) A diagnostic challenge!

This paper uses macroscopic and radiological examinations to provide differential diagnoses of pathological lesions in the well‐preserved skeleton of a young male from the medieval site of Zalavár in South‐West Hungary. Macroscopic inspection of the skeleton revealed conspicuous thickening of the tibiae and fibulae with ‘tree bark’ appearance of the cortex. Periosteal proliferations are also found on the calcanea and on the posterior part of the femora. The metatarsals showed bony proliferation and bone dissolution. No alteration of the axial skeleton or the skull was noted. Radiographs showed thickening of the cortex of tubular bones due to a multilayered type of periosteal apposition. The likelihood of these symptoms being the result of melorheostosis, hypervitaminosis A, fluorosis, thyroid acropachy, endosteal hyperostosis, tuberculosis (TB), hypertrophic osteoarthropathy (HOA), treponematosis and leprosy is reviewed. None completely explains the entire spectrum of pathological lesions in the current individual, but the individual may have suffered from two co‐existent diseases. As a clinical entity, the changes in the metatarsals are compatible with leprosy, whereas the periosteal proliferations of the lower limbs point to a diagnosis of HOA as a secondary syndrome. Thus, a combination of leprosy and TB is suggested as a potential diagnosis. Although not definitive, our differential diagnosis was able to exclude a number of conditions producing periosteal apposition. Copyright © 2011 John Wiley & Sons, Ltd.     

Notices of Certain Bronze Relics,of a Peculiar Type Assigned to the Late Celtic Period

The excavation of four hundred complete and partial in situ burials from the Hospital of St. John the Evangelist, Cambridge, represented one of the largest medieval hospital osteoarchaeological assemblages from the British Isles. The significance of the group is enhanced by the detailed investigation of a carefully maintained network of pathways associated with the cemetery, the archaeological sequence that pre- and post-dated its use and a number of contemporary properties that were situated immediately outside its bounds. This evidence allows the cemetery to be placed within its urban context in a way that is rarely possible. The overwhelming majority of the burials were extended west-east aligned supine inhumations without grave-goods. Atypical burials included examples aligned east-west and south-north, a double burial, a prone burial and individuals buried with a jet crucifix and a brooch. Other significant finds included a nearby pit with four bodies in it, an anthropomorphic bone handle and a reused cruciform horse harness pendant. The proportion of males and females in the burial population is similar, whilst individuals who died under the age of sixteen are relatively uncommon and individuals aged under five are completely absent.     

Medieval Ireland and the Shannon Hydro-Electric Scheme: reconstructing the past in independent Ireland

This essay considers the position of Irish medieval buildings in the early years of the twentieth century. Focusing on the treatment of the oratory of St. Lua at Killaloe, it examines the ways in which the ruins of the medieval past were used to signify a range of political, religious and cultural ideas and attitudes. The rising water levels following the Shannon Scheme works (begun in 1925) meant that this stone oratory was moved from its original position on Friar’s Island to the grounds of St. Flannan’s Roman Catholic Church in 1929. The resulting paper trail reflects the complex processes of decision-making within a civil service in transition as the new Irish Free State calibrated its position with regard to the past and the treatment of medieval ruins throughout the countryside. The case study of St. Lua’s oratory is considered here in the context of the nineteenth-century tradition of scholarship on medieval buildings, the development of the idea of a national Irish architecture during this period, and the impact of this tradition on subsequent engagement with the buildings of the medieval past.     

St Mary’s,Southwell, and the archbishops of York,c. 1100–15401

Although there may have been contacts between Southwell and York from the seventh century onwards, it was a royal grant to Archbishop Oscytel in 956 AD that formalised the relationship and led to the creation within the archbishopric of the Peculiar of Southwell. This centred on an impressive minster church, described by A. Hamilton Thompson as ‘the greatest of all the medieval collegiate foundations of England’. This paper considers aspects of its institutional organisation, its place in the archdiocese of York and its long enduring relationship with the archbishops, for several of whom Southwell was a favoured place of residence and burial. It particularly concentrates on the period from c. 1100 to the Reformation, exploiting the Minster's recently published main medieval cartulcary, The White Book of Southwell, to follow developments. It pays particular attention to the Chapter and its personnel, whose careers are set in a wider context by comparison with the experience of canons and prebendaries elsewhere, particularly at Beverley and Ripon, the other two major Minsters of the archdiocese.     

Dental chipping: Contrasting patterns of microtrauma in inuit and European populations

While the study of dental wear has enjoyed wide popularity for over 100 years, dental chipping, or microfractures of the tooth crown, has received little attention. Observations on dental chipping in populations from the Arctic (St. Lawrence Island, Alaska) and Europe (medieval Norway and Spain) reveal patterns of microtrauma that provide insights into the dietary and tooth‐tool use behaviour of earlier populations. St. Lawrence Island Inuit, with an emphasis on consuming tough and frozen foods, in combination with extensive tooth‐tool use, exhibit a pattern of chipping that is characterised as ‘molar dominant’. The two European samples exhibit an ‘incisor‐dominant’ pattern but contrast markedly in frequencies, with medieval Norwegians showing significantly more chipping than medieval and post‐medieval Spanish. The systematic study of chipping promises to provide a new perspective on how populations used and/or abused their dentitions in earlier times. Copyright © 2010 John Wiley & Sons, Ltd.