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 Hospital records and historical documents describing the incidence of scurvy in the local hospitals and the daily diet of the black mine workers supported these findings.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.     

An examination of skulls from two British sites for possible evidence of scurvy

Skulls and mandibles from the Romano‐British site of Poundbury, Dorset and a medieval site at Abingdon in Oxfordshire were examined for porosity which has been considered to be indicative of the presence of scurvy. In addition, a number of skulls from various locations in Peru were examined. Virtually all the skulls had porosity at at least one site and in all cases the palate was most frequently affected. The rank order of affected sites showed some differences between the three samples but the most striking change was the frequency with which the cranial vault and maxilla were affected in the Peruvian skulls compared with the British. The differences were not statistically significant, however. None of the appearances was consistent with those of known cases of infantile scurvy and we doubt whether scurvy can be diagnosed on the basis of porosity in the skull and mandible unless it conforms to recognized clinical patterns. Copyright © 2003 John Wiley & Sons, Ltd.     

Scurvy as a factor in the loss of the 1845 Franklin expedition to the Arctic: a reconsideration

In 1845, an expedition, commanded by Sir John Franklin, set out to discover the Northwest Passage. The ships entered the Canadian Arctic, and from September 1846 were beset in ice off King William Island. A note left by the expedition in May 1847 reported all was well, but by April 1848, 24 of the 129 men had died. The ice‐locked ships were deserted in April 1848, but the 105 survivors were so weakened that all perished before they could reach safety. The causes of the morbidity and mortality aboard the ships have long been debated, and many commentators have argued that scurvy was an important factor. This study evaluates the historical evidence for the likely effectiveness of anti‐scorbutic precautions taken on polar voyages at that time, and investigates whether the skeletal remains associated with the expedition provide evidence for scurvy. Skeletal remains available for study were carefully examined for pathological changes, and lesions potentially consistent with scurvy were subject to histological analysis. Where remains were no longer accessible, use was made of published osteological work. It is argued that the anti‐scorbutic measures customarily taken on mid 19^th century British naval polar voyages were such that there is no a priori reason to suppose that scurvy should have been a problem prior to the desertion of the ships. The analysis of the skeletal evidence provided little in the way of bony lesions consistent with the disease, and cannot therefore be used to support the presence of scurvy. Factors other than scurvy may been the main causes of morbidity and mortality in the 11 months prior to the desertion of the ships. Copyright © 2012 John Wiley & Sons, Ltd.     

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.     

Trephination as a possible treatment for scurvy in a middle bronze age (ca. 2200 BC) skeleton

Although trephination of sub-adults in antiquity is rare, scurvy both infantile and adult, is even more rare in the archaeological record. Pathological changes appearing in the maxilla, mandible and orbits of a child of 8–9 years of age are highly suggestive of infantile scurvy. Advanced forms of this metabolic disturbance lead to severe subperiosteal haemorrhaging, at times turning the skin of the face and skull black. This condition may have led to the trephination along the sagittal suture as a form of blood letting in hopes of draining the subperiosteal haemorrhage in the cranium. Although cause and effect are often confusing in antiquity, the surgical intervention presented here led to the ultimate death of the child.     

Scurvy‐related Morbidity and Death among Christopher Columbus' Crew at La Isabela,the First European Town in the New World (1494–1498): An Assessment of the Skeletal and Historical Information

This article explores the living conditions and specifically the possible etiologies of subperiosteal reactions among those seafarers who did not survive Christopher Columbus' second voyage to the Americas and died at La Isabela, the first permanent European settlement in the New World, which is located in the present‐day Dominican Republic. The town was founded in 1494 by Christopher Columbus (1451–1506) and occupied for only 4 years. This study analyses the macroscopic and histological evidence of the skeletal series excavated from this contact cemetery, which is presently curated at the Museo del Hombre Dominicano. Twenty of the 27 systematically scored individuals reveal subperiosteal bone accretions, and in at least 15 individuals, these accretions appear bilaterally. The morphology, distribution and healing stages of the majority of these lesions provide new, direct evidence suggesting severe adult scurvy, a condition caused by sustained vitamin C deprivation, which was common among seafarers before the 18th century. The historical context surrounding the individuals' death at the European contact settlement and the conditions and duration of Christopher Columbus' second transatlantic voyage to the New World represent key elements in the interpretation of these lesions. In this case, the evidence also corroborates the known failure of Columbus' crew to exploit the locally available foods rich in vitamin C. Scurvy probably contributed significantly to the outbreak of sickness and collective death within the first months of La Isabela's settlement, an aspect that inflects the current discussion about the degree of virulence of New World infections that decimated the European newcomers, who we conclude to have been already debilitated and exhausted by scurvy and general malnutrition. Copyright © 2014 John Wiley & Sons, Ltd.     

Childhood scurvy in a medieval burial from Mačvanska Mitrovica,Serbia

The type and distribution of abnormalities in the skeleton of a child 2 years of age indicates that the child likely suffered from scurvy at the time of death. The burial is from the archaeological site of Zidine, Mačvanska Mitrovica, Serbia dated to the Medieval Period. Abnormal porosity and reactive woven bone formation are present affecting both the axial and appendicular skeleton. This case of scurvy is important because archaeological evidence of scurvy in this geographical location and at this time period is unknown. It is also important because the relative completeness of the skeleton and the widespread evidence of skeletal abnormalities provide additional insight regarding the skeletal manifestations of scurvy in young children. Copyright © 2009 John Wiley & Sons, Ltd.     

Craniofacial trauma in the Prehispanic Canary Islands

The current project is a study of craniofacial trauma in a large sample (n = 896) of Prehispanic Canary Islanders (PCIs). The possible causes and social implications of the trauma found are considered, with reference to archaeological and historical data. Variables include the island, period and ecology, the sex and age of the individuals, the distribution of lesions across the skull (by side and by individual bone) and ante‐mortem tooth loss. The results show a fairly high trauma rate (16%), a low prevalence of peri‐mortem trauma (3.8% of all lesions), higher prevalence of trauma in males than in females (25% vs. 13% of all individuals), more cranial than facial lesions (8.9% vs. 3.5% of all elements) and more lesions on the left side of the skull (6.7% vs. 4.5% of all elements) which suggests that the lesions were sustained through intentional rather than accidental agency. There was no correspondence between trauma prevalence and ecology. The archaeological and historical data support the assertion that the lesions may be the result of skirmishing between groups, using weapons such as slingshots, stones and staves. The presence of edged‐weapon lesions on some individuals suggests that these may have been the victims of contact‐period European groups. Copyright © 2007 John Wiley & Sons, Ltd.     

Bone changes in the human skull probably resulting from scurvy in infancy and childhood

Scurvy in children is poorly known in the palaeopathological literature despite biomedical references indicating that bone changes do occur in some cases and should be observable in human skeletal remains. Research on infants' and children's skulls in museum and anatomical collections in the USA and Europe reveals a complex of features on the external surface of the greater wing of the sphenoid and adjacent bone tissue that may be caused by scurvy. The lesions are bilateral and are characterized by porosity and, in some cases, hypertrophic bone formation. These abnormal bone changes are probably the result of a reaction to chronic haemorrhage in the deep vasculature associated with temporalis muscle function. While these lesions resemble those seen in anaemia and infection, their distinctive anatomical location and association with chewing should differentiate them, in most cases, from other disease conditions. These features are also associated with porous, hypertrophic lesions of the orbital roof and provide additional evidence that caution is needed in attributing porous lesions of the orbital roof solely to anaemia. © 1997 John Wiley & Sons, Ltd.     

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.     

Pathological Evidence in Newborn Children from the Sixteenth Century in Huelva (Spain)

Archaeological infant remains rarely appear in the palaeopathological literature; above all there are few references to neonatal individuals. This work presents four infant pathological specimens from the crypt of the Ermita de la Soledad (sixteenth to nineteenth century, Huelva, Spain). The bones analysed—one right hemifrontal, two humeri and a femur—belong to at least two individuals of between 0 and 6 months of age. The differential diagnosis of the lesions—mainly detachments of the outer layer of cortical bone, areas of juxtametaphysial osteolysis and epiphysial destructuralization—supports the hypothesis of an infectious aetiology, such as congenital treponematosis and haematogenous osteomyelitis, although illness caused by a deficiency, such as scurvy or rickets, cannot be ruled out.     

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.     

Stable Isotope Analysis of Diet‐based Social Differentiation at Late Prehistoric Collective Burials in South‐Western Portugal

In the Neolithic and Copper Age collective burials of the Portuguese Estremadura, the majority of material culture and skeletal remains are highly commingled, making it difficult for archaeologists to evaluate social status by linking individuals with specific grave goods. In these circumstances, bio‐anthropological data about individual life histories offer an additional avenue of investigation into social complexity among prehistoric communities practising collective burial. In this study, stable isotope data were gathered from 81 individuals from seven collective burial sites and one settlement, the fortified site of Zambujal, in order to determine if significant dietary differences exist within or between burials that may point to patterns of social differentiation, both at individual sites and across the region. While in general all of the sampled individuals consumed fairly homogeneous diets based on terrestrial animal proteins and C₃ plants, this study found that statistically significant differences in δ¹³C_ap and δ¹⁵N values exist between several sites, which may indicate socially differentiated consumption of meat and plants. Additionally, statistically significant differences were found in δ¹⁵N values between adults and juveniles, which may either be attributable to protein‐restrictive child‐feeding practices or physiological processes related to skeletal growth and development.     

Endocranial lesions in non‐adult skeletons: understanding their aetiology

Reactive new bone on the endocranial surface of the skull in non‐adults has recently received a lot of attention in the palaeopathological literature. These features appear as layers of new bone on the original cortical surface, expanding around meningeal vessels, as isolated plaques, ‘hair‐on‐end’ extensions of the diploë or, as ‘capillary’ impressions extending into the inner lamina of the cranium. These lesions are commonly found on the occipital bone, outlining the cruciate eminence, but have also been recorded on the parietal and frontal bones, and appear to follow the areas of venous drainage. Although recognized as resulting from haemorrhage or inflammation, their precise aetiology is still a matter of controversy. This paper outlines their possible causes and examines their nature and distribution in a group of non‐adults from four archaeological sites in England. It is recommended that, when recording these lesions in the future, additional skeletal pathologies, the age of the child, and nature and distribution of the lesions also be taken into account. Copyright © 2004 John Wiley & Sons, Ltd.     

The Cost of a Commute: A Multidisciplinary Approach to Osteoarthritis in New Kingdom Egypt

This article evaluates rates of osteoarthritis of the lower limb in human remains from Deir el‐Medina in order to compare the health of the residents of Deir el‐Medina with previous studies on other ancient Egyptian and Nubian populations. This study focuses on osteological observations from the commingled New Kingdom human remains documented during the 2012–2014 field seasons of the Institut Français d'Archéologie Orientale. This is the first publication of osteoarthritis for the human remains at Deir el‐Medina, a dataset which complements comparable populations at sites such as Amarna, Giza, and Tombos. It demonstrates that men in the village of Deir el‐Medina experienced significantly higher rates of osteoarthritis in the ankle and knee in comparison to women at Deir el‐Medina. Rates of osteoarthritis in the lower limb at Deir el‐Medina generally fall between workers' cemeteries and middle‐class or elite cemeteries. This study also includes data from Deir el‐Medina's detailed textual record and intact landscape in order to determine how occupation influenced these higher rates of osteoarthritis. The duration, intensity, and frequency of the workmen's hikes are reconstructed based on the surrounding landscape and 42 texts recording work days. This study compares rates of osteoarthritis with these datasets in order to document how the strain, duration, and frequency of the workmen's hikes may have impacted overall rates of osteoarthritis. Consequently, data from the texts and landscape surrounding Deir el‐Medina not only corroborate osteoarthritis patterns, but offer detailed daily life activity which can be used as a comparison for broader studies on osteoarthritis in ancient and modern populations. Copyright © 2016 John Wiley & Sons, Ltd.     

Metropolitan Scurvy in the Shadow of the Cook Voyages

Recent scholarship on scurvy in 18th-century Britain has focused on the disease in the context of voyages of exploration, especially those bound for the Pacific Ocean. Using materials from quack physicians, print culture and popular song, this essay contends that the problem of scurvy was just as acute in metropolitan London and elsewhere in Britain. By studying representations of the disease and its markets at home in Britain, it aims to shed new light on the treatment and perception of the disease at sea, particularly during the voyages of James Cook (1768?79).     

Signs of meningiomas in a skull of the Mexican colonial period

The skull of a native Mexican from the colonial period is studied. The skull has a nasal trauma, dental pathology and two osteogenic lesions, one situated at the left wing of the sphenoid bone and the other in the infrainion occipital squamous bone, between the left mastoid process and the left occipital condyle. That involving the sphenoid occludes the optic nerve foramen and is evident through the orbit and at pterion. These osteogenic lesions are considered to be secondary to the soft tissue tumour mass, which, at the level of its implantation area, is usually present in meningiomas.     

Reconstructing Life Histories Using Multi‐Tissue Isotope Analysis of Commingled Remains from St Stephen's Monastery in Jerusalem: Limitations and Potential

The examination of isotope ratios from multiple tissues offers new life to interpretations of commingled assemblages where information regarding individual biological history has been lost. Here, life histories from a commingled sample of Byzantine monks were reconstructed using enamel and bone δ¹³C and δ¹⁵N values. The δ¹³C values suggest a diet dominated by C₃ products, while the δ¹⁵N ratios indicate variable contributions of animal protein. After correcting for tissue‐specific enrichment factors, bone δ¹³C values were significantly enriched over enamel; this may be due to an increase in protein consumption, but could also reflect structural differences between tissues or correction factors used to compare these data.