Weapon‐related Cranial Lesions from Medieval and Renaissance Turin,Italy

Archaeological excavations carried out in the square around the Cathedral of S. Giovanni in Turin brought to light burials referable to the medieval and Renaissance periods. The anthropological examination of the skeletal remains allowed to identify two skeletons from the medieval period (10th–11th centuries) and four skeletons from the Renaissance age (15th century) showing weapon‐related cranial injuries. These peri mortem lesions are indicators of interpersonal aggression and in particular of armed conflicts. The two individuals from the early medieval period presented three traumas consisting in sharp force lesions caused by bladed weapons. As regards the Renaissance sample, the majority of the nine peri mortem injuries were sharp force wounds, followed by a blunt force trauma. These distribution patterns might reflect different fighting techniques, whereas the side distribution and location of the skull trauma provide further indications on the fighting modalities. Identification of the weapons that caused these traumas is suggested. The lack of post‐cranial wounds at Piazza S. Giovanni might be explained by the greater attention paid to the head, which was the main target of attack, or by adequate protection of the body through medieval and Renaissance armours. Otherwise, the wounds in the body would have been found only in the soft tissues, with no involvement of the bones. Despite the presence of weapon injuries, the results obtained from the study of the Renaissance sample are different from the findings of other contemporary battlefields. It is highly likely that the individuals of the Renaissance age were not young soldiers employed in war episodes and brought back for burial in Turin after battles that had taken place elsewhere. Instead, they were probably individuals who had died in riots or in other violent city episodes, as the historical records for the Renaissance age seem to confirm. Copyright © 2013 John Wiley & Sons, Ltd.     

Radiographic clues to fractures of distal humerus in archaeological remains

Today, distal humeral fractures occur most frequently in children and adolescents, and are usually the result of a fall onto extended arms, or less often on flexed elbows. Trauma to the distal humerus at the physis and epiphyses often produces non‐displaced or mildly displaced fractures that are difficult to recognize radiographically. To help identify these types of injuries, clinicians have developed two measurement techniques that are applied to the X‐rays of the injured bones. In a preliminary attempt to assess the usefulness of these measurement techniques for recognizing trauma in archaeological skeletal remains, 25 humeri from two Ontario ossuary samples were submitted to radiography. Clinical data on distal humeral fractures, their incidence, and mechanisms of injury were also used to interpret the lifestyles and cultural activities of the aboriginal individuals under study. While only one healed fracture was suspected after gross observation, a total of four fractures were ultimately identified using the two measurements, the humerotangential‐angle (HTA) and the anterior hunieral line (AHL). Our results provide indirect, but telling, evidence of accidental childhood injuries to distal humerus in an archaeological population. Copyright © 2001 John Wiley & Sons, Ltd.     

Ancient injury recidivism: an example from the Kerma period of ancient Nubia

A topical trend in clinical research has been the study of repeat trauma, referred to by clinicians as “injury recidivism,” which lends itself to the assessment of accumulated injuries among ancient people. The present investigation examined the healed injuries among two archaeological skeletal samples from the Kerma period (ca. 2500–1500 BC) of Sudanese Nubia. Both groups were known to have a high prevalence of multiple trauma—80% of 54 adults from the rural sites (O16 and P37) located near Dongola and 42% of 212 adults from the urban site of Kerma sustained nonfatal injuries. It was observed that a higher frequency of multi‐injured adults displayed one or more violence‐associated injury (cranial trauma, parry fracture). When all injuries were considered 38% of individuals with violence‐related injuries had other traumatic lesions in contrast to 22% of individuals who experienced injuries associated with accidental falls (e.g., Colles', Smiths', Galeazzi, and paired forearm fractures), although this difference was not significant. When only the skulls and long bones were evaluated 81% of adults with multiple injuries to these major bones bore one or more violence‐related injuries, while 60% of adults with single injuries sustained violence‐related injuries. Most individuals with multiple injuries were male and less than 35 years of age; there was no significant difference in the frequency of violence‐ or accident‐related multiple injury between the rural and urban communities. Although it cannot be established whether or not some of an individual's injuries were experienced during simultaneous or independent incidents, the pattern of multiple injury among these two ancient Nubian skeletal samples reflected the profile of injury recidivism observed by modern clinicians cross‐culturally. Copyright © 2002 John Wiley & Sons, Ltd.     

Chinese Indentured Mine Labour and the Dangers Associated with Early 20th Century Deep‐level Mining on the Witwatersrand Gold Mines,South Africa

Trauma analysis in archaeological human remains can aid our understanding of cultural practices, socio‐economic status, environmental and social conditions, and even aspects of a person's occupation. For this reason, fracture patterns and frequencies can be useful in making inferences about the environment people lived and worked in. This is especially true for the 20th century mining industry where unskilled migrant labourers were often subjected to harsh working and living conditions. In this study, the skeletal remains of 36 Chinese indentured mine labourers, who worked and died on the Witwatersrand mines, South Africa, during the period ad 1904–1910, were assessed for evidence of trauma. Historical information suggests that these indentured Chinese labourers were unfamiliar with the workings of deep‐level mines and as a result sustained many work‐related injuries. Analyses suggest low frequencies of ante‐mortem trauma. In the few instances where they occurred, these healed fractures most probably reflect injuries already sustained in China, some time before Chinese indentured employment on the Witwatersrand mines. A high frequency of traumatic lesions, specifically peri‐mortem fractures, however, suggests a drastic shift in their working environment attesting to the hazardous working conditions associated with deep‐level mining in the early 20th century. Copyright © 2015 John Wiley & Sons, Ltd.     

Trauma and amputations in 19th century miners from Kimberley,South Africa

Trauma is the result of violent accidental or therapeutic events that cause physical or psychological injury. The frequencies and types of trauma within a population can give important information regarding their lifestyle as well as the quantity and quality of medical care available to them. The purpose of this study was to assess the incidence of trauma in the Gladstone sample population with regards to the presence of interpersonal violence a hazardous working environment strenuous working requirements and the availability of medical care. The individuals studied here were diamond miners from Kimberley dating to the late 19th century. A total of 107 well‐preserved skeletons were excavated from unmarked graves after accidental discovery. This sample included 86 males 15 females and 6 individuals of unknown sex. The majority of individuals (71%) were between 19 and 45 years of age. The remains were most likely those of migrant mine workers of low socioeconomic status who had passed away at the local hospitals. All bones were visually assessed for macroscopic indications of traumatic bone alterations and compared to standard palaeopathological texts and photographs. A total of 27% (n = 28) of the individuals in the sample presented with well‐healed healing or perimortem fractures. Fractures to the skull encompassed 49% (n = 20) of all the fractures that were observed. A total of six (6%) amputations were noted. Spondylolysis was observed in 7% (n = 7) of the individuals within the sample and longstanding subluxation was noted in two individuals. The high incidences of cranial fractures within this population are suggestive of high levels of interpersonal violence while long bone fractures spondylolysis and evidence of longstanding subluxations are indicative of the strenuous work requirements and the high‐risk environment to which these individuals were exposed. When considering the presence of well‐reduced fractures and healed amputations it seems that adequate medical care was available to at least some members of this community. Copyright © 2009 John Wiley & Sons Ltd. This article was published online on 17 February 2009. An error was subsequently identified. This notice is included in the online and print versions to indicate that both have been corrected 3 November 2009.     

Analysis of ante mortem trauma in three modern skeletal populations

When archaeological skeletons are assessed, the prevalence (and patterns of bone involvement) of trauma is important. The number and pattern of fractures can be used to gain insight into the occurrence of interpersonal violence, workload and living conditions. However, the question remains as to how these results should be interpreted—such as what constitutes high or low levels of trauma? The aim of this study was to investigate the occurrence of trauma in a population of modern Greeks living in Crete, as well as South African (SA) whites and blacks in the Pretoria Bone and Raymond Dart collections. The sample comprised mostly of older individuals (n = 90–100 within a sex‐population group). Each skeleton was studied for healed trauma. For the vertebrae, only spondylolysis was assessed. In the Greek sample, it was found that 42% of the males and 46% of females had at least one fracture, with corresponding figures of 63 and 44% for SA whites and 83 and 69% for SA blacks. Radius, rib and femur fractures were most common in Greeks, with skull, radius and ribs most common in SA whites and skull, ulna and ribs in SA blacks. These prevalences of trauma are high, but the composition of the samples (mostly of lower socio‐economic origin) should be kept in mind. It may also be questioned whether these individuals reflect the society as a whole. It seems that the fractures in Greeks are mostly related to old age due to falls and accidents (radius and hip fractures), while the SA black sample reflects high prevalences of interpersonal violence (such as cranial vault and ulna fractures). The SA white sample follows a comparatively moderate pattern of trauma. These comparative figures may be useful when assessing trauma in other skeletal populations. Copyright © 2009 John Wiley & Sons, Ltd.     

Childhood Cranial Trauma from a Late Roman and Merovingian Context from Michelet,Lisieux, France

The Michelet necropolis in Lisieux, France, dating to the late Roman and Merovingian period, comprises of a large number of well‐preserved subadult remains offering a unique opportunity to better understand childhood trauma in the past. The focus of this study was to determine the amount, type and mechanisms of trauma evidenced in subadults from the 4th–8th century AD, and explore potential circumstances surrounding the trauma. The remains of 109 subadults from the Michelet necropolis were examined for the presence of cranial and post‐cranial trauma. Three individuals exhibited perimortem trauma, one individual had an antemortem cranial injury, and no cases of post‐cranial trauma were identified. Cranial trauma affected 4.1% of children with observable cranial remains (N  = 4/97). The children affected were young (2–7 years old), making it unlikely that they would have participated in militaristic activities. Based on the location, morphology and mechanism of injury identified, it is likely that the perimortem injuries sustained by three children were not accidental. The presence of a number of cranial injuries from this site may be related to increased stress in the community related to the decline of the Roman Empire in Gaul, possible raiding barbarian groups during the 4th–5th centuries, or stresses related to the Gallic aristocracy solidifying political powers in northern Gaul during the 5th–7th centuries AD. The consideration and inclusion of childhood trauma in bioarchaeological analyses allows for a more detailed and in‐depth understanding of violence and childhood in the past. Copyright © 2017 John Wiley & Sons, Ltd.     

Skeletal trauma in the burials from the royal church of St. Mary in medieval Oslo

The considerable collection of skeletal remains from the royal Church of St. Mary (c.1050–1540 AD) in Oslo constitutes part of The Schreiner Collection at the Department of Anatomy, University of Oslo. The remains reveal a high incidence of skeletal trauma, especially injuries caused by sharp‐edged weapons and extensive violence. Evidence of sharp force trauma was primarily observed on the crania. There were a surprisingly few injuries on postcranial skeletal elements. The injuries were mostly observed on middle‐aged and older men, but also on women and subadults. Some of these injuries may be linked to the civil wars in Norway during the 12th and 13th centuries. In most cases, the trauma distribution pattern suggests standardized fighting techniques. Copyright © 2010 John Wiley & Sons, Ltd.     

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.     

Multiple Injury and Health in Past Societies: An Analysis of Concepts and Approaches,and Insights from a Multi‐Period Study

Earlier clinical and bioarchaeological studies found that injury recidivists were most likely to be young adult males. Since then, the clinical meaning of the injury recidivist has expanded to include all individuals with multiple injuries, and other aspects of health have been considered. Our study sought to apply these advances to paleopathology and place multiple injuries in a wider context by investigating: the age and sex distribution of those with single and multiple fractures, and if people with multiple injuries had poorer general health. The sample of 213 males and 190 females (≥18 years old) from six populations in England, Siberia, and Sudan ranged in date from the 3rd century BC to the mid‐19th century AD. Health variables included cribra orbitalia, porotic hyperostosis, periostitis, Schmorl's nodes, enamel hypoplasias, dental caries, and periodontitis. Ante‐mortem injuries were: fractures (0/1/≥2), myositis ossificans, dental trauma, and sharp‐force injuries. The data were analysed using chi‐square and hierarchical loglinear analyses (P = 0.05). No significant three‐way association between age, sex, and injury was found. There was no difference between the sexes when individuals with single versus multiple injuries were compared. There were significant differences in the age‐distribution of people with 0 and 1/≥2 fractures. Males and those 26–35 years old were most likely to have fractures and multiple injuries. Porotic hyperostosis was significantly associated with fractures. There was no significant relationship between general poor health and multiple injuries. Copyright © 2016 John Wiley & Sons, Ltd.     

Cranial traumatic injuries caused by weapons in Tokugawa Japan

Weapon‐related traumas on human skeletons provide us with direct evidence of violence in archaeological and forensic contexts. The purposes of this study are to describe the weapon‐related traumas on Edo‐period (AD 17th–19th centuries) human skeletons from the Hitotsubashi site (Tokyo, Japan), to examine their presence, distribution and variability, and finally to better understand violence during that period. The specimens observed here are two adult males exhibiting eight traumas: five sharp‐force traumas caused by edged blades (62.5%) and three blunt‐force traumas with radiating fractures (37.5%). The frequency of individuals with traumas is 1.0% out of 207 individuals and 3.3% out of 64 adult males. The traumas found on the Hitotsubashi crania are distinguishable from those on the medieval crania in terms of low traumatic frequency. These observations shed new light on the life and death situations of the Edo inhabitants from osteoarchaeological perspectives. Copyright © 2010 John Wiley & Sons, Ltd.     

Comment on the Analysis of Two Skeletons from Terqa,Syria

Recently, a report on two human skeletons from an Early Bronze Age tomb excavated at Tell Ashara, Syria has been published in International Journal of Osteoarchaeology. One individual was identified as a warrior following these criteria: (i) size and robustness of bones, (ii) cut marks on the humerus, (iii) reduction of the ulnar styloid process, both interpreted as healed weapon‐related trauma, (iv) well‐developed muscle insertions, and (v) degenerative joint disease. Actually, none of these five criteria support the conclusion because of the following reasons: (i) not necessarily all tall and robust men become warriors, (ii) the post mortem origin of cut marks on the humerus is more likely than sharp force trauma, (iii) there are several possible causes of the unusual ulnar styloid shape other than weapon‐related trauma, (iv) the interpretation of musculoskeletal stress markers and (v) degenerative joint disease lacked control for age, sex and body size. Copyright © 2012 John Wiley & Sons, Ltd.     

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.     

Fracture patterns among the Nubians of Semna South,Sudanese Nubia

A collection of 592 individuals from the site of Semna South in Sudanese Nubia was studied for evidence of healed fractures of the skull and appendicular skeleton. The sample included 241 males, 239 females, 109 subadults and three adults for whom a sex could not be determined. Potential analytical and interpretive bias due to vagaries of preservation was quantified and examined. Almost 21% of the adults exhibited at least one healed fracture, while only two subadults showed such trauma. Rates of fractures, calculated for each bone, varied from a high of 17.9% for the cranium to a low of 0% for the right femur. Some fractures were likely caused by the physical environment, for example, falls along the rocky shores of the Nile. Other trauma, such as craniofacial fractures, found in both males and females, may have been due to interpersonal violence. The high rate of craniofacial trauma may indicate that this group experienced social stress which could have precipitated or intensified interpersonal violence. Copyright © 1999 John Wiley & Sons, Ltd.     

Patterns of Cranial Trauma in a Prehistoric Population from Central California

Evidence of cranial trauma was investigated in a skeletal sample from the site CA-Ala-329 located on the eastern side of San Francisco Bay, Central California. The sample included 365 crania, including 134 adult males, 104 adult females, 22 adults of indeterminate sex and 105 subadults. Evidence of cranio-facial fracture was found in eight individuals, one of whom is an adolescent. Thus, the frequency in adult crania of traumatic injury is 7/260 (2.7 per cent). Of the seven individuals of known sex displaying such cranial trauma, all are male. The injuries are generally suggestive of some form of interpersonal aggression, with five healed vault fractures, one lesion with an embedded obsidian fragment (a probable projectile point) and two healed facial fractures. Further clear evidence of interpersonal aggression has been previously determined in this sample and has been reported at even higher levels elsewhere in California. © 1997 by John Wiley & Sons, Ltd.     

Mesolithic hunting in Denmark illustrated by bone injuries caused by human weapons

Animal skeletons from eight Danish Mesolithic settlements and 14 isolated bog finds have been investigated for injuries caused by hunters. The injuries comprise arrow-pierced limb bones, ribs and vertebrae together with healed and unhealed injuries found on shoulder blades. Special attention has been drawn to the skull lesions on Sus scrofa L. Some pathological features in the shoulder blades of the same animal are also discussed for comparison. The sizes and shapes of the injuries in some cases give an indication of the types of weapons that have been used. The proportion of unhealed to healed fractures seems to change during time. This feature may be related to the change to an increasingly stationary mode of life of the hunters.     

Childhood trauma in the archaeological record

Childhood trauma is an important class of pathology that is only occasionally discussed in the anthropological literature. As palaeopathologists, we usually analyse archaeological collections that consist of adult skeletons presenting healed injuries, with no real clues as to the timing of the associated traumatic events. We believe that with certain types of trauma, it maybe possible to determine if the injury was acquired during childhood. Clinical data show that evidence for childhood trauma is documented in unique patterns of injury that target particular bones, segments of bones, leading to changes in the orientation or alignment of bones. This presentation provides examples of two types of trauma found in an ossuary population from Ontario, Canada. On the basis of the skeletal evidence and clinical data, childhood trauma may be inferred for each example. Copyright © 2000 John Wiley & Sons, Ltd.     

Trauma to the Skull: A Historical Perspective from the Southern Levant (4300BCE–1917CE)

Background: Although the southern Levant is commonly perceived as having been a violent region throughout history, few studies have explored the pattern and intensity of skull trauma through time in the general population. The aim of this study is to follow changes in traumatic injury patterns in the southern Levant, over an extensive period of 6,000 years. Methods: 783 archaeological skulls from the Tel Aviv University osteological collection were examined for evidence of trauma. The specimens were divided into three periods: Chalcolithic‐Bronze‐Iron Age (4300–520 BCE), Hellenistic‐Roman‐Byzantine Period (332 BCE‐640 CE), and Early and Late Arab Period (640–1917 CE). The characteristics of injury on each skull were recorded. Results: A high frequency (25%) of traumatic lesions to the skull was evident among historic populations of the southern Levant, a rate that did not fluctuate significantly over 6,000 years. The most common pattern of trauma was minor circular depressed injuries. Most of the injuries were located on the parietal or frontal bones. Traumatic lesions were more frequent in males than in females, and in mature individuals than in adolescents and children, during all periods. Conclusions: The rate of trauma in the southern Levantine populations was shown to be considerably higher than in other archaeological populations worldwide. The fact that no significant differences in trauma rates were found over time implies that socio‐economical shifts (from agrarian to urban populations) had little impact on the local populations’ aggressive behavior. In contrast, changes in type of injury, from blunt force trauma to sharp force trauma and eventually projectile trauma, reflects changes in weaponry over time. The accumulated characteristics of cranial trauma pattern (type, location, side, size, sex, age) suggest that most of the individuals studied were not engaged directly in warfare. Rather, most injuries seem to be due to blows given during interpersonal violent encounters. Copyright © 2012 John Wiley & Sons, Ltd.     

Life on the Edge of the Arctic: The Bioarchaeology of the Keldudalur Cemetery in Skagafjörður,Iceland

Burials were examined from the late Viking Age early medieval Christian cemetery at the farm of Keldudalur in the Skagafjörður region, Northern Iceland. The cemetery likely served a single household for about 100–120 years, from the beginning of the 11th century AD to the turn of the 12th century. Cemetery inhabitants represent a population that lived through the transitional period when Christianity was established in Iceland. The changes are visible in the mortuary record with the changeover from outlying pagan graves to enclosed Christian cemeteries situated on the farmsteads. Keldudalur is one of the numerous early Christian family cemeteries that littered the 11th century Skagafjörður landscape. The burials included 53 well‐preserved skeletons of 27 adults and 26 subadults. Various factors such as fluctuating climate and environmental conditions, and seasonal or periodical availability of resources have the potential for impacting human diet and health over time. To assess the health status of the burials, data were collected for a number of health status indicators such as stature estimation, developmental enamel defects, porotic hyperostosis, infectious disease, trauma, degenerative joint diseases, dental caries, calculus and tooth loss. Results suggest that inhabitants of Keldudalur experienced periodic stress and rigorous living conditions. Infant mortality was great, although if individuals survived childhood, the age expectancy was fairly high. There was no obvious evidence for interpersonal violence or endemic infectious disease. However, the common occurrence of growth disturbances, generalised periostitis, trauma and degenerative joint disease all point to a number of stressors in the lives of the people at Keldudalur, which is suggestive of a resilient people living and adapting to a harsh and periodically resource scarce subarctic environment. Copyright © 2015 John Wiley & Sons, Ltd.     

The history of head injuries: an overview

The history of cerebral trauma is a large subject and this overview is an attempt to summarise the main trends of understanding and management over the millenia. Although beginning with anthropological evidence, papyrology and Homeric times, the main impetus for its scientific study began with Hippocrates, but little progress was made until the Salernitan period. Because the ancients believed it was the fractured bone and not the underlying neurological status that mattered, and determined whether an operation was to be performed, the classification of head injuries was based on the types of skull fracture and not the underlying neurological damage. Only in recent centuries was it realised that it was not skull fractures that were important but the brain lesion. Further improvement in management occurred during warring periods but the lessons learned were not passed on, although mortality from military wounds has steadily declined. Since only a small percentage of head injuries require surgery, consideration should be given to reserve the time and skills of the neurosurgeon to those cases requiring his expertise; this would require that the preliminary care should be undertaken by physicians with a specific interest in this field.