There is a tendency to think that cancer is a relatively new disease, but this is not the case. It is certainly true that there has been a growth in its incidence in the ‘developed world’, but whether this is due to better diagnosis or to lifestyle is a moot point. It may not have been expected that the archaeological record would produce evidence of cancer. However, the human remains i.e. bones, found during the archaeological dig in the former East Kirk during 2006 do show a few cases of cancer affecting bone.
The prostate gland is a small gland located just below the outlet of the bladder in males. The prostate gland was first described anatomically in 1536. Prostate cancer was not specifically recorded until 1853. Prostate cancer occurs when a growth starts within the gland. In most cases the only problem it is likely to cause is with urinating. However, like other cancers, it can spread outside the prostate into the lymph or metastasise into bone with the back and the hip the common sites of these bony metastatic tumours. It is at this stage that this cancer can become a threat to life.
The photograph shows part of the pelvis of an older man. Towards the top left of the bone are ‘spicules’ – the roughened area – which are characteristic of metastatic prostate cancer. It is likely that he developed considerable pain in his pelvis as a result, a common indication of progression of prostate cancer. We do not know whether this is what caused his death. The date when this man died is not known, but it was somewhere between 15th and 18th century, so was well before the disease was recognised.
(The photograph is copyright Aberdeen Art Gallery & Museums Collections and is used with permission).
It is surprising how many diseases, even relatively uncommon ones, can be identified in human remains uncovered during an archaeological dig. That was particularly true of the large dig which took place in the former East Kirk of St Nicholas in 2006. This blog deals with one of these less common conditions – usually known as Perthes Disease, but more properly known as Legg-Calve-Perthes disease (after the three doctors who identified the condition). The medical term is avascular necrosis.
The condition arises in childhood, between the ages of about 2 and 10, with the highest incidence in the range of 4-8 years. At this age, the bones are still growing, so anything which interferes with this is likely to cause problems. Perthes disease affects the head of the femur – the ball of the thigh bone which fits into the hip. For a reason which is not understood, there is an interruption of the blood supply to this actively growing region of the bone. That causes the bone cells to die – that is where the term avascular necrosis comes from. So the bone stops growing and there is a loss of bone mass resulting in a weakness and wearing away of the bone. At this stage a child will suffer aching in the hip (similar to ‘growing pains’) and may develop a limp. However, with time the blood supply re-establishes and the bone starts growing again. But damage will probably have been done to the bone during the phase when it was dead, often a change of shape will have occurred, so a deformity is a common outcome.
The photograph shows one of the examples found in the dig. This is of an adult man – it is more common in men – and the deformity of the ‘ball’ is quite clearly seen. The hip end of the femur is to the left, and the knee end to the right. At the head end of the bone, the ‘ball’ is pointing downwards. Obviously this is supposed to be round, but it clearly is not. The consequences for the sufferer is an initial shortening of the leg (it usually only affects one leg) giving a pronounced limp and there could be quite limited movement depending on the severity of the deformity. Longer term it is likely that osteoarthritis will develop with all the pain and difficulty which that will bring.
Ankylosis is the medical term used to describe an abnormal adhesion and rigidity of the bones in a joint. The potential causes are many, but frequently arise from injury or disease. Initially in ankylosis there is inflammation in the joints affecting the tendons, muscles and the membranes lining the surfaces of the bones. This is often associated with swelling and pain. The consequence of this is that the bones do not move easily and so they tend to become fixed in one particular position, which may be the one which causes least pain. However, this immobility can then lead to the bones fusing together. When this has happened no movement is possible in the joint, although surgical intervention can sometimes re-establish movement, such as with an elbow or shoulder. There are several different types of ankyloses. One of the common forms arises when the person has an inflammatory disease, such as rheumatoid arthritis which most often affects the fingers and wrist. During the archaeological dig in the former East Kirk a number of examples of ankylosis were found among the human remains, but they were affecting the feet.
The accompanying photographs show two examples of the completely fused bones in the foot which were found. The first one shows two metatarsals (the long bone in the mid-foo, to the rightt) fused to tarsal bones (in the ankle, to the left), whilst the second photograph shows a toe.
There is a tendency to imagine that this type of disease is ‘modern’ and confined to humans. The examples shown were of individuals who lived several hundred years ago. However, paleopathologists have found evidence of ankylosis in the fossil record, including one example of the famous dinosaur Tyrannosaurus rex!
(The photographs are copyright Aberdeen Art Gallery & Museums Collections and are used with permission).
A great deal about the health of individuals interred at St Nicholas Kirk can be learned from their remains uncovered during the archaeological dig. This is one example, others will also be featured, which perhaps comes as a surprise.
From both archaeological and written records, it appears that syphilis was unknown in Europe until the 1490s. It rapidly became a common venereal disease. It is caused by a micro-organism called Treponema pallidum – a spirochete for those interested. An infection can pass through three distinct stages if untreated. The initial stage is of a skin lesion at the site of infection – primary syphilis. Secondary syphilis occurs up to 6 months later and is characterised by a general rash. It may then enter a dormant phase which can last for several decades before entering the final tertiary phase. In this there are soft tissue swellings, called gumma, but these cannot be seen in archaeological specimens. However, there can be changes to the bone and this is how we know that there was at least one case of syphilis uncovered during the archaeological dig in the former East Kirk in 2006.
The photograph is of the skull of a person, probably male, aged between 17 and 25 years old. On it can be seen the characteristic lesions caused by tertiary syphilis. These lesions start as a small depression on the skull, called Caries Sicca, associated with inflammation in the tissue immediately in contact with the bone. This gradually deepens and widens and later new bone is deposited around the edge, giving a slight ridge (called a periosteal reaction). There can be similar reactions on other bones of the body. There were such lesions on all the ‘long bones’ of this person, but these lesions are not as easy to see or as distinctive. It can only be speculation, but the feeling is that whilst this young person could have acquired the infection through his own actions, it is equally possible that this is a case of so called congenital syphilis; in other words, his mother infected him before or during his birth.
We are very grateful to Dr Paul Duffy, our human bone specialist during and following the dig, for his detailed analysis. (His website is http://www.discoverbutearchaeology.co.uk/) The photograph is copyright Aberdeen Art Gallery & Museums Collections and is used with permission.
Skeletal remains can show quite a lot about the health of the deceased person. In the human remains uncovered during the archaeological dig in the former East Kirk in 2006, there were clear indications of diseases which are uncommon today, such as the rickets and osteomalacia shown in a previous post. However, some conditions are still prevalent today; indeed, they might be increasing. This post shows such an example ─ bunions!!
Technically, a bunion is called hallux abducto valgus deformity. It forms when there is pro−longed sideways pressure on the big toe (the hallux) forcing it inwards. The tissue around the joint becomes swollen and tender to touch and some bony tissue may be deposited. Both of these contribute to the pain associated with bunions. Not all the swelling is caused by these effects on the joint, because some is the exposed end of the first metatarsal. It is salutary that societies where shoes are not worn do not have cases of bunions.
A number of individuals were found during the archaeology who had suffered from bunions. One example is shown, the photograph having been taken by osteoarchaeologist Paul Duffy (Brandanii Archaeology and Heritage, www.discoverbutearchaeology.co.uk) during his detailed study of the remains.
Smoking tobacco in a pipe became popular in Europe in the late 16th century soon after the introduction of tobacco. At first tobacco was very expensive, so the bowl of a pipe was made small. As production of tobacco increased, so it became cheaper and the bowls were progressively made larger. A wide range of materials were used to make the pipes, but a common one in the early years was clay because it did not burn along with the tobacco. The disadvantage of clay is that it was easily broken. So, through the late 16th century and for the next couple of centuries, many towns around Europe had sizeable cottage industries producing the pipes to meet the demand to replace the breakages!
As with 20th century cigarettes, so with pipes, workmen often liked to have them in their mouths whilst working. To help a short-stemmed pipe was developed for this purpose, which could easily be held in the teeth to make it less likely that it would be dropped – and probably broken!
However, the constant rubbing of the teeth against the clay wore the surface of the tooth away. This produced a characteristic shape in the affected teeth. The first two pictures illustrating this article show the teeth of two individuals found during the archaeological dig on 2006. The ‘clay-pipe teeth’ wearing is obvious. The third photograph shows the same thing, but this time in a younger adult, before the teeth had been fully worn away, but nevertheless indicating that he had been smoking a pipe for quite some time. During the dig a large number of fragments of pipes were found, but none were complete.
(The photographs are copyright Aberdeen Art Gallery & Museums Collections and are used with permission).
Rickets was once a common bone disease of children. It has a number of potential causes, such as lack of Vitamin D or calcium, which lead to impaired mineralisation of the bone. Whilst Aberdonians in the past would have had a diet fairly rich in fish, which would have helped provide Vitamin D, any population is likely to have some cases of malnutrition. Rickets is usually regarded as a disease of the urban poor because they would probably also suffer from lack of sunlight (we can make Vitamin D in our skin when it is exposed to sunlight) as a result of cramped and smoky living conditions. One of the younger people buried in the grave yard of the Kirk of St Nicholas (and uncovered during the archaeological dig in 2006) had rickets. One of the legs is shown in the photograph. The effect of rickets is to make the bones soft and easily broken. It can be seen how thin and fragile the bone appears, although there is no evidence of a breakage.
The same condition in adults is called osteomalacia, although there can be some other causes as well as diet in adults. It is typically characterised by ‘bent legs’ although it can affect any bone not just those of the legs. The accompanying photograph shows the thigh bones of a person with osteomalacia. The curvature of the bone is very clear, but again this person does not seem to have any fractures.
As a footnote, in recent years there have been report of an increasing incidence in rickets in children. This is not because of poor living conditions but because of a wide and sensible use of sun protection!
Both the photographs, which are copyright of Aberdeen Art Gallery & Museums Collections and are used with permission, were taken during the detailed scientific study of the bones by Dr Paul Duffy, Brandanii Archaeology and Heritage who is a specialist osteoarchaeologist.