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Children of the Golden Minster: St. Oswald’s Priory and the Impact of Industrialisation on Child Health

Children of the Golden Minster: St. Oswald’s Priory and the Impact of Industrialisation on Child... Hindawi Publishing Corporation Journal of Anthropology Volume 2013, Article ID 959472, 11 pages http://dx.doi.org/10.1155/2013/959472 Research Article Children of the Golden Minster: St. Oswald’s Priory and the Impact of Industrialisation on Child Health Mary E. Lewis Department of Archaeology, University of Reading, Reading RG6 6AB, UK Correspondence should be addressed to Mary E. Lewis; m.e.lewis@reading.ac.uk Received 28 February 2013; Revised 1 May 2013; Accepted 13 May 2013 Academic Editor: Maryna Steyn Copyright © 2013 Mary E. Lewis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This study explores the disease experience of children buried within the cemetery of St. Oswald’s Priory, Gloucester from AD1153 to 1857. Evidence for ages-at-death, infant mortality, and the prevalence of stress indicators, trauma, and pathology were compared between the early and postmedieval periods. eTh skeletal remains of these children provide evidence for child health spanning the economic expansion of Gloucester at St. Oswald’s, from a mostly rural parish to a graveyard catering for families from the poorer northern part of the town and the workhouse. Results showed that the children from the postmedieval period in Gloucester suffered higher rates of dental caries (38%) and congenital conditions (17.3%) than their counterparts from the early and later medieval period. This paper serves to highlight the value of nonadult skeletal material in the interpretation of past human health in transitional societies and illustrates the wide variety of pathological conditions that can be observed in nonadult skeletons. 1. Introduction to the surrounding meadows and woodland [9]. Gloucester itself was a middle-ranking market town that benefited The importance of studying nonadult skeletal remains from from its position as an inland port situated along the River the archaeological context is gaining increasing recognition Severn [10, 11]. It received both raw and surplus goods for [1–3], but studies that focus solely on the diseases experience redistribution, and luxury items that were sold to the wealthy. of children from past populations is still uncommon. Due Most people in thetownwereemployedinmanufacturing to their rapid growth, children’s bodies react swiftly to envi- these raw items into goods to be sold. Iron, copper, and lead ronmental insults making nonadult palaeopathology a useful items were widely produced [12]. The rural communities that measure in our understanding of transitional populations. made up St. Oswald’s extramural population would have had This paper explores the health of 137 medieval children close links with Gloucester through the town’s market which buried at St. Oswald’s Priory, Gloucester between AD 1155 they wouldhavevisited regularlyinorder to sell livestock, and 1857 [4]. Results of the skeletal analysis were originally grain, and raw materials for craftsmen [ 8, 12]. presented by Rogers [5], but the palaeopathology of the In 1563, the parish of St. Oswald’s was relatively small children received little attention. and made up of 102 households. By 1743 this had only risen St. Oswald’s parish extended over a large geographical to 119 households with around 406 parishioners. But in the area and those buried at the cemetery would have originally late 1700s, Gloucester experienced rapid economic expansion come from a number of outlying villages [5, 6]. Between due to the growth of its various industries and manufacturing the1100and 1500sthe majority of thepeopleburiedatSt. trades which attracted vast numbers of young migrants from Oswald’s were living a rural lifestyle of subsistence agri- the surrounding countryside [13]. By 1850, shortly before the culture, with children being employed in tending animals, closure of the cemetery, the community of St. Oswald’s had lambing, and spinning wool [7, 8]. Tenant farmers rented increased to around 2000 parishioners [11, 14]and theParish their properties from a Lord and were allocated strips of Register of Baptisms and Burials suggests that the largest land which they harvested. Tenants were also provided with proportion of individuals buried at St. Oswald’s were now common grazing land for their livestock and shared access living within the town. 2 Journal of Anthropology This dramatic population increase led to overcrowding, FoundedinAD679the“newminster”hadRoyalconnections with the intensive development of existing streets forcing and was lavishly decorated, referred to as “golden” due to the expansion into the suburbs and surrounding villages [13]. The amount of gold contained within it [14, 19]. In AD 909, the crowded conditions led to problems with sanitation and waste new minster was rededicated to St. Oswald, whose relics were disposal and frequent epidemics wiped out large sections transferred (or translated) to the site [14]. By the 11th century, of the community [13]. Population growth in the 16th and St. Oswald’s parish had become a poor church, loosing much 17th centuries was dependent on rural-urban migration. The of its status as neighbouring St Peter’s Abbey expanded [19]. influx of migrants only served to swell the numbers of poor By AD 1462, St. Oswald’s was considered one of the poorest unskilled labourers who had difficulty finding employment. parishes in Gloucester. eTh Priory was eventually pulled In the records spanning AD 1595–1640, 69% of apprentices down in AD 1656, but the cemetery remained in use until AD came from the countryside outside the city [15]. Poor harvests 1857 [4]. in the 1580s and the 1640s led to u fl ctuations in food prices eTh total sample comprised 600 burials dating from and many people, especially the urban poor, had dicffi ultly the Roman to the postmedieval period, excavated between ao ff rding basic items, despite the provision of subsidised 1975-8 and 1983. Of these, 28 were reburied during a much food stocks from the town council. Tax records show that earlier excavation, and 508 are now held at the University of 58% of households in St. Oswald’s parish (now renamed St Reading. This study focuses on the 137 nonadults (defined Catherine’s) were exempt from paying tax on account of as those 17 years and under), dating from the Anglo-Saxon poverty [15]. In the 17th century, attempts were made to to postmedieval periods. In the original report the skeletal improve living conditions within the town, including banning sample was divided into four periods: Anglo-Saxon, here butchers from dumping offal into gutters and the River termed early medieval (AD 900–1120); Norman (AD 1120– Severn [16]. Nevertheless in 1832, when a board of health was 1230); later medieval (AD 1230–1540) and postmedieval (AD set up to deal with a cholera epidemic, they found the water 1540–1857). Individuals dating from the later medieval period systems and wells contaminated by cesspits and commented were defined as being buried within the Priory itself and that the streets were “generally squalid” [17]. areassumedtohavebeenthe most wealthyindividuals.For Apprentice records dating from the 1660s show that ease of analysis, the Norman and later medieval groups were Gloucester’s two main industries were metalworking and merged to comprise individuals buried between AD 1120 and clothing, with pin-making employing the greatest number 1540 (𝑛=87 or 55.4%). of men, women, and children [15]. In 1626, Gloucester One early medieval child, aged around 1.5 years, was council charged John Tylsley with the task of setting up contained within a charcoal burial (B113) suggesting a high a pin-making business to employ the disabled children of status, and eight children were located within the church, the town [11, 13]. By the 17th century, individuals buried probably representing children of wealthy parishioners (B170, at St.Oswald’s wouldhavebeenemployedinone of the 171, 370, 384, 398, 403b, 349, and 155). eTh y were all aged town’s manufacturing industries and probably represent the between 18 months and 9 years. In addition, ve fi later poorest sections of the community [4]. Listed occupations medieval babies (11-12th century) were found in a single grave included a cordwainer, labourer, pin-maker, soap-boiler, along the outer north wall of the nave [14]. servant, gardener, yeoman, blacksmith, brewer, hawker, boot- Age at death estimates were obtained using standards maker, baker, basket-maker, stone mason, tanner, and “the of development for the deciduous and permanent dentition infant daughter of Abraham Rudnell,” the bell-maker. From published by Moorrees et al. [20, 21] and tabulated by Smith the ten examples where the ages were recorded on the stone [22]. When no teeth were present, diaphyseal lengths and monuments, the average age of death of the population was skeletal maturation were used to assign age [23]. Perinates calculated to be 58 years [4]. Recordsshowthataworkhouse were aged using British standards developed by Scheuer et was established in Gloucester in 1701, catering for parishes al. [24] based on diaphyseal lengths, or assigned a general including St. Catherine’s, [18]andarecentreviewoftheParish age (early or late perinate) using the dimensions of the pars Records shows that several of the individuals buried in the basilaris [25] and the development of the tympanic ring [26]. cemetery came from the workhouse (Watts pers. comm.). The skeletons were then divided into seven age categories, The use of the cemetery at St. Oswald’s spans this with individuals in the oldest age category (14.6–17.0 years) transition from a predominantly rural burial area to a parish estimated to be older than 17.0 years when the root of the third catering for the poorer sections of the urban community. This molar was complete (Rc=16.9) but the apex open [21]. These paper explores the impact the social and economic changes biological ages are a useful tool for examining key stages of had on the health of children living in the town, that saw developmentinachild’slife(i.e.,atbirth,duringinfancy,early Gloucester transform from a mostly rural later medieval andlatechildhood andadolescence)and provideabaseline centre to a hub of postmedieval industry and trade. from which nonadult populations from different societies can be compared. eTh y are not meant to reflect the cultural concepts of age that existed in the medieval period, where 2. Materials and Methods individuals as old as 25 years were still considered “children” St. Oswald’s Priory is situated to the northwest of Gloucester, if they were employed as apprentices [27]. near thecitywalls.Inthe earlymedievalperioditwas one A general assessment of health is usually made by assess- ing the prevalence of “stress” indicators of the bones and of three major religious houses in the town, including the adjacent St. Peter’s Abbey and Llanthony Secunda Priory [12]. teeth that provide evidence for chronic physiological stress, Journal of Anthropology 3 such as poor nutrition and infections, during childhood Table 1: Proportion of the nonadults to adults in the study sample. [3] and comparing the growth of children at different ages Period Adults Nonadults Total % nonadults compared to modern standards. eTh prevalence of dental Early medieval 117 22 139 15.8 diseases (caries, abscesses, and antemortem tooth loss) on Later medieval 144 87 231 37.6 the deciduous and permanent teeth provides information on diet, oral hygiene, and more general health in children. Mean Postmedieval 94 28 122 22.9 diaphyseal lengths were plotted against dental age estimates Total 355 137 492 27.8 to produce skeletal growth profiles. Individuals aged using long bone lengths only were omitted from this part of the Table 2: Demographic profile of the nonadults divided into periods. analysis. eTh lower limbs are considered to be the most sensitivetoenvironmental stress as thefemur andtibia are Age Early Later Post-medieval Total (years) medieval medieval some of the fastest growing bones of the body [28]. eTh refore, femoral diaphyseal length measurements were chosen to Perinate 3 19 1 23 assess growth. 0.0–0.5 1 8 2 11 The term “cribra orbitalia” refers to pitted lesions on 0.6–1.0 0 5 0 5 the orbital roofs. Although traditionally considered to be 1.1–2.5 5 11 (10+1)3 19 indicative of iron deficiency anaemia [ 29], the exact aetiology 2.6–6.5 8 18 (15+3)11 37 of cribra orbitalia is still open to question, and recently it has been suggested that the marrow expansion typical of these 6.6–10.5 1 14 (10+4)4 19 lesions is the result of megaloblastic anaemia due to vitamin 10.6–14.5 3 4 7 14 B deficiency found in fresh meat and vegetables [ 30]. Iron 14.6–17.0 1 2 0 3 deficiency anaemia, caused by chronic low grade infections, ?age 0 6 0 6 has also been associated with these lesions, that result from Total 22 87 28 137 thinning of the cortical bone covering the orbital roof and (Numbers in brackets show number of “Norman” plus “later-medieval” expansion of the inner bone marrow [29]. This process can skeletons). only occur during childhood when this area contains red bone marrow. Dental enamel hypoplasia present as linear and pitted defects on the surface enamel and are known and a lesion was considered “absent” when the tibiae were to result from severe periods of stress that affect enamel available for examination but none of the bones showed any production [31]. All dental crowns develop during childhood infection. Finally, diseases of the metabolism (i.e., rickets and (c. 0–16 years) providing an almost permanent record of scurvy) were diagnosed using the criteria set out by Ortner childhood stress. New bone formation (or periostitis) on the and various colleagues [36–38], and Brickley and Ives [39]. skeleton, as a result of inflammation of the soft tissues during Other pathologies, including dental disease, were recorded an infection or resulting from mild trauma, is commonly using standard published criteria [29, 40]. recorded in bioarchaeology. eTh location of these lesions provides clues as to the cause of the condition. For example, 3. Results and Discussion new bone formation on the internal surface of the ribs signals a respiratory infection [29, 32], whereas new bone forming Table 1 presents the age-at-death distribution of the entire on the tibiae (shins) is often the result of inflammation due sample. At St. Oswald’s Priory, 27.8% of the whole sample was to a knock. Widespread new bone formation usually signals a made up of children less than 17 years of age. However, this more systemic disease (i.e., leprosy, syphilis, tuberculosis, or is not consistent throughout the periods, with the majority Caffey’s disease). of children (𝑛=87 , 63.5%) coming from the later medieval The frequency of cribra orbitalia, dental enamel hypopla- (or rather Norman) context. When the ages and periods are sia, and new bone formation was recorded in the St. Oswald’s broken down (Table 2;Figure 1), children aged between 2.6– nonadults. Chi-squared tests for 2 × 2and2×𝑐 tables, 6.5 years were the most numerous. with Yate’s continuity correction [33], were carried out to test the differences in prevalence of stress indicators between the three periods. Cribra orbitalia was graded using the 3.1. Infant Mortality. Full-term infants are recognised as scheme devised by Stuart-Macadam [34] and an assessment those aged between 38 and 40 weeks and in the past would of active and remodelled lesions was also recorded, using have been viable without the aid of modern intervention. the descriptions provided by Mensforth et al. [35]. In order Clinically, infant mortality rates are subdivided into those to ensure that nonspecific dental enamel hypoplasias were who die before birth (late fetal or stillbirths), those dying recorded, as opposed to those caused by localized trauma or at birth or within the first 27 days of extrauterine life infection, more than two teeth, on opposite sides of the jaw, (neonatal mortality), and those who die between 28 days and had to be affected before “presence” was recorded. Enamel one year (postneonatal mortality). eTh majority of neonatal hypoplasias were only considered “absent” when four or more deaths are considered to reflect the endogenous state of the anterior teeth were available for examination and did not infant as the result of genetic and maternal influences (e.g., display defects. Healed (lamellar form) and active (fibre bone congenital anomalies, prematurity, low birth weight, and form) periostitis was recorded throughout the skeleton [29] birth trauma), and post-neonatal mortality is seen more as 4 Journal of Anthropology 20 20 1 1 Early medieval Later medieval Postmedieval Neonatal Postneonatal Early medieval Figure 2: Number of perinates divided by gestational age (weeks) Later medieval and period. Postmedieval Figure 1: Number of nonadults by age and period. a consequence of the child’s external environment or exoge- nous factors (infectious diseases, poor nutrition, poisonings, and accidents) [41]. However, a crude estimate of exogenous and endogenous deaths can be established by looking at the numbers of individuals dying between the ages of c.28 and 40 weeks of gestation compared to 41–48 weeks. Hence, the percentage of neonatal deaths, including possible stillbirths and post-neonatal deaths, were compared between time periods to see if different patterns of infant mortality could be discerned. 0 0123456789 10 11 12 13 In total, 22 individuals from the site were classed as Mean age (years) neonates, with ages ranging from just 26 weeks to 40 weeks. The majority of neonates ( 𝑛=8 or 36%) were aged at 39 Later medieval weeks. There was only one postmedieval neonate (39 weeks) Postmedieval in thesample, andnoneonateswererecovered from inside Maresh [42] the church. The neonates from the “mass grave” (B421a-e) by Figure 3: Growth profiles of the later and postmedieval children, the external wall of the nave were aged between 35 and 40 compared to modern children. weeks and are therefore are likely to represent those who died from a variety of causes including prematurity and infection, rather than a single factor such as infanticide. Within the environmental impact to their death. The numbers were too later-medieval sample, one neonate displayed a series of small to test for significance. lesions that probably represented a fatal congenital syndrome where the notochord failed to regress. eTh child (B418) died aged 39 weeks, but it is impossible to tell if they were stillborn. 3.2. Growth Prole fi s. The growth profiles were plotted in eTh thorax revealed anumberofcleftvertebrae andfused one-year age categories. As there were only nine children (bifid) ribs, probably signalling other soft tissue anomalies in the early medieval sample with preserved femora, they thatwouldhavemadethiscongenitalsyndromeincompatible were removed from the analysis between periods. eTh profiles with life (Figure 2). There were nine postneonates (41–48 for the later and postmedieval children were compared, weeks) in the sample, with six or 67% derived from the with gaps in the data filled by taking an average of the later medieval group. When the proportion of neonates measurement in the age group above and below it (Table 3). and postneonates was compared (Figure 3), the number All data were then combined to provide a growth profile of neonates, or individuals dying from endogenous causes, for the St. Oswald’s children with individuals plotted and set outweighed postneonates in the early and later medieval against data from children in Denver between 1935 and 1955, samples, significantly so for the later medieval group ( 𝑋 = provided by Maresh [42] (Figures 4 and 5). Despite the small 13.52,𝑃=0.001 , 1d.f.). In the postmedieval period there were sample sizes, the trend was for the heights of the children more perinates dying several weeks after birth, suggesting an from St. Oswald’s to fall below those of the modern children Number Perinate 0–0.5 0.6–1.0 1.1–2.5 2.6–6.5 6.6–10.5 10.6–14.5 14.6–17 ?age Femoral diaphyseal lengths (mm) Number Journal of Anthropology 5 Table 3: Mean femoral diaphyseal lengths (mm). eTh numbers on italics are averaged from the measurements above and below them. Early medieval Later medieval Post-medieval Mean age (years) 𝑁 mm 𝑁 mm 𝑁 mm 0 1 83.98 5 97.51 1 84.2 12 137.7 3 149.3 0 20 1 139 0 3 0 2 188.5 2 210 42 208 2 189 1 239 52 250 3 213.3 0 247.5 60 4 223 1 256 70 1 268 0 267 Figure 4: Skeleton B418 showing congenital fusion of the ribs and 8 1 291 5 305.7 1 278 notochord regression failure. 90 1 297 0 305.5 10 1 286 0 301 3 333 11 1 305 2 326.5 12 0 327.2 1335 13 1 349.5 2 343 Total 9 29 14 aer ft 2 years of age, but with the postmedieval children showing similar heights to the modern children between the ages of 3–5 years. Overall, the urban postmedieval children were taller than the rural children from the later medieval period, although limited numbers meant that this could not be tested statistically. 0 2468 10 12 14 16 3.3. Dental Disease. Seventy-eight children had teeth avail- Age (years) able for examination; with 450 deciduous teeth (297 molars) Mean Later medieval and 660 permanent teeth (243 molars). Eleven children in Early medieval Postmedieval total had dental caries (14.1%), and three had developed dental abscesses. All of the children with abscesses came Figure 5: Growth profile of each individual against the mean, by from the postmedieval period. The true prevalence rate (TPR) period. was 3.3% caries for deciduous dentition and 1.8% caries for the permanent teeth (Table 4). When examined by period, the postmedieval children had the highest rates of caries with a crude prevalence rate (CPR) of 38%, followed by the for all periods, the overall prevalence of dental caries at St. early medieval group where 12.5% individuals had caries. eTh Oswald’s Priory is low in comparison. lowest rates were in the later medieval children with only 0.2% of teeth (TPR), or 2.4% individuals aeff cted (CPR). This pattern of caries rates through time differs from previous 3.4. Cribra Orbitalia. Of the 77 nonadults with preserved research into dental disease in medieval children where orbits, 40 (52%) children displayed cribra orbitalia; 25 (32%) reported rates for caries on deciduous teeth were at 3.5%, hadcribraorbitalia graded 2, and15(19%) hadmoresevere 4.5%, and 28.5% for early, later, and postmedieval children, cribra orbitalia at Grades 3 to 4 (Table 5,Figure 6), no respectively [43–45]. The drop in caries rates during the later cases were scored as severe as Grade 5, and Grade 1 was not medieval period is difficult to explain. James and Miller [ 46] considered pathological. eTh highest prevalence was in the found an overall caries rate of 9.1% for their later medieval latermedievalsamplewhere allcases were scored at Grade children buried at Chuddington Church in London and 3(𝑛=2 )and 4(𝑛=2 ). Six of the seven cases of Grade other English later medieval sites showed much higher crude 4 cribra orbitalia came from the later medieval group, with prevalence rates with 39% for Blackfriars in Ipswich (Mays the na fi l case from a postmedieval child. When then the early 1991), 34% at Taunton, Sussex 16% at Canterbury, Kent [47], and later medieval (arguably “rural”) samples were combined, and 17% at Wharram Percy, Yorkshire [48]. At just 14.1% 23% of the children with orbits had cribra orbitalia, compared Diaphyseal length (mm) 6 Journal of Anthropology Table 4: True percent prevalence of dental caries in the deciduous and permanent teeth. Deciduous Deciduous Permanent Permanent Period Total teeth % caries teeth/affected molars/affected teeth/affected molars/affected Early medieval 207 132/4 76/2 75/0 30/0 1.9% Later medieval 549 231/1 162/0 318/0 114/0 0.2% Post-medieval 354 87/10 59/9 267/12 99/11 6.2% Total 1110 450/15 297/11 660/12 243/11 % caries 3.3% 3.7% 1.8% 4.5% Table 5: Percent prevalence of cribra orbitalia. Early Later Post-medieval medieval medieval 𝑁 affected/ 𝑁 with orbits 2/10 9/37 4/16 % aeff cted 20 24.3 25 Table 6: Crude prevalence rate of dental enamel hypoplasia. Early Later Post-medieval medieval medieval Figure 6: Fibre (woven) bone endocranial lesions on the parietal of Hypoplasia/𝑁 with teeth 2/12 15/40 8/17 a 3-4 year old later medieval child (B403b). % aeff cted 16.6 37.5 47 Table 7: Crude prevalence rate of endocranial lesions. 37.5 36.2 Early Later Post-medieval medieval medieval Lesions/𝑁 with crania 0/14 6/57 0/20 24.3 25 23.8 %aeff cted 0 33.3 0 16.6 to 25% of the postmedieval children. This difference was not significant ( 𝑋 =0.02). 10.5 6.6 3.5. Dental Enamel Hypoplasia. Enamel hypoplasia was scored for presence or absence on individuals with at least four anterior teeth, including the canine. eTh type and Cribra orbitalia Enamel hypoplasias Endocranial lesions number of teeth aeff cted were not scored and so these gur fi es represent crude rates only. Of the 69 children with anterior Postmedieval Early medieval dentition, 25 (36%) displayed enamel hypoplasia suggesting Later medieval Total stress in early childhood (Table 6,Figure 6). The highest Figure 7: Crude percent prevalence of stress indicators, divided by prevalence (47%) came from the postmedieval sample, and period. 37.8% of the higher status later medieval children displayed enamel hypoplasia. When the early and later medieval groups were combined, 32.7% children had enamel defects, com- endocranial lesions in the form of active new bone formation pared to 47% of the postmedieval children. This difference (Figure 6). Table 7 (Figure 7) provides a breakdown of these was significant ( 𝑋 =6.65,𝑃=0.01 , 1.d.f.). cases. Allofthe casescamefromchildrendatingtothe later medieval period, with the highest prevalence (𝑛=2/6 or 3.6. Endocranial Lesions. These unusual lesions present as 33.3%) in the high status group buried inside the Priory, and new bone formation on the internal or endocranial surface of 10.5% affected overall. theskull,ofunknown aetiology[49], but they may be related to low grade inflammation of the meninges or conditions such as scurvy (vitamin C deficiency). As their aetiology 3.7. GeneralSkeletalPathology. In the initial skeletal report is obscure, they are considered evidence for nonspecific [5] no pathologies were recorded on the nonadult remains physiological stress in the group. Of the 77 children with (defined in 1999 as individuals between the ages of 0– cranial fragments available for observation, six (7.8%) had 15 years). Reanalysis of the material has revealed that of (%) Journal of Anthropology 7 Table 8: Number of cases of skeletal trauma or pathology in the nonadult sample. Period 𝑁 affected/ 𝑁 Individuals Trauma Infection Congenital Metabolic Other % aeff cted Early medieval 4/17 1 1 2 23.5 Norman 17/60 2 4 4 5 3 28.3 Later medieval 4/7 3 1 57.1 Post-medieval 9/23 1 4 6 39.1 Total 37/107 7 5 8 6 11 34.5 39.1 the 107 children from St. Oswald’s Priory with well-preserved 40 skeletonstoenableapathological assessment,37(34.5%) showed some form of skeletal pathology (Table 8). Overall, 29.7 therates of skeletal pathology, andinparticularcongenital conditions, were higher in the postmedieval sample (Fig- ure 8). Although the results for overall pathology were not 17.3 statistically significant for either the early medieval to later medieval transition (𝑋 =0.40), or the postmedieval period 7.1 7.1 (𝑋 =0.73), the variety of lesions in this sample is worthy of 5.9 5.9 4.7 4.3 note. Three of the eight (37.5%) high status children from the Nave of the church had head injuries: a blade injury (B403b, 3.5 years), a possible trepanation (B398, 8 years), and a depressed head injury (B171, 9 years). The most striking case Rural of nonadult trauma was a fractured left humerus of an 18- Urban month-old child (B376) from the Norman period (Figure 9). Figure 8: Percentage of pathologies in the rural (early and later This child was also notable as being the only one with clear medieval) and urban (postmedieval) children. signs of rickets (vitamin D deficiency) at the site, with frayed and expanded costal rib ends and pitting to the scapula. It is tempting to interpret this burial as one representing a child who was neglected and physically abused as shaft fractures of the humerus are rare in children [50]. However, the pathology may have other causes. In some cases children are born with a condition known as refractory rickets, where the child is unable to absorb vitamin D from their diet [51]. Thisinturnmakes thebones weak andliabletofracture. Perhaps this child is an example of this congenital disorder, and the fracture occurred accidentally when the child was picked up. However, fractures as the result of rickets are more commonly found at the metaphyseal or growing end of the bone [52], and this fracture also displayed a fairly new callus, suggesting that the child sustained the fracture shortly before their death. Other evidence for metabolic disease at the site is less conclusive. Five children demonstrate lesions that may be interpreted as demonstrating either vitamin C (scurvy) or vitamin D (rickets) deficiency (B404, B97, B162, B398, and B104)and alldatetothe latermedievalperiod. eTh re areno cases of metabolic disease in the earlier or later periods. Figure 9: Left humerus and scapula of B376 note the pitting of the eTh re were several other cases of trauma in the sample. superior subscapular margin, indicative of rickets, and the newly A 10-11-year-old early medieval child (B486) had a possible formed callus at the humeral midshaft. fracture to the ftfih lumbar vertebra; a 6-month-old Nor- man child (B153) had a fractured clavicle that suggested a birth injury. Birth injury is also a likely explanation for the hypertrophy of the left distal humerus seen in a 42- aspects of the lumbar vertebrae were compressed, and there week infant from the later medieval period (B15) (Figure 10. was shortening of the left arm and leg compared to the Verlinden pers. comm.). One 10–14-year-old child (B298) right which may indicate damage to the nervous system. A from the postmedieval period displayed a series of changes congenital syndrome may also have caused these changes, as that mayhavebeenassociatedwithtrauma. eTh anterior there was abnormal eruption of the dentition, with the lateral (%) Trauma Infection Congenital Metabolic Other Total 8 Journal of Anthropology neurological damage as the spinal cord is impinged and may have resulted in paralysis of the left arm. In addition to these changes, the child had premature suture closure to the side of the skull (occipito-mastoid suture) and possible hydro- cephalus (“water-on-the-brain”), which suggests a possible butunspeciefi dcongenitalsyndromeinthischild.Thesecond case is of a 10-year-old child (B306), who demonstrated severe dental overcrowding, maleruption, and a supernumerary (Figure 12) and enlarge tooth (macrodont). Although there was postmortem damage to the anterior aspect of the maxilla, these changes are indicative of a cleft lip and palate which oen ft accompanies a congenital syndrome. eTh child also demonstrated a cleft neural arch of the atlas that should fuse between 5 and 6 years of age [23]. In addition to the series of congenital defects already identified in the perinate B418, other congenital anomalies included a possible cervical rib (B163, 16 years), a possible cleft atlas (B42, 8 years), a reduced and narrow auditory meatus that may indicate the child was deaf or had defective hearing in one ear (B74, c.6 years), Figure 10: Probable spiral fracture of the distal humerus in B15. and cleft neural arches of the h lumbar vertebrae (B332, and B323 both c.10 years). It should be noted that congenital conditions are usually related to maternal stress or genetic maxillaryincisor hadfailedtoerupt,leaving thedeciduous mutations [54] and are equally distributed between the later tooth in place, and the canine displayed delayed eruption. and postmedieval periods. There was one case of joint disease, an unusual occurrence Two children had supercondylar processes of the humerus (one unilateral, one bilateral) and it is possible that they are in anonadultsample. A14–17 year adolescent from thelater the result of trauma (B 499, c.4 years; B107, c.7 years) as this is medieval (Norman) period demonstrated osteoarthritis in the left foot and right knee (patella), and osteochondritis one of the most common areas for children to suffer trauma today [50]. A postmedieval child aged around 6 years (B251) dissecans a circulatory disorder, on the left distal humerus. hadanexostosis on theright ulna that maybeinterpreted as a All of these features indicate a high degree of physical activity fracture, although these are all subtle and identifying trauma at a young age, and it is tempting to suggest this individual was is acomplex issueinchildren[53]. an apprentice. Finally, there were several cases of pathological Several of the children had evidence for asymmetry of changesthatcould notbeassignedtoaparticular disease the limbs that may have resulted from an infection such category; in particular, an infant (B430) showed honeycomb as poliomyelitis or chickenpox which can cause temporary lesions of the metatarsals and vertebral spinous processes, that appeared pathological. and permanent limb paralysis, or trauma at birth (Erb’s palsy). Five cases of disuse atrophy were of the upper limb, in children aged between 5 and 15 years, and there were 4. Conclusions three cases of lower limb atrophy in children aged between 5 and 11 years. The most prominent cases were in B95 and The paper examined the impact the transition from a B248 with 4 cm and 3.5 cm difference between the upper predominantly rural lifestyle to an urban manufacturing limbs, respectively, and B298 whose left leg was 3.5 cm environment had on the health of children from medieval shorterthanthe right. In most cases, thelimbs were not Gloucester. A secondary aim was to highlight the variety of pathological lesions that can be identiefi d on nonadult significantly thinner, suggesting some mobility had returned to the aeff cted limb before the child died. If all the children skeletal material. eTh St. Oswald’s Priory sample comprised came from the same time period, this may indicate the children dating from the early medieval period and contained troubling practices of a particular midwife operating in both high and low status later medieval nonadults, who may Gloucester, or perhaps the high incidence of breech births have been working as apprentices in the metal or leather in the town. However, the cases were spread across time working industry, and postmedieval children, some of whom periods, with two early medieval, one later medieval, and ve fi may have been living in the Gloucester Workhouse. In 1973, postmedieval cases. In most cases, the temporary paralysis Weiss estimated that 30–70% of children in a developing soci- caused by neural damage during a bout of polio is most ety would die before the age of 15 years [54], with the highest likely, but two cases, both dating to the postmedieval period mortalityrates in the1–5 year agegroup.This gfi ureisoeft n (AD1540-1857) are of more complex aetiology. B368, 2–6 used as a “gold-standard” for measuring the completeness of a years old, demonstrated severe wasting (thinning) of the skeletal sample and the level of child representation. However, left arm (Figure 11(a)), and a triangular rather than oval- thesedatashouldbeusedwithcaution as they maynot shaped foramen magnum (Figure 11(b)) with evidence of represent mortality rates of archaeological populations before basilar flattening was caused by the abnormal position of the industrialisation [55]. Infant mortality rates for many past first cervical vertebra (atlas). This condition usually results in populations are uncertain; however in 16th century England, fift Journal of Anthropology 9 (a) (b) Figure 11: (a) Comparison on the left and right humerus of B368. Note the significant shortening and thinning of the left humeral shaft, indicative of disuse atrophy. (b) Triangular foramen magnum of B368. Note the flattening of the areas to the right of the formen magnum, signalling basilar compression, and neural impingement. 44% children died before the age of 5 years, but only 10% of postmedieval child burials were recovered from the excavated area [5]. eTh growth data for the children from the later and postmedieval contexts show that both fell below modern standards, a typical result for archaeological populations, but interestingly the postmedieval children seem to keep pace with the modern children between 3 and 5 years and at 11 years. Although the number is too small to draw any firm conclusions, this may indicate that the postmedieval urban group was receiving adequate nutrition when they died, sug- gesting that their deaths were the result of an acute infection, as opposed to general chronic malaise [58]. This result may Figure 12: Unusual maxillary dentition of B306 showing a macro- also be interpreted as suggesting a high rate of mortality in dontia supernumerary tooth at the midline. es Th e features are seen this period that resulted in as many tall individuals entering in modern children with cleft lip and palate. the morality record as the short or stunted [59]. Other indicators of physiological stress suggested some adverse environmental eeff cts on the postmedieval children. Enamel it was estimated that around 27% of children died before the hypoplasias were significantly higher, and the majority of age of one year [56]. Given the inconsistency with which postmedieval perinates were aged over 40 weeks indicating stillbirths and neonatal deaths were reported in the past, factors relating to hygiene, diet, and exposure to infections historical records are likely to reflect a minimum number caused their death. However, given that the postmedieval only [57]. At St. Oswald’s Priory, only 27.8% of the whole child sample is likely to be skewed, this should be treated sample was made up of children less than 17 years of age, with some caution. Dental caries rates, which were higher suggesting that they are underrepresented. However, this is in the postmedieval group, can reflect general malnutrition not consistent throughout the periods, with the majority of in children if they occur as the result of occlusal enamel children (63.5%) coming from the later medieval context. defects that are subsequently hidden [60, 61]. The increased The infants (under 1-year) made up 28.4% of the nonadult levels of dental caries and abscesses certainly suggest they sample but only three came from the latest period of the had access to more refined foods such as sugar in their diet. What is evident is that there was a wide variety of congenital cemetery. A discrepancy between the burial registers and number of postmedieval infant skeletons recovered from the conditions in the postmedieval group, including cases of site led Rogers [5] to suggest that babies may have been buried basilar compression, cleft palate and lip, and upper and lower in a special area of the cemetery which was not excavated. limb atrophy. Such conditions often reflect maternal stress Additionally, in AD 1813-50 the burial registers recorded that during pregnancy [54]. 10 Journal of Anthropology The higher status later-medieval group buried within the [13] N. Herbert, “Gloucester, 1720–1835,” in AHistory of Gloucester- shire,C.Elrington,Ed.,pp. 124–169, Alan Sutton Publishing, Priory building, although few, also interesting. Despite their Gloucester, UK, 1988. potentially more privileged lifestyle, they had the most severe [14] C. Heighway and M. Hare, “Gloucester and the Minster of St forms of cribra orbitalia, and highest rates of dental enamel Oswald: a survey of the evidence,” in The Golden Minster. eTh hypoplasia and endocranial lesions. They were also the group Anglo-Saxon Minster and Later Medieval Priory of St Oswald, with three potential head injuries. Gloucester,C.Heighwayand R. Bryant,Eds., vol. 117, pp.1–46, In conclusion, its seems that the rapid population expan- Council for British Archaeology, York, UK, 1999. sion and increased poverty highlighted in the documentary [15] P. Clarke, “Early Modern Gloucester, 1547–1720,” in AHistory records for Gloucester during the postmedieval period is of Gloucestershire,C.Elrington,Ed.,pp. 73–123,AlanSutton evident on the skeletal remains of the children from St. Publishing, Gloucester, UK, 1988. Oswald’s Priory. This study illustrates the importance of care- [16] C. Heighway, The East and North Gates of Gloucester and Asso- ful examination of the nonadult material from archaeological ciated Sites. Excavation Monograph 4, Western Archaeological sites in order to gain a detailed insight into population health Trust, Bristol, UK, 1983. in transitional societies in the past. [17] A. Juˇrica, “Gloucester, 1835–1985,” in AHistory of Gloucester- shire,C.Elrington,Ed.,pp. 170–241, Alan Sutton Publishing, Acknowledgments Gloucester, UK, 1988. [18] S.S.f.t.P.o.C. Knowledge, An Account of Several Workhouses for The author is grateful for the comments of the Editor and Employment and Maintainance of the Poor, Joseph Downing, anonymous reviewers for their comments on an earlier ver- London, UK, 1725. sion of this paper. The St. Oswald’s Priory skeletal collection [19] R. Bryant and C. Heighway, “Excavations at the St Mary de is held at the University of Reading, on long-term loan from Lode Church, Gloucester 1978-9,” Transactions of the Bristol and Gloucester Museum, UK. Gloucestershire Archaeological Society,vol.121,pp. 97–178,2003. [20] C. F. Moorrees, E. A. Fanning, and E. E. Hunt, “Formation References and resorption of three deciduous teeth in children,” American Journal of Physical Anthropology,vol.21, pp.205–213,1963. [1] J. Wileman, Hide and Seek. The Archaeology of Childhood , [21] C. F. Moorrees, E. A. Fanning, and E. E. 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Children of the Golden Minster: St. Oswald’s Priory and the Impact of Industrialisation on Child Health

Journal of Anthropology , Volume 2013 – May 30, 2013

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Copyright © 2013 Mary E. Lewis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Hindawi Publishing Corporation Journal of Anthropology Volume 2013, Article ID 959472, 11 pages http://dx.doi.org/10.1155/2013/959472 Research Article Children of the Golden Minster: St. Oswald’s Priory and the Impact of Industrialisation on Child Health Mary E. Lewis Department of Archaeology, University of Reading, Reading RG6 6AB, UK Correspondence should be addressed to Mary E. Lewis; m.e.lewis@reading.ac.uk Received 28 February 2013; Revised 1 May 2013; Accepted 13 May 2013 Academic Editor: Maryna Steyn Copyright © 2013 Mary E. Lewis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This study explores the disease experience of children buried within the cemetery of St. Oswald’s Priory, Gloucester from AD1153 to 1857. Evidence for ages-at-death, infant mortality, and the prevalence of stress indicators, trauma, and pathology were compared between the early and postmedieval periods. eTh skeletal remains of these children provide evidence for child health spanning the economic expansion of Gloucester at St. Oswald’s, from a mostly rural parish to a graveyard catering for families from the poorer northern part of the town and the workhouse. Results showed that the children from the postmedieval period in Gloucester suffered higher rates of dental caries (38%) and congenital conditions (17.3%) than their counterparts from the early and later medieval period. This paper serves to highlight the value of nonadult skeletal material in the interpretation of past human health in transitional societies and illustrates the wide variety of pathological conditions that can be observed in nonadult skeletons. 1. Introduction to the surrounding meadows and woodland [9]. Gloucester itself was a middle-ranking market town that benefited The importance of studying nonadult skeletal remains from from its position as an inland port situated along the River the archaeological context is gaining increasing recognition Severn [10, 11]. It received both raw and surplus goods for [1–3], but studies that focus solely on the diseases experience redistribution, and luxury items that were sold to the wealthy. of children from past populations is still uncommon. Due Most people in thetownwereemployedinmanufacturing to their rapid growth, children’s bodies react swiftly to envi- these raw items into goods to be sold. Iron, copper, and lead ronmental insults making nonadult palaeopathology a useful items were widely produced [12]. The rural communities that measure in our understanding of transitional populations. made up St. Oswald’s extramural population would have had This paper explores the health of 137 medieval children close links with Gloucester through the town’s market which buried at St. Oswald’s Priory, Gloucester between AD 1155 they wouldhavevisited regularlyinorder to sell livestock, and 1857 [4]. Results of the skeletal analysis were originally grain, and raw materials for craftsmen [ 8, 12]. presented by Rogers [5], but the palaeopathology of the In 1563, the parish of St. Oswald’s was relatively small children received little attention. and made up of 102 households. By 1743 this had only risen St. Oswald’s parish extended over a large geographical to 119 households with around 406 parishioners. But in the area and those buried at the cemetery would have originally late 1700s, Gloucester experienced rapid economic expansion come from a number of outlying villages [5, 6]. Between due to the growth of its various industries and manufacturing the1100and 1500sthe majority of thepeopleburiedatSt. trades which attracted vast numbers of young migrants from Oswald’s were living a rural lifestyle of subsistence agri- the surrounding countryside [13]. By 1850, shortly before the culture, with children being employed in tending animals, closure of the cemetery, the community of St. Oswald’s had lambing, and spinning wool [7, 8]. Tenant farmers rented increased to around 2000 parishioners [11, 14]and theParish their properties from a Lord and were allocated strips of Register of Baptisms and Burials suggests that the largest land which they harvested. Tenants were also provided with proportion of individuals buried at St. Oswald’s were now common grazing land for their livestock and shared access living within the town. 2 Journal of Anthropology This dramatic population increase led to overcrowding, FoundedinAD679the“newminster”hadRoyalconnections with the intensive development of existing streets forcing and was lavishly decorated, referred to as “golden” due to the expansion into the suburbs and surrounding villages [13]. The amount of gold contained within it [14, 19]. In AD 909, the crowded conditions led to problems with sanitation and waste new minster was rededicated to St. Oswald, whose relics were disposal and frequent epidemics wiped out large sections transferred (or translated) to the site [14]. By the 11th century, of the community [13]. Population growth in the 16th and St. Oswald’s parish had become a poor church, loosing much 17th centuries was dependent on rural-urban migration. The of its status as neighbouring St Peter’s Abbey expanded [19]. influx of migrants only served to swell the numbers of poor By AD 1462, St. Oswald’s was considered one of the poorest unskilled labourers who had difficulty finding employment. parishes in Gloucester. eTh Priory was eventually pulled In the records spanning AD 1595–1640, 69% of apprentices down in AD 1656, but the cemetery remained in use until AD came from the countryside outside the city [15]. Poor harvests 1857 [4]. in the 1580s and the 1640s led to u fl ctuations in food prices eTh total sample comprised 600 burials dating from and many people, especially the urban poor, had dicffi ultly the Roman to the postmedieval period, excavated between ao ff rding basic items, despite the provision of subsidised 1975-8 and 1983. Of these, 28 were reburied during a much food stocks from the town council. Tax records show that earlier excavation, and 508 are now held at the University of 58% of households in St. Oswald’s parish (now renamed St Reading. This study focuses on the 137 nonadults (defined Catherine’s) were exempt from paying tax on account of as those 17 years and under), dating from the Anglo-Saxon poverty [15]. In the 17th century, attempts were made to to postmedieval periods. In the original report the skeletal improve living conditions within the town, including banning sample was divided into four periods: Anglo-Saxon, here butchers from dumping offal into gutters and the River termed early medieval (AD 900–1120); Norman (AD 1120– Severn [16]. Nevertheless in 1832, when a board of health was 1230); later medieval (AD 1230–1540) and postmedieval (AD set up to deal with a cholera epidemic, they found the water 1540–1857). Individuals dating from the later medieval period systems and wells contaminated by cesspits and commented were defined as being buried within the Priory itself and that the streets were “generally squalid” [17]. areassumedtohavebeenthe most wealthyindividuals.For Apprentice records dating from the 1660s show that ease of analysis, the Norman and later medieval groups were Gloucester’s two main industries were metalworking and merged to comprise individuals buried between AD 1120 and clothing, with pin-making employing the greatest number 1540 (𝑛=87 or 55.4%). of men, women, and children [15]. In 1626, Gloucester One early medieval child, aged around 1.5 years, was council charged John Tylsley with the task of setting up contained within a charcoal burial (B113) suggesting a high a pin-making business to employ the disabled children of status, and eight children were located within the church, the town [11, 13]. By the 17th century, individuals buried probably representing children of wealthy parishioners (B170, at St.Oswald’s wouldhavebeenemployedinone of the 171, 370, 384, 398, 403b, 349, and 155). eTh y were all aged town’s manufacturing industries and probably represent the between 18 months and 9 years. In addition, ve fi later poorest sections of the community [4]. Listed occupations medieval babies (11-12th century) were found in a single grave included a cordwainer, labourer, pin-maker, soap-boiler, along the outer north wall of the nave [14]. servant, gardener, yeoman, blacksmith, brewer, hawker, boot- Age at death estimates were obtained using standards maker, baker, basket-maker, stone mason, tanner, and “the of development for the deciduous and permanent dentition infant daughter of Abraham Rudnell,” the bell-maker. From published by Moorrees et al. [20, 21] and tabulated by Smith the ten examples where the ages were recorded on the stone [22]. When no teeth were present, diaphyseal lengths and monuments, the average age of death of the population was skeletal maturation were used to assign age [23]. Perinates calculated to be 58 years [4]. Recordsshowthataworkhouse were aged using British standards developed by Scheuer et was established in Gloucester in 1701, catering for parishes al. [24] based on diaphyseal lengths, or assigned a general including St. Catherine’s, [18]andarecentreviewoftheParish age (early or late perinate) using the dimensions of the pars Records shows that several of the individuals buried in the basilaris [25] and the development of the tympanic ring [26]. cemetery came from the workhouse (Watts pers. comm.). The skeletons were then divided into seven age categories, The use of the cemetery at St. Oswald’s spans this with individuals in the oldest age category (14.6–17.0 years) transition from a predominantly rural burial area to a parish estimated to be older than 17.0 years when the root of the third catering for the poorer sections of the urban community. This molar was complete (Rc=16.9) but the apex open [21]. These paper explores the impact the social and economic changes biological ages are a useful tool for examining key stages of had on the health of children living in the town, that saw developmentinachild’slife(i.e.,atbirth,duringinfancy,early Gloucester transform from a mostly rural later medieval andlatechildhood andadolescence)and provideabaseline centre to a hub of postmedieval industry and trade. from which nonadult populations from different societies can be compared. eTh y are not meant to reflect the cultural concepts of age that existed in the medieval period, where 2. Materials and Methods individuals as old as 25 years were still considered “children” St. Oswald’s Priory is situated to the northwest of Gloucester, if they were employed as apprentices [27]. near thecitywalls.Inthe earlymedievalperioditwas one A general assessment of health is usually made by assess- ing the prevalence of “stress” indicators of the bones and of three major religious houses in the town, including the adjacent St. Peter’s Abbey and Llanthony Secunda Priory [12]. teeth that provide evidence for chronic physiological stress, Journal of Anthropology 3 such as poor nutrition and infections, during childhood Table 1: Proportion of the nonadults to adults in the study sample. [3] and comparing the growth of children at different ages Period Adults Nonadults Total % nonadults compared to modern standards. eTh prevalence of dental Early medieval 117 22 139 15.8 diseases (caries, abscesses, and antemortem tooth loss) on Later medieval 144 87 231 37.6 the deciduous and permanent teeth provides information on diet, oral hygiene, and more general health in children. Mean Postmedieval 94 28 122 22.9 diaphyseal lengths were plotted against dental age estimates Total 355 137 492 27.8 to produce skeletal growth profiles. Individuals aged using long bone lengths only were omitted from this part of the Table 2: Demographic profile of the nonadults divided into periods. analysis. eTh lower limbs are considered to be the most sensitivetoenvironmental stress as thefemur andtibia are Age Early Later Post-medieval Total (years) medieval medieval some of the fastest growing bones of the body [28]. eTh refore, femoral diaphyseal length measurements were chosen to Perinate 3 19 1 23 assess growth. 0.0–0.5 1 8 2 11 The term “cribra orbitalia” refers to pitted lesions on 0.6–1.0 0 5 0 5 the orbital roofs. Although traditionally considered to be 1.1–2.5 5 11 (10+1)3 19 indicative of iron deficiency anaemia [ 29], the exact aetiology 2.6–6.5 8 18 (15+3)11 37 of cribra orbitalia is still open to question, and recently it has been suggested that the marrow expansion typical of these 6.6–10.5 1 14 (10+4)4 19 lesions is the result of megaloblastic anaemia due to vitamin 10.6–14.5 3 4 7 14 B deficiency found in fresh meat and vegetables [ 30]. Iron 14.6–17.0 1 2 0 3 deficiency anaemia, caused by chronic low grade infections, ?age 0 6 0 6 has also been associated with these lesions, that result from Total 22 87 28 137 thinning of the cortical bone covering the orbital roof and (Numbers in brackets show number of “Norman” plus “later-medieval” expansion of the inner bone marrow [29]. This process can skeletons). only occur during childhood when this area contains red bone marrow. Dental enamel hypoplasia present as linear and pitted defects on the surface enamel and are known and a lesion was considered “absent” when the tibiae were to result from severe periods of stress that affect enamel available for examination but none of the bones showed any production [31]. All dental crowns develop during childhood infection. Finally, diseases of the metabolism (i.e., rickets and (c. 0–16 years) providing an almost permanent record of scurvy) were diagnosed using the criteria set out by Ortner childhood stress. New bone formation (or periostitis) on the and various colleagues [36–38], and Brickley and Ives [39]. skeleton, as a result of inflammation of the soft tissues during Other pathologies, including dental disease, were recorded an infection or resulting from mild trauma, is commonly using standard published criteria [29, 40]. recorded in bioarchaeology. eTh location of these lesions provides clues as to the cause of the condition. For example, 3. Results and Discussion new bone formation on the internal surface of the ribs signals a respiratory infection [29, 32], whereas new bone forming Table 1 presents the age-at-death distribution of the entire on the tibiae (shins) is often the result of inflammation due sample. At St. Oswald’s Priory, 27.8% of the whole sample was to a knock. Widespread new bone formation usually signals a made up of children less than 17 years of age. However, this more systemic disease (i.e., leprosy, syphilis, tuberculosis, or is not consistent throughout the periods, with the majority Caffey’s disease). of children (𝑛=87 , 63.5%) coming from the later medieval The frequency of cribra orbitalia, dental enamel hypopla- (or rather Norman) context. When the ages and periods are sia, and new bone formation was recorded in the St. Oswald’s broken down (Table 2;Figure 1), children aged between 2.6– nonadults. Chi-squared tests for 2 × 2and2×𝑐 tables, 6.5 years were the most numerous. with Yate’s continuity correction [33], were carried out to test the differences in prevalence of stress indicators between the three periods. Cribra orbitalia was graded using the 3.1. Infant Mortality. Full-term infants are recognised as scheme devised by Stuart-Macadam [34] and an assessment those aged between 38 and 40 weeks and in the past would of active and remodelled lesions was also recorded, using have been viable without the aid of modern intervention. the descriptions provided by Mensforth et al. [35]. In order Clinically, infant mortality rates are subdivided into those to ensure that nonspecific dental enamel hypoplasias were who die before birth (late fetal or stillbirths), those dying recorded, as opposed to those caused by localized trauma or at birth or within the first 27 days of extrauterine life infection, more than two teeth, on opposite sides of the jaw, (neonatal mortality), and those who die between 28 days and had to be affected before “presence” was recorded. Enamel one year (postneonatal mortality). eTh majority of neonatal hypoplasias were only considered “absent” when four or more deaths are considered to reflect the endogenous state of the anterior teeth were available for examination and did not infant as the result of genetic and maternal influences (e.g., display defects. Healed (lamellar form) and active (fibre bone congenital anomalies, prematurity, low birth weight, and form) periostitis was recorded throughout the skeleton [29] birth trauma), and post-neonatal mortality is seen more as 4 Journal of Anthropology 20 20 1 1 Early medieval Later medieval Postmedieval Neonatal Postneonatal Early medieval Figure 2: Number of perinates divided by gestational age (weeks) Later medieval and period. Postmedieval Figure 1: Number of nonadults by age and period. a consequence of the child’s external environment or exoge- nous factors (infectious diseases, poor nutrition, poisonings, and accidents) [41]. However, a crude estimate of exogenous and endogenous deaths can be established by looking at the numbers of individuals dying between the ages of c.28 and 40 weeks of gestation compared to 41–48 weeks. Hence, the percentage of neonatal deaths, including possible stillbirths and post-neonatal deaths, were compared between time periods to see if different patterns of infant mortality could be discerned. 0 0123456789 10 11 12 13 In total, 22 individuals from the site were classed as Mean age (years) neonates, with ages ranging from just 26 weeks to 40 weeks. The majority of neonates ( 𝑛=8 or 36%) were aged at 39 Later medieval weeks. There was only one postmedieval neonate (39 weeks) Postmedieval in thesample, andnoneonateswererecovered from inside Maresh [42] the church. The neonates from the “mass grave” (B421a-e) by Figure 3: Growth profiles of the later and postmedieval children, the external wall of the nave were aged between 35 and 40 compared to modern children. weeks and are therefore are likely to represent those who died from a variety of causes including prematurity and infection, rather than a single factor such as infanticide. Within the environmental impact to their death. The numbers were too later-medieval sample, one neonate displayed a series of small to test for significance. lesions that probably represented a fatal congenital syndrome where the notochord failed to regress. eTh child (B418) died aged 39 weeks, but it is impossible to tell if they were stillborn. 3.2. Growth Prole fi s. The growth profiles were plotted in eTh thorax revealed anumberofcleftvertebrae andfused one-year age categories. As there were only nine children (bifid) ribs, probably signalling other soft tissue anomalies in the early medieval sample with preserved femora, they thatwouldhavemadethiscongenitalsyndromeincompatible were removed from the analysis between periods. eTh profiles with life (Figure 2). There were nine postneonates (41–48 for the later and postmedieval children were compared, weeks) in the sample, with six or 67% derived from the with gaps in the data filled by taking an average of the later medieval group. When the proportion of neonates measurement in the age group above and below it (Table 3). and postneonates was compared (Figure 3), the number All data were then combined to provide a growth profile of neonates, or individuals dying from endogenous causes, for the St. Oswald’s children with individuals plotted and set outweighed postneonates in the early and later medieval against data from children in Denver between 1935 and 1955, samples, significantly so for the later medieval group ( 𝑋 = provided by Maresh [42] (Figures 4 and 5). Despite the small 13.52,𝑃=0.001 , 1d.f.). In the postmedieval period there were sample sizes, the trend was for the heights of the children more perinates dying several weeks after birth, suggesting an from St. Oswald’s to fall below those of the modern children Number Perinate 0–0.5 0.6–1.0 1.1–2.5 2.6–6.5 6.6–10.5 10.6–14.5 14.6–17 ?age Femoral diaphyseal lengths (mm) Number Journal of Anthropology 5 Table 3: Mean femoral diaphyseal lengths (mm). eTh numbers on italics are averaged from the measurements above and below them. Early medieval Later medieval Post-medieval Mean age (years) 𝑁 mm 𝑁 mm 𝑁 mm 0 1 83.98 5 97.51 1 84.2 12 137.7 3 149.3 0 20 1 139 0 3 0 2 188.5 2 210 42 208 2 189 1 239 52 250 3 213.3 0 247.5 60 4 223 1 256 70 1 268 0 267 Figure 4: Skeleton B418 showing congenital fusion of the ribs and 8 1 291 5 305.7 1 278 notochord regression failure. 90 1 297 0 305.5 10 1 286 0 301 3 333 11 1 305 2 326.5 12 0 327.2 1335 13 1 349.5 2 343 Total 9 29 14 aer ft 2 years of age, but with the postmedieval children showing similar heights to the modern children between the ages of 3–5 years. Overall, the urban postmedieval children were taller than the rural children from the later medieval period, although limited numbers meant that this could not be tested statistically. 0 2468 10 12 14 16 3.3. Dental Disease. Seventy-eight children had teeth avail- Age (years) able for examination; with 450 deciduous teeth (297 molars) Mean Later medieval and 660 permanent teeth (243 molars). Eleven children in Early medieval Postmedieval total had dental caries (14.1%), and three had developed dental abscesses. All of the children with abscesses came Figure 5: Growth profile of each individual against the mean, by from the postmedieval period. The true prevalence rate (TPR) period. was 3.3% caries for deciduous dentition and 1.8% caries for the permanent teeth (Table 4). When examined by period, the postmedieval children had the highest rates of caries with a crude prevalence rate (CPR) of 38%, followed by the for all periods, the overall prevalence of dental caries at St. early medieval group where 12.5% individuals had caries. eTh Oswald’s Priory is low in comparison. lowest rates were in the later medieval children with only 0.2% of teeth (TPR), or 2.4% individuals aeff cted (CPR). This pattern of caries rates through time differs from previous 3.4. Cribra Orbitalia. Of the 77 nonadults with preserved research into dental disease in medieval children where orbits, 40 (52%) children displayed cribra orbitalia; 25 (32%) reported rates for caries on deciduous teeth were at 3.5%, hadcribraorbitalia graded 2, and15(19%) hadmoresevere 4.5%, and 28.5% for early, later, and postmedieval children, cribra orbitalia at Grades 3 to 4 (Table 5,Figure 6), no respectively [43–45]. The drop in caries rates during the later cases were scored as severe as Grade 5, and Grade 1 was not medieval period is difficult to explain. James and Miller [ 46] considered pathological. eTh highest prevalence was in the found an overall caries rate of 9.1% for their later medieval latermedievalsamplewhere allcases were scored at Grade children buried at Chuddington Church in London and 3(𝑛=2 )and 4(𝑛=2 ). Six of the seven cases of Grade other English later medieval sites showed much higher crude 4 cribra orbitalia came from the later medieval group, with prevalence rates with 39% for Blackfriars in Ipswich (Mays the na fi l case from a postmedieval child. When then the early 1991), 34% at Taunton, Sussex 16% at Canterbury, Kent [47], and later medieval (arguably “rural”) samples were combined, and 17% at Wharram Percy, Yorkshire [48]. At just 14.1% 23% of the children with orbits had cribra orbitalia, compared Diaphyseal length (mm) 6 Journal of Anthropology Table 4: True percent prevalence of dental caries in the deciduous and permanent teeth. Deciduous Deciduous Permanent Permanent Period Total teeth % caries teeth/affected molars/affected teeth/affected molars/affected Early medieval 207 132/4 76/2 75/0 30/0 1.9% Later medieval 549 231/1 162/0 318/0 114/0 0.2% Post-medieval 354 87/10 59/9 267/12 99/11 6.2% Total 1110 450/15 297/11 660/12 243/11 % caries 3.3% 3.7% 1.8% 4.5% Table 5: Percent prevalence of cribra orbitalia. Early Later Post-medieval medieval medieval 𝑁 affected/ 𝑁 with orbits 2/10 9/37 4/16 % aeff cted 20 24.3 25 Table 6: Crude prevalence rate of dental enamel hypoplasia. Early Later Post-medieval medieval medieval Figure 6: Fibre (woven) bone endocranial lesions on the parietal of Hypoplasia/𝑁 with teeth 2/12 15/40 8/17 a 3-4 year old later medieval child (B403b). % aeff cted 16.6 37.5 47 Table 7: Crude prevalence rate of endocranial lesions. 37.5 36.2 Early Later Post-medieval medieval medieval Lesions/𝑁 with crania 0/14 6/57 0/20 24.3 25 23.8 %aeff cted 0 33.3 0 16.6 to 25% of the postmedieval children. This difference was not significant ( 𝑋 =0.02). 10.5 6.6 3.5. Dental Enamel Hypoplasia. Enamel hypoplasia was scored for presence or absence on individuals with at least four anterior teeth, including the canine. eTh type and Cribra orbitalia Enamel hypoplasias Endocranial lesions number of teeth aeff cted were not scored and so these gur fi es represent crude rates only. Of the 69 children with anterior Postmedieval Early medieval dentition, 25 (36%) displayed enamel hypoplasia suggesting Later medieval Total stress in early childhood (Table 6,Figure 6). The highest Figure 7: Crude percent prevalence of stress indicators, divided by prevalence (47%) came from the postmedieval sample, and period. 37.8% of the higher status later medieval children displayed enamel hypoplasia. When the early and later medieval groups were combined, 32.7% children had enamel defects, com- endocranial lesions in the form of active new bone formation pared to 47% of the postmedieval children. This difference (Figure 6). Table 7 (Figure 7) provides a breakdown of these was significant ( 𝑋 =6.65,𝑃=0.01 , 1.d.f.). cases. Allofthe casescamefromchildrendatingtothe later medieval period, with the highest prevalence (𝑛=2/6 or 3.6. Endocranial Lesions. These unusual lesions present as 33.3%) in the high status group buried inside the Priory, and new bone formation on the internal or endocranial surface of 10.5% affected overall. theskull,ofunknown aetiology[49], but they may be related to low grade inflammation of the meninges or conditions such as scurvy (vitamin C deficiency). As their aetiology 3.7. GeneralSkeletalPathology. In the initial skeletal report is obscure, they are considered evidence for nonspecific [5] no pathologies were recorded on the nonadult remains physiological stress in the group. Of the 77 children with (defined in 1999 as individuals between the ages of 0– cranial fragments available for observation, six (7.8%) had 15 years). Reanalysis of the material has revealed that of (%) Journal of Anthropology 7 Table 8: Number of cases of skeletal trauma or pathology in the nonadult sample. Period 𝑁 affected/ 𝑁 Individuals Trauma Infection Congenital Metabolic Other % aeff cted Early medieval 4/17 1 1 2 23.5 Norman 17/60 2 4 4 5 3 28.3 Later medieval 4/7 3 1 57.1 Post-medieval 9/23 1 4 6 39.1 Total 37/107 7 5 8 6 11 34.5 39.1 the 107 children from St. Oswald’s Priory with well-preserved 40 skeletonstoenableapathological assessment,37(34.5%) showed some form of skeletal pathology (Table 8). Overall, 29.7 therates of skeletal pathology, andinparticularcongenital conditions, were higher in the postmedieval sample (Fig- ure 8). Although the results for overall pathology were not 17.3 statistically significant for either the early medieval to later medieval transition (𝑋 =0.40), or the postmedieval period 7.1 7.1 (𝑋 =0.73), the variety of lesions in this sample is worthy of 5.9 5.9 4.7 4.3 note. Three of the eight (37.5%) high status children from the Nave of the church had head injuries: a blade injury (B403b, 3.5 years), a possible trepanation (B398, 8 years), and a depressed head injury (B171, 9 years). The most striking case Rural of nonadult trauma was a fractured left humerus of an 18- Urban month-old child (B376) from the Norman period (Figure 9). Figure 8: Percentage of pathologies in the rural (early and later This child was also notable as being the only one with clear medieval) and urban (postmedieval) children. signs of rickets (vitamin D deficiency) at the site, with frayed and expanded costal rib ends and pitting to the scapula. It is tempting to interpret this burial as one representing a child who was neglected and physically abused as shaft fractures of the humerus are rare in children [50]. However, the pathology may have other causes. In some cases children are born with a condition known as refractory rickets, where the child is unable to absorb vitamin D from their diet [51]. Thisinturnmakes thebones weak andliabletofracture. Perhaps this child is an example of this congenital disorder, and the fracture occurred accidentally when the child was picked up. However, fractures as the result of rickets are more commonly found at the metaphyseal or growing end of the bone [52], and this fracture also displayed a fairly new callus, suggesting that the child sustained the fracture shortly before their death. Other evidence for metabolic disease at the site is less conclusive. Five children demonstrate lesions that may be interpreted as demonstrating either vitamin C (scurvy) or vitamin D (rickets) deficiency (B404, B97, B162, B398, and B104)and alldatetothe latermedievalperiod. eTh re areno cases of metabolic disease in the earlier or later periods. Figure 9: Left humerus and scapula of B376 note the pitting of the eTh re were several other cases of trauma in the sample. superior subscapular margin, indicative of rickets, and the newly A 10-11-year-old early medieval child (B486) had a possible formed callus at the humeral midshaft. fracture to the ftfih lumbar vertebra; a 6-month-old Nor- man child (B153) had a fractured clavicle that suggested a birth injury. Birth injury is also a likely explanation for the hypertrophy of the left distal humerus seen in a 42- aspects of the lumbar vertebrae were compressed, and there week infant from the later medieval period (B15) (Figure 10. was shortening of the left arm and leg compared to the Verlinden pers. comm.). One 10–14-year-old child (B298) right which may indicate damage to the nervous system. A from the postmedieval period displayed a series of changes congenital syndrome may also have caused these changes, as that mayhavebeenassociatedwithtrauma. eTh anterior there was abnormal eruption of the dentition, with the lateral (%) Trauma Infection Congenital Metabolic Other Total 8 Journal of Anthropology neurological damage as the spinal cord is impinged and may have resulted in paralysis of the left arm. In addition to these changes, the child had premature suture closure to the side of the skull (occipito-mastoid suture) and possible hydro- cephalus (“water-on-the-brain”), which suggests a possible butunspeciefi dcongenitalsyndromeinthischild.Thesecond case is of a 10-year-old child (B306), who demonstrated severe dental overcrowding, maleruption, and a supernumerary (Figure 12) and enlarge tooth (macrodont). Although there was postmortem damage to the anterior aspect of the maxilla, these changes are indicative of a cleft lip and palate which oen ft accompanies a congenital syndrome. eTh child also demonstrated a cleft neural arch of the atlas that should fuse between 5 and 6 years of age [23]. In addition to the series of congenital defects already identified in the perinate B418, other congenital anomalies included a possible cervical rib (B163, 16 years), a possible cleft atlas (B42, 8 years), a reduced and narrow auditory meatus that may indicate the child was deaf or had defective hearing in one ear (B74, c.6 years), Figure 10: Probable spiral fracture of the distal humerus in B15. and cleft neural arches of the h lumbar vertebrae (B332, and B323 both c.10 years). It should be noted that congenital conditions are usually related to maternal stress or genetic maxillaryincisor hadfailedtoerupt,leaving thedeciduous mutations [54] and are equally distributed between the later tooth in place, and the canine displayed delayed eruption. and postmedieval periods. There was one case of joint disease, an unusual occurrence Two children had supercondylar processes of the humerus (one unilateral, one bilateral) and it is possible that they are in anonadultsample. A14–17 year adolescent from thelater the result of trauma (B 499, c.4 years; B107, c.7 years) as this is medieval (Norman) period demonstrated osteoarthritis in the left foot and right knee (patella), and osteochondritis one of the most common areas for children to suffer trauma today [50]. A postmedieval child aged around 6 years (B251) dissecans a circulatory disorder, on the left distal humerus. hadanexostosis on theright ulna that maybeinterpreted as a All of these features indicate a high degree of physical activity fracture, although these are all subtle and identifying trauma at a young age, and it is tempting to suggest this individual was is acomplex issueinchildren[53]. an apprentice. Finally, there were several cases of pathological Several of the children had evidence for asymmetry of changesthatcould notbeassignedtoaparticular disease the limbs that may have resulted from an infection such category; in particular, an infant (B430) showed honeycomb as poliomyelitis or chickenpox which can cause temporary lesions of the metatarsals and vertebral spinous processes, that appeared pathological. and permanent limb paralysis, or trauma at birth (Erb’s palsy). Five cases of disuse atrophy were of the upper limb, in children aged between 5 and 15 years, and there were 4. Conclusions three cases of lower limb atrophy in children aged between 5 and 11 years. The most prominent cases were in B95 and The paper examined the impact the transition from a B248 with 4 cm and 3.5 cm difference between the upper predominantly rural lifestyle to an urban manufacturing limbs, respectively, and B298 whose left leg was 3.5 cm environment had on the health of children from medieval shorterthanthe right. In most cases, thelimbs were not Gloucester. A secondary aim was to highlight the variety of pathological lesions that can be identiefi d on nonadult significantly thinner, suggesting some mobility had returned to the aeff cted limb before the child died. If all the children skeletal material. eTh St. Oswald’s Priory sample comprised came from the same time period, this may indicate the children dating from the early medieval period and contained troubling practices of a particular midwife operating in both high and low status later medieval nonadults, who may Gloucester, or perhaps the high incidence of breech births have been working as apprentices in the metal or leather in the town. However, the cases were spread across time working industry, and postmedieval children, some of whom periods, with two early medieval, one later medieval, and ve fi may have been living in the Gloucester Workhouse. In 1973, postmedieval cases. In most cases, the temporary paralysis Weiss estimated that 30–70% of children in a developing soci- caused by neural damage during a bout of polio is most ety would die before the age of 15 years [54], with the highest likely, but two cases, both dating to the postmedieval period mortalityrates in the1–5 year agegroup.This gfi ureisoeft n (AD1540-1857) are of more complex aetiology. B368, 2–6 used as a “gold-standard” for measuring the completeness of a years old, demonstrated severe wasting (thinning) of the skeletal sample and the level of child representation. However, left arm (Figure 11(a)), and a triangular rather than oval- thesedatashouldbeusedwithcaution as they maynot shaped foramen magnum (Figure 11(b)) with evidence of represent mortality rates of archaeological populations before basilar flattening was caused by the abnormal position of the industrialisation [55]. Infant mortality rates for many past first cervical vertebra (atlas). This condition usually results in populations are uncertain; however in 16th century England, fift Journal of Anthropology 9 (a) (b) Figure 11: (a) Comparison on the left and right humerus of B368. Note the significant shortening and thinning of the left humeral shaft, indicative of disuse atrophy. (b) Triangular foramen magnum of B368. Note the flattening of the areas to the right of the formen magnum, signalling basilar compression, and neural impingement. 44% children died before the age of 5 years, but only 10% of postmedieval child burials were recovered from the excavated area [5]. eTh growth data for the children from the later and postmedieval contexts show that both fell below modern standards, a typical result for archaeological populations, but interestingly the postmedieval children seem to keep pace with the modern children between 3 and 5 years and at 11 years. Although the number is too small to draw any firm conclusions, this may indicate that the postmedieval urban group was receiving adequate nutrition when they died, sug- gesting that their deaths were the result of an acute infection, as opposed to general chronic malaise [58]. This result may Figure 12: Unusual maxillary dentition of B306 showing a macro- also be interpreted as suggesting a high rate of mortality in dontia supernumerary tooth at the midline. es Th e features are seen this period that resulted in as many tall individuals entering in modern children with cleft lip and palate. the morality record as the short or stunted [59]. Other indicators of physiological stress suggested some adverse environmental eeff cts on the postmedieval children. Enamel it was estimated that around 27% of children died before the hypoplasias were significantly higher, and the majority of age of one year [56]. Given the inconsistency with which postmedieval perinates were aged over 40 weeks indicating stillbirths and neonatal deaths were reported in the past, factors relating to hygiene, diet, and exposure to infections historical records are likely to reflect a minimum number caused their death. However, given that the postmedieval only [57]. At St. Oswald’s Priory, only 27.8% of the whole child sample is likely to be skewed, this should be treated sample was made up of children less than 17 years of age, with some caution. Dental caries rates, which were higher suggesting that they are underrepresented. However, this is in the postmedieval group, can reflect general malnutrition not consistent throughout the periods, with the majority of in children if they occur as the result of occlusal enamel children (63.5%) coming from the later medieval context. defects that are subsequently hidden [60, 61]. The increased The infants (under 1-year) made up 28.4% of the nonadult levels of dental caries and abscesses certainly suggest they sample but only three came from the latest period of the had access to more refined foods such as sugar in their diet. What is evident is that there was a wide variety of congenital cemetery. A discrepancy between the burial registers and number of postmedieval infant skeletons recovered from the conditions in the postmedieval group, including cases of site led Rogers [5] to suggest that babies may have been buried basilar compression, cleft palate and lip, and upper and lower in a special area of the cemetery which was not excavated. limb atrophy. Such conditions often reflect maternal stress Additionally, in AD 1813-50 the burial registers recorded that during pregnancy [54]. 10 Journal of Anthropology The higher status later-medieval group buried within the [13] N. Herbert, “Gloucester, 1720–1835,” in AHistory of Gloucester- shire,C.Elrington,Ed.,pp. 124–169, Alan Sutton Publishing, Priory building, although few, also interesting. Despite their Gloucester, UK, 1988. potentially more privileged lifestyle, they had the most severe [14] C. Heighway and M. Hare, “Gloucester and the Minster of St forms of cribra orbitalia, and highest rates of dental enamel Oswald: a survey of the evidence,” in The Golden Minster. eTh hypoplasia and endocranial lesions. They were also the group Anglo-Saxon Minster and Later Medieval Priory of St Oswald, with three potential head injuries. Gloucester,C.Heighwayand R. Bryant,Eds., vol. 117, pp.1–46, In conclusion, its seems that the rapid population expan- Council for British Archaeology, York, UK, 1999. sion and increased poverty highlighted in the documentary [15] P. 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