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Infectious disease can transmitted by by a range of routes such as viruses, bacteria and injury to the body. Before the discovery of antibiotics, such infections would have been a major cause of death amongst populations. Many of these diseases affect the soft tissues and organs of the body and may lead to the death of an individual before leaving any trace on the skeleton. Some infections, however, do reach the bone itself and may indicate a more longstanding illness or individuals with a strong immune system.

 When infectious disease does reach the skeleton it is shown as inflammation of the bone. This can occur in different ways and at any of the surfaces of the bone. Periostitis is where the outer layer of tissue that covers the cortical bone surface becomes infected and a new layer of bone is formed called woven bone. As this new bone heals it becomes smooth and compacted lamellar bone through remodelling and begins to resemble the original surface. Osteitis is inflammation to the outer cortical bone and osteomyelitis is infection of the inner surface and medullary or middle cavity of the bone. This can lead to destruction of the surrounding bone and a swollen, enlarged appearance as new bone is formed and remodelled changing the original shape. Infection in the middle cavity may be released through the formation of a small hole (sinus) that connects the interior to the exterior surface.

Many of the skeletons analysed at MoLAS show evidence of infection.  Diseases can often affect the bone in similar ways and it is not always possible to diagnose a particular type of illness. These infections are called non-specific and may have a variety of causes. Some infections however, display a certain distribution and type of lesion throughout the skeleton and from this it is possible to determine what disease was present. These are known as specific infections.

 One specific infection found in archaeological remains is tuberculosis. This can be transmitted to humans from cattle through infected milk or more commonly through human to human contact through the respiratory system and affecting the lungs. This can spread to other parts of the body including the skeleton where it mainly affects the spine and the joints of the hip and knee. Osteomyeltis may lead to destructive lesions and septic arthritis at the joints and can result in erosion and fusion of the joint surfaces. In the spine, destructive lesions may lead to collapse of the vertebral bodies causing curvature called a kyphosis.

 Another specific infection that can be seen in the skeleton is treponemal disease that includes syphilis. This may result in inflammation to the skull and face which can become pitted and crater like (caries sicca). In the long bones, infection may cause the bones to become expanded and distorted due to osteomyleitis.  The tibia may become bow shaped (sabre shin) due to remodelling through new bone growth.

Infectious disease affects many people in the world today and continues to be a major casue of death. Study of infection in archaeological skeletons may help us to understand how disease evolves and spreads through modern populations.

Many of the skeletons excavated at archaeological sites include the bones of those aged less than eighteen years of age at death. The buried population of the Catholic mission of St Mary and St Michael, Lukin Street, East London included over 400 child skeletons.  The majority of these children were aged between one and five years when they died suggesting a low chance of survival into adulthood for those inflicted by disease.

This cemetery revealed individuals buried in wooden coffins, placed into deep graves with many stacked on top of each other.  The recovered skeletons were found to be very well preserved.  The good condition of these burials enabled bone changes to be seen that are often lost through erosion or damage over time when buried in the ground. This provided an important opportunity to see what life was like for children growing up in the Victorian era, the hardships they faced and illnesses suffered.

A large proportion of the children recorded displayed signs of metabolic disorders. These can be caused by malnutrition and deficiencies in diet that can affect growth and prevent the development of strong and healthy bones.

 Seventy eight (11:1%) of the child skeletons showed signs of active rickets caused by a lack of vitamin D within the body that is normally obtained through exposure to sunlight and a healthy diet. Deficiency of vitamin D can result in weakened bones that become bowed as they are unable to support the bodies weight. The bone changes observed included areas of pitting to the surfaces of the skull, bent and deformed arms and legs with thick, widened ends and ribs that flared out towards the ends.

Another disease observed in the child population was scurvy, caused by a lack of vitamin C in the diet. Once the scourge of sailors on long sea voyages, a poor diet lacking in fresh fruit and vegetables can lead to vitamin C deficiency. This can result in bleeding into the skin and tissues surrounding the bones and tooth sockets and lead to impaired bone growth. Bone changes for this condition were recorded in forty two (6%) of children, these included porosity and pitting to regions of the skull and roof of the eye sockets and new bone formation to the surfaces of the long bones.

Diseases such as these would have thrived in the smog filled air, poorly sanitised and over crowded living conditions of 19th century London. The fast growing population living in poor conditions often with limited access to water, fresh food or waste disposal created an environment where infectious disease was common and many sick children may have been kept indoors away from the important sunlight. Swaddling, the practice of wrapping infants in tightly fitting blankets in order to restrict movement and malnourished mothers feeding their children with deficient milk may have also played a role.

Recently, a resurgence of these diseases amongst children has been reported. The knowledge gained from the bones of those afflicted in the past can help us to better understand the causes of such conditions and promote awareness of the recurrence in the modern world.

Over the past month the osteology team has completed the analysis of over 700 skeletons from the Catholic mission of St Mary and St Michael, Lukin Street, East London, who died between 1843 and 1854. This has involved collecting vast amounts of data from each skeleton including bone measurements, age and sex estimates, the presence and absence of certain traits and anomalies and descriptions of pathologies. All of this information was entered onto a relational database.

The next stage of the project is to extract this information in order to examine the results obtained and begin to build a profile of what the cemetery population was made up of. Some of this information can be used to tell us the overall age ranges of people, how many suffered from a particular illness or disease, the average height of the population and if there is anything to suggest certain individuals may have been related.

A large proportion of the skeletons recorded displayed evidence of broken bones including over 70 individuals with healed fractures. Other signs of trauma included healed injuries to the bones of the skull, dislocations of joints and indications that some had undergone surgery or autopsy. To help us better understand these fractures and try to tell if they were the result of an accident or possibly violence it is often helpful to have the bones X-rayed. This allows us to look inside the bones and see how well a fracture may have healed and estimate how long ago in a persons life the break occurred. Previously X-rays were taken and developed using a similar method to film photography. After being exposed onto special X-Ray film, the images were developed using a series of chemicals. This could be a time consuming method that meant large samples of bone could not be X-rayed.

Last week I took a collection of the fractured bones to the Department of Radiography at City University, London. The radiographers there have kindly allowed us to use their state of the art digital radiography machines. This equipment uses special X-Ray plates that can be immediately downloaded onto a computer. These digital images can then be manipulated, moved around, lightened or darkened and measures of bone length and fracture angles directly taken. This allows for a greater number of images to be taken and in much less time.

The results clearly show a variety of fractures, many of which were well healed and would have occured much earlier on in a persons life. These images, along with the bones themselves will add to our understanding of what life was like for the people buried in the Lukin street cemetery and give some indication of the hardships and dangers they may have faced during their everyday lives in the Victorian period.

Photos: See photos of the MoLAS osteology team on our Flickr pages

Name: Michael Henderson

Job Title: Human Osteologist

Department: Museum of London Archaeology Service

What is Human Osteology?

Osteology is the study of human skeletons. At MoLAS osteologists work with skeletons excavated or recovered from archaeological sites throughout London and further afield. This offers an exiting opportunity to investigate and understand our past through the actual physical remains of those that lived it. The bones may show evidence of disease, infection or injury as well as changes relating to growth and development. This information can contribute to our knowledge of who made up the populations of the past (demography), health and lifestyle and build a picture of how people lived and died.

About me:
I joined the Osteology team at MoLAS in October last year. Before heading to London I studied archaeology at the University of Newcastle and obtained a Masters degree in Human Osteology and Funerary Archaeology from the University of Sheffield. I have also spent time working in a pathology lab for the NHS, working as an archaeological records officer for Leicestershire museums and for the last two years was based at the University of Leicester Archaeology Service analysing skeletons excavated from the 12th to 16th century church of St Peters and the medieval church of St. Michael, Leicester.

I have always had an interested in the past, but became fascinated by the number of things that can be told about your skeleton once you have died.

My role as an Osteologist:
The main aspect of my work involves the analysis and recording of human skeletons that have been recovered from archaeological sites by MoLAS. I begin by identifying the different bones and laying them out in anatomical position, so that I can complete an inventory of what is present. After this I take measurements of certain bones that can be used to calculate stature and size. Using established methods I then make estimates of age at death, sex and examine the bones for signs of disease and injury. The information gathered is inputted into a relational database. This allows it to be linked to all the other data from the site, the finds, the animal bone and the excavation records and enables direct comparison with the thousands of skeletons recorded and curated by the Centre for Human Bioarchaeology at the Museum of London.

The best parts of my job:
The most interesting and fascinating part of my job is the variety and the chance to work with other specialists. I could be working on a Roman assemblage one week and a Victorian cemetery another. Next week I will be meeting up with radiographers from City University, London, to learn about their equipment and how we can work with them to help diagnose pathology present in the bones we find. The study of human remains is a constantly evolving field that involves the disciplines of biology, anatomy, anthropology, archaeology, medicine, forensic science and history to name a few and I enjoy researching different diseases and funerary practices.

As well as some injuries and illnesses that you can only imagine the pain an individual must have endured, some of my most memorable discoveries have been when a coffin plate with a name or age has been found with a skeleton. This provides an opportunity to really bring the past back to life and give a personality back to the skeleton that is often rare in archaeology.

Current work:
We have recently been busy with a range of projects examining the lives of past Londoners. Since starting at MoLAS I have been involved in the analysis of over 700 burials from the Catholic mission of St Mary and St Michael, Lukin Street, East London, who died between 1843 and 1854. These skeletons have shown a wide range of diseases that includes dental disease, tooth notches caused by pipe smoking, infections such as tuberculosis (TB) and syphilis, fractures and even a few people who had undergone autopsies. Around 60% of those buried were children, most of whom died when they were very young: between the ages of one and five years. A large proportion of these infants had pitting of the bones of the skull, bowed and deformed arms and legs with widened and thickened ends and flared rib ends. This indicates that they had suffered from rickets, a metabolic disorder which happens when the body is short of vitamin D. Study of this may help us to better understand the causes of this disease today and promote awareness of its recurrence in the modern world.

Photos: See photos of the MoLAS osteology team on our Flickr pages

Keep posted: to hear more about the lives of past Londoners as told from their very bones.