ABSTRACT

Subadult skulls from archaeological sites in Maryland and Georgia were examined for evidence of scurvy. Diagnoses of scurvy were made based on the presence of multiple lesions of abnormal porosity or porous bone formation in multiple areas of the skull known to be associated with hemorrhage in patients with the disease. Scurvy was prevalent in 15.4% of the skulls examined from the Maryland site. Only a few possible cases were found in the Georgia sample. We suggest that the lack of scurvy in the latter sample is most likely the result of an unrepresentative sample and not an indication of adequate vitamin C in the diet.

INTRODUCTION

Evidence of diseases resulting from nutritional deficiencies found in archaeological skeletal remains provides important information about the diet of past populations.

Scurvy is caused by a dietary deficiency in vitamin C. Vitamin C is needed in the formation of collagen, a major component of bones and blood vessels.

Inadequate vitamin C results in defective bones and blood vessels. Hemorrhage of defective blood vessels occurs at even the slightest trauma.

Additional defective blood vessels form as part of the vascular response to remove the clots caused by hemorrhaging. Pathways, or tiny pores, are formed through bone to accommodate these new vessels to the clot.

Thus abnormal porosity occurs in areas that are subject to trauma or to abrasion by muscle activity or that are supplied by or directly next to veins and arteries. Occasionally, if bleeding occurs between the periosteum and the cortex, formation of porous bone may also occur in these same areas.

METHODS

• Skulls examined came from the two sites described in Table 1.

• Only skulls of subadults ages 0-15 years were examined.

Age was determined based on dental eruption, femur length, or comparison of parietal size to skulls whose ages could be determined by other methods. The age distribution of total skulls analyzed and cases of probable or possible scurvy from each site are given in Tables 2 and 3.

• Only skulls with two or more of the anatomical sites listed in Table 4 present were examined.

• Skulls were diagnosed as probable scorbutic cases only if they exhibited one or both of the lesions defined in Table 5 in three or more of the anatomical sites listed in Table 4.

(Ambiguous cases were termed possible cases. None of these were included in the cases diagnosed as scorbutic from the Juhle ossuaries shown in Table 2. The three cases from the Irene Mound site shown in Table 3 are possible cases presented here because of the unexpected lack of more probable scurvy found in that sample.)

RESULTS

Age distribution of 10 probable cases of scurvy relative to the total subadults surveyed from the Juhle ossuaries:

Age distribution of 3 possible cases of scurvy relative to the total subadults surveyed from the Irene Mound site:

FIGURE 1. Porotic hyperostosis of the right orbital roof of a scorbutic case from the Juhle ossuaries.

FIGURE 2. Porotic hyperostosis of the left sphenoid of a scorbutic case from the Juhle ossuaries.

FIGURE 3. Porotic hyperostosis of the left infraorbital foramen of a scorbutic case from the Juhle ossuaries.

DISCUSSION

• Prevalence of probable scurvy in 15.4% of Juhle ossuary sample comparable to prevalence in other North American archaeological samples (range: 0 – 38%) (Ortner et. al. 2001)

Probable that many other Native American populations of protohistoric and early historic times suffered from a deficiency of vitamin C in the diet that is underreported in the paleopathological literature

• Lack of probable scurvy in Irene Mound sample more likely due to an unrepresentative sample than an indication of adequate vitamin C intake

Fewer subadults in youngest category than typical (e.g. Ubelaker 1981)

Differential burial of subadults common problem in reconstructing demography (Ubelaker 1989)

Poorer preservation of smallest most fragile bones of youngest subadults

• Thickened areas of porotic hyperostosis lesions on cranial vault in some cases not anemia

Evidence of bone formation superficial to cortex followed by subsequent remodeling of cortical bone

No enlargement of marrow

REFERENCES

Ortner, Donald J., Whitney Butler, Jessica Cafarella, and Lauren Milligan. 2001. Evidence of probable scurvy in subadults from archeological sites in North America. American Journal of Physical Anthropology 114: 343-351.

Ubelaker, Douglas H. 1981. The Ayalan cemetery: a late integration period burial site on the south coast of Ecuador. Smithsonian Contributions to Anthropology, Number 29. Smithsonian Inst. Press. Washington.

Ubelaker, Douglas H. 1989. Human Skeletal Remains: Excavation, Analysis, Interpretation. 2nd ed. Smithsonian Inst., Washington.

Skull outline images adapted from:

http://www.geocities.com/med_smurf/medical/skull_front_c2.gif
http://www.geocities.com/med_smurf/medical/skull_lat_c2.gif

ACKNOWLEDGEMENTS:

This project was funded by the Smithsonian Institution National Museum of Natural History Office of the Director.