There is a tendency to think that cancer is a relatively new disease, but this is not the case. It is certainly true that there has been a growth in its incidence in the ‘developed world’, but whether this is due to better diagnosis or to lifestyle is a moot point. It may not have been expected that the archaeological record would produce evidence of cancer. However, the human remains i.e. bones, found during the archaeological dig in the former East Kirk during 2006 do show a few cases of cancer affecting bone.

The prostate gland is a small gland located just below the outlet of the bladder in males. The prostate gland was first described anatomically in 1536. Prostate cancer was not specifically recorded until 1853. Prostate cancer occurs when a growth starts within the gland. In most cases the only problem it is likely to cause is with urinating. However, like other cancers, it can spread outside the prostate into the lymph or metastasise into bone with the back and the hip the common sites of these bony metastatic tumours. It is at this stage that this cancer can become a threat to life.

The photograph shows part of the pelvis of an older man. Towards the top left of the bone are ‘spicules’ – the roughened area – which are characteristic of metastatic prostate cancer. It is likely that he developed considerable pain in his pelvis as a result, a common indication of progression of prostate cancer. We do not know whether this is what caused his death. The date when this man died is not known, but it was somewhere between 15^th and 18^th century, so was well before the disease was recognised.

(The photograph is copyright Aberdeen Art Gallery & Museums Collections and is used with permission).

It is surprising how many diseases, even relatively uncommon ones, can be identified in human remains uncovered during an archaeological dig. That was particularly true of the large dig which took place in the former East Kirk of St Nicholas in 2006. This blog deals with one of these less common conditions – usually known as Perthes Disease, but more properly known as Legg-Calve-Perthes disease (after the three doctors who identified the condition). The medical term is avascular necrosis.

The condition arises in childhood, between the ages of about 2 and 10, with the highest incidence in the range of 4-8 years. At this age, the bones are still growing, so anything which interferes with this is likely to cause problems. Perthes disease affects the head of the femur – the ball of the thigh bone which fits into the hip. For a reason which is not understood, there is an interruption of the blood supply to this actively growing region of the bone. That causes the bone cells to die – that is where the term avascular necrosis comes from. So the bone stops growing and there is a loss of bone mass resulting in a weakness and wearing away of the bone. At this stage a child will suffer aching in the hip (similar to ‘growing pains’) and may develop a limp. However, with time the blood supply re-establishes and the bone starts growing again. But damage will probably have been done to the bone during the phase when it was dead, often a change of shape will have occurred, so a deformity is a common outcome.

The photograph shows one of the examples found in the dig. This is of an adult man – it is more common in men – and the deformity of the ‘ball’ is quite clearly seen. The hip end of the femur is to the left, and the knee end to the right. At the head end of the bone, the ‘ball’ is pointing downwards. Obviously this is supposed to be round, but it clearly is not. The consequences for the sufferer is an initial shortening of the leg (it usually only affects one leg) giving a pronounced limp and there could be quite limited movement depending on the severity of the deformity. Longer term it is likely that osteoarthritis will develop with all the pain and difficulty which that will bring.

We are grateful to Paul Duffy, osteoarchaeologist, for the detailed studies on the human remains (http://www.discoverbutearchaeology.co.uk/).

(The photograph is copyright Aberdeen Art Gallery & Museums Collections and used with permission.)

Ankylosis is the medical term used to describe an abnormal adhesion and rigidity of the bones in a joint. The potential causes are many, but frequently arise from injury or disease. Initially in ankylosis there is inflammation in the joints affecting the tendons, muscles and the membranes lining the surfaces of the bones. This is often associated with swelling and pain. The consequence of this is that the bones do not move easily and so they tend to become fixed in one particular position, which may be the one which causes least pain. However, this immobility can then lead to the bones fusing together. When this has happened no movement is possible in the joint, although surgical intervention can sometimes re-establish movement, such as with an elbow or shoulder. There are several different types of ankyloses. One of the common forms arises when the person has an inflammatory disease, such as rheumatoid arthritis which most often affects the fingers and wrist. During the archaeological dig in the former East Kirk a number of examples of ankylosis were found among the human remains, but they were affecting the feet.

The accompanying photographs show two examples of the completely fused bones in the foot which were found. The first one shows two metatarsals (the long bone in the mid-foo, to the rightt) fused to tarsal bones (in the ankle, to the left), whilst the second photograph shows a toe.

There is a tendency to imagine that this type of disease is ‘modern’ and confined to humans. The examples shown were of individuals who lived several hundred years ago. However, paleopathologists have found evidence of ankylosis in the fossil record, including one example of the famous dinosaur Tyrannosaurus rex!

(The photographs are copyright Aberdeen Art Gallery & Museums Collections and are used with permission).

A great deal about the health of individuals interred at St Nicholas Kirk can be learned from their remains uncovered during the archaeological dig. This is one example, others will also be featured, which perhaps comes as a surprise.

From both archaeological and written records, it appears that syphilis was unknown in Europe until the 1490s. It rapidly became a common venereal disease. It is caused by a micro-organism called Treponema pallidum – a spirochete for those interested. An infection can pass through three distinct stages if untreated. The initial stage is of a skin lesion at the site of infection – primary syphilis. Secondary syphilis occurs up to 6 months later and is characterised by a general rash. It may then enter a dormant phase which can last for several decades before entering the final tertiary phase. In this there are soft tissue swellings, called gumma, but these cannot be seen in archaeological specimens. However, there can be changes to the bone and this is how we know that there was at least one case of syphilis uncovered during the archaeological dig in the former East Kirk in 2006.

The photograph is of the skull of a person, probably male, aged between 17 and 25 years old. On it can be seen the characteristic lesions caused by tertiary syphilis. These lesions start as a small depression on the skull, called Caries Sicca, associated with inflammation in the tissue immediately in contact with the bone. This gradually deepens and widens and later new bone is deposited around the edge, giving a slight ridge (called a periosteal reaction). There can be similar reactions on other bones of the body. There were such lesions on all the ‘long bones’ of this person, but these lesions are not as easy to see or as distinctive. It can only be speculation, but the feeling is that whilst this young person could have acquired the infection through his own actions, it is equally possible that this is a case of so called congenital syphilis; in other words, his mother infected him before or during his birth.

We are very grateful to Dr Paul Duffy, our human bone specialist during and following the dig, for his detailed analysis. (His website is http://www.discoverbutearchaeology.co.uk/) The photograph is copyright Aberdeen Art Gallery & Museums Collections and is used with permission.