The leprosarium of Saint-Thomas d'Aizier: The cementochronological proof of the medieval decline of Hansen disease in Europe?

This study compares the adult survivorship profiles of people interred in the Saint-Thomas d'Aizier leprosarium, estimated by cementochronology, to eight archaeological series in northern France dated from Late Antiquity to the Late Middle Ages, periods of significant visibility for Hansen's disease (leprosy). The goals are to understand the impact of leprosy on various social groups and to explore the cause of leprosy's decline by analyzing male and female fertility. Survival rates differed between medieval leprosy-free sites and the Saint-Thomas d'Aizier leprosarium, although this difference was statistically significant only for the female leprosarium sample. The selective female frailty, a consequence of social exclusion and the collapse of the quality of life, combined with the infertility of lepromatous couples, offer a multi-causal explanation to the end of the expansion and then decline of leprosy in southern and western European countries.

Cementochronology and sex: A reappraisal of sex-associated differences in survival in past French societies.

The objective of the present study is to test our general knowledge of sex-specific survival differences in past northern France societies by implementing the tooth cementum annulations method of age estimation (i.e., cementochronology) to bio-archaeological series. 1255 individual estimated ages at death covering a millennium from the 3rd c. AD to the 15th c. AD matched different patterns of sex mortality from the late Antiquity to the Late Middle Age. Female survival curves are consistently inferior to those of their male counterparts. Maternal mortality is clearly visible in survival curves between 20 and 50 years of age in individual sites and pooled samples. Variations of sex mortalities also affected sites with peculiar recruitment, such as religious communities, pathological samples, leprosaria, and migrants. Whisker plots of median ages at death variations confirmed in both sex that populations within the Early Middle Ages were better off compared to Late Antiquity and Late Medieval Ages when group inequalities prevailed. Due to its sensitivity and applicability to small samples, cementochronology should be extended to other series.