Disability and care in Western Europe during Medieval times: A bioarchaeological perspective.

This Special Issue has its foundation in presentations delivered in the symposium Disability and Care in Medieval Times: a Bioarchaeological Perspective into Health-related Practices held at the 2019 European Association of Archaeologists conference in Switzerland. It comprises 12 papers, all relevant to aspects of pathology experience and/or care provision in Western Europe during the Early to Late Middle Ages (500 - 1500 CE). Reflecting the 1000 year timespan involved, these papers are characterised by diversity in subject matter and in the lifeways in which they are located, but all contribute to the symposium's primary aim: to demonstrate that our understanding of the Medieval period is enhanced by cross-disciplinary, bioarchaeological research into individual and collective experiences of disability and care. This Introduction provides the background to the 2019 symposium, and briefly discusses the papers contained in the Special Issue which emerged from this.

Contribution to Longobard dietary studies: Stable carbon and nitrogen isotope data from Castel Trosino (6th-8th c. CE, Ascoli Piceno, central Italy).

The arrival of the Longobards in Italy represents one of the most significant periods of the Early Middle Ages. Such arrival had social and political implications, particularly in relation to cultural admixture with local communities. One way to understand this is through the reconstruction of paleodiet via stable isotope analysis. So far, the subsistence strategy of this population in central Italy remains poorly explored. Stable carbon and nitrogen isotope analyses are presented here on a total of 19 human bone collagen samples from the cemetery of Castel Trosino. This isotopic investigation contributes to the dietary reconstruction of Early Medieval populations in Italy, providing a crucial isotopic dataset for an area still poorly explored.

Gastrointestinal infection in Italy during the Roman Imperial and Longobard periods: A paleoparasitological analysis of sediment from skeletal remains and sewer drains.

OBJECTIVE: This study aims to investigate parasitic infection in Italy during the Roman period (27 BCE-476 CE) and subsequent Longobard (Lombard) period (6th-8th CE). MATERIALS: Sediment samples from drains and burials from Roman Imperial-period sites in Italy (Lucus Feroniae, Oplontis, Vacone, and Vagnari), Late Antique and Longobard-period burials at Selvicciola (ca. 4th-8th CE), and Longobard-period burials at Vacone and Povegliano Veronese. METHODS: Microscopy was used to identify helminth eggs and enzyme-linked immunosorbent assay (ELISA) to detect protozoan antigens. RESULTS: Roundworm and whipworm were found in pelvic sediment from Roman-period burials, while roundworm and the protozoan Giardia duodenalis were identified in Roman-period drains. In pelvic sediment from the Late Antique through Longobard periods, roundworm and Taenia tapeworm eggs were identified. CONCLUSIONS: Fecal-oral parasites were found throughout Imperial Roman Italy, suggesting that gastrointestinal infections caused a significant disease burden. In the Longobard period we see continuity in transmission of fecal-oral parasites, and the appearance of zoonotic parasites acquired from eating undercooked meat. SIGNIFICANCE: A wealth of information exists about certain diseases in the Roman period, but relatively little is known about intestinal parasites in Italy during the Roman and Longobard periods. This is the first evidence for Giardia in Roman period Italy, and for any parasites in the Longobard period in Italy. LIMITATIONS: Low egg concentrations and lack of controls for some samples makes it difficult to differentiate true infections from environmental contamination in some cases. SUGGESTIONS FOR FUTURE RESEARCH: Continual study of samples from Roman and Longobard period Italy.

Digital imaging techniques applied to a case of concha bullosa from an early medieval funerary area in central Italy.

OBJECTIVE: Concha bullosa is a rather common condition of the nasal turbinates, rarely reported in archaeological skeletal collections. This paper examines a case of concha bullosa as seen in a female cranium from a burial in central Italy, dated to the Longobard domination in the Peninsula (mid-7th- early 8th century CE). MATERIALS: The individual under investigation (T86/17) comes from the funerary area of Selvicciola, located near the town of Viterbo in northern Latium, Italy. METHODS: The skeleton was macroscopically examined. We analyzed the CT-scans of the defect by applying innovative R-based virtual tools. RESULTS: It was possible to calculate the inner volume of the concha bullosa and to provide a 3D visual assessment of its shape. CONCLUSIONS: Its size and shape suggest that the individual had this condition for a considerable period of time, during which its presence may have had affected her daily activities and health status. SIGNIFICANCE: An under-represented paleopathological defect is examined for the first time through a virtual approach aimed at visualizing its shape and the assessment of its volume. New methods of 3D based virtual assessment can increase the informative value of defects. SUGGESTIONS FOR FURTHER RESEARCH: Techniques used in this assessment should be considered as an evaluative tool for other conditions when macroscopic and radiographic imaging are limited.

Strontium and oxygen isotopes as indicators of Longobards mobility in Italy: an investigation at Povegliano Veronese.

The arrival of the Longobards in Northern Italy in 568 CE marked a period of renewed political stability in the Peninsula after the collapse of the Western Roman Empire. The trajectory of the spread of Longobards in Italy across the Alps and into the South is known from many literary sources. However, their mobility and residence patterns at a population level remain to be fully understood. Here we present a multi-isotopic analysis (87Sr/86Sr and 18O/16O) of 39 humans and 14 animals buried at the Longobard necropolis of Povegliano Veronese (VR, Italy; 6th-8th century CE), to address mode and tempo of the spread of this population in the Peninsula. The geographical location of Povegliano Veronese plays a key role: the site lies along the Via Postumia, which was one of the main ancient Roman roads of Northern Italy, representing an important route in post-classical Italy. The integration of isotopic data with the archaeological evidence allowed us to determine the presence of individuals from at least three different regions of origin, building a diachronic map of the dynamics of mobility of this group in northern Italy.

A possible case of mycosis in a post-classical burial from La Selvicciola (Italy).

An examination of an adult male buried from the post-classical necropolis of La Selvicciola (Viterbo, Latium, Italy; 4th-6th centuries AD) revealed a series of skeletal lesions. The lesions, both proliferative and lytic, ranging in size from small (around 0.01 mm) to extensive (up to 16.00 mm) pits, occurred at multiple sites. A holistic approach assessed lesion type, frequency and location in a differential diagnosis, which included myeloma, metastatic carcinoma, tuberculosis, leukemia, osteomyelitis, and mycoses. It was concluded that a mycosis, specifically Cryptococcosis, was the most likely cause of these lesions. Both macroscopic analyses and X-ray scans support our diagnosis. We also provide a methodological scheme as a model for examining unknown lesion patterns.

Survival to amputation in pre-antibiotic era: a case study from a Longobard necropolis (6th-8th centuries AD).

The Longobard necropolis of Povegliano Veronese dates from the 6th to the 8th centuries AD. Among the 164 tombs excavated, the skeleton of an older male shows a well-healed amputated right forearm. The orientation of the forearm fracture suggests an angled cut by a single blow. Reasons why a forearm might be amputated include combat, medical intervention, and judicial punishment. As with other amputation cases reported in literature, this one exhibits both healing and osteoblastic response. We argue that the forelimb stump morphology suggests the use of a prosthesis. Moreover, dental modification of RI2 shows considerable wear and smoothing of the occlusal surface, which points to dental use in attaching the prosthesis to the limb. Other indications of how this individual adjusted to his amputated condition includes a slight change in the orientation of the right glenoid fossa surface, and thinning of right humeral cortical bone. This is a remarkable example in which an older male survived the loss of a forelimb in pre-antibiotic era. We link archaeological remains found in the tomb (buckle and knife) with the biological evidence to show how a combined bioarchaeological approach can provide a clearer interpretation of the life history of an individual.