The Middle Ages Viewed Through Physical Anthropology: Imago Temporis - Medium Aevum January 2011

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THE MIDDLE AGES VIEWED THROUGH PHYSICAL ANTHROPOLOGY
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The Middle Ages viewed through
Physical Anthropology
Assumpció Malgosa
Universitat Autònoma de Barcelona
Spain
Date of receipt: 7th November, 2010

Final date of acceptance: 19th of January, 2011
Abstract
The study of antiquity can be tackled from different angles and perspectives.
The biological vision of ancient humanity is the subject of physical anthropology,
which studies the variability of the human being in space and time. This discipline
studies human remains, principally bones, and analyses their composition,
form or anomalies, to determine the life story that has been “written” in them.
The archaeological register of the Middle Ages offers a large number of human
remains, the study of which should supply an interpretation of life in that context.
Moreover, the anthropological study of medieval remains allows us to go beyond
the interpretation of an extinct society, because at the methodological level, and
given the extensive existing documentation of all types, it offers the possibility of
defending, supporting and confirming data obtained empirically.
Key Words
Skeletal Remains, Palaeodemography, Palaeopathology, Paleogenetics.
Capitalia Verba
Sceletemata, Palaeodemographia, Palaeopathologia, Palaeogenesis.
Imago Temporis. Medium Aevum, V (2011): 23-53. ISSN 1888-3931 23
Imago 5.indb 23 02/10/2012 13:10:28

24 Assumpció Malgosa
1. Physical Anthropology
Biological anthropology studies the variability of the human being in space and
time. When the subject of the study is ancient man, we talk about skeletal biology,
palaeoanthropology or osteobiography. Personally, I like the latter term, coined by
the British, as it summaries in one word what is really being analysed: life through
bones. Perhaps it is not totally precise as it is not only bones but rather the whole
skeleton, bones and teeth, that supplies the information, but it does give a very clear
idea of the aim of this kind of study, namely to obtain all possible information about
the lives of the men and women of the past through studying their remains.
The application of this type of information is not limited to one period or moment,
but can explain many things about the people and societies of a specific time, based
as it is on direct evidence, i.e. skeletons, and can be compared with written sources
and other documents, images, etc.1
Medieval population has evidently been intensively studied through physical
anthropology,2 as there are many biological vestiges, and the discovery of remains
and necropoli from the medieval period fill the pages of many newspapers. They are
also on the agenda if we enter the right key words into any search engine: medieval
1. The research carried out for this work was supported by the Ministry of Science and Innovation of the
Spanish Government (MICINN) in the research project CGL2008-0800.
2. I mention the most notable works in Spain, mainly in the form of doctoral theses, but also some research
that has been published about human remains from the medieval period: Arenal, Isabel; de la Rúa Vaca,
Concepción. Antropología de una población medieval vizcaína, San Juan de Momoitio. Garai. Donostia-San
Sebastián: Eusko Ikaskuntza, 1990; Fadritque, Thais. La necròpolis Alt Medieval de Sant Esteve de Granollers
(Barcelona): Estudi bioantropològic. Bellaterra: Universitat Autònoma de Barcelona (unpublished research
work), 2006; Galera, Virginia. La población medieval cántabra de Santa María del Hito. Aspectos paleodemográficos,
morfológicos, paleoepidemiológicos y de etnogénesis. Madrid: Universidad de Alcalá de Henares (PhD. Dissertation),
1989; Hernández, Miquel; Turbón, Daniel. “Parámetros del esqueleto postcraneal en la población castellana
medieval de ‘La Olmeda’”. Boletín de la Sociedad Española de Antropología Physical, 12 (1991): 61-80; Jordana,
Xavier. Caracterització i evolució d’una comunitat medieval catalana. Estudi bioantropològic de les inhumacions de les
esglésies de Sant Pere. Bellaterra: Tesis doctoral Universitat Autònoma de Barcelona (PhD. Dissertation), 2007;
<http://www.tesisenxarxa.net/TDX/TDX_UAB/TESIS/AVAILABLE/TDX-0601107-162707//xjc1de1.pdf>;
Jordana, Xavier; Malgosa, Assumpció. “Terrassa, una villa medieval en transición a la Época Moderna.
Estudio bioantropológico de la necrópolis de la Plaça Vella”. Revista Española de Antropología Physical, 23
(2002): 1-25; López, Belén. Estudio antropológico de poblaciones históricas de Castilla y León. Leon: Universidad
de León (PhD. Dissertation), 2000; Martín, Encarna & Souich du, Philippe. “Estudio antropológico de
la necrópolis altomedieval del monasterio de Suso (San Millán de the Cogolla, Logroño)”. Antropología
y Paleoecología humana, 2 (1981): 3-20; Prada, Encina. Estudio antropológico de los restos humanos medievales
y modernos de la necrópolis leonesa de Palat del Rey. Lleó: Universidad de León (PhD. Dissertation), 1993;
Prevosti, María; 3Prevosti, Antonio. “Restos humanos procedentes de una necrópolis judaica de Montjuich
(Barcelona)”. Trabajos del Instituto Bernardino de Sahagún, 12 (1951): 69-148; Souich Philippe du. “Estudio
antropológico de la necrópolis medieval de la Torrecilla (Arenas del Rey, Granada)”. Antropología y
Paleoecología humana, 1 (1979): 27-40; Souich, Philippe du; Botella, Miguel Cecilio; Ruíz, L. “Antropología
de la población medieval de Palacios de la Sierra (Burgos)”. Boletín de la Sociedad Española de Antropología
Physical, 11 (1990): 117-146; Souich Philippe du & Botella, Miguel Cecilio. “Antropología de la población
medieval de Villanueva de Soportillo (Burgos)”. Antropología y Paleoecología humana, 6 (1991): 57-84;
Vives, Elisenda. Contribució al coneixement dels enterraments medievals a Catalunya i regions limítrofes. Bellaterra:
Universitat Autònoma de Barcelona (PhD. Dissertation), 1987; Vives, Elisenda. La població catalana medieval:
Origen i evolution. Barcelona: Eumo Editorial, 1990.
Imago Temporis. Medium Aevum, V (2011): 23-53. ISSN 1888-3931
Imago 5.indb 24 02/10/2012 13:10:30

The Middle Ages viewed through Physical Anthropology 25
human remains. Despite this, physical anthropology has not concentrated specifically
on this period. The fact that there is abundant documentation and that it is relatively
recent has meant that this period has not been as closely studied as other more
distant historical periods, and has not generated the same level of fascination as the
prehistoric era. However, the anthropological study of medieval human remains
is extremely interesting on many levels, both for the interpretation of an extinct
society, and on a methodological level because the parallel documentation offers the
possibility of debating, supporting and confirming empirically obtained data.
What can the physical anthropology of the Middle Ages explain? In fact, what we
should ask ourselves is what physical anthropology obtains from surviving human
remains. Initially, anthropology tells us personal stories: who the person was,
which is what we call the person’s biological profile (age, sex, stature, population
group), but also about their lives, each person’s biography, or rather osteobiography
—the register in the bones of how he or she lived, what diseases they suffered, the
circumstances that surrounded their lives and perhaps even their deaths.
Nevertheless, physical anthropology studies populations, so there are many
global questions about the groups that it can help to reconstruct. From an overall
description of medieval society, I will introduce the aspects to which anthropology
can contribute in the following paragraphs.
1.1 Physical anthropology and the medieval period
In the medieval period and in traditions from ancient times, when someone died,
they were wrapped in a white shroud and their relatives watched over them before
the burial. It was not infrequent to take them directly to the cemetery. This was
done not only to avoid the contagion of diseases, but also to keep the ghost of the
dead at a distance.
Anthropology in the field allows the questions related to the deposition of
the body through the excavation and recovery of the remains: the existence of
a wrapping, the type of place (silted up or not), association with material, such
peri mortem circumstances as fractures that occurred shortly before, during or after
death, non-habitual postures and particular situations to be interpreted.
The dead were buried in the village cemetery, as close as possible to the church
—especially since the 11th century— and also to the family. The nobility and clergy,
the most powerful groups, found their place closer to, and sometimes even inside,
the church.
The differences in status are often observed in nutritional markers or others
of activity, or even in the demographic data itself. On the other hand, the new
molecular analyses that can be used nowadays on skeletal remains sometimes allow
kinship to be established.
If we focus on the Middle Ages, we know that the society of the living was
predominantly rural for many centuries. At that time, ninety per cent of the
population lived in the country, which was the centre of all activity and life, and
Imago 5.indb 25 02/10/2012 13:10:31

peasants were organised around their own lands and other common lands they shared
with their neighbours.
Physical anthropology enjoys a series of tools at the level of markers of activity
and pathologies that give direct information about a type of activity and its effects
on people.
These communities were gradually taken over by lords, lay or religious, and feudalism
was adopted as a mode of social organisation. Society was divided into estates at the
base of which were the peasants, either free or serfs, who made up the vast majority
of the population. On the intermediate level were the military and the nobility, both
lay and ecclesiastical, who had different categories or status. At the top was the royalty.
This division in status not only affected everyday activities, but also access to food,
direct contact with specific pathogenic agents carried by livestock, the possibility of
suffering serious injuries, etc., where physical anthropology also supplies basic data
about lifestyle.
Membership of one group or another was decided by birth, and, given the
exclusive nature of these estates, it was not possible to move from one to another.
This was articulated by the scholars of the time, who sought a divine explanation
for this new social organisation. Each one fulfilled a function, all of which were
important, as everyone depended on everyone else through the intricate system of
dependence or vassalage.
This fact is very important as it means that the physical and environmental
conditions in which a person was immersed were maintained throughout his or
her life. Peasants, lords, soldiers and royalty had specific roles and obligations, with
few transgressions, which facilitated their recognition. Given that the bones register
acute changes that affect them directly, or chronic ones that affect them indirectly
but lastingly, the fact that [one’s social] status was maintained throughout one’s life
makes this easier to identify in anthropological studies.
The economy was one of subsistence and the family was the main unit of production
for the medieval peasantry. The nuclear family shared the houses, although it was
common to find homes with extended families. Each member of the family had a role,
and there was a division of labour according to the person’s sex, age or status. While
the men and young people worked the land, the women took care of the livestock, the
kitchen garden, the clothing, and preparing and conserving food and drink.
L’alimentació és un aspecte bàsic de la reconstrucció de les poblacions antigues. Què, com,

quant menjaven defineixen gran part de l’activitat humana ja que l’adquisició de l’aliment
ocupa una part important del dia; les preferències i el tractament que se li dóna depenen en
gran manera de la cultura, i el profit que se’n pot treure determinarà l’estat de salut de la
població, amb els condicionaments que els estatus proporcionen. És un d’aquells aspectes de
la vida humana on cultura i biologia són pràcticament indissolubles i impossibles de tractar
aïlladament (...) Per a la reconstrucció de la dieta, l’Antropologia biològica disposa, ara per
ara, de l’estudi de la composició química dels ossos mitjançant l’anàlisi d’elements traça i els
isòtops estables, l’estudi de les patologies dentàries, del desgast dentari i de l’anàlisi del càlcul
Imago 5.indb 26 02/10/2012 13:10:31

dentari. De totes maneres també port aportar dades sobre l’estat nutricional i de salut de la
població a través dels patrons demogràfics i de les patologies òssies.3
This was a convulsive period, which affected each feudal house’s differently.
While some families expanded greatly and established links to others through
marriage, there were also conflicts over succession and territory deriving from the
relations of vassalage and as an expression of the violence inherent in feudalism.
Although there were great population movements of conquest and territorial
predominance in great waves in earlier periods, physical anthropology can supply
genetic data from the genetic material contained in the bone remains and through
epigenetic skeletal markers. On the other hand, injuries from armed conflicts are
recognisable and allow a reconstruction of the strategies and weapons of combat.
The transformation of an eminently rural feudal society into an urban social class,
the bourgeoisie, started in the 11th century, and led to important urban growth,
thanks, among other things, to the expansion of agriculture and the spread of trade.
The model gradually evolved towards a society where the bourgeoisie marked out
their own space and functions as well as taking over small parcels of power, creating
a political and organisational system very different from the one practiced in the
country, and taking leadership over the cities.
The new bourgeoisie settled outside the walls, leading to the growth of the
suburbs, an area that would later be integrated into the city with a new wall that
included the new inhabitants, leading to an irregular layout that responded to the
new homes, and not to urban planning.
Aquest nou tipus de vida. afectarà també l’estil de vida i la salut de les persones. Els canvis
demogràfics, l’especialització que suposa algunes feines lligades als gremis i la insalubritat
dels burgs medievals, són alguns dels aspectes més notables en els que l’antropologia aporta
dades fonamentals. Ens podem preguntar doncs sobre l’estructura demogràfica de les
poblacions, cóm afectaria l’ambient a aquesta gent, quines malalties podrien patir, quin
tipus de patògens eren més freqüents en aquell lloc i època, la mortalitat concreta que van
provocar les grans epidèmies i quin era l’agent patogen responsable —ja que en un moment
donat tot rep el nom genèric de pesta—, quina importància van tenir en aquesta mortaldat
les grans fams, les dietes monòtones i escasses, etc.4
3. Malgosa, Assumpció; Subirà Mª Eulàlia. “Antropologia i dieta: metodologies per a la reconstrucció

de l’alimentació de les poblacions antigues”. Cota Zero, 12 (1996): 15-27: “Food is a basic aspect for
reconstructing [the lives] of ancient peoples. What, how and when they ate defines a large part of human
activity, as obtaining food takes up an important part of the day; the preferences and the treatment
it is given depend to a great extent on the culture, and the benefit that can be extracted from it will
determine the state of health of the population, with the conditioning factors that derive from status. It
is one of those aspects of human life where culture and biology are practically inseparable and impossible
to deal with in isolation (...) To reconstruct the diet, biological anthropology has, for now, the study of
the chemical composition of the bones by analysing trace elements and stable isotopes, the study of
dental pathologies and wear, and the analysis of dental plaque. Anyway, it also contributes data about
the nutritional state and health of the population through demographic profiles and bone pathologies”.
4. Lo scavo del cimitero di San Michele ad Alghero (fine XIII-inizi XVII secolo), Milanese, Marco, ed. Pisa:
Felici editore, 2010. This new lifestyle would also affect the lifestyle and health of the people.
The demographic changes, the specialisation that some jobs linked to the guilds meant and the
Imago 5.indb 27 02/10/2012 13:10:31

Both models, the rural and the urban, with their own social and economic
organisation, were not incompatible but rather coexisted throughout the Middle
Ages. The majority of the population continued to live off the land, the population
of the cities being a minority and so the advantages and disadvantages derived
from each of these situations, such as the greater freedom and higher income
enjoyed by the minority who lived in the towns, continued for centuries and in
some cases resulted in a longer life expectancy.
Physical anthropology studies the demographic profiles and analyses these in
the light of such other aspects as diseases and the degenerative markers and aging.
Some years ago, Wood, Milner, Harpending and Weiss demonstrated the problem
of selective mortality and the heterogeneity hidden in the susceptibility to disease,
and argued in their Osteological Paradox that interpreting the state of health of the
population from bone fragments is not simple. The palaeopathological findings
from the medieval period are more spectacular than those from other periods,
which is evidently linked to the exposure to pathological agents that can mean
worse living conditions, but is also related to a greater survival of the population,
both aspects which must not be underestimated.
The development of the city provoked a change in trade in the Middle Ages
and one must bear in mind a “before” and “after” for the 11th-century cultural,
economic and social renaissance. Since the fall of the Western Roman Empire,
there had been little trade and Early Middle Age societies were rather closed.
However, trade began to increase in the 11th century with the newly-acquired
importance of the cities and their populations. The cities had a very important
role in medieval Europe as centres of teaching, government and religion, but
especially as key places in the new trade system. Moreover, despite the economic
depression of the early medieval centuries, the demand for luxury goods and
spices from the Orient, such as silk or pepper, had not disappeared, and all Europe
was affected by the expansion in international trade.
Trade meant movement not only of goods but also people, which meant a
mixing of populations and the introduction and expansion of diseases previously
confined to certain areas of the world, both of which aspects are analysed by
physical anthropology.
unhealthiness of medieval towns are some of the most notable aspects for which anthropology supplies
fundamental data. Thus we can ask ourselves about the demographic structure of the populations,
how the environment would affect these people, which diseases they might have suffered, what type
of pathogens were more common at that time and place, the specific mortality caused by the great
epidemics, and which pathogenic agents were responsible —since at a given moment everything was
given the generic name of plague—, what importance the great famines, the monotonous and poor
diet, etc, had on this mortality”.
Imago 5.indb 28 02/10/2012 13:10:31

2. The study of human remains
A few years ago, when human remains appeared in excavations, archaeologists

threw their hands up in despair as finding skeletons meant a lot of work to
recover all the remains, all the tiny bones and, in return, they seemed to gain
little information: only whether it was a man or a woman, and not much else.
What really happened was that anthropologists did not know how to transmit
the potential for information that a skeleton harboured and that could be of
use for the historian. It only required deciphering. The wealth of new data that
this supposed for interpreting the past indicates the importance of studies in
collaboration.
The physical anthropologist attempts to rebuild the life of human populations
in the past from their biological vestiges, always studied in a geographical,
chronological and cultural setting. Thus, they try to find out how the people
lived, who they were, which groups they belonged to and the their composition
and lifestyle of these were. The social schemes of the past must surely have been
very varied and different from our westernised concept of the world. Some of
these social aspects can be reflected in the skeleton. For example, there must
have been some groups in which men, women, and children all had a more
or less equal role in the structure of the society, in the way of life. However,
this was probably an exceptional case and the habitual social structures were
discriminatory, thus affecting the health or physical activity of a specific segment
of the population, and both aspects —health and activity— leave their marks on
bones. Thus, differences regarding occupation can almost always be observed,
in which one part of the population is dedicated to certain specific tasks, and
another, to others. The rituals related to death can also be interpreted from an
anthropological perspective.
These then, are all these aspects that we wish to analyse to reconstruct life
in the past. Where should we start? Where does the work of the anthropologist
begin? Anthropologists not only work with the data that can be obtained in
the laboratory, but their task can start much earlier and has an important role
beside that of the archaeologist, taking part in the excavation of human remains
in both programmed work and unplanned urgent interventions and in rural and
urban contexts.
Thus, our work as anthropologists begins on the site, observing, documenting,
excavating the skeletal remains and collecting samples, in short, collaborating
with the archaeologist. Sometimes, in single graves where the skeletons are
individualised and linked anatomically, the task of documentation and recovery
may seem relatively simple, without the need for specialists. However, even in
these cases, the information that an anthropological examination can supply
may be essential for studying the individual and interpreting the rites. Thus, if
the anthropologist observes the exact position of the fragments of broken bone,
this can mean the difference between diagnosing a chance fracture, whether
old or not, or a peri mortem fracture related to the circumstances of death and
Imago 5.indb 29 02/10/2012 13:10:31

perhaps even its cause (Figure 1). On other occasions, it can be a question of
being able to differentaite between stones and calcified structures of organic
origin, such as kidney or liver stones.
Figure 1. Peri mortem fractures in both legs of the skeleton of a soldier

from the Spanish Civil War. This type of fracture must be interpreted
in the field to enable the moment of the injury and the circumstances
surrounding the death to be determined.
Figure 2. Coraliform type lithotripsy, associated with a mature male individual in

the Visigoth necropolis of Casserres (Berguedà).
Imago 5.indb 30 02/10/2012 13:10:33

At other times, the skeletons in an individual grave are accompanied by other

remains for which a detailed analysis is needed at both the anthropological
and taphonomic levels to interpret whether these are intrusive elements from
previous or later burials, related offerings, or other possibilities.
With group burials, the situation can be more complicated, given that the
remains may be widely scattered, and the possible connections and relations
between them must first be analysed to be able to individualise the skeletons
as the first step towards identifying the individuals anthropologically, and in
second place, to interpret the nature of the site.
Detailed fieldwork, with archaeologists and anthropologists collaborating
and working together, allows detailed and precise images of the burials to be
constructed. On the other hand, on-site identification of a large part of the
material to be studied later, makes the laboratory work easier, and often supplies
unique data, while reinforcing the results.
The work in the anthropology laboratory begins with cleaning, identifying,
reconstructing, measuring and interpreting the remains of bones and teeth. These
often have to be separated from bone remains derived from fauna. This first
stage of the study is a morphological examination and is the basis for any later
analysis because, however much the technologies we can apply to studying the
skeletal remains advance, it will always be essential to identify the material that
is to be analysed. The application of morphological methodologies is complex.
In contrast, the tools required are not at all sophisticated, although they are
very precise. It must be emphasised that a large part of the resources in our
anthropology laboratories are dedicated less to instrumentation and apparatus,
but rather, a great deal of space, and especially personnel, is dedicated to what
are very laborious tasks that require a lot of experience. (Figure 3).
That does not mean that anthropology is not a very modern science in which
very advanced technologies are applied, as in any other sciences. Anthropologists,
like researchers in any other scientific discipline, are very involved in the vertiginous
changes that are occurring in scientific research, incorporating new methodologies,
from statistical tools or treatment of the image, to innovations at histological, physical-
chemical, microscopic or even molecular levels. The fact that the work begins by using
very simple tools, does not mean that the only equipment used in anthropology are
the tools for cleaning and measuring.
Thus, after the initial information at the morphological level, the need to move on
to other levels of analysis, whether microscopic or even molecular, has to be evaluated.
Finally, all this information must be summarised, relating it with what is known from
other types of study (archaeological, botanic, faunistic, documentary), presenting it
in a comprehensible way and transmitting it to others, either as reports, articles or
monographic studies.
Imago 5.indb 31 02/10/2012 13:10:34

Figure 3. Bronze Age hypogeum with a mass grave at Mas d’en Boixos (Pacs, Alt Penedès).
Thus, the anthropologist’s work covers a wide spectrum of tasks: from the
field and the laboratory, to making “a history of life” and presenting it to society
in the form of scientific information and popular divulgation.
This review of the work of anthropologists introduces the tasks they undertake
and which allow them to reconstruct the past from remains. I believe that it is
interesting to define the work of the anthropologist through the title of the book
by Mehmet Iscan and Kenneth Kennedy, Reconstruction of Life from the Skeleton,5
which talks about the methodologies for reconstructing life from skeletal
remains, and goes beyond the idea of studying exclusively the dead, which is
often associated with the study of death and not the people, who lived and died
at some moment in the past.
And it is possible to do this: it is possible to reconstruct life in the past,
obviously within limits, but it can be done, and this work can be carried out in
our laboratories. Many will ask how human remains, often scarce or damaged,
can tell us so much. The answer is “reading the bones”. The secrets are guarded
5. Iscan, Mehmet Yasar; Kennedy, Kenneth A. R., eds. Reconstruction of life from the skeleton. New York:
Alan R. Liss, 1989.
Imago 5.indb 32 02/10/2012 13:10:37

in the skeleton, which gradually changes throughout a person’s lifetime, and

these changes are the reflection of the events that affected the person, and are
registered in the bones. We must bear in mind that while bone may seem a very
inert material, it is a living tissue, in constant change. Bone is continually being
destroyed and rebuilt in response to the body’s needs. Bones grow during the
early stages of life; morphologically they are designed to fulfil different functions
(protection, support, the possibility of movement, etc,) and they adapt to these
during their development; they are repaired when they break; they store minerals
and free these when the body requires them; they react to aggressions, either
the impact of a blow, the attack of a microorganism or another environmental
agent; they grow old and degenerate, etc. If we observe these changes and know
how to interpret them, we can reconstruct that person’s life. This way, bones are
like a book we must learn to read, but also to interpret, as it is not fully written.
On the other hand, no two bones are completely equal. Being from different
individuals, they have lived different histories, developed under individual
genetic directives and been submitted to specific environmental circumstances
and, thus, tell different stories. It is a question of knowing how to read the data
they supply.
3. In the laboratory
The first thing we look at in the anthropological analysis of bone remains

is the individual biological profile, mainly defined by age, sex, size, physical
characteristics and what the British call the determination of ancestry, in the
sense of knowing to what kind of population the person belonged. Once this
profile has been obtained, the next step is the individual study, with an analysis
of the pathologies and lifestyle.
3.1 Biological profile
The biological profile is defined by the individual’s basic biological data.

Regarding age, firstly the age group of the individual, child, juvenile or adult,
must be determined and then a profile drawn up with specific methodologies.
The diagnosis in pre-adult individuals is based on the process of skeletal
development and maturing. Although there is a certain regional disparity, mainly
due to environmental differences, this is a very reliable diagnosis, which helps to
quickly obtain a high level of precision. In the earliest stage (foetal, prenatal or
newborn), the diagnosis is based on both the length of the long bones and the
state of development of bones with a complex morphology with different nuclei
of ossification, such as temporal or occipital. In children under twelve, the most
widely used criteria are development and dental eruption (Figure 4a) and the
Imago 5.indb 33 02/10/2012 13:10:38

length of the long bones, and after the age of twelve, in adolescence, the most
reliable criteria are those of epiphyseal fusion (Figure 4b). These methodologies
can be used, not only in skeletal remains, but also in recent cadavers and in
x-rays of living people. To obtain results, a reference series as close to the case
study as possible is needed, both geographically and chronologically. To evaluate
age in adults (when the growth and development of the bones has ceased),
markers that indicate degenerative processes are used. These include changes in
the sternal face of the 4th rib, the morphological changes in the pubic symphysis
(Figure 4c), or the auricular surface of the coxal.
Regarding gender, there are differences between the skeletons of men and
women that allow a reliable diagnosis (figure 5). It should be borne in mind
that the design of our skeleton has been profoundly modified by having to adapt
to an upright posture. These changes affect the position and shape of the head,
the curve of the spine, the freeing of the upper limbs, the verticality of the lower
limbs and their convergence in the supporting polygon. But they especially
affect the shape of the pelvis that, with evolution, has evolved into a bony ring
that supports the limbs, which bears all the weight of the entrails internally,
and externally allows the connection of muscles strong enough to maintain the
upright posture. These are the changes that we see in men, changes towards a
compact pelvis that has to bear the bodyweight and house stabilising muscles for
the upright position. However, in women, this pelvis must also shelter a baby for
nine months, then allow it come out, so the female pelvis has to be wider, lower
and have bigger internal cavities.
On the other hand, other secondary sexual characteristics linked to
development, such as the greater size of the skeleton and musculature in men,
also help the diagnosis (figure 5). Gender can also be analysed at the molecular
level. This methodology is mainly used in the case of infants. It must be borne
in mind that all the characteristics described to here are little developed in pre-
adults, and more reliable forms of diagnosis are required.
Imago 5.indb 34 02/10/2012 13:10:38

Figure. 4 Skeletal markers for age; a) development and dental eruption6 b) epiphyseal
fusion, c) changes in the sternal faces and the pubic symphysis, collected by Krogman
and Iscan.7
6. Ubelaker, Douglas H. Human Skeletal Remains. Excavation, Analysis, Interpretation. Washington:

Taraxacum, 1989.
7. Krogman, Wilton M.; Iscan, Mehmet Yasar. The Human Skeleton in Forensic Medicine. Springfield
(Illinois): Ch. C. Thomas, 1986.
Imago 5.indb 35 02/10/2012 13:10:41

Figure 5. Sexual differences in the pelvis and skull.
The characteristics of the long bones also contribute to other diagnoses, for
example, of stature. The bones of the limbs let us estimate the size of the person
(child or adult) while alive, through formulas that take into consideration their
length. The most reliable are those of the lower limbs, as these make the biggest
contribution to the stature. However, the body structures of each population group
are slightly different, and therefore adequate formulas must be used for each case.
Finally, this initial description includes attributing the remains to a population
group. Despite the difficulties of establishing osteological criteria that differentiate
populations, it is true that there are general characteristics that broadly differentiate
the three great branches of human population, at both cranial and postcranial
levels. The high forehead and prominent chin of the Caucasians, the wide faces of
the Mongoloids, or the wide nose of the Negroids, are some of the traits that guide
the diagnosis of population filiation.8
8. Krogman, Wilton M. & Iscan, Mehmet Yasar. The Human Skeleton...
Imago 5.indb 36 02/10/2012 13:10:43

3.2 Palaeodemography
The diagnosis of the gender and age of remains from a necropolis leads the
study towards the issue of population structure. This is a question of analysing
the population biodynamics from the data on the mortality of a human group,
and interpreting other demographic parameters, such as fertility, migration and
population growth, all within an ecological context. Although there is a degree of
controversy about the possibility of carrying this out on ancient populations, the truth
is that there is a set of information to interpret and for which palaeodemographic
tools are essential. Palaeodemography9 is a developing discipline.
First of all, basic information is required to identify the type of funeral deposit
and whether it is a sample of a natural population where all ages and sexes will be
represented in varying proportion, or whether the sample is skewed in any way, in
one specific cemetery. The cause of this bias must be interpreted. Ancient populations
follow the pattern of populations that have not reached the demographic transition,
with high birth and mortality rates, and a very high infant death rate —with a higher
exogenous than endogenous mortality, that diminishes in adolescence and increases
progressively through adulthood. The ages with the highest mortality rates indicate
crucial moments in life —birth, infancy, and the change to adult life. An important
imbalance in the ages of female mortality is also seen in natural populations, being
much higher at earlier ages, with the increased mortality related to problems
derived from the precocity of maternity and risky pregnancies.10 The interpretation
of the structure of age and gender also supplies very valuable information about the
situation and history of that population and the conditions of life and health, and
are thus a good indicator of the demographic and social situation.11
The age bias can be due to different motives. The absence of children in a necropolis
must be considered at different levels.12 On the one hand, the taphonomic processes
must be taken into consideration as possible causes of the greater deterioration and
loss of the remains of children, leading to them being less well represented in the
9. Bocquet-Appel, Jean Pierre. “La paleodemographie”, Objets et Méthodes en Paléoanthropologie, Olivier

Dutour, Jean-Jacques Hublin, Bernard Vandermeersch, eds. Paris: Comité des travaux historiques et
scientifiques, 2005: 271-313; Alesan, Alícia; Malgosa, Assumpció; Simó, Carles. “Looking into the
demography of an Iron Age population in the Western Mediterranean. I. Mortality”. American Journal
of Physical Anthropology, 110 (1999): 285-301; Marquez Morfín, Lourdes; Hernández, Olga Patricia.
Principios básicos, teóricos y metodológicos de la Paleodemografía. Mexico: Instituto Nacional de Antropología
e Historia, 2001.
10. De Miguel Ibáñez, Paz. “La infància a través de l’estudi de les restes humanes des del Neolític a l’Edat
del Bronze en terres valencianes”, Restes de vida, restes de mort, Ángela Pérez Fernández, Begoña Soler
Mayor, coords. Valencia: Museu de Prehistòria de València, 2010.
11. Jordana, Xavier. Caracterització i evolució d’una comunitat medieval catalana. Estudi bioantropològic de les
inhumacions de les esglésies de Sant Pere. Bellaterra: Universitat Autònoma de Barcelona (PhD.Dissertation),
2007.
12. Guerrero Víctor María. “Posibles sacrificios infantiles en la cultura talayótica de Mallorca”. Cuadernos
de Prehistoria y Arqueología Castellonenses, 14 (1989):191-203.
Imago 5.indb 37 02/10/2012 13:10:43

archaeological register.13 At other times, the imbalance can be related to selective

burial, as seems to be the case with the tophets of Carthage, Sant’Antioco or those
at Son Oms, where only children were buried. This type of burial has generated a
great deal of speculation and has been attributed to a social origin, which considers
that at the moment of death, children were not yet part of society, or religious
roots, for example, that they had yet to be baptised and were an offering to the
Gods, as the name tophet itself suggests.14 Thus some demographic patterns suggest
infanticide.15 Ritual killing is known from some historical contexts and from a range
of different places and cultures, where the anthropological and demographic data
demonstrates the ritualistic meaning of violence against children.16 Finally, in the
context of ancient excavations, two methodological questions should be taken
into consideration. On one hand, there is a lack of experience in recognising and
gathering the remains of children, and on the other, lesser importance is attributed
to the study of children.17
The imbalance of the sexes among children might be related to differences in
attention to one gender or the other, and even infanticide, as has happened in the
recent history of China, when the choice of a boy as the first and only child led to
extremely high female perinatal mortality. These cases can be detected through a
predominance of one sex in the pre-natal or early postnatal ages, or the detection of
pathologies related to postnatal malnutrition.
The imbalance of the sexes among adults can be related to other processes such
as outbreaks of violence18 or selective burials.
13. Guy, Herve A.; Masset, Claude; Baud, Charles-Albert. “Infant taphonomy”. International Journal of
Osteoarchaeology, 7 (1997): 221-229; Walker, Phillip L.; Johnson, John R.; Lambert, Patricia M. “Age and
sex biases in the preservation of human skeletal remains”. American Journal of Physical Anthropology, 76
(1988): 183-188.
14. In the Old Testament, the tophet is a holy place, an altar, placed at the gates of Jerusalém where the
Israelites and resident immigrants practiced human sacrifices —specifically young children submitted to
fire in honour of Moloch.
15. Coleman, Emily. “L’infanticide dans le Haut Moyen Age”. Annales Économies, Sociétés, Civilisations,
29 (1974): 315-335; Crawford, Sally. Childhood in Anglo-Saxon England. Stroud: Alan Sutton Publishing,
1999; Watts, Dorothy J. “Infant burials and Romano-British Christianity”. Archaeological Journal, 146
(1989): 372-383.
16. Hernández Espinoza, Patricia Olga. La regulación del crecimiento de la población en el México prehispánico.
Mexico: Ed. Instituto Nacional de Antropología e História, 2006; Lewis, Mary E. The Bioarchaeology of
Children Perspectives from Biological and Forensic Anthropology. Cambridge-New York: Cambridge University
Press; 2007; Perry, Megan A. “Redefining Childhood through Bioarchaeology: Toward an Archaeological
and Biological Understanding of Children in Antiquity“. Antiquity. Archeological Papers of the American
Anthropological Association, 15/1 (1995): 89-111.
17. Malgosa, Assumpció. “Vida, enfermedad y muerte en la antigüedad: lo que nos cuentan los esqueletos
de los niños”, Los niños, actores sociales ignorados. Levantando el velo una mira al pasado, Lourdes Márquez,
coord. Mexico: Instituto Nacional de Antropología e Historia, 2010: 21-50.
18. Etxeberria, Francisco; Herrasti, Lourdes; Bandrés, Antxon. “Muertes violentas determinadas a través
de estudios de paleopatologia“. Munibe (Antropologia-Arkeologia), 57 (2005-2006): 345-357; Etxeberria,
Francisco; Vegas, José Ignacio. “¿Agresividad social o guerra? Durante el Neo-eneolítico en la cuenca
media del Valle del Ebro, a propósito de San Juan ante Portam Latinam (Rioja Alavesa)”. Munibe
(Antropologia-Arkeologia), suplemento 6 (1988): 105-112.
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3.3 Palaeopathology
While the demographic structure supplies indications about the lifestyle and
health of ancient populations, it is palaeopathology that provides more direct
data about the diseases or conditions that affected humanity in ancient times.19
Etymologically, the word Palaeopathology derives from the Greek paleos (old),
pathos (condition), and logos (study), and thus literally means the study of the
diseases of the past. Palaeopathology works in a multidisciplinary terrain where
physical anthropology goes hand in hand with medicine, which supplies the clinical
information, and history, which situates us in the context. This information helps to
rebuild the history and geography of diseases, examining the interactions between
disease and cultural processes, documenting the evolution of the diseases over time,
and understanding the effects of the pathological processes on the development and
growth of bones. Thus, the study of ancient remains facilitates the interpretation of
the state of health of the individuals or population under study, and relates this to
the biological, social and geographic context in which they lived. It is true that this
has strong limitations, as we can only know about the diseases that affected the
bone either directly, like a fracture, or indirectly, by becoming chronic and affecting
the entire organism. Thus, it must be borne in mind that the cause of death can only
be determined on very few occasions, as many types of pathology leave no mark
on the bone. On the other hand, the non-specificity of the bone reactions and the
lack of supporting data, such as the medical history, soft tissues and diagnostic tests,
mean that the diagnoses are often suppositions.
The pathologies of the bone that are most often diagnosed in ancient remains are
congenital, inflammatory, traumatic, tumoral, and degenerative, and those caused
by nutritional deficiencies. Additionally, non-pathological morphological variants
and alterations of the bone surface in places of muscle insertion (the presence of
enthesopathies, etc.) are found that can be used to know about the way of life of
the individual. Regarding the specific case of palaeostomatology, the most common
lesions are caries, alveolar recession and fistulas. Moreover, kidney and liver stones,
ante mortem tooth loss and hypoplasia of dental enamel are also among the indicators
of oral health.
Finding an anomaly by macroscopic observation and detailed examination
of the remains leads to a series of other tasks: the description of the lesion, the
contextualisation of the piece or individual, complementary tests and differential
diagnosis. A detailed description and documentation of the lesion and its context
(individual, geographical, historical, cultural) is essential for the following stages.
Complementary tests, such as x-rays or DNA analysis, supply basic data. Sometimes
these tests can be destructive, so a prior evaluation of the singularity of the specimen
and the documentation should always be undertaken before applying them. Finally,
differential diagnosis brings us closer to a probable diagnosis, but will hardly ever be
19. Isidro, Albert; Malgosa, Assumpció, eds. Paleopatología la enfermedad no escrita. Barcelona: Masson,
2003.
Imago 5.indb 39 02/10/2012 13:10:43

a certainty, given that there are too many diseases that produce the same pattern of
lesions in the bone, and the evidence can be very limited.
3.3.1 Congenital anomalies
The term congenital comes from the Latin congenitus, and literally means “born
with”. Thus, the congenital anomalies or pathologies are those that affect the
embryo and foetus during gestation or at birth. They refer to the characteristics or
traits an individual is born with, and not only depend on hereditary factors, but also
include characteristics acquired during gestation and birth.
These anomalies can be of varying severity, ranging from those that are
incompatible with life and cause the death of the embryo or foetus, to those that are
subclinical and do not lead to any disease. They can be due to genetic (hereditary)
factors or alien or external causes (the effect of drugs, radiations, infections, etc.).
In ancient times, for a person to survive, this type of disease could not be severe
or life-threatening, but rather minor (dental agenesis, some alterations of the shape
of the skull, hidden spina bifida, variations in the number of vertebrae), so that the
congenital anomaly or disease allowed these people to obtain the resources needed
to live, either alone or with the help of the community (Figure 6). This allows us to
infer data about the sociability in the population in the context of the time.
Figure 6. A case of Humerus Varus Deformity

in the individual PE’02 UF 9 (♀ adult-young)
in the medieval necropolis of St. Esteve de
Granollers. The shortening of the left arm was
not invalidating.
Imago 5.indb 40 02/10/2012 13:10:45

3.3.2 Infections
An infection is the colonisation of a host organism by microorganisms (bacteria and

fungus, but also prions and viruses) that are prejudicial for the normal functioning and
survival of the host. In the case of other living pathogenic agents (protozoa, parazoa,
etc.), the term is infestation. In fact, living beings have the capacity and necessity to live
and relate to other beings, such as microorganisms, for mutual benefit, which is called
symbiosis (as in the case of the anaerobic bacteria that colonise the colon of mammals,
or the different species of staphylococcus on the skin of humans). When this relation is
of no benefit to the host, parasitism occurs; while in that which causes damage to the
receptor, infection appears, causing pathology.
Infectious disease has been very frequent in humans throughout history, but only
a small part of these affect the skeleton and, of these, an even smaller part leaves
evidence that can be observed. Despite this, infections are a fairly frequent finding in
archaeological remains.
Although the reaction of the bone to an infection is fairly non-specific, there are
diseases which are easier to diagnose given the morphology or localisation of the lesion,
such as tuberculosis and brucellosis (Malta fever, Figure 7). In these diseases, the causal
germ can be inferred. However, the majority of infections occur without clearly defining
signs, such as periostitis (thickening of the cortical bone), many osteolytic lesions
(destruction of parts of the bone), the drainage holes (cloacas), or the insufflation of
the bone etc.
Figure 7. Fusion of the wrist bones. Necropolis

of Monte d’Argento (Fondi, Rome/Italy). 12th
century. The fusion and forming of a block at the
wrist without signs of traumatism is habitually due
to rheumatic diseases or, as in this case, a chronic
infection that, through the affectation of other
parts of the skeleton, was diagnosed as brucellosis
(Malta fever), although it is very rare for this to
affect the wrist.
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3.3.3 Tumours
Tumours are anomalous growths of any part of the organism. In old remains
they can be seen in both the skeleton and soft tissues in the case of mummies,
but the tumours that are seen most often in the field of archaeology are those
of the bones. Despite their varied morphology, tumours are evident, either
through the anomalous growth of some part of the bone which provoke bumps
and excrescence, either through the destruction of the bone, which appears like
“hair on end”, often affecting the cortical bone and leaving the spongy tissue
exposed. When the tumour does not affect the bone directly, through contiguity
it can leave an imprint in the form of depressions and even cavities. They can be
benign or malignant, the latter being cancerous tumours.
Benign tumours are much more frequent in the field of old findings and can
vary from small rounded lesions (like the osteomas of the skull) to large tumours
that can cause injury through compression of neighbouring structures. On the
other hand, the malignant or cancerous tumours that can be detected in the
bone develop either from the bone itself, which means their origin is a malignant
and uncontrolled proliferation of cells from the bone or bone marrow, or lesions
through the metastasis of a cancer of unknown origin. The morphological
characteristics of all malignant tumours are their irregularity and the almost
constant destruction of the cortical bone. They can be generators (osteoblastic
metastasis) or destroyers (osteolytic metastasis) of bone (Figure 8).
Figure 8. Metastasis in the frontal

region. Church of Sant Pere (Terrassa,
Barcelona). 9th-13th centuries. Museu de
Terrassa. The circular frontal lesion with
irregular edges is suggestive of osteolytic
metastasis of a cancer of unknown origin.
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3.3.4 Degenerative and rheumatic articular pathology
This section includes those diseases that affect the joints, being mainly of two
types: rheumatic and degenerative articular diseases. The joints are the points on
the skeleton where movement takes place, made up of two or more bones and
covered in cartilage, a tissue very rich in collagen and whose notable characteristics
are low friction and the absorption of weight.
Rheumatic disease is often general or systemic, their origins lying in chronic
inflammatory alterations generated in the sinovial membrane, which is the layer
that surrounds the joint. Its origins are immunologic. Some of these diseases have
a predilection for a specific sex; thus, the best known, rheumatoid arthritis, is
more common among women, while some of the seronegative spondilytis, such as
ankylosing spondilytis, are more frequent in males. Rheumatic diseases are chronic,
with relapses, and are usually quite crippling.
The degenerative articular pathology or arthrosis is an alteration very directly
related to the physical activity of a certain population segment and age. The increase
in physical activity in a joint means that this loses part of its physiological properties
and leads to arthrosis. On the other hand, on reaching a certain age, the joint
cartilage loses its properties and intra-articular (erosions and loss of cartilage) and
extra-articular (osteophyte) lesions appear. Arthrosis is very frequent in the spine
(cervical and lumbar regions) and in the load-bearing joints, mainly the hips and
knees.
Given that in antiquity, many everyday activities required a greater physical
effort, lesions to the joints were more frequent and occurred at earlier ages than
nowadays. The evidence for this type of pathology is found in the modifications
to the area of the joint, with the presence of fusions, erosions, eburnations or the
production of bone excrescences (syndesmophytes).
3.3.5 Traumatisms
Fractures are the loss of the normal continuity of the bone material. The term
is used for all kinds of breaks in bones, from those in which the bone is widely
destroyed, to very small, and even microscopic, lesions. They are very varied in
origin, from accidental or provoked traumatisms, in which a direct or indirect impact
breaks the bone, to those lesions caused by the bone’s inability to bear normal loads
or the persistence of loads on a normal bone.
Accidental traumatisms, such as those from falls or blows, can affect the skeleton,
producing fractures or dislocations of the joints. Although fractures can happen to
any bone in the body, they are more evident in the long bones, such as those in
the arms and legs. In other types of fracture, the bone cannot bear the repetition of
impacts, loss of resistance, lack of solidity or the loads it is submitted to. An example
of this are fractures of the vertebra through osteoporosis.
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Figure 9. DISH. (Lleida) Can Maginet (Lleida) 11th C.

Biological Anthropology Unit (Universitat Autònoma de
Barcelona). DISH (difuse idiopatic skeletal hyperostosis)
is a disease that occurs in the old due to the calcification
of the ligaments on the back of the spine, predominantly
on the right side. This condition does not mean any risk
except the possible loss of mobility if the fusion of the
vertebral segments is important enough.
The physiological repair of the fracture takes place through the production of
a more or less evident bone callus, depending on whether the bones have been
displaced and if the fracture has been reduced (realigned) or not. Thus, the evidence
of a misalignment of the principal axes of the bones (Figure 10), the presence of bone
callus or the clear separation of two fragments allows a fracture to be diagnosed.
On the other hand, if the fracture is not correctly immobilised, a solid callus is
not formed and pseudo-arthrosis appears in its place (mobility of the callus of the
fracture).
Dislocations, being mainly lesions of the soft parts that surround the ends of the
bones at the joints, cannot be seen directly in the archaeological remains, but, in
some cases, their side effects may be seen through the formation of neo-articulations
in anomalous places.
Imago 5.indb 44 02/10/2012 13:10:53

Figure 10. Fracture of the right tibia in

burial 32 in the necropolis of the Plaça
Vella in Terrassa. Although the fracture was
remodelled, it produced a misalignment of the
bone diaphysis and the anomalous position of
the foot.
3.3.6 Oral pathology and conditions

Teeth and the bone that supports them are the skeletal indicators most directly
related to diet and indirectly to nutrition, as they are in direct contact with the food.
This contact produces a wide range of reactions, which differ according to the make-
up of the diet and its metabolism and can easily be observed in the anthropological
Imago 5.indb 45 02/10/2012 13:10:56

material (Figure 11)20 (Malgosa and Subirà, 1996), namely caries, the loss of bone
support, alveolar abscesses, hypoplasia of the enamel, dental plaque and wear.
Caries is the result of bacterial action on the dental plaque. Its presence is due to
the high consumption of simple sugars and soft-textured foods typical of vegetarian
populations who cook their food. The frequency of caries generally reflects
the changes in diet better than other markers, although oral hygiene and other
constitutional factors also have an influence.
Figure 11. Maxillaries of the individual CT-

1118 from Castell de Termens (Lleida) in
which we can see caries of the LAC in the
three lower molars, alveolar recession and
generalised deposits of tartar, and fistulas in
the alveoli of the upper molars.
The loss of bone support as a consequence of periodontal disease is also related to

sticky foods that facilitate the development of microorganisms and infection of the
periodont. With time, this leads to the loss of teeth.
Teeth are also often lost through alveolar abscesses. What is observed in skeletal
remains are alterations in the bone that surrounds the tooth caused by the
introduction of bacteria through non-natural openings in the teeth caused by decay
or extreme attrition. Both dental abscesses and the ante mortem loss of teeth are
associated with the accumulative effect of the dental pathologies.
However, lesions to teeth can also be genetic or caused by deficiency. This is the
case of hypoplasia of the dental enamel. This is an alteration of the enamel provoked
by the temporary interruption of its process of formation, and it adopts different
forms: bands, lines or wells. It is believed that these are non-specific indicators of
individual physiological stress and can be produced by a large variety of factors that
affect the growth of the child.
Other markers of diet or dental use are related to wear of the oclusal surface
of the teeth and the deposits of tartar. The type of wear is associated with soft or
abrasive, cooked, food, with a high level of contaminants, etc., and also with para-
alimentary or extra-alimentary activities. This information is obtained through both
20. Malgosa, Assumpció; Subirà Mª Eulàlia. “Antropologia i dieta: metodologies...”: 15-27.
Imago 5.indb 46 02/10/2012 13:10:57

macroscopic and microscopic study.21 On the other hand, it is a lack of oral hygiene,
which is behind the presence of deposits of dental plaque. Microscopic analysis
offers more direct information about the composition of the diet (micro-residues
from plants (microcarbons, phytoliths, etc,) and animals (fragments of fish bones,
spicules, etc.).
3.3.7 Pathologies and nutritional state
It is important to note that, to a great extent, the environment where a population

lives determines its eating habits in its contents, resources, forms of consumption
and traditions. A poor diet causes malnutrition, both if it is not adequate or through
shortage. Ancient peoples must frequently have suffered from malnutrition due to
both of these causes. For example, consider the limited variety of foods at certain
times of year (in winter, for example) or the depletion of products in times of
drought.
However, perhaps one of the manifestations in bones most related to the
processes of malnutrition that lead to anaemia is osteoporotic hyperostosis.
Osteoporotic hyperostosis habitually affects the external table of the cranial bones,
in which there is a notable thinning, leaving the hypertrophied diploe exposed. Its
etiology is poorly understood and various origins have been proposed, but it should
be considered a skeletal manifestation of anaemia in any of its forms: nutritional,
parasitary, hereditary, etc. In any population, the groups most susceptible to anaemia
are those undergoing high rates of growth and development, and who thus have
high nutritional requirements. These are mainly the youngest children and women
during pregnancy and breastfeeding.
Cribra orbitalia is also of interest and can be considered an osteoporotic lesion
localised in the orbital roofs, predominantly in the medial-superior portion
and normally bilateral. This is one of the most intriguing palaeopathological
manifestations, given the lack of observations and comparison with current clinical
experience.
Stature, platybasia, pelvic morphology, diaphyseal shape and other morphological
aspects are also indicators of the state of skeletal development22 related to the
nutritional state of the person.
21. Romero, A.; Martínez-Ruiz, N.; De Juan. “Quantitative relationship of paleonutritional indicators:
dental microwear analysis and biochemical aspects in an Islamic sample from Alicante, Spain”. International
Journal of Dental Anthropology, 3 (2002): 1-13; Romero, A.; De Juan. “Intra- and interpopulational human
buccal tooth surface microwear analysis: inferences about diet and formation processes”. Anthropologie,
45/1 (2009): 61-70.
22. Larsen, Clark Spencer. Bioarchaeology. Interpreting behavior from the human skeleton. Cambridge:
Cambridge University Press, 1997.
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3.3.8 Palaeoepidemiology
From all the data obtained at the pathological level and of the presence of
anomalies, an evaluation can be made of the significance in the population of the
possible diseases that our ancestors suffered most frequently, at what age they were
most susceptible, which groups were most affected, and by what. The pathologies
not only tell us about the disease itself, but also about many other aspects: whether
the victims overcame it or not; their susceptibility; what cures they were given; their
diet and nutritional state; the resources they had available and their adequacy; the
environment; they moreover tell us about health, available products, and the origin
of the group; about the social status related to the distribution of tasks, access to
resources, etc.; occupational habits after the lesions and morphological variability;
the existence of conflicts and interpersonal violence or war; social questions, such
as customs, or support.
To obtain this data, however, one must start with the study of the disease in
the population through statistical analysis and comparison with other groups and
populations, both ancient and modern. In other words, the palaeopathological analysis
of the population has to be a palaeoepidemiological analysis. Palaeoepidemiology
is heavily restricted as, unlike epidemiology, it has no control over the selection of
the sample and is limited by a series of extrinsic and intrinsic factors. The extrinsic
factors (the proportion of deaths buried in a site, the proportion of buried individuals
who last long enough to be discovered, the proportion of those discovered, and,
finally, the proportion of individuals recovered)23 are independent on the biological
characteristics of the population, and all of these tend to reduce the size of the
sample. Among the intrinsic factors, the most important in our case is to recognise
that the sample we are studying is of dead individuals. Such an obvious point is
often forgotten, and it must be kept in mind that it is not the same to characterise
the part of the population that lives and survives, as the part that dies.
Thus, the palaeoepidemiological analysis of the population has to bear in mind
the size of the sample (one of the basic limitations of this type of study), the
distribution of the pathology or anomaly by groups (conditioned by the above issue
of sample size), and the frequency of the pathology or anomaly in the population, to
determine the importance that it might have. It must also be borne in mind where
we are. We must consider, on one hand, the geographical setting, as diseases can be
subject to very different geographical spread, and, on the other hand, the time frame
of the study. That will influence the possibility of interaction with other groups,
etc. Finally, palaeodemography is a basic prop for interpreting populations, as we
have to refer to those who suffered disease or lesions, and why; which subgroup
of the population they belonged to and what susceptibility to the disease they had,
and why. Thus, we can infer the possibility of high-risk groups and also their life
expectancy.
23. Waldron, Tony. Counting the Dead. The Epidemiology of Skeletal Populations. Chichester: John Wiley and
Sons, 1994.
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4. Lifestyle
Anthropology can supply a great deal of information about the lifestyle of a

person or population. To begin with, their pathologies tell us about their exposure
to a specific pathogenic agent, either biological, chemical or physical, and thus
they tell us about the place, work or the way in which they came into contact. The
traumatisms also give us details about the lifestyle by showing the possibility of
suffering a fracture in function of the environment or the person’s occupation. Nor
should we forget the indicators of diet and nutrition mentioned in the previous
section, as they have much to do with the lifestyle.
However, there are more markers than the strictly pathological ones. These
are the so-called activity markers.24 They are modifications of the internal and/
or external architecture of the bone, which are produced under the conditions
of prolonged and continuous stress that derive from habitual or occupational
activities. These are modifications of the surface or shape of the bone due
to an extraordinary action by the muscles that are connected to, or act on, it.
Remodelling of the joints, when not associated with a pathological process or
age, also indicates an intensive and habitual use, which is related to habitual
activities. The evidence obtained from these skeletal marks is a valuable source
of information for generating hypotheses about certain antecedents in the life of
a person. For example, one can mention the subperiosteal haematomas on the
femurs of cobblers due to the constant hammer blows against the shoe resting
on the thigh; the absence of fusion of the acromial end of the shoulder blade of
archers, owing to the constant tensions this part of the bone undergoes, and which
ends up becoming a separate bone, the acromial bone;25 or the pulling of the end of
the neural spines of the first vertebrae from strong jerking movements in workers
who apply great force with their shoulders and arms, such as is common among
shovelers.26 However, there are also marks from non-occupational customs, such
as that of gripping a pipe with the teeth.27
24. Galtés, Ignasio; Jordana, Xavier; García, Carlos; Malgosa, Assumpció. “Marcadores de actividad en
restos óseos”. Cuadernos de Medicina Forense, 48-49 (2007): 179-189.
25. Capasso, Luigi; Kennedy, Kenneth A. R.; Wilczak, Cynthia A. Atlas of occupational markers on human
remains. Teramo: Edigrafital S.P.A., 1999.
26. Jordana, Xavier; Galtés, Ignasi; Busquets, F; Isidro, Albert; Malgosa, Assumpció. “Clay-Shoveler’s
Fracture: An Uncommon Diagnosis in Palaeopathology”. International Journal of Osteoarchaeology, 16
(2006): 366-372.
27. Goyenechea, Alberto; Eguren, Eva; Etxeberría, Francisco; Herrasti, Lourdes; Ibáñez, Alex. “Morfología
del desgaste dentario en fumadores de pipas de arcilla”. Munibe (Antropologia-Arkeologia), 53 (2001): 151-
157.
Imago 5.indb 49 02/10/2012 13:10:57

5. Social questions
Certain aspects of the society in which one lives are reflected in the skeleton.
For example, bone28 or dental modifications,29 specific diseases, treatments (also
specific), rites of passage, types of food, etc, are associated with distinct social or
population groups and can be observed in their bones and teeth. The phenomenon of
trepanations that has appeared since prehistory30 supplies important data about the
population and their beliefs or knowledge, although there is no single justification
for this practice.
The findings in themselves, the structure of age and sex, the injuries, etc, and all
the anthropological characteristics analysed in perspective can tell us about possible
interpersonal or other types of violence, social conflict, or war. On the other hand,
the survival of people with handicaps indicates collaboration, help and solidarity.
In these cases, we can detect aspects where the person managed to overcome their
difficulties (Figure 6), for example the loss of a limb or malfunction of an organ. The
treatments of diseases also tell us about the existence of medical knowledge, or even
people who had this knowledge, such as shamans or medicine men.
Cut marks and descarnation indicate secondary burial of the body,31 for
cannibalistic rituals or food, especially when there bones have been broken to reach
the marrow or brain or they have been exposed to fire, practices which, despite the
modern Western point of view, seem to have existed in different parts of Europe at
least during the Neolithic.32
However, the analysis of an individual’s burial ritual also sheds light on cultural
and social aspects. For example, it is known that in Roman times, some bodies
were buried in decubitus prono (face down) and their presence begs the question
about the reason for this practice. Some authors tend towards, ritual or deliberate
ceremonies,33 while others mention negligence, irreverence, or the absence of a
28. Lagunas Rodríguez, Zaid; Hernández Espinosa, Patricia. “Las prácticas culturales”, Manual de Osteología.
Mexico: Escuela Nacional de Antropología e Historia, 2007: 125-141.
29. Romero, Alejandro; De Miguel Ibáñez, María Paz; Buikstra, Jane E.; Knudson, Kris J.; Prevedorou E.
A.; Díaz Zorita Bonilla, Marta; De Juan, Joaquín. “Mutilación dentaria en la necrópolis islámica de Plaza
del Castillo (siglo VIII d.C.) de Pamplona (Navarra)”. Revista Española de Antropología física, 29 (2009):
1-14.
30. Campillo, Domingo. La trepanación prehistórica. Barcelona: Bellaterra, 2007; Roca de Togores Muñoz,
Consuelo; Soler Díaz, Jorge A. “Trepanacions en la Prehistòria. Los casos datats per C14 de las Coves de la
Pastora (Alcoi) i d’en Pardo (Planes)”, Restes de vida, restes de mort, Angela Pérez Fernández, Begoña Soler
Mayor, coords. Valencia: Museu de Prehistòria de València, 2010: 117-140.
31. Duday, Henri; Courtaud, Patrice; Crubezy, Eric; Sellier, Pascal; Tillier, Anne-Marie. “La Anthropologie
du terrain: Reconnaissance et interprétation des gestes funéraires“. Bulletins et Mémoires de la Société
d’Anthropologie de Paris, 3-4 (1990): II, 29-50.
32. Botella López, Miguel C.; Alemán, Inmaculada; Jiménez, Sylvia A. Los huesos humanos. Manipulaciones
y alteraciones. Barcelona: Bellaterra, 1999; Solari, A. Identificación de huellas de manipulationn intencional en
restos óseos humanos de origen arqueológico. Granada: Universidad de Granada, 2010 (PhD. Dissertation).
33. Vaquerizo, Desiderio. ”Mortes singulares. Suicidio y muertes traumáticas”, Funus Cordubensium.
Costumbres funerarias en the Córdoba romana, Desiderio Vaquerizo, ed. Cordoba: Universidad de Córdoba,
2001: 66-67.
Imago 5.indb 50 02/10/2012 13:10:57

gravedigger.34 Thus, the analysis should not be merely archaeological, considering,

for example, the type of tomb or trousseau, but also anthropological including,
for example, studying the primary or secondary situation of the skeleton and thus
the body, the position of the individual and his or her limbs, their relation to other
human remains, etc...
6. The origin of the population: genetic composition
6.1 Palaeogenetics
One of the most important secrets held by old remains is their identity and, when
talking about a population, who it was made up of and where its members came
from. Nowadays, palaeogenetics offers very important data about this, unimaginable
only a dozen years ago. By 1989 or 1990, progress in molecular techniques
had allowed genetic information to be obtained directly from old samples, both
bones,35 and teeth,36 thus beginning the development of palaeogenetics and
palaeomicrobiology.37 At a human level, work is principally done with the recovery
of small fragments of the hypervariable region of the mitochondrial DNA (ADNmt),
as this molecule is more widely represented than the nuclear genome and thus can
more feasibly be recovered from old remains. Moreover, this little molecule is of
matrilineal transmission so it makes it possible to trace female lineages and thus see
kinship in a population nucleus. On the other hand, in the cases where it is possible
to recover nuclear DNA, it is also possible to reconstruct male lineages through
the markers of the Y chromosome. In both cases, the data can be dealt with at a
population level to offer us a vision of the genetic make-up of the population. In
34. Review of García Prósper, Elisa; Polo Cerdá, Manuel. “Enterramientos de decúbito prono y un
posible preso entre los primeros pobladores de Valencia (Siglos II a.C.- III d.C.)”, VI Congreso nacional
de Paleopatología. ¿Dónde estamos?. Pasado, presente y futuro de the Paleopatología. Madrid, 13 a 16 septiembre
2001, Manuel Campo, Francisco José Robles, eds. Madrid: Universidad Autónoma de Madrid-Asociación
Española de Paleopatología, 2001: 298-316.
35. Hagelberg, Erica; Sykes, Brian; Hedges, Robert. “Ancient bone DNA amplified”. Nature, 342 (1989):
485; Horai, S.; Hayasaka, K.; Murayama, K.; Wate, N.; Koike, H.; Nakai, N. “DNA amplification from
ancient human skeletal remains and their sequence analysis”. Proc. Japan Acad, 65B (1989): 229-233.
36. Hänni, C.; Laudet, V.; Sakka, M.; Begue, A.; Stehelin, D. ”Amplification of mitochondrial DNA
fragments from ancient human teeth and bones”. Comptes Rendus de la Académie des Sciences III, 310 (1990):
365-370.
37. Malgosa, Assumpció; Montiel, Rafael; Díaz, Nancy; Solórzano Eduvigis; Smerling, A.; Isidro, A.;
García, C.; Simón, M. “Ancient DNA. A modern look at the infections of the past”. Recent Res. Devel.
Microbiology, 9 (2005): 213-236.
Imago 5.indb 51 02/10/2012 13:10:57

these cases, the kinship between people in a group,38 or between populations, can
be reconstructed.39
On the other hand, palaeomicrobiology helps to corroborate the diagnosis of
some diseases, both genetic and infectious.40 The latter is possible thanks to the
recuperation of fragments of DNA from the pathogenic agent involved in the disease.
In some cases, the origin of these diseases is still to be found. This is the case with
syphilis, where the recovery of the DNA of the Treponema pallidum pallidum41 from
remains diagnosed with this disease in different parts of the world is fundamental
to enable us to work with real data.
However, the recovery and study of old DNA is not free of difficulties, mainly
concerning degradation and contamination.42
6.2 Palaeobiochemistry
From the molecule, we can move on to the analysis of the chemical elements
that form it. Traditionally, the trace elements and stable isotopes in skeletal remains
have been analysed to determine the diet of an ancient population.43 In both cases,
38. It is difficult to establish kinship relations as quite a lot of markers are required. However, I cite some
examples of that type of study: Haak, Wolfgang; Brandt, Guido; de Jong, Hylke N.; Meyer, Christian;
Ganslmeier, Robert; Heyd, Volker; Hawkesworth, Chris; Pike, Alistair W. G.; Meller, Harald; Alt, Kurt W.
“Ancient DNA, Strontium isotopes, and osteological analyses shed light on social and kinship organization
of the Later Stone Age”. Proc Natl Acad Sci U S A, 105/47 (2008): 18226-18231; Keyser-Tracqui, Christine;
Ricaut, François; Crubézy, Eric; Ludes, Bertrand. ”Populations anciennes et ADN ancien: état actuel de
the question.” Antropo, 2 (2002): 1-8; Keyser-Tracqui, Christine; Crubézy, Eric; Pamzsav, Horolma; Varga,
Tibor & Ludes, Bertrand. “Population Origins in Mongolia: Genetic Structure Analysis of Ancient and
Modern DNA”. American Journal of Physical Anthropology 131 (2006): 272-281.
39. There are few cases of genetic studies of ancient populations. Some examples are: Díaz, Nancy. Bahía
de Alcúdia, Mallorca: Un crisol genético en the Mediterráneo. Bellaterra: Universitat Autònoma de Barcelona,
2010 (PhD. Dissertation); Montiel Rafael. Estudio diacrónico de the variabilidad del DNA mitocondrial en
poblationn Catalana. Bellaterra: Universitat Autònoma de Barcelona, 2001 (PhD. Dissertion). <www.
tdcat.cesca.es/TDCat-0726101-095837>; Sampietro, Lourdes; Caramelli, David; Lao, Oscar; Calafell,
Francesc; Comas, David; Lari, Martina; Agustí, Bibiana; Bertranpetit, Jaume; Lalueza-Fox, Carles. “The
genetics of the pre-Roman Iberian Peninsula: a mtDNA study of ancient Iberians”. Ann Hum Genet, 69
(2005): 535-548.
40. Malgosa, Assumpció; Montiel, Rafael; Díaz, Nancy; Solórzano, Eduvigis; Smerling, A; Isidro, A; García,
C; Simon, M. “Ancient Dna: A Modern Look at the infections of the Past”, Recent Research developments in
microbiology. Trivandrum: Research Signpot, 2005: 213-236.
41. Kolman, Connie J.; Centurion-Lara, Arturo; Lukehart, Sheila A.; Owsley, Douglas W.; Tuross,
Noreen. “Identification of Treponema pallidum subspecies pallidum in a 200-year-old skeletal specimen”.
The Journal of Infectious Diseases, 180 (1999): 2060-2063.
42. Lalueza-Fox, Carles. “ADN and Arqueologia”, Restes de vida, restes de mort: la mort en la prehistòria,
Ángela Pérez Fernández, Begoña Soler Mayor, coords. Valencia: Museu de Prehistòria de València,
2010: 73-80; Montiel, Rafael; Francalacci, Paolo; Malgosa, Assumpció. “Ancient DNA and Biological
Anthropology: Believers vs. Skeptics”, Recent Advances in Molecular Biology and Evolution: Applications to
Biological Anthropology, Christina Santos, Manuela Lima, eds. Kerala: Research Singpost, 2007: 209-249.
43. Ambrose, Santley H.; Katzenberg, M. Anne, eds. Biogeochemical approaches to paleodietary analysis. New
York-London: Kluwer Academic Press-Plenum Publishers, 2002.
Imago 5.indb 52 02/10/2012 13:10:58

the chemical elements become part of the body, in its mineral part or in the organic
matrix, through the diet. This information can be useful in itself for reconstructing
the basic food sources of a group of people. However, the study of the stable isotopes
now also covers another aspect related to the origin of persons and migrations. The
isotopes of carbon, oxygen and hydrogen can help to determine the geographic
origin of a person through the proportions in the water they drank.44 In the same
way, strontium isotopes and lead in the teeth and bones can be used to reconstruct
the migration of human populations and their cultural affinity.
7. General considerations
Physical anthropology nowadays has a wide range of methodologies and

techniques adapted from other neighbouring disciplines, which allow it to tackle
the reconstruction of ancient populations in depth. The information contributed
by anthropology, together with that from others who study the past, namely
archaeologists and historians, has allowed us to approach this reconstruction of
the life of the people in the past. It is collaboration between different scientific
disciplines that brings us forward. Each field of science contributes its own
experience: Without going any further, this joint work is very evident in the field
of palaeopathology, where anthropology supplies knowledge about the variability
and population, medicine contributes the individual and the clinical aspects, and
archaeology provides the context.
The contribution of physical anthropology is through the study of biological
aspects, from the recognition of the biological profile of the dead, to their funeral
rites, via the reconstruction of their lifestyle, the illnesses they suffered, what they
ate, what their habits were, their phylogeographic origin and perhaps what they
died of. Moreover, if our intention is to reconstruct human populations from the
past, we should pay attention to all stages of a person’s life, from birth to death.
How can we acquire this knowledge? It is exhaustive work from the study and
recovery of the remains in the excavation and their reconstruction, to the study
in the laboratory, applying all the methodologies available to us, and exchanging
information with other researchers. All this should allow us to reach a logical
explanation about the life and death of the people in question.
44. Some examples of this type of analysis can be found in: Daux, Valérie; Lécuyer, Christophe; Héran,
Marie-Annie; Amiot, Romain; Simon, Laurent; Fourel, François; Martineau, François; Lynnerup, Niels;
Reychler Hervé; Escarguel Gilles. “Oxygen isotope fractionation between human phosphate and water
revisited”. Journal of Human Evolution, 55/6 (2008): 1138-1147; Thompson, Alexandra H; Chaix, Louis;
Richards, Michael P. “Stable isotopes and diet at Ancient Kerma, Upper Nubia (Sudan)”. Journal of
Archaeological Science, 35/2 (2008): 376-387; Ehleringer, James R.; Bowen, Gabriel J.; Chesson, Lesley
A.; West, Adam G.; Podlesak, David W.; Cerling, Thure E. “From the Cover: Hydrogen and oxygen
isotope ratios in human hair are related to geography”. Proceedings of the National Academy of Sciences,
105/8 (2008): 2788-2793.
Imago 5.indb 53 02/10/2012 13:10:58

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THE MIDDLE AGES VIEWED THROUGH PHYSICAL ANTHROPOLOGY

Article in Imago Temporis - Medium Aevum · January 2011

genética de poblaciones humanas View project

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Date of receipt: 7th November, 2010

Skeletal Remains, Palaeodemography, Palaeopathology, Paleogenetics.

Sceletemata, Palaeodemographia, Palaeopathologia, Palaeogenesis.

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1.1 Physical anthropology and the medieval period

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L’alimentació és un aspecte bàsic de la reconstrucció de les poblacions antigues. Què, com,

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3. Malgosa, Assumpció; Subirà Mª Eulàlia. “Antropologia i dieta: metodologies per a la reconstrucció

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2. The study of human remains

A few years ago, when human remains appeared in excavations, archaeologists

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Figure 1. Peri mortem fractures in both legs of the skeleton of a soldier

Figure 2. Coraliform type lithotripsy, associated with a mature male individual in

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At other times, the skeletons in an individual grave are accompanied by other

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in the skeleton, which gradually changes throughout a person’s lifetime, and

The first thing we look at in the anthropological analysis of bone remains

3.1 Biological profile

The biological profile is defined by the individual’s basic biological data.

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6. Ubelaker, Douglas H. Human Skeletal Remains. Excavation, Analysis, Interpretation. Washington:

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Figure 5. Sexual differences in the pelvis and skull.

8. Krogman, Wilton M. & Iscan, Mehmet Yasar. The Human Skeleton...

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9. Bocquet-Appel, Jean Pierre. “La paleodemographie”, Objets et Méthodes en Paléoanthropologie, Olivier

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archaeological register.13 At other times, the imbalance can be related to selective

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3.3.1 Congenital anomalies

Figure 6. A case of Humerus Varus Deformity

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