A regional examination of surgery and fracture treatment in Iron Age and Roman Britain

Abstract

The study macroscopically examined 270 sexed adults and 190 subadult individuals for evidence of ante mortem fractures and surgical practice in Dorset, during the Iron Age (5th century BC to 1st century AD) and Romano-British period (1st century to the end of the 4th century AD), in order to understand medical treatment in both periods and determine the extent to which these practices changed post conquest (43 AD).As treatment during these periods is not well understood, a conservative approach to fracture analysis was employed, which attempted to minimise the influence of fracture type and location on results by excluding bones in which fracture deformities may only be corrected by surgery. The study also excluded fractures resulting from bone mineralisation diseases or neoplasms. Skeletal evidence for surgical treatment was identified using funerary, taphonomic and osteological criterion to determine when the surgery took place, and to establish that changes were not caused by post mortem activity.The analysis of fracture treatment demonstrated that in both periods, adult fractures were well set with few secondary changes; a result also influenced by the stable nature of the fracture types. No evidence for sex-differences in treatment was observed. Evidence for surgery was identified in two Romano-British individuals: an unsuccessful limb amputation, and an embryotomy procedure that was most likely carried out in an attempt to save the mother.This regional assessment of medical treatment has shown that in both periods, highly skilled practitioners were able to successfully treat a range of fractures and by doing so, minimised the patient's risk of impairment. The study also supplements the very limited archaeological evidence for medical practice and surgery in Iron Age and Roman Britain, and suggests that post conquest, surgical knowledge rapidly increased in association with wider socio-cultural developments in education, pharmacology and sanitation.

Gendered Differences in Accidental Trauma to Upper and Lower Limb Bones at Aquincum, Roman Hungary

“…The well-reduced nature of fractures at Graphisoft is comparable with results reported by Novak and Šlaus (2010) at Continental Croatia, and by Redfern (2010) at Romano-British sites in Dorset, UK; in both studies fractures were predominantly well-healed, suggesting that fracture treatment skills were known in these regions. Although the Graphisoft fractures meet Roberts' (1998a) standards, seven of the Graphisoft fractures had marked deformities of 15 degrees or greater; three of these, all belonging to males, possess both angular and rotational deformities greater than or equal to 15 degrees.…”

“…Roman physicians were trained by practical experience and apprenticeship, rather than in medical schools, and remedies from medicine makers and magicians may have been considered as alternatives to a doctor's care (Cilliers and Retief 2006;Redfern 2010;Scarborough 1970). Although medicine was not standardized in the Roman world, physicians were typically present in each settlement, and specialists were accessible in larger cities (Zsidi et al 2004).…”

“…Today, effective fracture healing is influenced by a person's diet, medications, activity level, co-morbidities, as well as nutritional and metabolic deficiencies (e.g., vitamin D deficiency) (Gaston and Simpson 2007;Mirhadi et al 2013). People in antiquity were aware of techniques for non-surgical realignment (reduction) and stabilization of fractured bones using splints and poultices (Brorson 5 2009;Celsus 1961;Hippocrates 2004;Redfern 2010). However, the application of these treatments may not always have been successful due to treatment incompetence or personal noncompliance (Redfern 2010).…”

“…People in antiquity were aware of techniques for non-surgical realignment (reduction) and stabilization of fractured bones using splints and poultices (Brorson 5 2009;Celsus 1961;Hippocrates 2004;Redfern 2010). However, the application of these treatments may not always have been successful due to treatment incompetence or personal noncompliance (Redfern 2010). Fracture complications, including infection, osteoarthritis, and maland non-union, may also provide insight into fracture severity and possible treatment interventions, and yield information about social stability and living conditions in the past (Dellinger et al 1988;Grauer and Roberts 1996;Karladani et al 2001).…”

“…As such, appliances used for treatment, for example splints, are not usually buried with the deceased (Roberts 1988b). If they were, it is unlikely that they would preserve archaeologically due to the biodegradable nature of most Roman medical interventions, including splints, poultices, and bandages made from organic materials such as wood, wool, oil, and fabric (Hippocrates 2004;Redfern 2010;Roberts 1988b). …”