Evidence of skeletal treponematosis from the medieval burial ground ofSt.MarySpital,London, and implications for the origins of the disease inEurope

Abstract

Treponematosis is a syndrome of chronic infectious diseases. There has been much debate on its origins and spread, particularly with regard to venereal syphilis, an unsightly and debilitating disease in preantibiotic populations. The osteological analysis of 5,387 individuals excavated by Museum of London Archaeology from the medieval burial ground of St. Mary Spital in London (dated c 1120-1539) provided an unprecedented opportunity to investigate the nature and prevalence of disease over a period of time. Twenty-five individuals were found with suspected treponematosis, originating from all but the earliest period of the burial ground. Descriptions of affected individuals from each period, together with supporting images, are provided. In this work, particular emphasis was given to the distribution of lesions on the skeleton and the variation in patterns by sex and over time. Little change was observed in the distribution of bony change between individuals dated to pre- and post-Columbian periods. However, a dramatic rise in the prevalence of the disease in the final period (c 1400-1539) may reflect documentary reports of a European epidemic from the late 15th century.

Advancing the understanding of treponemal disease in the past and present

“…The overall findings showed that there was a rise in treponemal infection in the late 15th century, in keeping with historical accounts at this time. However, it also indicated that evidence of treponemal disease was present in phases that dated as early as the 13th century (Walker, Powers, Connell, & Redfern, ). Such studies represent the cutting edge of what is now possible in radiocarbon dating and should provide the blueprint for future chronological analyses of treponemal disease.…”

“…A few studies describe individuals with treponemal disease within the context of large skeletal samples. Walker et al (), for example, described 25 affected skeletons within a very large sample of 5,387 individuals from Medieval St. Mary Spital in London. Henneberg et al () and Henneberg & Henneberg () studied a sample of 272 ancient Greek skeletons in which they found signs possibly indicating treponemal disease in 47 skeletons, including two with dental lesions of CS.…”

“…Very few include histological (e.g., Von Hunnius, Roberts, Boylston, & Saunders, ) or biomolecular analyses (e.g., Schuenemann et al, ). Lesions observed were sometimes described thoroughly (e.g., Walker et al, ), although many reports do not contain enough detail for independent evaluation, and some provide very little information. Supporting images were very helpful in assessing diagnoses (e.g., Lauc et al, 2015), but images were not always included or there was an insufficient number (e.g., Šlaus and Novak, ).…”

“…Some reported evidence from the Old World is clearly pre‐Columbian in date based on standard archaeological methods and carefully conducted radiocarbon dating (see section 4.1). Much evidence, however, is post‐Medieval (after the mid‐16th century), and tertiary skeletal changes are found more commonly in later periods in Europe (e.g., Walker et al, ). Most of the reported evidence from the late Medieval and post‐Medieval periods is from urban contexts, possibly because far fewer rural cemeteries have been excavated in comparison to those necessitated by modern urban development.…”

Syphilitic infection in a pre-modern population from South Korea (19th century AD)

“…Treponematosis is a chronic infectious disease caused by bacteria of the genus Treponema (de Melo et al, 2010;Walker et al, 2015), and its geographical origins have been intensely debated for nearly 500 years. All paleopathological evidence from the Old World and the New World (Brothwell, 1976;Kennedy, 1990;Pàlfi et al, 1992;Zhang, 1994;Rao et al, 1996;Mays et al, 2003;Suzuki et al, 2010) indicates that acquired syphilis did not exist prior to several hundred years ago, and that it evolved from a progenitor similar to yaws in the New World prior to being transmitted to the Old World (Harper et al, 2011).…”