Scurvy in the Great Irish Famine: Evidence of vitamin C deficiency from a mid‐19th century skeletal population

Abstract

Scurvy has increasingly been recognized in archaeological populations since the 1980s but this study represents the first examination of the paleopathological findings of scurvy in a known famine population. The Great Famine (1845–1852) was a watershed in Irish history and resulted in the death of one million people and the mass emigration of just as many. It was initiated by a blight which completely wiped out the potato—virtually the only source of food for the poor of Ireland. This led to mass starvation and a widespread occurrence of infectious and metabolic diseases. A recent discovery of 970 human skeletons from mass burials dating to the height of the famine in Kilkenny City (1847–1851) provided an opportunity to study the skeletal manifestations of scurvy—a disease that became widespread at this time due to the sudden lack of Vitamin C which had previously almost exclusively been provided by the potato. A three-scale diagnostic reliance approach has been employed as a statistical aid for diagnosing the disease in the population. A biocultural approach was adopted to enable the findings to be contextualized and the etiology and impact of the disease explored. The results indicate that scurvy indirectly influenced famine-induced mortality. A sex and stature bias is evident among adults in which males and taller individuals displayed statistically significantly higher levels of scorbutic lesions. The findings have also suggested that new bone formation at the foramen rotundum is a diagnostic criterion for the paleopathological identification of scurvy, particularly among juveniles. Am J Phys Anthropol, 148:512–524, 2012. © 2012 Wiley Periodicals, Inc.

Dental markers of poverty: Biocultural deliberations on oral health of the poor in mid‐nineteenth‐century Ireland

“…48–49) is a possible noncarious‐related cause of tooth loss of relevance for this population sample. This condition has previously been diagnosed in high rates in these individuals (Geber & Murphy, 2012). A chi‐square test, however, failed to detect a difference in the frequency of tooth loss between nonscorbutic and scorbutic (possible, probable, and definite diagnoses) individuals for both anterior (χ 2 (1) = 0.140, p  = .708) and posterior (χ 2 (1) = 0.005, p  = .943) dentitions.…”

“…A previous paleopathological study of the Kilkenny population sample has suggested that Vitamin C deficiency compromised the ability of these individuals to combat infectious diseases and greatly influenced their risk of death when entering the overcrowded workhouse institution. The mass mortality in this environment was mainly the result of infectious so‐called “famine diseases” such as typhus, typhoid fever and cholera (Geber & Murphy, 2012). The inclusion of periodontal disease, caused by lifestyle factors, as a potential contributor to the physical demise of a large proportion of the Irish population during the mid‐nineteenth century, further highlights the complexity and variability of the human experience of the Great Irish Famine.…”

Macroscopic features of scurvy in human skeletal remains: A literature synthesis and diagnostic guide

“…However, its application is not universally practical considering problems with preservation and completeness. Although interpretative caution is needed in order to avoid over diagnosis in paleopathology, the Ortner suite and other proposed hemorrhagic lesions (e.g., new bone around the foramen rotundum; Geber & Murphy, 2012) are logical from an anatomical and pathophysiological standpoint and their continued use in paleopathological research is tenable. However, as discussed in section five, the diagnostic weight attributed to these lesions should be explicitly justified and continually reassessed in paleopathological work.…”

“…Subperiosteal new bone on the shafts of long bones, as well as evidence of hemarthrosis, has been radiographically observed in adults with this disease, but these features also occur in a number of other pathological conditions, including trauma and infectious disease (Jaffe, 1972; Joffe, 1961). As chronic hemorrhage occurs in both scorbutic adults and children, the macroscopic lesions reported by Ortner and others can theoretically be applied to adult individuals and well as subadults (Crandall & Klaus, 2014; e.g., Buckley et al, 2014; Geber & Murphy, 2012). Jaffe (1972) reports that autopsy findings of adults with scurvy include bloody discoloration of muscle bellies and attachments, which lends clinical credibility to this argument (Jaffe, 1972, p. 454).…”

“…This proliferation of research began with the identification by Donald Ortner and colleagues of a suite of dry bone lesions which the authors argue can be intuitively linked to the unique pathophysiology of this disease (Ortner, Butler, Cafarella, & Milligan, 2001; Ortner & Ericksen, 1997; Ortner, Kimmerle, & Diez, 1999). Subsequent researchers have expanded on this work, both by extending Ortner's logical process of lesion identification to osseous changes at other sites in the skeleton and by integration of clinical radiographic and histological features of scurvy (Brickley & Ives, 2008; Geber & Murphy, 2012; Maat, 2004; Mays, 2008; Moore & Koon, 2017; Stark, 2014). …”