Webster (1986:156) suggests that the way to solve the problems within medieval archaeology is through a framework where “documentary and archaeological evidence are scrupulously assessed in tandem”. However, for a fuller understanding of the past, we must also include the people who lived in it through paleopathological and bioarchaeological data. In order to find leprosy, as defined not by modern standards, but by medieval perceptions, there must be a holistic synthesis of biological, historical and archaeological evidence. By using Soren’s study of malaria (2003) as a model, we can begin to develop a list of indicators that reveal the traces of leprosy. Soren argues that there are eleven indicators that when satisfied suggest the presence of malaria in a cemetery (2003:204-206). Using this type of study as a guide, from our data we can begin to create the osteological, historical and archaeological conditions which will suggest the presence of leprosy.
Paleopathological/Osteological Indicators:
The paleopathological indicators of leprosy can be narrowed down to a list of seven bone changes: deformation of the nasal aperture, destruction of the anterior nasal spine, absorption of the bone in the premaxilla alveolar processes, pitting and absorption in the palate, inflammation of the periosteum of the fibula, swelling of fibula, and changes in fifth metatarsal (Boldsen and Mollerup 2006:346). Osteological studies can also reveal the overall health of a population, including any signs of malnutrition, and the contemporary factors that constituted a diagnosis of medieval leprosy that would have lead to a separate burial.
Historical Indicators:
Historical markers of leprosy are easy to identify because they are prefaced by name. References to leprosy, lepers, skin ailments, tsara’ath, elephantiasis or leprae could indicate the medieval conception of the disease. Maps, documents and folklore referring to places by the names of the aforementioned patron saints of leprosy, or leprosy in general may also reveal valid locations of hospitals or leprosaria. The documents of the time can also reveal what may be found in the archaeological record, such as types of food eaten, clothing worn, special buildings, physician’s instruments or other related material remains.
Archaeological Indicators:
Archaeology can indicate leprosy through a variety of methods. Cemeteries can be compared based on their layout and organization to reveal abnormalities that may indicate disease. Churches and hospitals can inform choices of settlement layout based on their distance from the main community centers, and architecture can reveal some purpose. Material remains like special clothes, bottles for urinalysis and treatment, irons used for cauterization, and other medically related tools could be excavated. Through zooarchaeology, one can analyze the non-human bone material to discover the diet.
From these indicators, one can see how paleopathological, historical and archaeological markers can all inform one another. Osteological analysis of malnutrition, combined with animal bone fragments and historical accounts of diet can create a holistic picture of what their eating habits were. In trying to learn if a cemetery is considered leprous, one can correlate the paleopathological evidence, with the relative location of the cemetery and its layout, and then check for historical sources citing the cemetery. Manchester and Roberts (1989) argue that the only objective data is from the bones, and Austin (1990) proposes that archaeology cannot rely on historical data. As discussed earlier, each of these forms of study has their limitations in determining the presence of what the medieval people perceived as leprosy. I propose that by accepting a multidisciplinary viewpoint, these limitations can not only be minimized, but that we can produce a more holistic understanding of the United Kingdom in the Middles Ages.
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