Scurvy is caused by a lack of vitamin C in one’s nutrition. Historical accounts of the disease are first recorded in 1845, noting the presence of rosy patches of skin, swollen muscles and aching bones. It also includes gingivitis, tooth loss, swelling of the lower extremities, vertigo, faintness, profuse sweating, hemorrhagic spots in the eyes, and impaired healing of wounds. In the skeleton, the swelling in the joints and limbs causes porotic and hypertrophic bone formation at the affected areas. Fractures can also occur. Since vitamin C is required for bone formation, the skeletal lesions only become apparent if there is healing. Usually when we find this disease in historic populations it is found in sailing populations or in famine conditions. Scurvy has been found in skeletal remains from the Franklin Expedition, or from Christopher Columbus’ crew, and was frequent during the Irish Famine. All of these were times for people when vitamin C wasn’t readily available- it makes sense. Where we don’t expect to see this type of malnutrition is in areas where citrus fruits and plants high in vitamin C are found… which makes this case even more interesting.
A new journal article by Gabriel Wrobel (2014) argues for a possible case of scurvy found in an Early Classic Maya Burial. He notes that scurvy has been generally overlooked or ignored in this population for a number of reasons: 1) skeletal preservation isn’t usually good enough to identity the bony features of scurvy, 2) vitamin C deficiency often takes the form of non-specific indicators of new bone growth that can be interpreted in many ways, and most importantly, 3) the tropical settings of this area and abundant vitamin C resources make malnutrition highly unlikely. However, regardless of difficulty of interpretation and how unlikely it is- we cannot just assume that nutritional deficiencies aren’t present. Wrobel (2014) notes that current reconstructions of Maya paleodiet based on isotopic, paleoethnobotanical (ancient plant remains), paleopathological (ancient diseases) and faunal analyses shows that there is a high amount of variability in diet based on location, social or economic status, and gender that could limit access to even abundant resources. Further, vitamins can be lost during the cooking process, and seasonal variation in resources could lead to malnutrition as well. Recent work by White et al. (2006) found 58% of sub-adults had vitamin C deficiencies, showing that we need to re-assess our assumptions about nutrition in the Maya.
The individual under analysis by Wrobel (2014) was found in Actun Uayazba Kab, meaning the “Handprint Cave” in Central Belize. Numerous burials were found in the cave, though most were disturbed due to encroaching newer burials. The burials were typical for this region and period, and consist of simple pit interment with few or no grave goods. The surrounding area was populated by small rural farming communities, and there is no evidence for complex social hierarchy.
Burial 98-3 consists of a female aged around 19-20 years old based on the presence of nearly but not completed fused epiphyses. The individual had mild porotic lesions found along portions of the cranium, an indicator of nutritional deficiencies such as anemia and scurvy, as well as lesions within the skull including the sphenoid- a trait that is considered common among victims of scurvy. The maxilla (upper jaw) and mandible (lower jaw) show signs of bone remodeling- scurvy often causes bleeding and infection in the mouth. Burial 98-3 displays 7 of the 12 signs that are commonly used to diagnose scurvy. However, it is possible that it may indicate other types of pathology. Anemia, iron deficiency, has similar pathological indicators including porosity in the cranium, as does Leukemia and generalized infection- however the two latter possibilities usually result in lesions in other regions of the skeleton that were not found in this individual.
Based on the evidence, Wrobel (2014) argues that this is one of the first documented cases of scurvy found among the Maya. It demonstrates the importance of considering all pathologies when examining skeletal remains, and not discounting specific deficiencies just because they may be unlikely. It is important to look outside the box and not be biased by prior assumptions regarding health. This diagnosis further aids our interpretation of this period. Generally, decline in health for the Maya has been attributed to environmental change and urbanization- however here we have a rural individual suffering from nutritional deficiency. Instead, we need to look at health holistically, considering whether cultural behavior may have led to changes in health, or changes in food preparation decreased nutritional value, or that perhaps there were diseases present that prevented absorption of the vitamin. Wrobel (2014) concludes that we need to look at changes in health and stress more broadly, and see how social, political and economic changes affected the different populations.
Interested in excavating a Mayan cave site? Check out The Central Belize Archaeological Survey Program. It is run by Dr. Wrobel, a Michigan State University professor!
Wrobel G (2014). A likely case of scurvy in a rural early classic maya burial from Actun Uayazba Kab, Belize. American journal of physical anthropology PMID: 25105478
White C, Maxwell J, Dolphin A, Williams J, & Longstaffe F (2006). Pathoecology and paleodiet in postclassic: historic Maya from northern coastal Belize. Memorias do Instituto Oswaldo Cruz, 101 Suppl 2, 35-42 PMID: 17308807