Reconstructing the Epidemiology of Medieval Leprosy: Preliminary Efforts with Regard to Scandinavia
Stephen R. Ell
RECONSTRUCTING THE EPIDEMIOLOGY OF MEDIEVAL LEPROSY: PRELIMINARY EFFORTS WITH REGARD TO SCANDINAVIA STEPHEN R. ELL* Introduction Since the diagnosis of leprosy in period between 1250 and 1550 Denmark has been shown to have accurate [1-6], wè can at least speak confidently as we know it regard that region time. While there are excellent reconstructions daily life ofleprosy patients provocative efforts summarizing literary imagery surrounding disease, well many works on medical writing period, notable among recent being those Demaitre Dois [6-9], nothing epidemiology disease beyond estimates number institutionalized patients, mainly Spain England around 1300 [6, 10]. This is not a criticism, because no records known exist from which such information might be gleaned. The same skeletal remains initially employed by M0ller-Christensen demonstrate persons buried cemetery leprosarium St. Jorgens Hospital Naestved, Denmark, actually suffered can, however, with aid another generation knowledge used reconstruct an overall for . Specifically, analysis certain bone changes, conjunction sex distribution cases, make possible epidemiologic assessment. In arriving this end, necessary review themselves. Then must consider social, religious, legal situaThe author expresses his gratitude Director H. Koch Medinsk-Historiske Museet Copenhagen gracious assistance reviewing Naestved materials. ?Department Radiology, Box 429, University Chicago Medical Center, 5841 South Maryland Avenue, Chicago, Illinois 60637.© 1988 Chicago. AU rights reserved. 0031-5982/88/3104-0589$01.00 496 I Stephen Ell ¦ MedievalLeprosy TABLE 1 Summary Statistics Based Data Malaysia Sample size ............................................................ 25 Descriptive statistics: Average years untreated LL ............................. 9.1 percent alveolar loss .................................. 32.0 Raw rate loss/year ............................................ 3.6 Test randomness (Student t ?2, P) ................................ -001 Regression analysis: Slope ................................................................ 2.4 Correlation coefficient ................................................ .62 analysis, employing interactive outlier rejection: .......................................................... 21 regression line ............................................... 1.7 .83 P ....................................................................01 Note.—Cases were wherein history led reliable estimate duration ofuntreated lepromatous (LL). Cases unclear histories or interrupted treatment excluded. effect intermittent was but could apply Middle Ages. Rejected outliers three endentulous cases— all their late seventies time study, age achieved any medieval subjects. Another case 15 only one year ofdisease alleged rejected totally inconsistent other data. Source.—See [5]. tion order correct biases vitiate purely statistical Finally, having elaborated overview Scandinavia thirteenth through sixteenth centuries, will how may extrapolated parts Europe. Skeletal Remains Their Significance 1953, Vilhelm began publish results series excavations associated Jorgen's Naestved. As work progressed, established pathognomonic facial so-called facies leprosa, became accepted feature when demonstrated living African [1, 1]. These changes complex, involving destruction nasal bone, resorption anterior process maxilla, coarsening thé sinuses, thickening squaring orbits. Most important our purposes fact that, general, amount ofloss ofalveolar maxillary bone—a midline phenomenon, central incisors canine teeth ultimately—correlates [12; data article form basis table figs. 2]. Hoo Nah, Marks, Perspectives...
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