Durham E-Theses Health in urban late medieval North-West Europe: a bioarchaeological study of Caen, Canterbury and Ghent GERNAY, MARIEKE,JOSY,CHANTAL How to cite: GERNAY, MARIEKE,JOSY,CHANTAL (2015) Health in urban late medieval North-West Europe: a bioarchaeological study of Caen, Canterbury and Ghent, Durham theses, Durham University. Available at Durham E-Theses Online: http://etheses.dur.ac.uk/11433/ Use policy The full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that: • a full bibliographic reference is made to the original source • a link is made to the metadata record in Durham E-Theses • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders. Please consult the full Durham E-Theses policy for further details. Academic Support Oce, Durham University, University Oce, Old Elvet, Durham DH1 3HP e-mail: [email protected] Tel: +44 0191 334 6107 http://etheses.dur.ac.uk 2 Abstract Health in urban late medieval North-West Europe: a bioarchaeological study of Caen, Canterbury and Ghent M.J.C. Gernay Over half of the global population currently lives in an urban environment and this is still increasing rapidly in developing countries. This thesis aims to provide a comparative picture of health in the rapidly developing urban centres in late medieval NW Europe - here defined as northern France, England and Belgium - through bioarchaeological analysis. This study focused on macroscopic methods and “stress indicators” (cribra orbitalia, dental enamel hypoplasia, adult stature and periosteal reaction on the tibiae) as a proxy for health and sanitation in these populations and respiratory disease (periosteal rib lesions and maxillary sinusitis) as a proxy for air quality. A 100 adult skeletons were analysed from the Darnétal cemetery of Caen (12th – 18th century AD), northern France, which had a reputation for poor sanitation. A further 100 adult skeletons were analysed from the cemetery of St. Gregory’s priory in Canterbury (12th – 16th century AD), whose economy is based around entertaining pilgrims and travellers. Lastly, The St. Pieter parish in Ghent (12th – 18th century AD) occupies a unique position on the edge of the town and 83 adult skeletons were analysed from this site. The skeletal evidence did not reflect the differences in sanitary conditions expected originally. Similar results were recorded for average adult stature estimates as well as the prevalence of cribra orbitalia, and dental enamel hypoplasia across the sites. It has been suggested that urban centres throughout the region may have been challenged to provide a healthy living environment. High prevalence rates of maxillary sinisusitis (Caen: 71%, Canterbury: 64%, and Ghent: 61%) and high prevalence rates of periosteal reaction on the ribs in Caen (63%) and Canterbury (63%) suggest significant levels of air pollution in these populations. The unusually high levels of rib lesions in Caen and Canterbury set the agenda for further research into their occurence and the development of recording standards. Lastly, the historical differences between the towns, and the location of the St Pieter parish, challenge the simplistic division of settlements into ‘urban’ and ‘rural’ types. It reveals the perspective for a more nuanced interpretation of urbanisation in NW Europe. HEALTH IN URBAN LATE MEDIEVAL NORTH-WEST EUROPE: A BIOARCHAEOLOGICAL STUDY OF CAEN, CANTERBURY AND GHENT Marieke Josy Chantal Gernay Submitted for the Degree of PhD Department of Archaeology Durham University Year of submission: 2015 Table of Contents Abstract .............................................................................................................................. i Table of Contents ............................................................................................................... i Table of Figures ................................................................................................................ vi Table of Tables .................................................................................................................. x Statement of Copyright ................................................................................................... xiv Acknowledgements .......................................................................................................... xv Dedication....................................................................................................................... xvi Chapter 1 Introduction..................................................................................................... 1 1.1 Introduction ........................................................................................................ 1 1.2 Aims and objectives ........................................................................................... 2 1.3 Hypotheses ........................................................................................................ 3 1.4 Research questions ............................................................................................ 3 1.5 Significance of the research ............................................................................... 3 1.6 The history of bioarchaeology in Belgium, England and France ......................... 4 1.6.1 France ............................................................................................................ 5 1.6.2 England .......................................................................................................... 5 1.6.3 Belgium .......................................................................................................... 5 1.7 Definitions .......................................................................................................... 6 1.7.1 Urban ............................................................................................................. 6 1.7.2 Geographical terms used in this research ....................................................... 8 1.7.3 Late Medieval ............................................................................................... 10 1.7.4 Health ........................................................................................................... 10 1.7.5 Stress and adaptation in bioarchaeology ...................................................... 11 1.8 Thesis structure ................................................................................................ 12 Chapter 2 Adaptation to environmental impacts: Clinical and bioarchaeological evidence for poor urban health ........................................................................................ 13 2.1 Introduction ...................................................................................................... 13 2.2 Clinical evidence for poor urban health ............................................................. 13 2.2.1 Socio-economic status ................................................................................. 14 i 2.2.2 Outdoor air quality ........................................................................................ 14 2.2.3 Housing ........................................................................................................ 15 2.2.4 Waste management ..................................................................................... 18 2.2.5 Water management ...................................................................................... 18 2.2.6 Availability and accessibility of food .............................................................. 19 2.2.7 Health care and education ............................................................................ 20 2.2.8 Migration ...................................................................................................... 21 2.2.9 Summary ...................................................................................................... 22 2.3 Bioarchaeological evidence of urban health ..................................................... 22 2.3.1 Indicators of adaptation ................................................................................ 23 2.3.2 Bioarchaeological evidence of poor air quality .............................................. 33 2.3.3 Dental disease .............................................................................................. 38 2.3.4 Summary ...................................................................................................... 41 2.4 Conclusion ....................................................................................................... 41 Chapter 3 Historical background ................................................................................... 43 3.1 Introduction ...................................................................................................... 43 3.2 Climate ............................................................................................................. 44 3.3 Socio-economic status ..................................................................................... 47 3.4 The urban environment: The anatomy of an urban settlement .......................... 50 3.4.1 Settlement size ............................................................................................. 51 3.4.2 Population