Dr Shirley Curtis-Summers is a bioarchaeologist, a Trustee for the Tarbat Historic Trust, and a lecturer in Archaeological and Forensic Sciences at the University of Bradford. Shirley’s research focuses on reconstructing medieval and early modern diet, health and disease from skeletal and stable isotope analyses, with an interest in the lifeways of Scotland’s past inhabitants. In this second part of Shirley’s blog, she discusses some of the osteological evidence from the children of medieval Portmahomack.
Of the 40 child skeletons assessed from Portmahomack,[i] 19 had evidence of skeletal pathologies, some of which will be presented here. The highest prevalence was found in conditions associated with nutritional deficiencies and infections. Only a few children were affected by scurvy (vitamin C deficiency) and rickets (vitamin D deficiency) but all were less than two years old when they died. This places these children within the breastfeeding age and suggests some cultural and economic factors that hindered adequate nutritional health. For example, we receive up to 90% of vitamin D from sunlight, but for some in antiquity, sun exposure was drastically reduced, especially for child workers (e.g. mills, factories, mines) or by swaddling babies, hence depletion of the vital mineral component needed for healthy bone growth. Foetal and infant health could be severely compromised if pregnant and nursing mothers had poor health or nutritional stress. This may have been the result of bouts of harvest failure in the Highlands, hence poor maternal diet and inadequate breastmilk available, or that mothers were too busy to breastfeed (from agricultural duties for example) and weaned the child early, if the child was breastfed at all that is.
One interesting case was from a child who was merely a few months old yet had infectious lesions on the inner ribs (against the chest cavity). This suggests an acute form of respiratory disease, which may have been caused by poor air quality such as indoor smoke inhalation. This is a plausible suggestion, especially if the child was born and nursed in the winter months, thereby confined to a damp and smoky environment. Even with ventilation, a newborn’s lungs are more sensitive to even modest amounts of smoke, let alone concentrated bursts that emit from an open fire, which was the standard form of heat in dwellings of the period. An alternative diagnosis is pneumonia, often caused by an underlying condition, such as congenital heart disease or low birth weight, a consequence of the mother’s poor health.
Inside a weaver’s cottage on Islay, 1772, by Charles Grignion. © British Library (shelfmark 185.a.18) [ii]
It is very rare in the archaeological record to find obstetric burials (mother and unborn child) and even rarer that we see skeletal evidence of pathology that links poor health between the pregnant mother and unborn child. At Portmahomack one such case was found. Osteological assessments on the foetus, which was close to full-term, revealed evidence of iron deficiency but no pathologies of consequence were identified on the mother.[iii] It is unknown what caused the death of the mother, although the foetus was in a very precarious position (a ‘transverse lie’), which meant that unless the baby turned spontaneously or was turned by means of external or internal version, natural delivery would have been impossible and would have proved fatal for the mother. Preeclampsia (from high blood pressure) or antepartum haemorrhage are therefore possibilities for the death of the mother, especially if no midwifery expertise was available. We may draw some interpretations from the later Old Statistical Accounts of Scotland that recorded a lack of midwives in the region. For example, in 1791 Kiltearn (Ross and Cromarty) it was noted with concern for pregnant mothers that they “seldom have proper assistance when in child-bed, as there is no regularly bred midwife in the parish”.[iv] Evidence of inadequate midwifery care from the historical record, combined with osteological evidence of a complex pregnancy, goes some way to shed light on the fatal consequences of childbirth around this time in the Highlands.
I have highlighted just a couple of interesting cases here but from the osteological evidence, nearly half of Portmahomack’s children had some form of pathology and more alarmingly, high mortality occurred in those within first few months of life. This suggests socio-economic factors were involved that restricted adequate nutrition to the child (mother having poor health or overworked?); enabled greater susceptibility to infections (living conditions?), and even possibly, the effect of traditional treatments of newborn babies (swaddling practices?) The latter reminds us of the fatal consequences of poor hygiene from cultural practices on newborn babies from St Kilda, where during the eighteenth and nineteenth centuries, seventy-six infants died. In 1890, the Reverend Angus Fiddes, a Free Church clergyman and Scientist, finally linked these deaths to unsanitary treatment of the umbilical cord, after which deaths quickly ceased. It was believed that a combination of a dirty knife to cut the cord; fulmar oil (stored in ‘unclean’ gannets’ stomachs) to heal the cord, and unclean swaddling all attributed to neonatal tetanus.[v] Could cultural practices at Portmahomack have contributed to the cause of infections and nutritional deficiencies of their infants? What step did parents take to treat their sickly child? Next time, we look at some of the methods that were used to treat the shilpit bairn.
[i] Curtis-Summers, S., 2015, Reconstructing Christian lifeways: a bioarchaeological study of medieval inhabitants from Portmahomack, Scotland and Norton Priory, England, PhD thesis, University of Liverpool.
[ii] Pennant, T., 1774, A tour of Scotland and Voyage to the Hebrides, 1772. Chester: John Monk Publishers. Image source: https://www.bl.uk/collection-items/inside-of-a-weavers-cottage-in-islay-after-miller [Accessed 27/12/2019].
[iii] However, only part of the female skeleton was recovered during excavation (Cecily Spall, pers.comm, 18th June 2019), hence a full osteological assessment could not be carried out.
[iv] OSA, Vol. I, 1791, p. 288. https://stataccscot.edina.ac.uk/static/statacc/dist/viewer/osa-vol1-Parish_record_for_Kiltearn_in_the_county_of_Ross_and_Cromarty_in_volume_1_of_account_1/osa-vol1-p288-parish-ross_and_cromarty-kiltearn [Accessed 17/12/2019].
[v] Stride, P., 2008, St Kilda, the neonatal tetanus tragedy of the nineteenth century and some twenty-first century answers, Journal of the Royal College of Physicians of Edinburgh 38: 70–7.