Epidemiological aspects of paleopathology in Denmark • 143 



Present 



Within the last decade several studies on different pal- 

 eopathological aspects have been carried out, and several 

 reports on dentition (Lunt 1978) and cervical changes of the 

 back in relation to dental abscesses (Ingelmark 1956) have 

 been based on the medieval skeletons from yCbelholt monas- 

 tery. 



A very interesting study was also carried out by Andersen 

 ( 1 969) who compared the skeletal changes of the medieval 

 skeletons from Nsstved with people affected with leprosy in 

 living populations from India. 



Smaller studies of pathological changes found on mainly 

 newly excavated skeletons have continuously been pub- 

 lished. 



A recent study by the author was primarily based on 

 Danish prehistoric skeletons and seems to constitute an addi- 

 tional step in the development of pathological studies on 

 epidemiological aspects (Bennike 1985). As an important 

 f)oint, the study provided us a catalogue of information on the 

 dating of all Danish prehistoric skeletons available for future 

 studies of paleopathological aspects. This introductory part 

 of the study was based on an archeological/anthropological 

 collaboration which later resulted in several joint publica- 

 tions of some of the special finds (Bennike and Ebbesen 

 1986; Bennike et al. 1986). As a part of the work on the 

 paleopathology of prehistoric skeletons all bones were regis- 

 tered in a computer system containing changes of patholog- 

 ical, traumatic, or degenerative character of the joints, the 

 long bones, the irregular bones, and the skull. The many 

 results have provided us with incidences of a number of 

 pathological changes, comparative analysis of the results 

 between different groups (age and sex) and between the pre- 

 historic periods. This may be very useful in the planning of 

 future studies in paleopathology of epidemiological and ana- 

 lytic character. 



Future 



Shortly, we will begin a study of epidemiological aspects 

 which may be considered a development and continuation of 

 the previous paleopathology study of Danish skeletons men- 

 tioned above. The title of the new study is: " A comparative 

 analysis of methods to study nutritional and/or age depen- 

 dent changes of the skeleton." The applied methods will 

 include measurements of bone mineral content (BMC), 

 osteon-analyscs (individual age determination), radiography 

 (proximal femur spongiosa, Harris' lines), and finally the 

 measurement and weight of a removed bone core (os- 

 teoporosis). With regard to the dentition, the presence of 

 enamel hypoplasia and paradontosis will be registered. The 

 study may be divided into three steps: a test of the applied 

 methods by the dissection of material of known age and sex, 

 an analysis of possible correlation between the results of the 

 different methods applied, and finally a discussion of the 



'/jignb Paleopathology Symp. 1988 



State of nutrition and the onset of aging in prehistoric man, 

 based on the results of the study. 



With regard to the chemical analyses, especially the BMC, 

 a control study of possible correlation between the content of 

 calcium in the surrounding soil and in the bones will be 

 performed. The skeletal material forming the basis of this 

 analysis has been carefully selected. Most of the well- 

 preserved skeletons were recently recovered in graves from 

 the Viking period, and most skeletons were studied in situ by 

 the author. 



Conclusions 



The Danish paleopathological studies of the past , present and 

 future together form a developmental pattern of three stages: 

 the descriptive, the epidemiological, and the analytical. In 

 the years of the establishment of a Danish skeletal collection 

 the pathological studies could naturally only be of a purely 

 descriptive character. At that time nothing more could actu- 

 ally be done owing to the small number of bones available, 

 often from different locations. The lack of comparative stud- 

 ies has also been a very important factor. In addition, most 

 scholars had only a restricted experience in studying human 

 bones and especially bones several thousand years old. 



Skeletal samples of a considerable size from the same 

 excavation and site were later recovered allowing new kinds 

 of paleopathological studies emphasizing epidemiological 

 aspects. They were, however, still restricted to a presentation 

 of tables of incidences of pathological skeletal and dental 

 changes. The danger of making analytical studies and inter- 

 preting the results at that time, without having comparative 

 studies available, is clearly seen in the conclusion stated by 

 Hansen as a result of his study of the Norse skeletons from 

 Greenland. 



The almost contemporary work of Isager on medieval 

 skeletons from 0m monastery has not been of much value to 

 later studies either, but he did not draw any false conclusions. 

 A new type of investigation started with the epoch of the 

 many studies by M0ller-Christensen. His registration forms 

 clearly show a new kind of development of the paleopatho- 

 logical aspects. Systematically and in detail he registered 

 both the normal and the pathological parts of the bones. 

 There are several reasons why his work on the skeletons of 

 medieval people affected with leprosy has been so highly 

 acknowledged on the international stage: his systematic 

 work, his comparison with studies of modem populations, 

 and finally his well-planned projects. As one of very few 

 scholars of paleopathology he also succeeded in transferring 

 his results to clinical medicine. The facial changes of the 

 skeletons affected with leprosy turned out to be useful in 

 clinical diagnosis of the disease. 



Today almost 90% of all excavations take place without 

 extensive planning because of the construction of new roads 

 or buildings. The skeletal material is recovered by chance, 

 and it is almost impossible to determine which skeletal 



