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Health Trends Among Roman Period Burials Robert R. Paine, 

Professor of AnthropologyUniversity of Roma. “La Sapienza”

March 5, 2017

Paleopathology Club, USCAP Meetings San Antonio, Texas

Disclosure of Relevant Financial Relationships

USCAP requires that all planners (Education Committee) in a position to 

influence or control the content of CME disclose any relevant financial 

relationship WITH COMMERCIAL INTERESTS which they or their 

spouse/partner have, or have had, within the past 12 months, which relates to 

the content of this educational activity and creates a conflict of interest.  Dr. Paine has nothing to disclose.

As a skeletal biologist, I have spent 30 years working on forensic cases as a forensic anthropologist.

Since 1981 I have worked as a dry bone histologist.Focused on bone fragment identification and age at death assessment. 

Healed Fractured mandible, Male 67 years old

From the Raymond Dart autopsy collection, South Africa

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Dr. George Armelagos

Emory University

UMass-Amherst

Skeletal biologistand academic leader of thebiocultural approach towardsinterpreting health trends

Anthropology studies bridge the gap between medical science and sociology

The perspective offered by anthropology provides a cultural context by which health is maintained or diminished.

A 46 year old male, with a rib that is only one secondary osteon thick  

Rib Cortical area, Mean values, mm2

Cortical areaPellagra    Black South African samples                       13.65Malnutrition Black South African samples 18.36RRP  US autopsy samples                                               22.36

Dietary Health Does Affect Histological Age Assessment: An Evaluation of the Stout and Paine (1992) Age Estimation Equation Using Secondary Osteons from the Rib

J Forensic Sci, May 2006, Vol. 51, No. 3 doi:10.1111/j.1556‐4029.2006.00118.x 

Rita Vargiu

Giovanni Destro Bisol 

Istituto Italiano di Antropologia , Universita , Roma, "La Sapienza"

Andrea Cucina

Dr. Alfredo Coppa, Universita “La Sapienza”, Roma, Italia.

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Among the Alfedena Iron Age burials 22% showed cranial trauma healed and 

unhealed. 

Blunt force trauma healed

Axe wound to the skull unhealed

Sword wound to the skull unhealed

Beveled edge wound, endo‐cranial view 

What caused this injury?

Lead projectiles and over head sling

What caused this injury??

The pilum (plural pila) was a heavy javelin commonly used by the Roman army in ancient times

D. Mancinelli

The Iron Age site of Fossa located in Abruzzi, with over 10,000 burials yet to be recovered

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The focus of this presentation will center on two Roman Period Collections, of adult skeletal material

Roman Republic burials from the archaeological site of Casilina, the Roman city of Aquinum. The site is 144 km south of Rome on route A1, and dates to the 2ndcentury BC to 2nd century AD.

The Imperial Roman burials from the Roman city of Urbino. The site is located 45 km for the current city of Pesaro, Italy. The material dates to the 1st - 3rd centuries A.D.

The site of Aquinum

Urbino

Aquinum

Roman site locations  Three sub groups of burials are examined:1. Roman Republic burials      35 males and 39 females

2. Roman Imperial Burials      29 males and 26 females

3. Tomb 58 from the Roman Republic period (slaves/warcaptives) 11 males and 5 females

Casilina burials from the Necropoli Di Aquinum. Roman Republic era. 

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D. Mancinelli, working on a Roman Republic Tomb

The site of Aquinum.

Roman tomb from the site of Aquinum.

Casilina burials from the Necropoli Di Aquinum, this is T58 with with16 adults.

Biological anthropologists tend to focuson dry bone skeletal defects/lesions

Osteoarthritic lesions, osteophytes, Pitting, eburnation

Long bone defects Periostitis

Cranial pitting

Trauma defects, fractures

Dental defects, Enamel Hyperplasia & caries

Group (n) Pathologies  OA DJD Periostitis Cranial pitting 

Trauma

Male, Imperial (5) 4 2 4 4 0 2

Female, Imperial (5) 3 3 2 1 0 0

Male Republic (35) 14 8 12 6 1 1

Female Republic (39) 16 4 9 4 1 4

Male Tomb 58 (11) 9 0 5 6 2 3

Female Tomb 58 (5) 5 4 3 0 0 1

The number of Aquinum males and females, by Period and Tomb 58. The number of individuals with skeletal lesions are also presented.

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Group  Percent 

Male, Imperial  80%

Female, Imperial  60%

Male Republic  40%

Female Republic  41%

Male Tomb 58  81%

Female Tomb 58  100%

Aquinum males and females percent of individuals with skeletal lesions

Group (n) Pathologies OA DJD PeriostitisCranial pitting 

Trauma

Male (28) 25 12 19 12 9 7Female (25) 20 10 13 5 7 4

The number of Aquinum & ^Urbino Imperial males and females. The number of individuals with skeletal lesions are also presented.

^ Urbino data comes from (Paine et al., 2009).

Path OA DJD Periostitis Cranialpitting

Trauma

male 89% 42% 69% 42% 32% 25%

female 80% 40% 52% 20% 28& 16%

This is an example of cranial pitting, often associated with metabolic disorders and dietary deficiencies.

This is an example of degenerative joint disease specific to the knee joint, from the Imperial roman site of Urbino.  

Eburnation  along with osteophytes and bone loss

Eburnation  of the first metacarpal joints  ThumbOsteoarthritis, specific to the vertebral bones.,  osteophytes' (bone lipping).  From Urbino.

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Long bone (Tibia) showing a moderate example of Periostitis.  Specimen is from Aquinum

This is often an indicator of an infection

Finger bones from a male burial excavated from the site of Aquinum, This is an example of leprosy. 

Healed rib fractures, from Aquinum Dental defect.. Enamel Hyperplasia, first molar, from Urbino.

This is connected to metabolic problems during early childhood

A parasitic tooth attached to a third molar,  from a 14 year old male, Imperial Roman period, Urbino. 

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Table 3 . Results of the Fisher’s Exact two-tailed test on the frequencies of skeletal lesions between Aquinum burials

The Aquinum Republic burials do not include those from Tomb 58.

Samples With pathology

With OA

DJD Periostitis Cranial pitting

trauma

Aquinum Republic 

burials by sex1.0000 0.2078 0.4165 0.5020 1.000 0.3613

There are no differences in the frequency of lesions between males and females

Results of the Fisher’s Exact two-tailed test on the frequencies of skeletal lesions between Aquinum Republic burials and individuals from tomb 58, by sex.

Samples With pathology

With OA

DJD Periostitis Cranial pitting

trauma

Aquinum Males Republic and Tomb 58

*0.0381 0.1691 0.7215 *0.0225 0.1376 *0.03741

Aquinum Republic Females and Tomb 58

*0.0187 *0.0023 0.1157 1.0000 1.0000 *0.0000

Individuals from Tomb 58 are more likely to show indicators of skeletal lesions and chronic  health problems.  Specifically, males with infections and both sexes with trauma.

Samples With pathology

With OA

DJD Periostitis Cranial pitting

trauma

Males Aquinum Rep. and UrbrinoImperial^

*0.00006 0.1086 *0.0259 *0.0477 *0.0019 *0.0175

Females, AquinumRep. and UrbinoImperial^

*0.0040 *0.0068 *0.0299 0.4630 *0.0044 0.7008

Results of the Fisher’s Exact two-tailed test on the frequencies of skeletal lesions between Aquinum Republic burials and Imperial burials from Aquinum and Urbino.

^Urbino Data comes from Paine et al. (2009). The Aquinum Republic burials do not include those from Tomb 58.

There are issues of diet, labor, and violence in which Imperial Romanburials are showing more indicators than the Republic burials

Male Female Total

Enamel hypoplasiaUrbinoQuaderella

100%92%

93%100%

97%95%

CariesUrbinoQuaderella

57%84.6%

64%71.4%

60%71.6%

Periapical abscessUrbinoQuaderella

29%26.9%

29%14%

29%20.3%

Table 8. The frequency of oral pathology, by site.

The Quaderella data comes fromBonfiglioli et al. (2003).

Age classes Dx dx lx qx Lx Tx ex

0‐0 3.3333 3.4722 100.0000 34.7220 98.2639 2659.6066 26.5961

1‐5 11.7163 12.2046 96.5278 126.4361 445.2525 2561.3427 26.5348

6‐10 4.0456 4.2142 84.3232 49.9768 411.9414 2116.0902 25.0950

11‐15 6.6433 6.9202 80.1090 86.3848 383.6984 1704.1488 21.2729

16‐20 4.8607 5.0633 73.1888 69.1814 352.9192 1320.4504 18.0417

21‐25 9.8494 10.2598 68.1255 150.6015 317.3224 967.5312 14.2022

26‐30 13.5922 14.1586 57.8657 244.6804 254.3025 650.2088 11.2365

31‐35 14.5327 15.1383 43.7071 346.3579 182.1622 395.9063 9.0582

36‐40 12.4385 12.9568 28.5688 453.5297 110.2753 213.7441 7.4817

41‐45 7.5067 7.8196 15.6120 500.8711 58.8936 103.4688 6.6275

46‐50 4.3653 4.5472 7.7924 583.5429 25.9591 44.5752 5.7203

+50 3.1160 3.2452 3.2452 1000.0000 18.6161 18.6161 5.7365

96.0000 100.0000

Life-table for the Urbino skeletons with cremation burials added to the sample.

At birth, the estimated life expectancy for Urbino, Romans was under 27 years of age.

Cultural period Male Female

aEarly Upper Paleolithic 172.2 @68in 169.9

aLate Upper Paleolithic 165.6 153.5

bIron Age 166.6 65.5 in 154.3

bRome Imperial 164.4/ 64.5 in 152.1

bMedieval 166.9 154.4

Urbino Rome Imperial 164.0 64.5 in 150.0

.Adata comes from Formicola & Holt, 2007;bdata comes from Giannechini & Moggi-Cecchi, 2008.

Height trends in prehistoric Italy

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The health status for Romans changed over time resulting in an increase set of problems related to inter-personal violence and diet. Violence increased and the quality of food decreased over time.

The general state of health in the Republic period of Rome appears to be better than the Imperial. This may reflect thedifficulty in maintaining the Empire by the common people as they served in the military and provided resources to support its expansion and maintenance.

Despite the considerable advantage that the Roman Imperial culture offered its citizens, it came at a very high price that appears to be reflected in numerous and common ailments seen in the Imperial burials

Dinner with Italian colleagues

Current research (this past month) includes this case ofproto-historic amputation from a Lombard necropolis in Veneto,

Northern Italy, dated from 568 AD (the first generation of Lombards in Italy).

They are a Germanic people who ruled large parts of the ItalianPeninsula from 568 to 774The forearm comes from a 40–50 year old male,.

Skeletal indicators of some type of arthritic related condition

From a modern cemetery case from Cyprus, an 80 year-old female

Possible conditions that were considered

Ankylosing spondylitis, psoriatic arthropathy, or enteropathicarthropathy, rheumatoid arthritis, reactive arthritis, Diffuse idiopathic skeletal hyperostosis

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Skeletal indicators of reactive arthritis: A case study comparison to other skeletal conditions, such as rheumatoid arthritis, ankylosing spondylitis, ankylosing sero-negative SpA, and DISH

International Journal of Paleopathology Volume 11, 2015, Pages 70–74

Cawley & Paine 

Lunch at the vineyard.. Montepulciano grapes and wine