Resurrecting Pompeii (29 page)

It is notable that more techniques could be used for the establishment of age at death from the Herculaneum sample as the skeletons were articulated and, in general, better preserved than the Pompeian skeletal sample. Also, combinations of techniques could be used for individual skeletons, which means that the ages obtained for the Herculaneum sample are potentially more accurate than those obtained from the samples of individual bones in the Pompeian sample.

Bisel determined age-at-death of the Herculaneum skeletal sample from an examination of epiphyseal fusion, tooth eruption, changes in the faces of the pubic symphysis, skull suture closure and the general appearance of the bone, including age-related pathological change.
⁷³
Like Henneberg and Henneberg, she produced an age distribution, with a five-year range for each group, which could only be described as optimistic as the margin of error for adult age-at-death based on macroscopic examination substantially exceeds that figure (Table 7.11).

It is signi ficant that Bisel
⁷⁴
reported a lower than expected incidence of juveniles in the Herculaneum sample she examined. This sample was excavated in the 1980s under the guidance of Bisel and it is highly unlikely that any remains were missed. Out of 139 skeletons, five (3.6 per cent) were aged at less than one year, 23 (16.5 per cent) covered the span of one to ten years and 12 (8.6 per cent) were interpreted as between ten and 16. Bisel considered that the proportion of sub-adult bones should have been much higher to ensure that the population could be sustained. Initially, she dismissed the possibility that a disproportionate number of juveniles were able to escape or that they sought shelter in a chamber that has not yet been excavated, though in more recent work by Bisel and Bisel, consideration was given to sample bias.
⁷⁵
One argument presented by Bisel for the comparatively small number of children she observed was that it was a reflection of decreased parity amongst the Herculanean women, as a result of the ingestion of lead or other causes. The issues associated with this suggestion are discussed in Chapter 8.

Capasso used a raft of macroscopic and microscopic methods to establish the age-at-death of the Herculaneum sample, including: tooth eruption and attrition, epiphyseal fusion, ectocranial and endocranial suture closure, changes to the surface of the pubic symphysis, the auricular surface of the ilium and the sternal extremity of the ribs, accumulation of osteons in cortical bone and radiological examination of bone to establish degree of thinning of bone cortex.
⁷⁶
Only 143 of the 163 skeletons that were examined by Capasso were sufficiently preserved to enable age at death to be determined. He excluded two foetal skeletons from his palaedemographic study.
⁷⁷
The ages that Capasso obtained can be viewed in Table 7.12.

Petrone
et al
. published a preliminary study of 215 Herculaneum skeletons, including those studied by Bisel and Capasso, in 2002. The criteria they used to estimate age at death were: tooth eruption and attrition, epiphyseal fusion, ectocranial and endocranial suture closure, the degree of resorption of spongy bone in the proximal epiphyses of the humerus and femur, the changes to the surface of the pubic symphysis, the auricular surface of the ilium and the sternal extremity of the ribs.
⁸⁰

Petrone
et al
. argue that the sample is representative of the population, which they estimate at 4000. They considered that the proportion of subadults to adults was insufficient for a stable population and like Capasso, suggest that the reason for the population imbalance was the impact of the
_AD
62 earthquake. They presented various scenarios that might account for

The skeletal evidence does not support the popular notion that the very young and the elderly inhabitants of Pompeii were more likely to have become victims of the eruption of Mt Vesuvius. The frequency of HFI suggests that the adult sample was not skewed, though the overall sample is obviously biased towards adult material. Further, the evidence of age-related pathology indicates that the Pompeians did not necessarily have a shorter lifespan than modern populations. Survival, therefore, was probably more related to personal decisions about whether and when to escape than on issues related to age or sex.

In the majority of cases it was possible to separate adults from juveniles and subadults. The factor which determined whether this was possible was the degree of completeness of the specimen. The available techniques that were used to establish adult age-at-death in this study were not very reliable. This is only partly related to the constraints of the Pompeian sample. Techniques, like tooth attrition, which are generally considered good for age estimation could only be used with limited confidence for the Pompeian sample because of the lack of complete dentition in virtually all of the jaws and the disarticulation of mandibles and maxillae in nearly all cases. Other techniques, like changes to the face of the pubic symphysis, which have been established on the basis of extensive research, have major limitations because biological and chronological age do not necessarily correspond. The margin of error associated with the Suchey–Brooks technique can be as high as 14.6 years for females and 12.2 years for males. Further, it is difficult to modify these techniques to account for the acknowledged interpopulation differences for pubic symphyseal age changes. This is a particular problem for archaeological samples. In addition, it has been demonstrated that there is a tendency to underage older individuals with this and other ageing methods.
⁸²

Because of human variability for age changes it is unlikely that an accurate, objective test can be developed. The use of histological techniques, such as dentine root transparency and cemental annulations, appear to be the most promising for the future, though they are destructive and costly to perform. Jackes, in her review of current methods of age determination from skeletal remains, suggested that a complex system based on a number of techniques involving dentition may ultimately be able to produce results with a relatively high correlation to ‘real age’. She did, however, concede that it is impossible to extrapolate ages with any degree of certainty onto ancient unknown samples as it would be impossible to account for environmental variables.
⁸³

Despite the increased potential for more reliable age estimates from the Herculaneum sample it should be noted that the tendency to apply ages within five-year intervals suggests greater accuracy than the methods that were employed in these studies can provide.

The disparity between the conclusions of this Pompeian study and that of Henneberg and Henneberg about the presence of a significant number of older individuals in the sample can be seen as a reflection of the inability of the available techniques for the determination of age-at-death to discriminate between adult ages from the skeletal record. In contrast with the conclusions of Henneberg and Henneberg about the demographic makeup of the Pompeian sample, the Herculaneum studies all suggest that, at least at Herculaneum, there was not a stable population. It could be argued that had the earthquake of
_AD
62 had such a devastating impact on the population of Herculaneum, it would be likely to have had a similar effect on the Pompeian population. It is therefore possible that the sample bias against very young individuals in the Pompeian skeletal collection may not entirely be due to failure to recognize infant bones in excavation and poor storage.

Determination of health from skeletal evidence is fraught with dif ficulties, as many disorders that involve soft tissue do not present on bone. Most pathological changes to the skeleton reflect chronic ailments. Conversely, acute disorders, apart from trauma, are not likely to leave any trace on the skeleton. Further, bone can only respond to insult in a very limited number of ways; it can be lost or resorbed, new bone can be deposited or a combination of the two can occur. As a result, a number of diseases leave a similar appearance on the skeleton. It is preferable to base diagnoses on an examination of the entire skeleton as some pathology can be distinguished by the pattern of changes that can be observed on different bones.
¹
The disarticulated nature of the Pompeian sample limited the study to disorders that could be diagnosed with confidence from gross inspection of a single bone, like healed trauma. In addition, the lack of access to x-ray facilities and destructive techniques, like sampling for histological analysis, constrained the kinds of questions that could be asked of the evidence.

While the Pompeian skeletal record only provides a very limited view, all signs of pathology reveal clues about the general health of the sample of victims. The presence of certain pathology and other indicators, like stature, act as health markers and assist in constructing a picture, albeit a rather indistinct one, of the general well-being of individuals and the sample as a whole. Apart from elucidating oral health and diet, dental data can provide some indication of underlying health problems as bacteria associated with dental and other pathology of the oral cavity have been implicated in some soft-tissue disease, like heart-valve problems. Stature is, in part, a reflection of health and nutrition during the growing years. Similarly, bone alterations, such as flattening of the proximal shaft of the tibia and femur, have been interpreted as indicators of stress during the period of skeletal development. Healed injuries, infections and other diseases yield information about the status of the immune system, while age-related disorders are a valuable gauge of health, as they do not manifest until an individual has achieved a certain age.

The main issues to be considered were whether there was any skewing towards individuals with signs of infirmity in the Pompeian sample and if the observed pathology was likely to have impeded escape from the eruption. Another issue that was considered was whether it was possible to detect any evidence of surgical or dental intervention. Comparisons could then be made with the bones that have been excavated from Herculaneum. The Herculaneum material should provide more information as complete skeletons were available for investigation, which not only provided more reliable diagnostic opportunities, but also increased the range of pathology that could be studied. In addition, researchers in Herculaneum have had access to radiography and funding to employ various destructive techniques to facilitate diagnosis.

The skeletal record has also been invoked as a valuable guide to professional activities and other aspects of life that can be reflected in changes to bones and teeth as a result of habitual activity. Brief consideration is given to the actual potential of the Pompeian and Herculaneum skeletal record to indicate ancient lifestyles.

The dif ficulty of attempting to gain some insight into the general health of the Pompeian victims without the benefit of soft tissue may be partly mitigated by a study of oral health. An association has been found between poor oral health, infections and various systemic conditions. Micro-organisms in the oral cavity can be responsible for infections in a number of locations in the body. These are known as focal oral infections and they result from the introduction of oral micro-organisms or toxins from oral pathology into the bloodstream or the lymphatic system. Focal oral infections are exacerbated in elderly people and individuals with compromised immune systems. The bacteria associated with the formation of dental plaque have developed special mechanisms to ensure their adhesion to hard and soft oral tissues, as well as other oral bacteria. These bacteria, when transported in the bloodstream, can reach the heart and are well suited to adhere to damaged heart valves and can cause infective endocarditis. This is a disease that involves inflammation and infection of the inner surface of the heart. Correlation has also been found, between dental pathology, particularly periodontitis, and other cardiovascular disease, pre-term low birth rate, diabetes, aspiration pneumonia and abscesses of the lung. In addition, the bacterium associated with gastric ulcers,
Heliobacter pylori
, has been identified in samples of saliva and dental plaque.
²

An examination of the maxillae and mandibles of the Pompeian sample provides some indication of the oral health and diet of the population. The state of the teeth and the alveolar region was assessed to establish the level of oral hygiene, whether there was any evidence of dental intervention and the general health of individuals during childhood. Dietary factors, such as the impact of the milling process of flour on the teeth, were also considered.
³

Ninety-seven maxillae and 80 mandibles were examined. These represent all the mandibles and maxillae from the Forum and Sarno Bath collections that were available at the time of this study. Before one could assess the dental health of the population it was necessary to establish the number of teeth that remained
in situ
and the degree of post mortem tooth loss. The incidence of tooth retention determined the potential value of the survey of frequency of carious or decayed teeth, alveolar bone loss, calculus or calcified plaque deposits and enamel hypoplasia in the sample. There were very few cases where the mandible and maxilla of an individual could be rearticulated. This meant that for the majority of cases it was not possible to assess occlusion or bite.

Only one of the 97 available maxillae retained a full complement of teeth. Most of the maxillary teeth had suffered either ante or post mortem loss. No teeth at all survived in 42.3 per cent of the maxillae. Only 14 maxillae, or 14.4 per cent of the sample, retained eight or more teeth. A higher proportion of mandibular teeth were still
in situ
. No full sets of teeth were preserved. Only three mandibles were completely devoid of teeth. Twenty-three, or 19.8 per cent, of the 81 mandibles contained eight or more teeth. The high incidence of post mortem tooth loss means that the cases of caries and the degree of calculus and linear enamel hypoplasia can only be interpreted as their minimum expression in the Pompeian sample.

Ante mortem tooth loss can be distinguished from post mortem loss as the process of healing, which involves the closing of the socket hole in the mandible or maxilla, usually takes about six months. The principal function of the alveolar bone is to support and maintain teeth in position so that they can function properly. It is gradually resorbed when deprived of this function as a result of tooth loss. It is possible to determine whether ante mortem loss occurred some time before death by the degree of remodelling of the socket and subsequent alveolar bone loss. The only ambiguity that cannot be accounted for is perimortem loss as it is impossible to differentiate teeth lost just prior to or after death from the skeletal record. In addition, it is not possible to establish whether teeth that were lost ante mortem were purposely extracted.
⁴
Ante mortem loss was scored as the number of teeth that were unequivocally lost before death, namely, in cases where some degree of bone remodelling had occurred.

At least one tooth had been lost prior to death in 69 per cent of the maxillae (n = 79) and 48 per cent of the mandibles (n = 56) in the Pompeian sample. The highest number of teeth lost from an individual mandible in the sample was 5 as compared to 14 for a single maxilla.

A strong association has been recorded between ante mortem tooth loss and advancing age for American Indian sites. The Pompeian results are not that conclusive, though a number of the mandibles and maxillae that have been interpreted as belonging to older individuals who had lost teeth prior to death.
⁵

There are some problems in comparing the Pompeian dental data with those from the Herculaneum sample as different scholars presented their findings in various ways. Further, comparison between the results of scholars who have worked on the Herculaneum skeletons is hampered by the different methods that they have used to record their results. Bisel, for example, described her results in terms of mouths, as she had the advantage of access to articulated jaws and did not see the need for separate discussion of the upper and lower dentition. By comparison, Capasso presented his data in terms of numbers of individual teeth and related these to the quantity of affected individuals, as did Torino and Fornaciari and Petrone
et al
.
⁶
These problems are exacerbated by the fact that none of the various data sets have been published in a standard format.

Bisel calculated a mean ante mortem tooth loss per mouth of 1.79 for males and 2.07 for females. As Bisel did not present her raw data it is not really possible to compare her results with those of the Pompeian sample.

Capasso presented data on the numbers and types of teeth that were lost prior to death. He noted that 37.4 per cent of a sample of 139 individuals lost, at least, one tooth prior to death. In most cases, only one tooth was lost, though there were three individuals who respectively lost 10, 12 and 30 teeth.
⁷

The degree of attrition or tooth wear can give some indication of dietary behaviour and methods of food processing. Alternatively, it can provide clues about habitual behaviour, such as tooth grinding or bruxism, or the industrial usage of teeth as tools.
⁸
It is often used as an indicator of age-at-death in archaeological samples (see Chapter 6). If attrition is very severe it can result in the use of the roots as an occlusal surface. The pulp cavity may then be exposed, leaving the tooth liable to bacterial infection. Resultant abscesses were potentially lethal in antiquity.

The frequencies of the different degrees of attrition were comparable for both mandibular and maxillary teeth, with the exception of those cases where the teeth were worn down to the roots, which had a mandibular incidence that was three times higher than for maxillae. This may just be a reflection of the greater likelihood of roots surviving
in situ
in mandibles, as they were generally stored with the teeth facing upwards, whereas maxillae were usually stored with the teeth facing down. However, a study of the dentition of a Roman skeletal sample from Quadrella, Molise, also revealed a higher frequency of wear on mandibular teeth.
⁹

For the purposes of this study, attrition was generally scored to indicate relative adult age-at-death. Severe attrition was probably the result of dietary intake of stone as a result of the milling process.
¹⁰
The flour the Pompeians used for baking was ground in large basalt mills (Figure 7.6), which led to small particles of stone becoming incorporated into bread. No apparent evidence was observed for industrial usage of teeth but such wear is not precluded because it was not possible to fully assess the majority of mouths due to the high incidence of post mortem tooth loss. The loss was especially evident for the anterior teeth, which are most commonly employed as tools.
¹¹
It is notable that Bisel observed what she interpreted to be industrial wear on the right maxillary incisors of one individual from Herculaneum.
¹²
Capasso also recorded evidence of industrial wear, most notably on anterior teeth, of 18 individuals in the Herculaneum sample. Apart from attrition as a result of tool use, he noted severe tooth wear in five per cent of the 2966 teeth that he examined.
¹³

The tooth wear patterns observed in Pompeii are consistent with those observed on other ancient populations that apparently had constantly masticated abrasive substances in their food. For example, the tooth wear patterns from a series of small Pueblo sites in north-eastern Arizona were similarly interpreted as age-related and resultant from constant mastication of abrasive substances in food, rather than other factors. Conversely, little heavy wear was observed on the Roman dental sample from Quadrella. This was interpreted either as a reflection of a diet that was low in hard fibrous foods which required vigorous chewing, or care with cleaning and food preparation to soften the final product and to minimize the presence of abrasive material.
¹⁴

The presence of caries cavities gives an indication of diet and oral hygiene. This pathology is directly related to the presence of dental plaque and a dietary intake of fermentable carbohydrates. It involves the progressive decalcification of enamel or dentine. Several bacterial organisms are associated with dental caries, though the main one is
Streptococcus mutans
. The position of caries can provide dietary information about the afflicted individual.
¹⁵
For the purposes of this study the survey of caries in the Pompeian sample was limited to the number of caries observed in each mouth and the degree of destruction. Scoring was based on the largest carious lesion in the mandible or maxilla under investigation. This study was based on direct visual inspection of the teeth with the aid of a dental probe.
¹⁶
It was not possible to undertake x-ray analysis, which would have produced more reliable results, especially for the size of carious lesions.

Of the 314 surviving maxillary teeth, 50, or nearly 16 per cent, were carious. Forty-three, or 9.7 per cent, of the 444 mandibular teeth that were still
in situ
had carious lesions. Because it was impossible to assess cases where teeth had been lost, the sample was limited to 27 mandibles and 27 maxillae. As a result of the lack of complete dentition for virtually all the maxillae and mandibles, it is impossible to determine the number of carious lesions per mouth. The data merely provides the minimum number of caries cavities per mouth. The degree of carious involvement was substantially greater for a higher proportion of maxillary than mandibular teeth. Nearly half of the caries in the maxillary teeth were described as advanced or gross as compared to just under a quarter for the mandibular teeth.

The Pompeian data set was too incomplete to draw firm conclusions about the relationship between the degree of carious lesions and advancing age, though it is not uncommon to observe a considerable involvement of the crowns of teeth with caries cavities in the mandibles and maxillae of individuals interpreted as older on the basis of attrition.
¹⁷
These results suggest that fermentable carbohydrates formed a significant part of the diet and that oral hygiene was not widely practised.

Bisel recorded an average of 0.92 caries per mouth for males and 0.68 for females in the Herculaneum sample.
¹⁸
The Pompeian material, which could only be used to assess the minimum number of caries, does not give an indication of the number of caries per mouth.

Bisel attributed the apparently low number of lesions in the mouths that she examined to a lack of sugar in the Herculanean diet. Honey was known to the Romans but was not used as extensively as sugar is used in a modern Western diet. In addition, Bisel suggested that a less processed diet would have been advantageous in that caries would have been worn away before they could develop. Hillson reasoned that low sugar consumption would provide a more likely explanation than attrition for the low incidence of caries in ancient populations as attrition would have to be very rapid to remove active deep fissure caries before the pulp cavity was penetrated.
¹⁹

Torino and Fornaciari undertook a preliminary study of 87 victims, 64 of whom were adults and 23 juveniles. They documented 58 carious teeth in a sample of 2,020 teeth. Four of these were deciduous, while the remainder were permanent dentition. These reflected 1.8 per cent of the deciduous sample of 222 teeth and 3 per cent of the 1,798 permanent teeth. They considered that rate of caries in the sample was extremely low by both modern and ancient standards. They partially attributed this finding to the consumption of water and food with high fluorine levels, as attested to by the presence of cases of fluorosis in the sample.
²⁰

Like Torino and Fornaciari, Capasso recorded the presence of caries in relation to the total number of teeth he studied, rather than per mouth. He recorded 135 cases in 3,236 teeth, which is a 4.17 per cent incidence of teeth with carious lesions. Nine of these teeth were deciduous and they reflected 3.33 per cent of the sub group of 270 deciduous teeth in the sample. In contrast, Petrone
et al
. observed that 78.6 per cent of the 56 mouths that they examined had carious teeth, with 20 per cent of the 1,358 permanent teeth displaying evidence of tooth decay. Even though there is considerable variation in size between samples, it is difficult to account for the different results obtained by different researchers from the Herculaneum sample.
²¹
Interdental alveolar resorption

Periodontal tissues, including jaw bone, gingivae or gums, cementum and the periodontal ligament, surround and support the tooth. Interdental alveolar resorption is generally the result of periodontal disease. On a living person, periodontal disease is marked by inflammation. The first stages only involve the soft tissue, notably the gingivae. All the periodontal tissues are involved in the most advanced stage, which is known as periodontitis. The most common form in modern Western populations is mostly seen in adults over thirty years of age. It can occur as a result of a lack of dental hygiene, advanced attrition or poor diet and causes the alveolar bone to recede. As bone loss increases, the teeth become loose and, if left unchecked, can ultimately be lost. It is generally marked by a ridge-like change to the labial side of the alveolus. The degree of recession can be recorded if the teeth are still present. Though more difficult to score, alveolar loss can be observed in mouths where no teeth are
in situ
but teeth have been lost some time prior to death and considerable remodelling and subsequent loss of bone has occurred.
²²