Ludgate Hill collection (1500-1800)

Skull of a male with tertiary syphilis from Ludgate Hill cemetery

This collection represents a pathological collection of post-medieval remains from a number of individuals that were uncovered from Ludgate Hill.

Individuals

Indeterminates

Origins of the collection

According to archival documentation, this series of pathological specimens (PA SK 4009-4019) originate from Ludgate Hill Cemetery which was in use from about 1500 to 1800.

Today this might be the site of St Martin's Church.

The collection represents the remains of at least 11 different people and were received in exchange from SA Balwdin, Esq. MPS in November 1961.

Individuals of note

Syphilis

PA SK 4009

An incomplete cranium of an adult male with pathological changes from tertiary (late-stage) syphilis.

Cranium of adult male with tertiary syphilis
Rear view of cranium of adult male with tertiary syphilis

The disease causes extensive damage to the cranium.

There are numerous foci of caries sicca (lytic lesions) and stellate (star-like) scarring throughout, giving the cranial surface a moth-eaten appearance. The infection also penetrated the outer table of the bone and there is a perforation into the frontal sinuses.

Diffuse idiopathic skeletal hyperostosis (DISH)

PA SK 4010

Seven thoracic vertebrae from an adult which are ankylosed (abnormally adhered) together.

This individual suffered from a condition which caused ossification of the spine.

Thoracic vertebrae exhibiting diffuse idiopathic skeletal hyperostosis (DISH) — Thoracic vertebrae exhibiting pathological changes from diffuse idiopathic skeletal hyperostosis (DISH).

The bodies of the fourth to the ninth thoracic vertebrae have fused due to syndesmophytes (bony growths originating inside ligaments) along the right anterior surfaces of the bodies. The resulting smooth 'candle-wax' effect from this extra bone growth is characteristic of diffuse idiopathic skeletal hyperostosis (DISH).

The spinous processes of some of the vertebrae also exhibit hypertrophic bone. Arthritic changes are also common in individuals suffering from DISH and nearly all the vertebrae exhibit osteoarthritic changes to the rib and transverse process facets in the forms of porosity, erosion, lipping and osteophyte formation.

Schmorl's nodes

The fourth thoracic vertebra also has eburnation and joint changes to the superior articular facets. The inferior surface of the body of the tenth thoracic vertebrae also exhibits Schmorl's nodes, or intravertebral disc herniations.

Paget's bone disease

PA SK 4012

Right femur of an adult.

It has very obvious thickening of the proximal head and whole shaft with abnormal woven bone matrixes, characteristic of Paget's bone disease (osteitis deformans).

This disease causes the excessive breakdown and formation of bone, followed by disorganised bone remodelling.

The individual would have had weakened bone, and the observed arthritic changes to this femur were likely associated with this condition.

Rickets

PA SK 4013

A left and right femora and left tibia of a young adult (MNI 1).

From femoral head and bicondylar widths this individual is a probably female (Bass 1995), but sex estimation is tentative due to pathological bone changes.

A left and right femora and left tibia of a young adult with rickets

This individual has bowed bone shafts due to rickets - the defective mineralization or calcification of bones leading to deformity.

There is also bilateral osteoarthritis on the anterior surfaces of the femoral heads, in the forms of porosity, erosion and slight eburnation.

The left tibia also has possible myositis ossificans of the semi-tendinous muscle on the superior medial part of the shaft.

Blunt force trauma

PA SK 4016

A mandible of an adult of indeterminate sex with two healed fractures that changed the appearance of this individual's jaw.

One fracture runs obliquely through the body below the right second incisor to the second right molar, and the other the through the left ascending ramus below the condyle. The blunt force appears to have come from the front-left side, displacing the left side of the mandible and resulting in misaligned bone. This left a gap at the dental sockets, culminating in a large abscess below the first and second right molars.

Mandible of an adult with fractures. The misalignment of the bone is observable at the metal eminence.
$Mandible of an adult with fractures$

Mandible of an adult with fractures. The misalignment of the bone is observable at the metal eminence.

This individual additionally suffered from three carious lesions (tooth decay) and slight dental calculus (hardened plaque) adhesions.

Although poor by today's standards, this individual's dental hygiene was not as bad as we might expect given the trauma and malformation of the mouth that they sustained.

Bone trauma

PA SK 4017

The upper shaft of a severely malformed left femur from a displaced fracture.

This individual was adult but their sex is indeterminable from the available evidence.

Femoral shaft with severe displacement — A femoral shaft with severe displacement resulting from fracture

A break to the femoral shaft caused the lower half of the bone to be displaced anteriorly (upwards) by approximately 70 millimetres and at an angle of approximately 35 degrees posteriorly.

The trauma occurred ante-mortem (during life) as the bone exhibits advanced healing with an extensively remodelled callus.

This person would have not been able to use this leg normally as the lower part would have been visibly angled to their rear and it would have been a few inches shorter than the other.