- Geof Kron –
consumption of processed carbohydrates, and perhaps also some honey and other luxury
foods, can be documented by contrasting several suburban Roman necropoleis and the
likely poorer rural settlement of Vallerano (Catalano et al. 2007). Likewise, two studies of
the transition from the Roman era to the signifi cantly harsher economic conditions of the
early Medieval period (Manzi et al. 1999; Belcastro et al. 2007), in a number of different
communities – ranging from the prosperous urban slaves, freedmen and middle classes of
Portus, buried in Isola Sacra, to the rather poor rural mountain town of Lucus Feroniae,
and several settlements in the Apennines – are signifi cant. They demonstrate that the
early Medieval population suffered much more severely from heavy tooth wear, abscesses,
calculus, LEH and ante-mortem tooth loss than the Roman populations, particularly
the urban middle class population of Portus, despite having slightly fewer caries and
relatively good heights, indicative of reasonably good access to meat, as a result of their
largely rural, and often pastoral, economy, although the contrast was muted for the
economically marginalized community of Lucus Feroniae. One can also observe greater
sexual dimorphism and overall internal variation in tooth size, arguably the result of class
differences, among the rural population of Lucus Feroniae, than the more urbanized and
prosperous people buried in Isola Sacra.
A few studies have also been made comparing Greco-Roman or Etruscan indicators
of dental health and of general health stress, which are of some interest in putting the
Etruscan and Greco-Roman experience in some perspective. One detailed comparison
of Hellenistic and twentieth century Greek skeletal collections (Vanna 2007) revealed
dramatically lower ancient levels of caries and ante-mortem tooth loss, signifi cantly
lower rates of periodontitis, and slightly lower levels of LEH for males, although not for
females. Fractures are slightly less common in the ancient population, and dramatically
so when ancient (0.08 percent) and modern (0.38 percent) females are compared – this
result might suggest alarmingly high levels of spousal abuse in the modern period, as
accidents or occupational injuries seem rather unlikely explanations. Modern levels of
osteoarthritis are also higher, more so for women than for men.
The incidence of cribra orbitalia or porotic hyperostosis, a fi ne pitting particularly of
the orbital vaults of the skull, found in skeletal samples from many ancient and modern
cultures, is often taken as a likely indication of nutritional or health stress (e.g. Manzi et
al. 2001). The aetiology is controversial, however. Theories of its origin include anemia
brought on by an inadequate supply of iron in the diet, or the consumption of iron-
depleting phytates in a largely cereal diet, or the result of the consumption of goat’s
milk rather than mother’s milk by young children, as well as the possible nutritional
stresses caused by parasitic infections or weanling diarrhea (Sandford et al. 1983; Stuart-
Macadam 1987). Others explain it instead as evidence of an inherited thalassemia,
like sickle cell anemia, a genetic response to chronic exposure to malaria on the part
of previous, and perhaps contemporary generations (e.g. Angel 1966; Fornaciari et al.
1989). Unfortunately, many physical anthropologists simply note the presence of the
syndrome, not noting the severity, for which there are few objective standards recognized,
or the percentage of the population affected, or the extent to which the lesions are active
or healed (Manzi et al. 2001 and Fox 2005 are notable models of good method). The
relatively mild effects of most cases of cribra orbitalia typically encountered and duly noted
in Etruscan and Greco-Roman skeletal samples, when compared to skeletal examinations
of actual sufferers from thalassemia (Ascenzi and Balistreri 1977; Lagia et al. 2007), and
the rarity of unhealed lesions in adults and their overwhelming preponderance in young