- chapter 4: Fleshing out the demography of Etruria –
children (at least before the successful challenge of senatorial power in the confl ict of
the orders, Salvadei et al. 2001: 714–5) suggest that sufferers from genetic anemias like
thalassemia were relatively rare. More likely, we are primarily dealing with childhood
iron defi ciencies caused by nutritional iron defi cits or by gastrointestinal complaints such
as weanling diarrheal or parasitic infections. The severity and extent of this syndrome
seems, even in relatively poor Roman communities like Lucus Feroniae, to have been
signifi cantly lower than in early Medieval populations (Salvadei et al. 2001), and cribra
orbitalia do not seem particularly common or severe among the Etruscan population (see,
e.g. Mallegni et al. 1979; Pacciani et al. 1996; Brasili Gualandi et al. 1997: 257; Robb et
al. 2001: 219, table 4).
Linear enamel hypoplasia, or LEH, generally fi ne lines, or, in severe cases, visible
grooves, on teeth, particularly canines, caused by short interruptions in the enamel
forming process as a result of bouts of malnutrition or sickness in childhood, is also
often seen as a helpful indication of poor health or nutrition (Goodman and Armegalos
1985). As with many cases of cribra orbitalia, however, LEH need not represent evidence
of severe illness or acute malnutrition, and are relatively common, often in fairly mild
forms and disproportionately affecting the poor or disadvantaged, in relatively healthy
and tolerably well-fed populations, including many inhabitants of modern cities, and not
just in the developing world. The syndrome is strongly associated with weaning stress,
poor childhood nutrition, or periods of rapid dental development (Dobney and Goodman
1991; Goodman et al. 1992; Moggi-Cecchi et al. 1993). Such defects are therefore able
to reveal, like cribra orbitalia, or studies of child growth and development, mild to
moderate malnutrition or disease stresses. In a few instances, we can show individuals for
whom a wide range of indicators of malnutrition, poverty and ill-health come together
in severe form, as in the case of one, very short (150 cm), woman from Herculaneum
(Erc 106), suffering from rickets and poor teeth, including several lost ante-mortem
and others affected with very serious enamel hypoplasia, abscesses, or severe tooth wear
(Bisel 1991: 16–18). The prevalence of LEH among the disadvantaged is also evident
from an interesting study of the Sabine population of Corvaro di Borgorese, during the
Republican period (Catalano 1996), which sees a notable increase in LEH, arguably
connected with rapid urban growth and the associated health problems of the urban
poor. The observation that the cases observed were excavated in a single restricted part of
the burial ground (Catalano 1996: 435) suggests that among the ancient Italians, as in
the contemporary studies cited above, socio-economic status is extremely important in
predicting the likelihood of LEH. For a number of Roman populations, particularly those
which were economically deprived, relatively large proportions were affected with LEH
(e.g. Bonfi glioli et al. 2003; Cucina et al. 2006; see Lea 2010: 26–30), but in slightly
more affl uent communities, it seems that a signifi cantly lower proportion, and often
only a minority, are affected (Manzi et al. 1989; Lea 2010: 108). Certainly, our studies of
Etruscan teeth, already cited, tend to suggest rather lower rates, although, admittedly,
few studies are fully quantifi ed or studied in the same depth as some of the more recently
excavated Roman-era samples.
Many diseases fail to leave clear diagnostic evidence on bones, but studies of Etruscan
skeletal remains have shown possible cases of leprosy (Mariotti 2005), acromegaly (Brasili
Gualandi et al. 1997), brain injuries treated using trepanation (Fornaciari et al. 1990;
Fornaciari 2004), and even, much more rarely, cardiovascular disease, such as aortic
coarction (Ciranni and Fornaciari 2006). The most frequent ailments revealed in the