Disease-ridden peasants?

A recent paper deserves our attention for the light it sheds on the day-to-day realities of early medieval diet, disease, and mortality. Spoiler: it wasn’t a great time to be alive.

The journal Genome Biology published “Pathogen genomics study of an early medieval community in Germany reveals extensive co-infections” in December of 2022. The team of sixteen authors performed DNA analysis on the bones and teeth of individuals buried between 650 and 800 (the dating is rough) in a German town now called Lauchheim (part of Frankish Allemania). Their findings illustrate a population ravaged by disease and hardship.

Of the seventy remains investigated, twenty-two had active infections (31% of the population!), of four different viral and bacteriological diseases. Seven individuals had two infections, and one unfortunate young man had three different diseases going on. Just what were these diseases, how prevalent were they, and what were the immediate and long-term effects?

• Hepatitis B – 11% of the population (7% of the adults; 27% of the “sub-adults”): Yep, the same HepB that has infected humans for at least 10,000 years, and even today infects 3.8% of the global population (7.5% in Africa). It’s an infectious liver disease, contracted through blood or bodily fluids. The usual symptoms include fatigue and jaundice, before the symptoms clear after a few weeks. But if not cured it becomes a chronic case, which can lead to cirrhosis, sometimes liver cancer, and eventual liver failure.
• Parvovirus B19 – 30% of the population (40% of the young; 27% of the adults): No, not a dog illness. B19 is exclusive to humans, and spread through respiratory droplets. Most infections lead to no symptoms, while the rest get “fifth disease” which is generally a mild rash in children. It can cause arthritis-like symptoms that clear up after a few weeks. In pregnant women it can cause miscarriage and stillbirth.
• Mycobacterium leprae – (one case): Leprosy! Spread through close contact with someone else, probably through droplets. Sometimes symptoms show up in a year, sometimes it takes more than 20 years. “Most leprosy complications are the result of nerve damage…. This damage usually results in hair loss to the area, a loss of the ability to sweat, and numbness (decreased ability to detect sensations such as temperature and touch). Further peripheral nerve damage may result in skin dryness, more numbness, and muscle weaknesses or paralysis in the area affected. The skin can crack and if the skin injuries are not carefully cared for, there is a risk for a secondary infection that can lead to more severe damage.”^1.Given the extraordinary social responses to leprosy a separate post on simply that topic is merited.
• Variola virus – (one case): Smallpox!

For what could be any number of reasons, there are nine females and thirteen males in the list of the twenty-two disease-carrying individuals.

Lastly let’s take a look at the age at death of those twenty-two persons. Despite a few descriptions like “Senile” or “Early mature”, I came up with an average age at death of 29.^3.The average age is skewed by that “senile” description, which I put at 70 – if I take that out, the average age drops to 27. The median age (half died younger, half older) was 25. Median or average, life was short. Looking at just male or female deaths didn’t change the life expectancy – males and females died at the same age. Of course this cohort were the disease carriers, which naturally would shorten the lifespan. But I doubt those in “good health” would have lived much longer, particularly since the most common disease, B19, didn’t impact the body that badly.

All in all the evidence paints a grim picture. Malnutrition was probably the norm, punctuated by starvation or at least hunger. This led to a vicious circle, as weakened bodies and immune systems couldn’t cope with an unending influx of bacteriological and viral infestations.^4.One bit of good news – you may have noticed that Yersinia pestis, our old friend the black death, did not make an appearance. Small comfort. Remember, too, that this analysis could find only infections that embedded themselves in the bones and teeth of the inhabitants. There must have been dozens of other ailments, including the flu (still deadly today), typhus, and malaria,^5.Which was in Europe from antiquity, and not just in the Mediterranean that swept the population but left no osteological mark.

This paper presents us with a wealth of information about life as an “average citizen” of the Frankish realm. While no doubt our early medieval ancestors enjoyed some quality of life benefits that we have devolved out of (a permanent sense of place and purpose, connection to the natural world, etc.), I’m sure they would have traded almost anything for reliable food supplies and some penicillin.

Programming note: I’ve previously covered disease and medicine in some detail:
A couple of examples of surgical survival.
An overview of early medieval medicine in general.
The Etymologiae of Isidore, and examples of healing by saints.

I still haven’t covered the theoretical underpinning of early medieval medicine, but that will come soon. In hindsight and retrospect a more cohesive approach would have yielded better results. The perils of the hobby historian.