Boldsen Jesper L, Mollerup Lene
Department of Anthropology, ADBOU, Institute of Forensic Medicine, University of Southern Denmark, DK 5230 Odense, Denmark.
Am J Phys Anthropol. 2006 Jul;130(3):344-51. doi: 10.1002/ajpa.20363.
Leprosy was a common and dreaded disease in the Danish Middle Ages (AD 1050-1536). Starting in the second half of the 13th century, leprosaria were established in many Danish towns and cities. In the city of Odense (on the island of Funen, Denmark), the cemetery of the leprosarium was totally excavated, and four nonleprosarium medieval and early modern cemeteries have been partly excavated. This paper explores the frequency of leprosy in the nonleprosarium cemeteries in Odense, and looks for evidence of selective exclusion from the ordinary population. The analyses are based on 733 skeletons from four cemeteries in Odense: the Gray Friars monastery, St. Albani parish church, St. Knuds cathedral, and Black Friars monastery. Seven lesions are scored and, based on known epidemiological properties (i.e., specificity and sensitivity) of these lesions, scores were transformed to statistics characterizing an individual's risk of having suffered from leprosy. This statistical approach remains of primary theoretical value, pending confirmation by independent research groups at other sites. Prevalence of the skeletal manifestation of leprosy at death varied between 0-17% among the different cemeteries in Odense. The highest prevalence was seen in cemeteries with many burials before AD 1400. It is estimated that before AD 1400, between 14-17% of those buried in the nonleprosarium cemeteries suffered from leprosy. In all nonleprosarium cemeteries, there was evidence for selective exclusion of people with facial leprosy lesions. For a short period just up to AD 1300, the cemetery of the Odense leprosarium had, on average, more than 20 yearly burials. The establishment of the leprosarium was followed within a relatively short period by a dramatic decline in the number of sufferers of leprosy in the nonleprosarium cemeteries. The number of yearly burials in the leprosarium cemetery also declined rapidly during the 14th century. The present analyses do not permit conclusions about the reasons for this decline in leprosy prevalence.
麻风病在丹麦中世纪（公元1050 - 1536年）是一种常见且可怕的疾病。从13世纪后半叶开始，许多丹麦城镇都建立了麻风病院。在欧登塞市（丹麦菲英岛），麻风病院的墓地已被全部发掘，四个非麻风病院的中世纪和近代早期墓地也已部分发掘。本文探讨了欧登塞非麻风病院墓地中麻风病的发病频率，并寻找从普通人群中被选择性排除的证据。分析基于欧登塞四个墓地的733具骨骼：方济各会修道院、圣奥尔巴尼教区教堂、圣克努德大教堂和多明我会修道院。对七种病变进行评分，并根据这些病变已知的流行病学特性（即特异性和敏感性），将评分转换为表征个体患麻风病风险的统计数据。在其他地点的独立研究小组进行确认之前，这种统计方法仍具有主要的理论价值。欧登塞不同墓地中，死亡时麻风病骨骼表现的患病率在0 - 17%之间。患病率最高的是公元1400年之前有许多墓葬的墓地。据估计，在公元1400年之前，埋葬在非麻风病院墓地的人中，有14 - 17%患有麻风病。在所有非麻风病院墓地中，都有证据表明面部有麻风病病变的人被选择性排除。就在公元1300年之前的短时间内，欧登塞麻风病院的墓地平均每年有超过20次埋葬。麻风病院建立后，在相对较短的时间内，非麻风病院墓地中麻风病患者的数量急剧下降。14世纪，麻风病院墓地的年埋葬数量也迅速下降。本文的分析无法得出关于麻风病患病率下降原因的结论。
