Spitalfields in London is thought to be the largest excavated cemetery in the world. Recent research has focussed on the site’s mass graves, uncovering a wealth of new information about the population of Medieval London.

One of the archaeological advantages of mass burials is that the urgency of the situation leaves no time to sort the deceased into different groups. Rather than segregating bodies by class, gender or faith, they all go straight into the pit. This should create a burial group that is a truer reflection of the living population. Comparing the bodies in the pits to those interred under normal circumstances in individual grave shafts reveals a larger number of children and adolescents — a feature that dovetails with known famine burials elsewhere — as well as near parity of the sexes. While the gender of those buried during everyday use of the cemetery was skewed towards males, there was a ratio of almost 1:1 in the pits.

Comparison of male and female skeletons reveals that life in mid-13th century London could be harsh regardless of gender. Yet while signs of stress brought on by repeated incidences of famine, such as below average height and striations on teeth, afflicted both sexes, some fractures show a strong gender bias. Men were most likely to break their bones, with their skeletons preserving far more evidence for injuries. These take many forms, but fractured vertebrae caused by falls or perhaps from carrying heavy loads are a reasonably representative example. Women, however, were far more likely to sustain broken forearms, and in particular a distinctive fracture to the ulna. Experts remain divided about the explanation for this, but the injury is a textbook example of a ‘parry-fracture’ caused when an individual raises their arms to defend them self during an attack. Conceivably these breakages were an occupational hazard in an industry that favoured females, but they might paint a bleak picture of a world rife with domestic abuse. Either way, such gender-specific injuries reflect real differences in day-to-day life.

Although men were more likely to receive injuries than women, they also appear to have had access to better healthcare. Male fractures tend to show a greater degree of successful healing, suggesting that once an injury occurred females were in a far more vulnerable situation. We know that women had a hard time establishing themselves in business, and were not heavily involved in guilds. The consequence of this may have been that while men received a greater degree of support as they convalesced, women had to fend for themselves. Money pressures could easily force them to return to work before their injuries were properly healed, compounding the original problem.

One disease that afflicted male and female alike was tuberculosis. Caused by a bacteria that can target the lungs or stomach, if left untreated tuberculosis typically kills over 50% of sufferers. Around 100 of the Spitalfields skeletons preserved traces of the disease, making up 2% of the overall study group. As only between 5 and 7% of those infected with the illness receive permanent skeletal scarring from it, this means that as many as 30% of the population may have been sufferers. This is a far higher incidence than occurred in, say, Roman Londinium, and it reflects a key element of the contemporary narrative of the capital. Tuberculosis is most commonly transmitted by coughing, and so is particularly devastating in over-crowded and polluted urban areas. We know that the population of London increased rapidly during the 12th and 13th centuries as migrants from rural communities around the country were drawn to the city by the jobs on offer. Tragically this influx of newcomers seeking their fortune, or at least a better way of life, contributed to over-crowding and the acute health risks that accompany it.

Some of the human remains from Spitalfields – and what we can tell from them.

Blunt force injury

Sharp force injury


Tubercular infection of wrist

Syphilitic skull


Enamel hyperplasia

Metatarsal with evidence of tuberculoid leprosy


This is an extract but you can read the full article in CA 270

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