Detecting Orthopaedic Healthcare Practices in Late Medieval and Early Modern Netherlands. A paleopathological analysis of three infirmary collections

This thesis analysed orthopaedic treatment in three infirmary collections from Late Medieval and Early Modern period, The Netherlands; Delft Old and New Infirmary, Haarlem st. Gangolf Infirmary and Breda Vlaszak Infirmary. Macroscopic, radiologic, and handheld x-ray fluorescence (hhXRF) analysis were applied to cases of fractures, dislocations, kyphosis, scoliosis, rickets and poliomyelitis (in total n=88) to understand the nature, access and quality of treatment provided to individuals from a lower segment of society. Treatment was most abundantly detected in the fracture sample (n=25). Stable fracture types appeared well healed consistently throughout the Late Medieval and Early Modern period. More complicated, unstable fractures, carried a poor prognosis. Deformations of the spine and ribs suggested active treatment through orthopaedic corseting for one individual suffering from kyphosis in the Delft infirmary. Metal staining on the affected limb of an individual with...Show moreThis thesis analysed orthopaedic treatment in three infirmary collections from Late Medieval and Early Modern period, The Netherlands; Delft Old and New Infirmary, Haarlem st. Gangolf Infirmary and Breda Vlaszak Infirmary. Macroscopic, radiologic, and handheld x-ray fluorescence (hhXRF) analysis were applied to cases of fractures, dislocations, kyphosis, scoliosis, rickets and poliomyelitis (in total n=88) to understand the nature, access and quality of treatment provided to individuals from a lower segment of society. Treatment was most abundantly detected in the fracture sample (n=25). Stable fracture types appeared well healed consistently throughout the Late Medieval and Early Modern period. More complicated, unstable fractures, carried a poor prognosis. Deformations of the spine and ribs suggested active treatment through orthopaedic corseting for one individual suffering from kyphosis in the Delft infirmary. Metal staining on the affected limb of an individual with poliomyelitis suggested active treatment with a metal artefact, possibly an orthopaedic brace of an individual from the Breda collection. Handheld XRF analysis identified the metal as brass. The distribution of the conditions suggests that the Breda infirmary was perhaps more focussed on the medical component of the infirmary than the Delft and Haarlem infirmary. However, similar relative frequencies of actively treated individuals of the Delft and Breda collection suggest access to care would have been comparable. Analysis of the conditions grouped by period showed that stable fractures, such as the Colles’ and parry fractures, were treated proficiently from the Late Medieval period onwards. In addition, the individual with active kyphosis treatment from the Delft collection predates historical references to orthopaedic corsets. The findings of this study suggest that orthopaedic healthcare was of good quality and, in contrast to historical sources, accessible to individuals of all layers of society. The importance of osteoarchaeology in creating a more holistic narrative on the past is underlined by the detection of complicated forms of treatment predating historical sources.Show less

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Detecting Orthopaedic Healthcare Practices in Late Medieval and Early Modern Netherlands. A paleopathological analysis of three infirmary collections