Professional Documents
Culture Documents
b
e
l
h
o
l
t
0
2
.
5
2
9
1
0
(
6
)
2
1
1
9
0
(
0
)
0
1
9
0
(
0
)
0
2
5
7
7
(
7
)
2
8
1
1
0
(
0
)
0
2
.
6
6
.
5
3
7
3
7
(
2
1
)
5
8
4
8
0
(
0
)
0
3
7
3
(
3
)
8
4
5
2
2
(
2
)
4
3
6
0
(
0
)
0
6
.
6
1
0
.
5
2
5
2
8
(
1
6
)
6
4
3
1
5
2
(
1
1
)
3
5
2
1
2
(
2
)
1
9
2
3
0
(
0
)
0
2
0
5
7
(
4
)
2
0
1
0
.
6
1
4
.
5
1
2
1
9
(
1
1
)
9
2
1
8
3
8
(
8
)
4
4
5
5
0
(
2
)
5
0
1
2
0
(
0
)
0
1
1
4
3
(
3
)
2
7
1
4
.
6
2
0
.
0
5
5
(
3
)
6
0
7
9
(
2
)
2
8
3
0
(
0
)
0
7
0
(
0
)
0
4
0
(
0
)
0
T
o
t
a
l
1
0
8
5
3
(
5
7
)
1
2
3
1
7
(
2
1
)
8
8
8
(
7
)
1
1
2
8
(
9
)
8
2
8
.
5
(
7
)
N
s
t
v
e
d
0
2
.
5
1
3
1
9
(
7
)
5
4
*
1
0
9
(
2
)
2
0
7
1
4
(
2
)
2
8
1
3
5
4
(
6
)
4
6
8
8
(
1
)
1
2
2
.
6
6
.
5
1
0
1
9
(
7
)
7
0
7
0
(
0
)
0
5
7
(
1
)
2
0
1
0
3
6
(
4
)
4
0
*
8
0
(
0
)
0
6
.
6
1
0
.
5
1
5
1
7
(
6
)
4
0
1
2
3
9
(
9
)
7
5
9
1
4
(
2
)
2
2
6
9
(
1
)
6
1
2
1
5
(
2
)
1
7
1
0
.
6
1
4
.
5
7
1
7
(
6
)
8
6
9
2
2
(
5
)
7
5
7
1
4
(
2
)
2
8
8
0
(
0
)
0
8
2
3
(
3
)
3
7
1
4
.
6
2
0
.
0
1
5
2
8
(
1
0
)
6
7
1
7
3
0
(
7
)
5
6
1
1
5
0
(
7
)
6
4
1
7
0
(
0
)
0
1
8
5
4
(
7
)
3
9
T
o
t
a
l
6
0
6
0
(
3
6
)
5
5
4
2
(
2
3
)
*
3
9
3
5
(
1
4
)
6
4
1
7
(
1
1
)
5
4
2
4
(
1
3
)
*
1
%
A
,
p
e
r
c
e
n
t
a
g
e
a
f
f
e
c
t
e
d
o
f
t
o
t
a
l
i
n
d
i
v
i
d
u
a
l
s
o
b
s
e
r
v
e
d
;
%
b
,
p
e
r
c
e
n
t
a
g
e
a
f
f
e
c
t
e
d
i
n
e
a
c
h
a
g
e
g
r
o
u
p
.
*
S
i
g
n
i
c
a
n
t
l
y
h
i
g
h
e
r
a
t
N
s
t
v
e
d
c
o
m
p
a
r
e
d
t
o
b
e
l
h
o
l
t
(
2
,
P
0
.
0
0
5
)
.
Fig. 4. Prevalence of stress indicators.
Fig. 5. Developmental age of dental hypoplasia.
742 P. BENNIKE ET AL.
would suggest that they contracted the disease in utero,
or shortly after birth. Such infections are rarely recog-
nized today, and even less so in the medieval period
(Alford et al., 1975). The small number of fetal and infant
remains (n 14) at Nstved suggests that few babies
were born in the hospital sample. Those born to mothers
with lepromatous leprosy today are very weak, grow
slowly, and die early if untreated. Therefore, if babies
were regularly born in the leprosarium, a higher number
of infant deaths would be expected than at belholt, even
though the fertility rate was lower.
It is more probable that children who entered the lepro-
sarium with their parents eventually developed the dis-
ease. In South India, a study of children living in a lepro-
sarium showed that, after long exposure to the disease
through parents and patients, children did contract the
disease, but that 75% of them had complete remission
within 6 years (Berreman, 1984). It is possible that some
of these children relapsed with the onset of puberty.
Children may also have contracted the disease in the vil-
lage and surrounding area and been brought into the lepro-
sarium during later childhood, around age 610 years.
Modern studies show an increase in the prevalence of lep-
rosy in children by the age 7 years, and indeed in the
Nstved sample, the youngest skeleton displaying rhino-
maxillary changes is 8 years old. The increase in number of
preadults older than 6.6 years may indicate that after this
age, children were being identied as leprous and entered
the sample from outside. The greater number of children
between ages 617 in the leprosarium would of course have
increased the number of children who died and entered the
mortuary sample. This further increase in number of indi-
viduals is consistent with the observation that the disease
is most prominent in the late teens (Duncan, 1985).
CONCLUSIONS
Compared with children interred at the monastery site
of belholt, those from the leprosarium at Nstved can
be considered socially disadvantaged and suffering from
compromised health. They displayed higher frequencies of
stress indicators, which is likely an illustration of the
higher exposure to risk and greater susceptibility of these
individuals to infection and malnutrition.
While the demographic prole at belholt was similar
to an ordinary medieval parish cemetery, Nstved had
rather few young children but high numbers in their late
teens. This pattern is clearly a product of the articial
nature of the Nstved population, reecting the late age
of admission to the leprosarium and an altered reproduc-
tive pattern of the inmates. Also, the adult population
from Nstved displays a skewed prole, with high gures
for young adults and a sparse representation of old adults.
Thus the nonattritional demographic prole at Nstved is
characteristic of the entire population. It indicates the
socially imposed selection of the living population and the
inevitably resulting unusual mortality prole in the skele-
tal assemblage. Leprosy and its concomitant pathological
changes only exacerbated a situation in which social seg-
regation was already a high price to pay.
The distribution of stress indicators of preadults at
belholt and Nstved related to age bears a vague indi-
cation that, in general, stress indicators were more preva-
lent in older age groups. However, this may in part be
inuenced by both the age distribution of the samples and
the skeletal modications themselves. Yet there is a clear
trend toward gradual age-related accumulation of stress
indicators in the leprosarium sample. The only lesions
that were signicantly associated with decreased longev-
ity in both groups were those on the endocranial surfaces.
By age 10 years, long bone growth of the Nstved chil-
dren fell behind that of belholt, which is most likely
attributable to growth retardation resulting from effects
of leprosy. This is corroborated by a drop in bone mineral
content values during adolescence, demonstrating the
usefulness of this noninvasive method in providing data
on appositional growth and mineralization.
Studies of preadult samples are benecial to skeletal
studies because they are not stricken with the inherent
methodical aws of adult aging, and are thus able to pro-
vide a sensitive indicator of health for past societies by
examining those particularly susceptible to disease and
most at risk. However, these studies are limited to those
individuals who failed to adapt to the environmental and
cultural factors inuencing their community. At Nstved,
preadults were selected to enter the leprosarium, and
later the mortuary sample, because they were suffering
from a disease, and therefore their members are not repre-
sentative of the society from which they were drawn. The
TABLE 5. Mean ages at death for individuals with and without stress indicators
1
Stress indicator
With Without
Difference
(years)
Statics
(Kolmogorov-
Smimov) Mean SD Mean SD
belholt
Cribra orbitalia 7.62 3.69 4.79 4.4 2.8
Enamel hypoplasia 10.8 2.53 6.27 4.06 4.5
**
K 2.0
Periostitis 8.1 3.03 5.6 4.22 2.5
Endocranial lesions 1.62 0.77 6.8 4.34 5.1
*
K 1.78
Sinusitis 8.0 3.49 5.57 4.24 2.4
*
K 1.43
Nstved
Cribra orbitalia 9.91 6.28 9.3 6.57 0.6
Enamel hypoplasia 12.7 5.03 9.16 6.21 6.5
Periostitis 13.8 5.48 9.83 5.86 3.9
Endocranial lesions 3.4 3.02 10.9 5.89 7.5
*
K 1.84
Sinusitis 12.45 6.52 9.27 5.16 3.1
Rhinomaxillary syndrome 14.4 4.29 8.89 5.49 5.5
*
K, Kolmogorov-Smimov.
**
Signicant at P < 0.05.
743 CHILD MORBIDITY IN DENMARK
study shows that it is imperative to be aware of the cul-
tural, historical, and economic context from which a popu-
lation is derived before the morbidity and mortality pat-
terns of a past society can be reconstructed.
This becomes evident, in particular, when single age
groups rather than bulk categories are examined. While
the combined preadult samples create patterns that favor
traditional views on the meaning of skeletal modications,
only a differential analysis of single age groups reveals the
paradoxical relationship of health, morbidity, and osseous
manifestations that is advocated as typical of skeletal
assemblages. Thus the characteristic distribution of stress-
related skeletal modications across various preadult age
groups lends itself to a biocultural analysis that is able to
identify the more subtle effects of social disadvantage and
compromised health.
ACKNOWLEDGMENTS
The research was funded by grant ERBCHRXCT
930193 to P.B. under EU Program Human Capital and
Mobility and carried out at the Museum of Medical His-
tory and Laboratory of Biological Anthropology, Univer-
sity of Copenhagen, Denmark. We are most grateful to
Inger Kjr,Verner Alexandersen and Birgitte Sejersen for
helpful discussions.
LITERATURE CITED
Acheson RM. 1959. Effects of starvation, septicaemia and chronic
illness on the growth cartilage plate and metaphysis of the
immature rat. J Anat 9:123134.
Acheson RM, MacIntyre MN. 1958. The effects of acute infection and
starvation on skeletal development. Br J Exp Pathol 39:3745.
Alford CA, Stagno S, Reynolds W. 1975. Diagnosis of chronic
perinatal infections. Am J Dis Child 129:455463.
Andersen JG. 1969. Studies in the medieval diagnosis of leprosy
in Denmark: an osteological, historical and clinical study.
Copenhagen: Costers Bogtrykkeri.
Andersen JG. 1991. The medieval diagnosis of leprosy. In: Ortner
DJ, Aufderheide AC, editors. Human paleopathology: current
synthesis and future options. Washington, DC: Smithsonian
Institution Press. p 205208.
Arentoft E. 1999. De spedalskes hospital. Fynske studier 18.
Odense: Odense Bys Museer.
Beaton GH. 1989. Small but healthy? Are we asking the right
question? Hum Organisation 48:3039.
Bennike P. 2000. A Medieval mass grave from Denmark (1300
1350 AD). Am J Phys Anthropol [Suppl]30:106 [abstract].
Bennike P. 2002. Vilhelm Mller-Christensen: his work and leg-
acy. In: Roberts CA, Lewis ME, Manchester K, editors. The
past and present of leprosy. BAR international series 1954.
Oxford: Archaeopress. p 135144.
Bennike P, Brade AE. 1999. Middelalderens sygdomme og
behandlingsformer i Danmark [Disease and treatment in medi-
eval Denmark]. Copenhagen: Museum of Medical History.
Bennike P, Bohr H, Toft T. 1993. Determination of mineral con-
tent and organic matrix in bone using dual photon absorpti-
ometry. Int J Anthropol 8:111116.
Berreman JM. 1984. Childhood leprosy and social response in
South India. Soc Sci Med 19:853865.
Boldsen J. 2001. Epidemiological approach to the paleopatholog-
ical diagnosis of leprosy. Am J Phys Anthropol 115:380387.
Boocock PA, Roberts CA, Manchester K. 1995. Prevalence of
maxillary sinusitis in leprous individuals from a medieval lep-
rosy hospital. Int J Lepr 63:265268.
Brody SN. 1974. The disease of the soul: leprosy in medieval lit-
erature. Ithaca: Cornell University Press.
Buikstra JE, Ubelaker DH. 1994. Standards for data collection
from human skeletal remains.Arkansas Archaeological Survey
research series44. Fayetteville: Arkansas Archaeological Survey.
Carlson DS, Armelagos GJ, Van Gerven DP. 1976. Patterns of
age-related cortical bone loss (osteoporosis) within the femoral
diaphysis. Hum Biol 48:295314.
Cohen MN, Armelagos GJ. 1984. Paleopathology at the origins
of agriculture. New York: Academic Press, Inc.
Cole TJ. 1989. Relating growth rate to environmental factors
methodological problems in the study of growth-infection in-
teraction. Acta Paediatr Scand Suppl 350:1420.
Cook DC. 1984. Subsistence and health in the Lower Illinois
Valley: osteological evidence. In: Cohen MN, Armelagos GJ,
editors. Paleopathology at the origins of agriculture. Orlando,
FL: Academic Press, Inc. p 235269
Cook DC, Buikstra JE. 1979. Health and differential survival in
prehistoric populations: prenatal dental defects. Am J Phys
Anthropol 51:649664.
Duncan ME. 1980. Babies of mothers with leprosy have small
placentae, low birth weights and grow slowly. Br J Obstet
Gynaecol 87:471479.
Duncan ME. 1985. Leprosy in young children-past, present and
future. Int J Lepr 53:468473.
Duncan ME, Melsom R, Pearson JMH, Ridley DS. 1981. The
association of pregnancy and leprosy. Lepr Rev 52:245262.
Duray SM. 1996. Dental indicators of stress and reduced age of
prehistoric Native Americans. Am J Phys Anthropol 99:275286.
El-Najjar M, Ryan DJ, Turner C, Lozoff B. 1979. The aetiology
of porotic hyperostosis among the historic and prehistoric
Anasazi Indians of southwestern United States. Am J Phys
Anthropol 44:477488.
Eveleth PB. 1986. Population differences in growth: environ-
mental and genetic factors. In: Falkner F, Tanner JM, editors.
Human growth: a comprehensive treatise. New York: Plenum
Press. p 221239.
Eveleth PB, Tanner JM. 1990. Worldwide variation in human
growth. Cambridge: Cambridge University Press.
Falkner F, Tanner JM. 1986. Human growth: a comprehensive
treatise. New York: Plenum Press.
Gilbert RI. 1985. Stress, paleonutrition, and trace elements. In:
Gilbert RI, Mielke JM, editors. The analysis of prehistoric
diets. Orlando, FL: Academic Press, Inc. p 339356.
Goodman AH. 1993. On the interpretation of health from skele-
tal remains. Curr Anthropol 34:281288.
Goodman AH, Rose JC. 1990. Assessment of systemic physiolog-
ical perturbations from dental enamel hypoplasia and associ-
ated histological structures. Yrbk Phys Anthropol 33:59110.
Goodman AH, Rose JC. 1991. Dental enamel hypoplasia as indi-
cators of nutritional status. In: Kelley MA, Larsen CS, edi-
tors. Advances in dental anthropology. New York: Wiley and
Liss Inc. p 279293.
Goodman AH, Martin DL, Armelagos GJ, Clark G. 1984. Indica-
tors of stress from bone and teeth. In: Cohen MN, Armelagos
GJ, editors. Paleopathology at the origins of agriculture.
Orlando, FL: Academic Press, Inc. p 1349.
Goodman AH, Thomas RB, Swedlund AC, Armelagos GJ. 1988. Bio-
cultural perspectives on stress in prehistoric, historical, and con-
temporary population research. Yrbk Phys Anthropol 31:169202.
Grauer AL. 1993. Patterns of anaemia and infection from Medi-
eval York, England. Am J Phys Anthropol 91:203215.
Hauhnar CZ, Mann SBS, Sharma VK, Mehta S, Radota BD.
1992. Maxillary antrum involvement in multibacillary lep-
rosy: a radiological, sinuscopic and histological assessment.
Int J Lepr 60:390395.
Hillson S. 2000. Dental anthropology. Cambridge: Cambridge
University Press.
Huss-Ashmore R. 1978. Nutritional determination in skeletal
populations. Am J Phys Anthropol 48:407.
Jantz RL, Owsley WD. 1984. Long bone growth variation among
Arikara skeletal populations. Am J Phys Anthropol 63:1320.
Johnston FE. 1962. Growth of the long bones of infant and young
children at Indian Knoll. Am J Phys Anthropol 20: 249254.
Jopling WH, McDougall AC. 1988. Handbook of leprosy. Oxford:
William Heinemann Medical Books.
Kieffer-Olsen J. 1993.Grav og gravskik i det middelalderlige
Danmark. 8 kirkega rdsudgravninger. Unpublished Ph.D. the-
sis. Aarhus: Aarhus University.
744 P. BENNIKE ET AL.
Kirkwood BR. 1988. Essentials of medical statistics. London:
Blackwell Scientic Publications.
Lampl M, Johnston FE. 1996. Problems in the aging of skeletal
juveniles: perspectives from maturation assessments of living
children. Am J Phys Anthropol 101:345355.
Lara CB, Nolesco JO. 1956. Self-healing or abortive, and resid-
ual forms of childhood leprosy and their probable signicance.
Int J Lepr 24:245263.
Larsen CS. 1997. Bioarchaeology. Interpreting behavior from
the human skeleton. Cambridge: Cambridge University Press.
Lewis AB, Garn SM. 1960. The relationship between tooth forma-
tion and other maturational factors. Angle Orthod 30:7077.
Lewis M. 2002a. Urbanisation and child health in medieval
and post-medieval England. BAR British series 339. Oxford:
Archaeopress.
Lewis M. 2002b. The impact of industrialization: comparative
study of child health in four sites from medieval and post-
medieval England (8501859 AD). Am J Phys Anthropol
119:211223.
Lewis M. 2002c. Infant and childhood leprosy: clinical and
palaeopathological implications. In: Roberts C, Lewis M,
Manchester K, editors. The past and present of leprosy.BAR
international series1954. Oxford: Archaeopress. p 163170.
Lewis M. 2004. Endocranial lesions in non-adult skeletons:
understanding the aetiology. Int J Osteoarchaeol 14:8297.
Lewis ME, Roberts CA, Manchester K. 1995. Comparative study
of the prevalence of maxillary sinusitis in later medieval
urban and rural populations in Northern England. Am J Phys
Anthropol 98:497506.
Little MA. 1995. Adaptation, adaptability and multidisciplinary
research. In: Boaz NT, LD Wolfe, editors. Biological anthropol-
ogy: the state of the science. Corvallis: Oregon State Univer-
sity Press. p 121147.
Lunt DA. 1969. An odontometric study of Medieval Danes. Acta
Odontol Scand [Suppl]55:27.
Macey JF. 1996. Demography and disease of the Nstved Helli-
ga ndshus collection. MA thesis. Memorial University of
Newfoundland, St. Johns.
Malina RM, Bouchard C. 1991. Growth, maturation and physi-
cal activity. Champaign: Human Kinetics Publishers Inc.
Maresh MM. 1940. Paranasal sinuses from birth to adolescence.
Am J Dis Child 60:5578.
Martin D, Armelagos GJ. 1979. Morphometrics of compact bone:
an example from Sudanese Nubia. Am J Phys Anthropol
51:571578.
Melsom R, Harboe M, Duncan ME. 1982. IgA, IgM and IgA
anti-M-leprae antibodies in babies of leprosy mothers during
the rst 2 years of life. Clini Exp Immunol 49:532542.
Mensforth RP. 1985. Relative tibia long bone growth in the Lib-
ben and Bt-5 prehistoric skeletal populations. Am J Phys
Anthropol 68:247262
Mensforth RP, Lovejoy CO, Lallo JW, Armelagos GJ. 1978. The
role of constitutional factors, diet and infectious disease in
the aetiology of porotic hyperostosis and periosteal reactions
in prehistoric infants and children. Med Anthropol 2:159.
Merrett DC, Pfeiffer S. 2000. Maxillary sinusitis as an indicator
of respiratory health in past populations. Am J Phys Anthro-
pol 111:301318.
Mittler DM, Van Gerven DP, Sheridan SG, Beck R. 1992. The
epidemiology of enamel hypoplasia, cribra orbitalia, and sub-
adult mortality in an ancient Nubian population. J Palaeopa-
thol 2:143150.
Mller-Christensen V. 1961. Bone changes in leprosy. Copenha-
gen: Munksgaard.
Mller-Christensen V. 1978. Leprosy changes of the skull.
Odense: Odense University Press.
Mller-Christensen V. 1982. belholt kloster. 2nd ed. Copenha-
gen: Nationalmuseet.
Mller-Christensen V, Sandison AT. 1963. Usura orbitae (cribra
orbitalia) in the collection of crania in the Anatomy Department
of the University of Glasgow. Pathol Microbiol 26:175183.
Moorrees CFA, Fanning EA, Hunt EE. 1963a. Formation and
resorption of three deciduous teeth in children. Am J Phys
Anthropol 21:205213.
Moorrees CFA, Fanning EA, Hunt EE. 1963b. Age variation of
formation stages for ten permanent teeth. J Dent Res 42:
14911502.
Olivier G, Pineau H. 1960. Nouvelle determination de la taille
ftale dapre`s les longueurs diaphysaires des os longs. Ann
Med Legale 40:141144.
Ortner DJ. 1991. Theoretical and methodological issues in pale-
opathology. In: Ortner DJ, Aufderheide AC, editors. Human
paleopathology: current synthesis and future options. Washington,
DC: Smithsonian Institute Press. p 511.
Ortner DJ. 2003. Identication of pathological conditions in
human skeletal remains. London: Academic Press.
Ortner DJ, Ericksen MF. 1997 Bone changes in the human skull
probably resulting from scurvy in infancy and childhood. Int
J Osteoarchaeol 7:212220.
Ortner DJ, Butler W, Cafarella J, Milligan L. 2001 Evidence of
probable scurvy in subadults from archaeological sites in
North America. Am J Phys Anthropol 114;343351.
Rallison ML. 1986. Growth disorders in infants, children and
adolescents. New York: John Wiley and Sons, Inc.
Reinhard KJ. 1992. Patterns of diet, parasitism and anaemia in
prehistoric west North America. In: Stuart-Macadam P, Kent S,
editors. Diet, demography and disease: changing perspectives of
anaemia. NewYork: Aldine de Gruyter. p 219260.
Richards P. 1977. The medieval leper and his northern heirs.
Cambridge: D.S. Brewer.
Roth EA. 1992. Applications of demographic models to paleode-
mograpy. In: Saunders SR, Katzenberg MA, editors. Skeletal
biology of past peoples: research methods. New York: Wiley-
Liss, Inc. p 175188.
Ruff CB, Haynes C. 1984. Bone mineral content in the lower
limb. J Bone Joint Surg [Am] 66:10241031.
Saunders SR, Hoppa RD. 1993. Growth decit in survivors and
non-survivors: biological mortality bias in subadult skeletal
samples. Yrbk Phys Anthropol 36:127151.
Scheuer L, Black S. 2000. Development: juvenile osteology. Lon-
don: Academic Press.
Schour I, Massler M. 1940. Studies in tooth development: the
growth pattern of human teeth. J Am Dent Assoc 27:1778
1793, 19181931.
Schultz M. 2001. Palaeohistopathology of bone: a new approach to
the study of ancient diseases. Yrbk Phys Anthropol 44:106147.
Schutkowski H, Grupe G. 1997. Correlations between cribra
orbitalia, archaeometric analyses and habitat conditions.
Anthropol Anz 55:155166.
Scrimshaw NS, Young WR. 1989. Adaptation to low protein and
energy intakes. Hum Organisation 48:2030.
Scrimshaw NS, Taylor CE, Gordon JE. 1959. Interactions of
nutrition and infection. Am J Med Sci 237:367403.
Seckler D. 1982. Small but healthy? Some basic problems in the
concept of malnutrition. In: Sukhatme PV, editor. Newer
concepts in nutrition and their implications for policy. Pune,
India: Maharashtra Association for the Cultivation of Science.
p 139148.
Smith HB. 1991. Standards of human tooth formation and den-
tal age assessment. Adv Dent Anthropol 8:143168.
Soni NK. 1989. Antroscopic study of the maxillary antrum in
lepromatous leprosy. J Laryngol Otol 103:502503.
Stini WA. 1985. Growth rates and sexual dimorphism in evolu-
tionary perspective. In: Gilbert RI, Mielke JH, editors. The
analysis of prehistoric diets. Orlando: Academic Press. p 191
222.
Stuart-Macadam P. 1991. Anaemia in Roman Britain.BAR inter-
national series199. Oxford Archaeopress. p 101113.
Stuart-Macadam P, Kent S. 1992. Diet, demography and dis-
ease: changing perspectives of anaemia. New York: Aldine de
Gruyter.
Subira M, Alesan A, Malgosa A. 1992. Cribra orbitalia and
nutritional deciency. Studies of trace elements. Munibe
[Suppl]8:153158.
Tanner JM. 1990. Foetus into man: physical growth from concep-
tion to maturity. Cambridge, MA: Harvard University Press.
Thompson DD. 1980. Age changes in bone mineralization, cortical
thickness, and Haversian canal area. Calcif Tissue Int 31:511.
745 CHILD MORBIDITY IN DENMARK
Van Gerven DP, Armelagos GJ. 1983. Farewell to paleodemog-
raphy? Rumours of its death have been greatly exaggerated.
J Hum Evol 12:353360.
Van Gerven DP, Sandford MK, Hummert JR. 1981. Mortality
and culture change in Nubias Batn el Hajar. J Hum Evol 10:
395408.
Wald ER, Milmoe GJ, Bowen AD, Ledesma-Medina J, Salamon
N, Bluestone CD. 1981. Acute maxillary sinusitis in children.
N Engl J Med 304:749755.
Wall CE. 1991. Evidence of weaning stress and catch-up growth
in the long bones of a central California Amerindian sample.
Ann Hum Biol 18:922.
Wapler U, Crubezy E, Schultz M. 2004. Is cribra orbitalia syn-
onymous with anemia? Analysis and interpretation of cranial
pathology in Sudan. Am J Phys Anthropol 123:333339.
Weinberg ED. 1992. Iron withholding in prevention of disease.
In: Stuart-Macadam P, Kent S, editors. Diet, demography and
disease: changing perspectives of anaemia. New York: Aldine
de Gruyter. p 105150.
WHO Working Group. 1986. Use and interpretation of anthro-
pometric indicators of nutritional status. Bulletin WHO 64:
929941.
Wood JW, Milner GR, Harpending HC, Weiss KM. 1992.
The osteological paradox. Problems of inferring prehis-
toric health from skeletal samples. Curr Anthropol 33:
343370.
Wright D. 1979. Acute sinusitis. In: Ballantyne J, Groves J,
editors. Scott-Brownes diseases of the ear, nose and throat.
London: Butterworths. p 243271.
746 P. BENNIKE ET AL.