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Archaeologists shed light on the treatment of individuals with disabilities in the late Middle Ages

The skeleton of a man with a severe dislocated fracture of the knee, found in a cemetery in Lund, southern Sweden, is helping to unravel the complexities of social attitudes toward individuals with disabilities in the late medieval period. The research combines traditional osteological methods and 3D modeling—a cutting-edge technique for viewing and studying traumatic injury and related skeletal changes—with contextual information from historical texts and digitized excavation records to build a more nuanced understanding of disability and care in the past.

The study, conducted by Blair Nolan of Lund University, Sweden, and colleagues, and in Open Archaeology, is the first to apply this approach to medieval remains in the Nordic region.

The skeleton, referred to as individual 2399, belonged to a man of about 30 years of age who lived in the late Middle Ages (1300–1536 CE). At some point in his twenties, his left femur (thigh bone) was badly broken at the knee joint, leaving him unable to walk unaided until his death. The injury could have been caused by a kick from a horse or a heavy object falling on the knee, such as a stone, while working on a building. For the remainder of his life, he required a mobility aid to get around, such as crutches or a leg stand.

Contextual analysis of his skeleton revealed that the man received considerable short- and long-term care. Following his injury, he was likely given forms of pain relief available at the time, such as ointments made of lavender oil, opium and alcohol, and would have required help to clean and dress the wound. He also required regular treatment for inflammation of the bone marrow—osteomyelitis—which probably included opening the wound to drain the pus.

When the researchers analyzed historical records to deduce the social impacts of individual 2399's disability, they uncovered a very complex picture.

Religious views of physical disability at the time were complicated: It could be considered both a punishment from God and a divine test requiring penance. Nevertheless, the Church promoted and took part in collecting and distributing alms for the disabled, and monasteries were the main providers of institutionalized medical care.

Other cultural attitudes can be deduced from the legal codes of the time. For example, penal punishments could include removal of body parts such as hands, feet, eyes, nose or ears, leading to an association of disability with criminality in some cases. Also, the severity of a disability was defined not just by how much the individual was impaired but also by its visibility. An injury that could be concealed by hair or clothing was considered less severe.

Despite these negative cultural views of disability, individual 2399's social status was still high enough to afford him both long-term medical care and a prominent burial place in the cemetery. Individuals of higher socioeconomic status, such as members of the burgher class, strove to be buried as close to the church as possible, and individual 2399 was buried on top of the foundation stones at the base of a church tower. Thus, his higher social status may have outweighed the fact that he had a disability.

Nolan said, "Deducing social norms regarding physical impairment and disability from religious and legal texts is difficult because it presents an idealized perspective. We can enrich our understanding of disability and identity through detailed osteological and archaeological analysis."