The Bioarchaeology of Structural Violence: A Theoretical Framework for Industrial Era Inequality [1st ed.] 9783030464394, 9783030464400

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Bioarchaeology and Social Theory Series Editor: Debra L. Martin

Lori A. Tremblay Sarah Reedy  Editors

The Bioarchaeology of Structural Violence A Theoretical Framework for Industrial Era Inequality

Bioarchaeology and Social Theory Series Editor Debra L. Martin, Professor of Anthropology, University of Nevada, Las Vegas, NV, USA

More information about this series at http://www.springer.com/series/11976

Lori A. Tremblay • Sarah Reedy Editors

The Bioarchaeology of Structural Violence A Theoretical Framework for Industrial Era Inequality

Editors Lori A. Tremblay School of Liberal Arts and Sciences State University of New York at Delhi Delhi, NY, USA

Sarah Reedy Department of Sociology, Anthropology, and Criminal Justice Quinnipiac University Hamden, CT, USA

ISSN 2567-6776     ISSN 2567-6814 (electronic) Bioarchaeology and Social Theory ISBN 978-3-030-46439-4    ISBN 978-3-030-46440-0 (eBook) https://doi.org/10.1007/978-3-030-46440-0 © Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG. The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

We dedicate this book to Loretta Beddow and Beatrice Tremblay, grandmothers of Lori Tremblay, and Floyd Reedy, grandfather to Sarah Reedy.

Foreword

While health disparities and the ill effects of inequality within and between populations was not invented during the Industrial Revolution, that particular era ushered in many profound and lasting changes that, while modernizing the world, contributed to human suffering and early death in very particular ways. The case studies in this volume demonstrate with empirical data sets derived from bioarchaeological investigations the ways that power structures within political-economic systems created a well-defined underclass that cross-cut age, sex, gender, nationalities, and social status. While this volume could have only focused on the uptick in diseases, disabilities, occupational hazards, and child endangerment, the authors do much more than this. They integrate data from human skeletal collections curated during this era along with archival and historic resources and public documents available for the time. In addition to this, they all relied on theoretical framing that has come to be known as structural violence. Structural violence is nothing more than a series of connected ideas about the ways that violence (writ large) underpins many culturally sanctioned activities that are designed by those in power to subordinate, control, and impair large portions of society in order to create more wealth for some and no wealth for the masses. Structural violence is a powerful tool for social scientists who wish to isolate and identify the underlying factors that are the root causes of human suffering. This suffering results from a system of inequality defined by restricted access to crucial resources such as food, water, shelter, living wages, and health care. When these resources are managed and manipulated by laws, regulations, public policies, and policing, groups without access generally suffer more with a higher morbidity burden and earlier death. Thus, the social forces that control and restrict resources constitute a form of violence against those who have little authority or power to intervene on their own behalf. The violence of these laws and rules governing people’s lives causes as much harm as a lethal blow to the head might, but structural violence is more hidden and shrouded within cultural sanctions, and so in that way, the violence of the system also acts to normalize the harm and violence being done to people.

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The case studies here present a structural violence approach that permits the authors to organize factors of importance moving out from the body (in the form of skeletal remains) to factors within society that impede health, and further out to political-economic policies and rules that formalize (and normalize) situations where people (children, men, and women) are forced to work and live under conditions which are dangerous, harmful, and unhealthy. Further lack of health care means any injury sustained during time spent in factories goes untreated, contributing to an increased morbidity burden and the sequelae associated with ongoing health issues. This approach essentially permits a focus on the deep intersections of bodies and power. The case studies presented here cover an impressive array of topics revealing the ways that both structural and direct physical violence were embedded in everyday life during the industrial era and the ways that historical contingency, political forces, and power shaped and normalized these forms of violence within industrial settings. These studies offer ways of seeing the intersectionality of violence (both structural and direct/physical) with factors such as sex, gender, identity, social class, ethnicity, and poverty. To highlight just one example, Aja Lans focuses her case study on the marginalization of Black women in New York who were systematically targeted as subjects of study for newly developing medical colleges. She expertly utilizes structural violence to show how these women were subjected to cruel treatment in life through medical experimentation, and how their bodies continued to be abused by the medical schools even in death. Furthermore, this one case study raises questions about bioarchaeological research itself as a possible factor in perpetuating a form of structural violence that continues for these women far past their deaths. Here can be seen the power of the use of a theoretical perspective, in this case, structural violence, in upending normal research trajectories in ways that both affirm the roots of suffering, but also question the ethics of doing so at the expense of furthered study of bodies that ended up in medical and museum collections. All of the case studies in this volume detail these kinds of intersectionality and complexities in teasing out how human suffering, illness, disease, and trauma of all kinds become normalized and naturalized within a system that uses power in the form of policies, rules, regulations, and other forms of cultural sanctions to prevent people from living with equal access to all necessary means of survival. This book is the first of its kind to focus in on the structural violence built into urban areas undergoing industrialization and its impact on human well-being. In this sense, it has opened up new avenues of research for bioarchaeologists, and it has reimagined how a focus on skeletal collections can reorient our narratives not only about inequality, but also about the kinds of engaged, ethical, and integrative research that needs to be done in the future. Series Editor, Bioarchaeology and Social Theory University of Nevada, Las Vegas, Las Vegas, NV, USA

Debra L. Martin

Acknowledgments

We want to, first and foremost, acknowledge the authors who contributed their work to this volume. Without their hard work, dedication, and willingness to push the boundaries of our field, this book would not be possible. They graciously tolerated our barrages of emails and met our sometimes very tight deadlines, occasionally on somewhat short notice. To each and every one of you, we give our sincere thanks and gratitude. We also owe a debt of gratitude to a few others without whom this book would not have been possible (and certainly not as good). Primarily, we want to thank Debra Martin for her always phenomenal advice, magical editing skills, and her endless enthusiasm for this volume. She has been a consistent source of support and we truly appreciate her. We also want to thank our colleague(s) who agreed to take on the not-so-small feat of providing anonymous peer reviews for all of the chapters. We would also like to, individually, thank our colleagues and mentors who provided support and encouragement through this process and all that led up to it. Lori Tremblay would like to thank Julie Field, Paul Sciulli, Leigh Oldershaw, Emily Wolfe-Sherrie, Melissa Clark, and Dana Santos. Sarah Reedy would like to thank Brigitte Holt, Laurie Godfrey, Lynnette Sievert, Robert Schwartz, Jackie Urla, Hillary Haldane, and Jaime Ullinger.

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Contents

1 Introduction����������������������������������������������������������������������������������������������    1 Lori A. Tremblay and Sarah Reedy Part I The Structural Violence of Gender Inequality 2 Female Beauty, Bodies, Binding, and the Bioarchaeology of Structural Violence in the Industrial Era Through the Lens of Critical White Feminism ������������������������������������   13 Pamela K. Stone 3 Embodied Discrimination and “Mutilated Historicity”: Archiving Black Women’s Bodies in the Huntington Collection ��������   31 Aja M. Lans 4 Embodying Industrialization: Inequality, Structural Violence, Disease, and Stress in Working-Class and Poor British Women ��������   53 Sarah Mathena-Allen and Molly K. Zuckerman 5 Patriarchy in Industrial Era Europe: Skeletal Evidence of Male Preference During Growth��������������������������������������������������������   81 Sarah Reedy Part II The Structural Violence of Social and Socioeconomic Inequalities 6 The Erie County Poorhouse (1828–1926) as a Heterotopia: A Bioarchaeological Perspective������������������������������������������������������������  111 Jennifer L. Muller, Jennifer F. Byrnes, and David A. Ingleman 7 Norway’s Industrial Beginnings: New Life Challenges, Recurring Poverty, and the Path to Tukthuset, Oslo House of Corrections����������������������������������������������������������������������  139 Gwyn Madden and Rose Drew xi

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8 A New Division of Labor? Understanding Structural Violence Through Occupational Stress: An Examination of Entheseal Patterns and Osteoarthritis in the Hamann–Todd Collection ������������  169 Anna Paraskevi Alioto 9 Products of Industry: Pollution, Health, and England’s Industrial Revolution������������������������������������������������������������������������������  203 Sara A. McGuire 10 Health, Well-being, and Structural Violence After Sociopolitical Revolution ��������������������������������������������������������������  233 Gina Agostini 11 Structural Violence in Antebellum New Orleans: How the Interplay of Socioeconomic Status and Law Impacted the Class Structure of Louisiana’s Port Populations����������  253 Christine L. Halling and Ryan M. Seidemann 12 Conclusion������������������������������������������������������������������������������������������������  277 Sarah Reedy Index������������������������������������������������������������������������������������������������������������������  283

About the Editors and Contributors

Editors Lori A. Tremblay  holds a PhD in Anthropology from The Ohio State University and a master’s degree in English from the University at Albany. Her primary areas of expertise are in human osteology, bioarchaeology, and forensic anthropology. She is an Assistant Professor of Anthropology at the State University of New York at Delhi. Her research interests include social and historical bioarcheology in the United States, structural violence, health and inequality, and the Bioarchaeology of Care. Sarah Reedy  holds a PhD in Anthropology from the University of Massachusetts, Amherst and a master’s degree from the State University of New York, Albany. She is currently a Visiting Assistant Professor of Anthropology at Quinnipiac University. Sarah is a bioarchaeologist who is interested in understanding how stressed environmental conditions, especially those of gender and economic inequality, impact the growth and development of children from the Industrial Era.

Contributors Gina  Agostini  College of Dental Medicine, Arizona Midwestern University, Glendale, AZ, USA Anna Paraskevi Alioto  Western Michigan University, Kalamazoo, MI, USA Jennifer F. Byrnes  Department of Anthropology, University of Nevada, Las Vegas, Las Vegas, NV, USA Rose Drew  Department of Archaeology, University of Winchester, Winchester, UK

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Christine  L.  Halling  Department of Lands & Natural Resources, Louisiana Department of Justice, Baton Rouge, LA, USA David A. Ingleman  Department of Anthropology, University of California Santa Cruz, Santa Cruz, CA, USA Aja M. Lans  Department of Anthropology, Syracuse University, Syracuse, NY, USA Gwyn Madden  Grand Valley State University, Allendale, MI, USA Sarah Mathena-Allen  Department of Anthropology, University of Massachusetts Amherst, Amherst, MA, USA Sara  A.  McGuire  Department of Anthropology, The Ohio State University, Columbus, OH, USA Jennifer L. Muller  Department of Anthropology, Ithaca College, Ithaca, NY, USA Sarah  Reedy  Department of Sociology, Anthropology, and Criminal Justice, Quinnipiac University, Hamden, CT, USA Ryan  M.  Seidemann  Department of Lands & Natural Resources, Louisiana Department of Justice, Baton Rouge, LA, USA Pamela  K.  Stone  School of Critical Social Inquiry, Hampshire College, Amherst, MA, USA Lori  A.  Tremblay  School of Liberal Arts and Sciences, State University of New York at Delhi, Delhi, NY, USA Molly K. Zuckerman  Department of Anthropology and Middle Eastern Cultures, Mississippi State University, Mississippi State, MS, USA

Chapter 1

Introduction Lori A. Tremblay and Sarah Reedy

Human rights violations are not accidents; they are not random in distribution or effect. Rights violations are, rather, symptoms of deeper pathologies of power and are linked intimately to the social conditions that so often determine who will suffer abuse and who will be shielded from harm. ― Paul Farmer (2004b), Pathologies of Power: Health, Human Rights, and the New War on the Poor

The advent of the Industrial Era ushered in a whole new way of life that has shaped the course of human history. It altered how we live, how we work, and how we experience the world around us. In hierarchically organized and stratified societies, such as those in the contemporary Western world, anthropologists and other scholars have argued that the relationship between socioeconomic inequality and differential health outcomes is a form of structural violence (Farmer 2004a). Bioarchaeological research often focuses on the presence and prevalence of physiological stressors, including those that indicate infectious and degenerative diseases, malnutrition, and traumatic experiences. Patterns are then noted for subgroups within the population along the lines of sex, age, and socioeconomic status. While disease and trauma caused by violence has always been noted in studies on past populations, few studies have looked at the ways that violence is interrelated with disease, socioeconomic status, and sex. Studies in violence and how it becomes embodied on the human skeletal remains of past people who were marginalized and targeted by those with the power to do so have played a significant role in the development and growth of our field (e.g., Klaus et al. 2010; Knusel and Smith 2014; Martin et al. 2013; Martin and Harrod 2015; Perez 2012; Robb 2008; Tung 2007; Walker 2001). Agarwal and Glencross

L. A. Tremblay (*) School of Liberal Arts and Sciences, State University of New York at Delhi, Delhi, NY, USA e-mail: [email protected] S. Reedy Department of Sociology, Anthropology, and Criminal Justice, Quinnipiac University, Hamden, CT, USA © Springer Nature Switzerland AG 2020 L. A. Tremblay, S. Reedy (eds.), The Bioarchaeology of Structural Violence, Bioarchaeology and Social Theory, https://doi.org/10.1007/978-3-030-46440-0_1

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(2011) were the first to discuss to the waves of bioarchaeology that demonstrates the growth and evolution of our field. In the 1980s and 1990s, the first wave of bioarchaeology saw the use of hypothesis-driven research that incorporated biocultural models to reveal the biological effects of cultural changes as they can be observed on human skeletal remains. The second wave of bioarchaeology, which began in the 1990s, saw methodological and technological advancements as well as the “critical examination of the nature of the skeletal samples themselves,” (e.g., Wood et  al. 1992) (Agarwal and Glencross 2011, p.2). In the third wave of bioarchaeology, we have seen a movement toward the use social theory to help frame the interpretations in a more richly configured context of factors (e.g., Geller 2017; Nystrom 2014). Many scholars in cultural and medical anthropology use a structural violence framework to explore how social, political, and/or socioeconomic structures and institutions create inequalities resulting in health disparities for the most vulnerable or marginalized segments of contemporary populations (e.g., Farmer 2004a). In this volume, we explore how this theoretical framework could allow researchers to interpret such sociocultural factors through analyzing human skeletal remains of historic populations where additional archival, ethnohistoric, and other documents can be used. Thus, bioarchaeological research combined with the theoretical underpinnings of structural violence poses a promising approach for examining and highlighting how structural violence affected historic populations (Klaus 2013; Nystrom 2014). Human skeletal remains, as the only direct record of the biological experience, serve as the perfect medium through which to examine the biological impact of social processes (Larsen 2015). Therefore, it is a framework bioarchaeologists are now using to examine how social and socioeconomic inequalities put an individual or group at a higher risk for experiencing physiological stressors (e.g., Halling and Seidemann 2017; Klaus 2013; Nystrom 2014). Furthermore, this approach has the potential to allow us to explain and explore the biological impact of intersectional inequalities (e.g., Cho, Crenshaw, and McCall 2013). Using a structural violence framework provides bioarchaeologists with the unique opportunity to delve deeper into the lived experiences of the most marginalized and vulnerable members of society during the Industrial Era, since most written records have largely left them out, diminishing them within their historical context. The use of a structural violence lens thus provides an opportunity for bioarchaeologists whose research focuses on Industrial Era populations to contextualize their work under a single theoretical framework. As the chapters that follow illustrate, this combined approach provides a more in-depth, nuanced understanding of the lived experiences of the people being studied. It also provides a voice to those who were muted in and by history. An additional value of this approach is that it ties the work of bioarchaeologists more closely to the work of cultural and medical anthropologists who often are asking the same questions about violence, health, and social processes.

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Structural Violence Johan Galtung (1969) proposes that structural violence is, essentially, social injustice. He states that it is a result of differential access to, or unequal distribution of, resources including not only food but also medical services and income. Galtung (1969) argues that structural violence is the result of all of the rules, laws, public policies, and political maneuvering that limits access to critical resources to some groups within a society, while others are given access. The enforcement of this through the laws and policies normalizes the inequality so that it appears at first to be a normal part of societal functioning. Once normalized, it is difficult to “see” or measure the violence of these policies as they play out. Physical or direct violence, on the other hand, such as bruises, cuts, gunshot wounds, and other injuries associated with interpersonal fighting can be easily seen (Galtung 1969). However, we can see the results of structural violence in the form of biomarkers of physiological stress. Medical anthropologist and physician Paul Farmer (2004a) argues that structural violence is not only social injustice but also the “social machinery of oppression,” (p.  307). He argues that to use a structural violence framework, anthropologists must incorporate the intersecting aspects of social injustice and oppression that include culture, history, economy, and biology (Farmer 2004a). Thus, using a structural violence lens allows anthropologists to explore and provide a more nuanced understanding of how differential risk for injury, illness, and death is the embodiment of social and socioeconomic inequalities (Tremblay 2017). While Farmer (2004a) uses this framework in a medical anthropological context, it is relevant to, and we would argue, necessary for, bioarchaeological studies of the Industrial Era. Not only does the use of a structural violence theoretical framework provide a deeper, more nuanced understanding of why certain individuals and segments of a given population are at higher risk for experiencing various kinds of physiological stress, but the use of bioarchaeological data provides evidence of the scope and scale of the biological impact of structural violence on those who were oppressed or marginalized in those populations. This is one area in which this volume seeks to expand, and therefore strengthen, the literature on Industrial Era bioarchaeology (Tremblay 2017).

Structural Violence and Bioarchaeology While cultural anthropologists, and more specifically, medical anthropologists, have been using a structural violence framework for over 15 years, its use in bioarchaeology is still relatively new. Klaus (2013) argues that bioarchaeologists should expand their studies of violence to include structural violence because many of the early studies of violence were focused on trauma that resulted from intentional injuries and warfare. These descriptive studies were important to establish the

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methodology for diagnosing direct violence on skeletal remains, and they were important for demonstrating patterning across time and space of direct violence. However, Klaus (2013:32) urges bioarchaeologists to incorporate theoretical framing that would elicit a more nuanced understanding of the “mechanisms and effects” of structural inequalities on those who were members of marginalized and oppressed groups. This integration of cultural and scientific research enables researchers to observe how markers of physiological stress are the result of socially constructed hierarchies of power that constrain or deny access to resources for members of particular groups, and thus the society itself acts as a stressor for those who are socially or socioeconomically marginalized (Schell 1997). The disruptions of homeostasis that result from that differential lack of access to resources can lead to higher risk for nutritional deficiencies, infectious and degenerative diseases, and trauma because individuals and groups of lower socioeconomic and/or lesser social status may have engaged in higher-risk types of labor than those of higher statuses, particularly in the Industrial Era. Klaus (2013) rightly maintains that a structural violence framework is most appropriate for Western capitalist societies due to their specific historical processes. As such, it is well suited to for bioarchaeological research on Industrial Era populations.

The Industrial Era Industrialization is not a simple process or period of time, but rather a complex, multivariate process spanning the seventeenth to twentieth centuries and includes many social and political changes resulting in poor living conditions for the vast majority of populations.This period is often credited as a time of development, innovation, and economic growth, but also vast urbanization, pollution, hard labor, distinct social classes, poor nutrition, and rampant infectious diseases (Thompson 1963; Hobbs et al. 1999; Cardoso and Garcia 2009; DeWitte et al. 2015; Leatherman and Jernigan 2015; Hughes-Morey 2016). It is under these conditions that structural violence is evident through immense inequality among the most marginalized within populations. Many cities experienced rapid urbanization that infrastructure, political structures, agriculture, and medicine could not keep up with. Most of the lower classes lived in overcrowded and poor conditions and dealt with rising costs and declining wages, pollution, malnutrition, poor sanitation, and lack of health care (Thompson 1963; Webster 1975; Szreter 1988, 2004; Hobbs et al. 1999; More 2000; Johnson 2006; Cardoso and Garcia 2009). Their experiences are often neglected in written history furthering the violence inflicted upon them.

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Structural Violence for Industrial Era Bioarchaeology Bioarchaeological research on Industrial Era populations has been primarily concerned with the examination of the patterns and trends of the evidence of disease and trauma, but there has not been, to date, any single, overarching theoretical framework used to contextualize those bioarchaeological analyses that have been conducted for those populations who were living during this time of rapid urbanization and technological expansion (Tremblay 2017). A structural violence framework functions as an explanatory framework that has the potential to provide a deeper, more nuanced understanding of lived experiences of marginalized and oppressed groups and the biological impact of structural violence during the Industrial Era.

Case Studies Pamela Stone, in Chap. 2, provides a thought-provoking and engaging discussion of how structural violence can be seen in the social control of women that shaped their bodies for the benefit of the male gaze during the Victorian Era. She explores how normalization of a specific beauty standard that was met via corseting resulted in deformation of the female body. Stone notes that this sort of violence, in the form of deformation of the female body, is not always readily visible in the skeletal remains, but it is one that likely resulted in experiencing nearly lifelong chronic physiological stressors. She further argues that understanding this practice as a form of structural violence allows us to better understand the intersectional forces that shaped the ideal female body in both the cultural and scientific realms of the day. In Chap. 3, Aja Lans delivers a powerful exploration of the impact of structural violence on the lives and bodies of black women in New York in the late nineteenth and early twentieth centuries. She provides a thorough description of the history of how black women were marginalized and turned into subjects of study for medical colleges. Lans then takes us on a compelling and heartbreaking narrative journey through which she explores the lived experiences of three women who were subjected to structural violence both in life and in death and reflects on how we, as researchers, should rightly consider how our research may or may not contribute to a continuation of that violence. Sarah Mathena-Allen and Molly Zuckerman, in Chap. 4, delve into the biological impact of structural violence on working class women in the United Kingdom during the Industrial Era using a life course approach. They do so by examining markers of physiological stress in females from childhood and later in life both in and outside of London while addressing the contributions of public health initiatives and health-care institutions in maintaining structural violence. Mathena-Allen and Zuckerman explain that by centering the narratives on the lived experiences of those who were marginalized via the confluence of using skeletal markers, historical, and

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politico-economic data, we can better understand the ways in which structural violence had a biological impact on poor and working class women in Industrial Era England. In Chap. 5, Sarah Reedy examines the biological impact of structural violence on children in three major European cities during Industrial Era. She finds that while all children were affected, those of lower socioeconomic status suffered more from structural violence as they did not have the financial and social buffering of their  counterparts of middle and higher socioeconomic status. Like Lans and Mathena-Allen and Zuckerman, Reedy found that females exhibited more signs of physiological stress. Particularly, she found that the social preference for males subjected the female children to unequal access to the resources necessary for healthy growth and development. Jennifer Muller, Jennifer Byrnes, and David Ingelman, in Chap. 6, explore the poorhouse as a heterotopia. The focus of their compelling diachronic analysis is the Erie County Poorhouse in upstate New York, which served as a both heterotopia of deviance and a heterotopia of crisis. Muller et al. explore how identity and classification affected an individual’s risk for being subjected to structural violence in this sort of Institution of Care. To illustrate this, they provide detailed context of six individuals who resided at the Erie County Poorhouse as well as larger, population-­ level data on the presence and prevalence of physiological stress markers. Muller et al., in this exciting chapter, demonstrate the complexity and intersectionality of social identities and how those identities put individuals in need of services from these Institutions of Care while simultaneously subjecting them to structural violence as a result of that care. In Chap. 7, Gwyn Madden and Rose Drew similarly examine the structural violence associated with inhabitants of a workhouse, another form of an Institution of Care, in Oslo, Norway. This workhouse was the destination of the poor, the vagrant, and older people who did not have any other means of support. Madden and Drew found evidence of syphilis and tuberculosis as well as trauma. While a number of these individuals exhibited trauma, the skeletal evidence shows they received care for that trauma. While they may have received care in life, in death these already marginalized people were subjected to more structural violence in the form of dissection. Anna Alioto, in Chap. 8, explores how we can see structural violence via the analysis of entheses and osteoarthritis in early twentieth-century Cleveland, Ohio. She finds that the physical and occupational stress that resulted in the presence and prevalence of osteoarthritis and entheseal changes are indicative of structural violence in those of lower class status in the industrial area of northeastern Ohio. Alioto notes that this type of analysis, while compelling, is limited. Yet this type of analysis is an important contribution to our understanding how we can see the physical embodiment of structural violence on human skeletal remains. In Chap. 9, Sara McGuire discusses the potential impact of exposure to pollutants on health outcomes as a form of structural violence during Industrial Era England. She notes that agency in relation to pollution exposure is shaped by social identity and socioeconomic status. McGuires find that sex, as one aspect of identity,

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did affect age at death. However, she also found that our previously held notions that urban living had deleterious effects on overall health does not hold true in terms of stature. McGuire’s work in this volume is the start of a much larger, and exciting, exploration of the biological impact of pollution on health in the Industrial Era. Gina Agostini, in Chap. 10, discusses the impact of structural violence on working and lower class in the Estado Novo in Portugal. Like Alioto, she explores how industrialization and social change had an impact on physical workload and finds evidence that those in the working and lower classes in Lisbon suffered from higher workloads than their counterparts in other parts of Europe. This engaging work demonstrates the need for the synthesis of skeletal data with historical records to obtain a clearer, more nuanced understanding of the impact of social and political change on those who did not financially benefit from those changes. In Chap. 11, Christine Halling and Ryan Seidemann examine the impact and presence of structural violence in antebellum New Orleans. They find that contrary to the idea that the Spanish and French were more egalitarian than the Americans who later controlled the city, the legal and social structures oppressed and caused harm to immigrants and people of color via unsafe and unsanitary environments as well as processes of exclusion before and during the Industrial Era in the American south. Halling and Seidemann find that the impact of the structural violence against those who were marginalized is evident in the trauma and pathological lesions observed on the human skeletal remains from two cemeteries that represent a cross section of this growing city.

Conclusion Using a structural violence framework for bioarchaeological research of the Industrial Era has been demonstrated by these case studies to be a useful approach in seeing the larger picture of industrialization, sociopolitical processes, and the origins of deep inequalities that adversely affected millions of people. Through oppression, marginalization, public policies, and the normalization of dangerous conditions in factories, people suffered. While we see these processes continue to play out across the world today, understanding the beginnings of industrialization and its effects on human health and well-being highlights where possibilities for resistance, agency, prevention, and change might best be implemented. It also provides a longer time line for understanding the origins and evolution of industrialization into the present. The critical perspectives honed in these chapters have relevance to the work of medical anthropologists who attempt to place health and health care within broad cross-cultural perspectives, as well as with anthropologists who hope to clarify the embedded and underlying social processes that produce and reproduce inequalities. Our hope is that these case studies lead us one step closer to eradicating inequality and social injustices.

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References Agarwal, S., & Glencross, B.  A. (2011). Building a social bioarchaeology. In S.  Agarwal & B. Glencross (Eds.), Social bioarchaeology. West Sussex: Blackwell. Cardoso, H., & Garcia, S. (2009). The not-so-dark ages: Ecology for human growth in medieval and early twentieth century Portugal as inferred from skeletal growth profiles. American Journal of Physical Anthropology, 138, 136–147. Cho, S., Cresnshaw, K.  W., & McCall, L. (2013). Toward a field of intersectionality studies: Theory, applications, and Praxis. Signs, 38(4), 785–810. DeWitte, S., Hughes-Morey, G., Bekvalac, J., & Karsten, J. (2015). Wealth, health, and frailty in industrial-era London. Annals of Human Biology. https://doi.org/10.3109/03014460. 2015.1020873. Farmer, P. (2004a). An anthropology of structural violence. Current Anthropology, 45(3), 305–325. Farmer, P. (2004b). Pathologies of power: Health, human rights, and the new war on the poor. Berkeley: University of California Press. Galtung, J. (1969). Violence, peace, and peace research. Journal of Peace Research, 6(3), 167–191. Geller, P. L. (2017). The Bioarchaeology of Socio-Sexual Lives. Cham: Springer. Halling, C., & Seidemann, R. (2017). Structural violence in New Orleans: Skeletal evidence from Charity Hospital’s Cemeteries, 1847–1929. In K.  C. Nystrom (Ed.), The Bioarchaeology of dissection and autopsy in the United States. Cham: Springer. Hobbs, S., McKechnie, T., & Lavalette, M. (1999). Child labor: A world history companion. Santa Barbara: ABC-CLIO. Hughes-Morey, G. (2016). Interpreting adult stature in Industrial London. American Journal of Physical Anthropology, 159, 126–134. Johnson, S. (2006). The ghost map: The story of London’s most terrifying epidemic and how it changed science, cities, and the modern world. New York: Riverhead Books. Klaus, H. (2013). The Bioarchaeology of structural violence: A theoretical model and case study. In D.  Martin, R.  Harrod, & V.  Perez (Eds.), The Bioarchaeology of violence. Gainesville: University of Florida Press. Klaus, H., Centurion, J., & Curo, M. (2010). Bioarchaeology of human sacrifice: violence, identity and the evolution of ritual killing at Cerro Cerrillos, Peru. Antiquity, 324(86), 1102–1122. Knusel, C., & Smith, M.  J. (Eds.). (2014). The Routledge handbook of the Bioarchaeology of human conflict. Abingdon: Routledge. Larsen, C. S. (2015). Bioarchaeology: Interpreting behavior from the human skeleton (2nd ed.). New York: Cambridge University Press. Leatherman, T., & Jernigan, K. (2015). Introduction: Biocultural contributions to the study of health disparities. Annals of anthropological practice, 38(2), 171–186. ISSN: 2153-957X. Martin, D. L., & Harrod, R. P. (2015). Bioarchaeological contributions to the study of violence. Yearbook of Physical Anthropology, 156(59), 116–145. Martin, D., Harrod, R., & Perez, V. (2013). The Bioarchaeology of violence. Gainesville: University Press of Florida. More, C. (2000). Understanding the industrial revolution. London, New York: Routledge. Nystrom, K. (2014). The Bioarchaeology of structural violence and dissection in the 19th-century United States. American Anthropologist, 116(4), 765–779. Perez, V. R. (2012). The politicization of the dead: Violence as performance, politics as usual. In D. L. Martin, R. P. Harrod, & V. Perez (Eds.), The Bioarchaeology of violence. Gainesville: University of Florida Press. Robb, J. (2008). Meaningless violence and the lived Body: The Huron-Jesuit collection of world orders. In D.  Boric & J.  Robb (Eds.), Past bodies: Body-centered research in archaeology. Oxford: Oxbow Books. Schell, L. (1997). Culture as a stressor: A revised model of biocultural interaction. American Journal of Physical Anthropology, 102(1), 67–77.

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Szreter, S. (1988). The importance of social intervention in Britain’s mortality decline c. 1850–1914: A re-interpretation of the role of public health. Social History of Medicine, 1, 1–37. Szreter, S. (2004). Industrialization and health. British Medical Bulletin, 69, 75–86. Thompson, E. P. (1963). Making of the english working class. New York: Pantheon Books. Tremblay, L. A. (2017). The impact of structural violence in the industrial era: A Bioarchaeological analysis of institutionalized and impoverished populations in the United States. PhD dissertation, The Ohio State University. Tung, T. (2007). Trauma and violence in the Wari empire of the Peruvian Andes: warfare, raids, and ritual fights. American Journal of Physical Anthropology, 33, 941–956. Walker, P. L. (2001). A bioarchaeological perspective on the history of violence. Annual Review of Anthropology, 30, 573–596. Webster, R.  A. (1975). Industrial Imperialism in Italy 1908–1915. Berkeley: University of California Press. Wood, J. W., Milner, G. R., Harpending, H. C., & Weiss, K. M. (1992). The Osteological paradox: Problems of inferring health from skeletal samples. Current Anthropology, 33(4), 343–370.

Part I

The Structural Violence of Gender Inequality

Chapter 2

Female Beauty, Bodies, Binding, and the Bioarchaeology of Structural Violence in the Industrial Era Through the Lens of Critical White Feminism Pamela K. Stone

Introduction The female body is often a site of complex interactions between social and political expectations and controls. Across time and cultures, female bodies have been subjected to the male gaze and have been modified and guided to conform to masculist ideologies (Dowson 2006). Beauty expectations and practices that bind the body, while culturally diverse, are often set to serve male expectations and are understood as socially important to the success of the individual and family. Many practices, such as foot-binding for the Chinese, neck rings for the Kayan, and tight-lacing of corsets for the Europeans, are all examples of the ways in which the female body can be controlled through direct forms of binding which ultimately disable the individual (Stone 2012, in press). Within these frameworks of control, females are immobilized and rendered unable to perform daily activities and tasks. This disabling of females serves to underscore cultural practices that create a weak and fragile female, without considering how binding serves to compromise health and agency in the performance of gendered expectations. This chapter focuses on the practice of tight-lacing corsets during the Victorian era, which coincides with dramatic political, economic, social shifts in industry, codes of morality, and colonial science and enterprise in Victorian England. Specifically, I consider here the ways in which this hegemonic cultural practice in which females perform to meet the moral expectations of civility and social standing required white, middle- and upper-class females to bind their bodies with corsets from very young ages. The tight-laced corseted female body reinforced social ideals of a white, civilized, feminine body which both produced and supported a biologically deterministic construction of the “normal” female body. P. K. Stone (*) School of Critical Social Inquiry, Hampshire College, Amherst, MA, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 L. A. Tremblay, S. Reedy (eds.), The Bioarchaeology of Structural Violence, Bioarchaeology and Social Theory, https://doi.org/10.1007/978-3-030-46440-0_2

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By examining the ways in which the white, bound, Victorian female body becomes a site of social and political engagement requires the examination of historically contingent and direct forms of control and body policing, in conjunction with the long-term consequences of these activities. When read properly, the structural violence embedded in expected social performance by females can be seen to underscore inequalities across gender, race, and class. Supported by social ideals and dress codes, these narratives further the subordination of females and are directly tied to race science and correlated to the legacy of female subordination in bioarchaeological analyses in the past and today. Until recently, modalities of control over females have lacked interrogation. By engaging in social theory through an analysis of the structural violence embodied in the performance of beauty, new ways to consider how to read chronic health issues as related to violence can be undertaken. By weaving together historic contexts, ethnology, health stressors, and skeletal markers of deformation, through the lens of the tight-laced corset which “binds females” and shapes their bodies to fit social standards, systemic structural violence is revealed. Further, exploring the impact of the chronic health issues illuminated by tight-lacing uncovers the ways in which these practices have reinforced a dominant white narrative, privileges white female bodies over all others, and continues to impact bioarchaeological interpretations of females in the past. Finally, I engage a critical white feminist lens1 to reveal how female bodies have been (and continue to be) shackled by a colonial white praxis that values white, middle- and upper-class female bodies while devaluing all others, a practice bound to the Victorian era but consistently reproduced into the present.

Corsets and Body Modifications Corset use and its role in shaping the female body to fit cultural assumptions of beauty and worth reflects the ways in which identities become intimately tied to the social and political frameworks that culture dictates (Knudson and Stojanowski 2008). There are many examples of body modifications that range from permanently changing body structures to being reversible. Only some are clearly visible in the skeletal record such as cranial deformations and tooth filing, while others that may dramatically change the body in life leave no direct trace in death such as tattoos and piercings. Nonetheless these modifications reflect the embodiment of social identity, cultural beliefs, social dynamics and boundaries, and political conformity or deviance (Reischer and Koo 2004). In the cases of deformations that are ascribed to females, they are usually performed by mothers to their daughters, shaping the individual body to appeal to the males in the social framework (Stone, in press). Many of these practices are embedded in structural violence as they are “exerted systematically, that is, indirectly by

 Caroline McFadden (2011, 2017) coined the term critical white feminism.

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everyone who belongs to a certain social order” (Farmer 2004, p. 307). Today structural violence is evidenced in oppression, health inequalities, and other invisible ways in which populations are disempowered through political and cultural frameworks; in the past these same issues are harder to read.

Structural Violence As I have discussed elsewhere (Stone 2012, in press), it is useful to understand how structural violence provides a heuristic framework in which to clarify the relationships between forms of violence and the social process and structures in the examination and interpretation of human interactions and behaviors from the past. To do this requires us to define what we mean by violence and how the body is implicated in its’ performance. Galtung (2002) offers a framework to examine structural violence in his “triangle of violence,” in which human action is examined through the invisible lenses of cultural and structural violence and is interpreted through the direct violence in visible, physical manifestations on the body. He argues that there are root forces (behaviors, attitudes, conditions) that shape the actions of the individual or the social group and that these actions are often in response to the threat or the actual occurrence of direct violence, which reinforces the cultural and structural violence. By placing the female body within these frameworks, we can begin to assess the impact of violence – interpersonal, social, and political. The body can also be assessed within another triangle coined by Scheper-Hughes and Lock (1987) as the “three bodies.” Here the body is intersectionally performing within personal frameworks (the individual body), and as a social body, and as a body politic. In unpacking Scheper-Hughes and Lock’s framing, the individual body reflects the lived experiences, which are often shaped by both the social body defined as “a natural symbol with which to think about nature, society, and culture” and juxtaposed against the body politic, in which the “regulation, surveillance, and control of bodies (individual and collective)” (Scheper-Hughes and Lock 1987, p. 7 & 8). When we consider the bound female body and the personal, social, and political motivation in the Victorian era, we see a body that is controlled, shaped, and surveilled in its performance of structural expectations. Layering Scheper-Hughes and Lock’s three bodies with Galtung’s violence triangle (Fig.  2.1), it becomes clear how external actions can be performed on, or understood through the performance of, the body woven inside the triangle of violence. In addition, if we consider Whitehead’s (2004) “poetics of violence” in our analysis of violence within the context of a culture’s history and norms to understand the meanings behind violence, we begin to understand how participation contributes to the formation, or confirmation, of the social identity of individuals and communities, in this case the appropriate white female. Thus, in understanding violence in the past, we need to remember that presence of direct, visible violence on the body, while important in the analysis, is only one part of the transcript of violence that impacts individuals and communities through time and across the globe.

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Fig. 2.1  Triangle of violence, defining and framing violence and the female body

My analysis of tight-lacing intertwines these social theories to contextualize how the hard to read lessons of corset use need to be considered within larger contexts. By not engaging in how the individual, social, and political roles of body modification, when they leave little direct evidence on the skeleton, is to miss the ways in which lived experience shapes, and is shaped by, structural violence. This complex relationship between the performance of social expectations and body modifications needs to be considered so that we don’t miss the larger social dynamics that influence the role and agency of the individual, or the social group, within the particular culture being examined. This is especially important as current assessments of gender and race are predicated on the construction of these Victorian norms. Recognizing that the normal white female body as a construction of Victorian norms is to recognize the deeply embedded structural violence that shapes how we read bodies and has deep implications for understanding binary frameworks of gender and the intersections of race science and white supremist framing of normal bodies, all of which inform current bioarchaeological analyses.

Indirect Violence and Bioarchaeological Interpretations Interpretations of indirect violence are complicated within the analysis of the bioarchaeological record as it is hard to see particularly when there is an absence of cultural artifacts, written records, and ethnographic analogies. Thus, the analysis of structural violence can be hindered, as it is often invisible or attributed to other issues of disparities, which are most often ascribed to women and children. But there are markers that when assessed together can begin to shed light on these larger frameworks. The opportunity to combine archaeological analysis and

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interpretations with the transcript of life as embedded on the physical remains can offer new lines of inquiry and models to think about the body and its relationship to the cultural structures that the individual lived within. Traditionally, the bioarchaeologist has looked for evidence of direct forms of violence, which tended to be limited to visually assessable markers on the skeleton, for example, healed defensive fracturing (Walker 1989; Frayer and Martin 2014), cut marks (Lewis 2008; Perez et al. 2008), blunt force trauma (Standen and Arriaza 2000; Martin 2012), and in some cases burial positions (Martin 1997). These markers have most often been analyzed within strictly defined parameters: first, conflict between groups for resources (e.g., war, raiding) and, second, through narrowly defined gendered roles, placing men as the perpetrators of violent acts and making women the victims (or in some cases the benefactors) of male actions. But these analyses were often taken out of context or were done with limited context. Today, more complex interpretations of direct violence are beginning to emerge, suggesting that conflict is more complicated and governed by other cultural structures and that women are as likely as men to perpetrate violent acts to keep the cultural systems in place (Martin et al. 1995; Martin 1997; Stone 2001, 2018). These new interpretations are starting to make visible the cultural and structural violence that underlies long-term chronic stressors that may appear alongside direct markers of physical violence or may be seen without these direct markers. For females, we can begin to see how higher rates of morbidity and early death may have more complex interpretations than we often ascribe. At the center of this work is understanding how new interpretations are being made within bioarchaeological analyses of power structures that may underlie markers of direct violence or may be invisible without a more in-depth framing of cultural systems. Another goal is to offer a new way to think about females in the past, to give them agency as well as to explore how agency can support structures that continue to disempower females, and to think about why females of reproductive age are more likely to have higher rates of morbidity and mortality than their male counterparts beyond the assumptions that reproduction is the sole issue. Corset use, specifically tight-lacing, is a form of body modification but also body mutilation that was developed to communicate a specific narrative about social standing and beauty expectations. Evaluating tight-lacing for its individual physical impact, as well as its social and political positioning in Victorian culture, can offer new ways to think about how the body can be literally shaped and subsequently compromised physically in response to cultural systems of control. Practices that immobilize the female body and create higher risks of long-term ill health, which may leave direct markers on the skeleton, are often not interpreted as markers of cultural violence for females in the past. The lack of direct skeletal evidence for cultural practices such as binding, which may be invisible or hard to interpret in the archaeological record, may hinder our understanding of the past. There are other ways to consider chronic health stressor and the role that long-term cultural violence may have in these conditions, for the tight-laced female documentation, commentaries, and social discourse all help to unpack how the Victorian female body was read and can inform us about how we read the female body today.

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 inding the Female Body: Chronic Stress B and Structural Violence Invisible aspects of cultural violence and behavior can result in chronic stressors and modes of control that can be seen in direct relationship to many practices of body deformation. While these practices regularly occur over culturally long periods of time, they are seldom included in the suite of bioarchaeological indicators of violence or discussed as part of the subordination of females in the distant past as well as into the present. This absence is due in part because these markers are generally invisible or not interpreted as signifiers of violence in the archaeological record, and yet it is these interrelationships that bioarchaeological analyses need to focus on as modifications of the body reflect larger social meanings and political structures (Geller 2006). Tight-lacing, as a method of body modification, reflects larger social meanings and reveals socially constructed frameworks of identity and behavior for white females in the past.

Tight-Lacing Corsets in one form or another have been part of European culture for centuries, but the Victorian era marked a dramatic change in the styles and the ubiquitous use of the garment for all classes of white females (Steele 2003) as well as the introduction of tight-lacing. For the proper, middle- and upper-class female, fashion dictated that tight-lacing be the goal of the wearer “training” the waist to be as small as possible (Fig. 2.2). This new model of tightly binding the body brought on a set of debilitating physical consequences that were joined with social discourses on the proper, fragile, white female.

Biological Consequences A proper fitting, or tight-laced, corset targets the waist. When the corset is contracted and tight-laced, the internal organs are displaced, shifting up into the thorax or down into the pelvic girdle. In either direction, pressures are exerted on lungs or in the bowels and bladder (Fig. 2.3). The lower, or floating, ribs are also squeezed in and up, shifting at the vertebral articulation. The direct consequences of the pressure are shortness of breath (as the lungs lack their full capacity), obstructed bowels, incontinence, and prolapsed uterus (Crutchfield 1897; Kunzle 2006). The long-term effects of wearing a corset from childhood, for many, may have also resulted in deformation of the pelvic architecture and a reduction in overall mobility for the wearer. In addition, during childbirth, the early and long-term use of the corset coupled with other health factors most likely added to complicated and obstructed

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Fig. 2.2  Waist by tight-lacing (1898)

labors, resulting in higher risk for morbidity and early mortality in childbirth (Stone 2009) (Fig. 2.4a and b). It does, however, offer a nice small waist (Fig. 2.5). Corset use and tight-lacing coincide with the rise of the Industrial Revolution, which sees a dramatic increase in pollution. It is well documented that Victorian era children from all classes were suffering from record-high levels of chronic childhood rickets as a consequence of both the darkening skies attributed to the increase in pollution, which resulted in a decrease in sun exposure, and subsequently a lack of vitamin D. In addition, the rates of poverty placed many poor children at risk for undernutrition. For those in the upper classes, Victorian moral codes not only required girls to keep out of the sun but to also stay thin and fragile (Stacey 2002) – which also resulted in lack of sun exposure and undernourishment. No matter the social class, children’s growth and development was dramatically compromised during this period, and the risk of childhood rickets was at epidemic levels during this era. The addition of corset use, which began for Victorian era girls around age nine facilitated by their mothers (Stone, in press), alongside this confluence of health factors, had a lasting effect on the shape of the pelvic girdle. The pelvic bones, softened by rickets, overreacted to the pressures exerted by the corset, garments, and the weight of the upper body all resulting in a frontal pull of muscles and tendons producing a flattening of the pelvis from front to back (Ortner and Putschar 1981; Roberts and Manchester 1997; Loudon 1997). Tight-lacing capitalized on this

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Fig. 2.3  Impact of tight-lacing on the internal organs (Gibson 1903:107, Library of Congress, http://www.loc.gov/pictures/item/2002716762/)

pliability, which resulted in added pressures on the pelvis at these points resulting in a waist that could become smaller than ever before (Fig.  2.4). This tiny waist is reminiscent of the scene in the movie Gone with the Wind as Scarlet O’Hara tried to make her waist measure only 18 inches, despite a recent pregnancy. For girls living in this era, both medical notes and personal letters reveal a female’s waist could be as small as the circumference of the thumbs and forefingers, or about 14 inches (Fig. 2.5) (Barry 1870; Kunzle 2006). The confluence of biological indicator (high incidences of rickets, poor nutrition, and pressures on the internal organs, pelvis, and ribs) and social performance (corset use starting at a very early age, tight-lacing, and adherence to the Victorian moral codes) clearly explains the increase in morbidity and mortality across class, and particularly for the elite, for nineteenth-century females (Loudon 1997; Stone 2009). But, our research into the direct consequences left on the body is limited by a lack of direct examples of skeletal markers of corset use, as access to white, female bodies from the Victorian era is highly limited. White females from middle and upper social classes are highly protected as a result of the social frameworks of the Victorian era and interments in churchyards. Instead, bodies that can be studied from this era are often lower class, not white, or otherwise from marginalized groups.

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Fig. 2.4 (a) Un-corseted skeleton (b) Impact of tight-lacing on the skeleton (ribs and pelvis)

Some current research has tried to explore the markers of corset use (Gibson 2015) yet has neglected to consider the racist frameworks of the era, the structural violence of social performance, as well as the role of scientists and museum curators in creating the imagery of the corseted body through their own renderings of skeletal bodies. Female bodies on display, or available for study, are often not white and even more often do not reflect the elite class. While others have examined the literal size of corsets if tightly laced to show that upper- and middle-class white female bodies were in fact bound by dress to such a level that it impacted their fertility as well as morbidity and mortality (Davies 1982; Richardson and Kroeber 1940); all in the performance of gender expectations. While the direct research on Victorian era corseted skeletal bodies is thin, we do know from other sources (vital statistics on health and economics, personal narratives, medical discussions)2 that the practice of tight-lacing resulted in physical consequences that most likely had morbid impacts. In this juxtaposition of fashion and codes of behavior alongside of the documented physical consequences, we can

 Different resources can be used to access nineteenth-century discourses and discussions on corset use. A few examples of these resources include the following: For vital statistics, Loudon (1997) and McNay et al. (2005) both utilize direct data from the British townships and government agencies; personal narratives can be found in many of the British society publications, for example, the Englishwoman’s Domestic Magazine (Lord, 1868); and medical discussions can be accessed through many old medical texts, for example, Comstock (1848), and which are now very accessible online. 2

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Fig. 2.5  Wasp-waist, less than 14-inch waist by tight lacing (1890)

unravel the constructed narrative of the weakened white female. Her physical state brought on by adherence to social status scripts, middle- and upper-class white females, as fragile and pathologized, becomes the representative “normal” female body, a body unable to participate, which is privileged over all others.

 ineteenth-Century Construction of the Normal, Fragile, N White Female Beyond the Victorian era codes of dress and morality, the construction of the normal white female human body was also girded by the developing discourse in the science of human difference. The nineteenth century’s focus on social characteristics as having deeply rooted biological basis (Smith-Rosenberg and Rosenberg 1999) meant that physicians and scientists saw females as both the product and prisoner of their reproductive systems (Smith-Rosenberg and Rosenberg 1999). The ontological status and the interpretability of biological differences as assessed by the Victorian scientists supported their efforts to maintain the social order in a new era of industry and control of populations (Foucault 1990). This framing placed white female bodies within a political field of power and privilege, as well as being seen

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as normal and expected, and the performance of these expectations was upheld by mothers, assuring daughters’ adherence to civilized fashion and behaviors. Deviance from this constructed normal behavior resulted in non-white female bodies becoming sites of analysis and inquiry while also serving to protect the normal, white female body from study. For nineteenth-century men of science, this gave them access to the globe as their laboratory. The essentialized and civilized white European-born scientist of the nineteenth century saw all non-white people as specimens of which they could study and order difference. For science the display of the sexualized black female was designed as a way to distinguish the primitive from the civilized (white female). …the black occupied the antithetical position to the white on the scale of humanity. This polygenetic view was applied to all aspects of mankind, including sexuality and beauty. The antithesis of European sexual mores and beauty is embodied in the black, and the essential black, the lowest rung on the great chain of being, is the Hottentot. The physical appearance of the Hottentot is, indeed, the central nineteenth-century icon for sexual difference between the European and the black.… (Gilman 1985, p. 212)

The story of Saartjie Baartman,3 a young woman taken from Cape Colony in South Africa in the early nineteenth century who was exhibited and subsequently autopsied, reflects how science used black bodies to cement assumptions of “biological” difference as deviance. This Victorian picture of human difference was fueled by the Bible, imperialism, economics, and a desire to elevate white humans as superior and apart from everyone else; the result was that certain bodies became valued over others. Evolutionary explanations supported these ideas of difference in the nineteenth century. Finding their foundation with the framings of the eighteenth-century ranking of races as part of the “great chain of being” as Lewin notes “…with blacks on the bottom and whites on the top… [was seen as] the natural order of things: before 1859 as the product of God’s creation, and after 1859 as the product of natural selection” (1989, p.3). For sex differences, it was further proposed “…that differences between male and female bodies were so vast that women’s development had been arrested at a lower stage of evolution” (Schiebinger 1986, p.63). This neotenic idea of females was supported by their generally smaller stature, and smaller and more gracile crania, ribs and feet, and mandibles, and the fact that females generally stopped growing by age 14 (Schiebinger 1986). The scientific logic was that since females were physically more childlike, their behaviors and intellects were childlike as well (Schiebinger 1986). Medicine viewed the female body as unequal to their male counterparts. Biology was seen as absolute and inescapable, and the medical story was clear: differences were “…designed by nature as a necessary basis to ensure the social order between men, women, and the family” (Pockles as cited by Schiebinger 1986, p.69). A framing that fit nicely into the social area of the Victorian era. With science proving that “natural inequalities” existed (Schiebinger 1993), it

3  Saartjie Baartman, also called Sarah Bartmann or Saat-Jeet and known as the “Hottentot Venus” (Gilman, 1985, p. 213)

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also supported the contentions that “…white women ranked below European men in scales of both ontogeny and phylogeny” (Schiebinger 1986, p.63). While all women were less than white men, it followed that white females were still evolutionary superior to all other non-white identified females who ranked further down the evolutionary chain. Today these assessments are troubling because they have become embedded in the interpretations about female bodies in the past. As a result, the normal, universal female body is labeled as childlike, weak, fragile, and white.

Science and the Normal White Female The framing of the “normal white female” finds its roots in the developing evolutionary thought, science, and Victorian social codes of the nineteenth century. The focus on difference, the Great Chain of Being, and the search to solidify polygenetic origins become intertwined with medical assessments and skeletal analyses. The Victorian era is pivotal in its role in shaping how science, and subsequently anthropological studies, framed the concept of the “normal body” and continues to use this framing without interrogation. What we call the “normal body” is a product of the social system constructing it – a white male system that saw the rest of the world less significant – engaging in not only ethnocentrism but in chronocentrism; this is the platform that all bodies are measured today. By failing to recognize the way in which nineteenth-century colonial science has shaped our understanding of the human experience is to reproduce the same flaws and miss the complexity of being human. The narrative of the weak and fragile female is deeply rooted in the Victorian era’s social controls, colonial practices, and in the development of race science. The “normal white female body” is predicated on the structural violence fundamental to the mandatory cultural performance of beauty for the economically secure and obviously white female, without consideration of the resilient unbound female body in all other contexts. The constructed “normal female” is assumed to be “civilized” and “evolved” which are culturally contingent biologically deterministic racist and sexist scaffolds. In addition, these discourses suggested that females were biologically childlike, weak, and pathologized by their positioning, without considering the social expectations that created and reinforced these behaviors and biological experiences. As white anthropologists and feminists, we need to consider how this narrative persists and has served to devalue the non-white female body. We need to bring forward the participation of white females (and males) in upholding Victorian beauty standards that supported a system of structural violence that girds current norms. In doing this we also need to unravel the deeply seeded colonial, white, chronocentrism of the nineteenth century and engage with a critical white feminist lens that is reflexive and recognizes the complexity of historic narratives of direct and indirect cultural violence and the influences over how females have been, and continue to be, assessed.

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 ritical White Feminism, Structural Violence, C and Bound Bodies That man over there says that women need to be helped into carriages and lifted over ditches, and to have the best place everywhere. Nobody ever helps me into carriages, or over mud-puddles, or gives me any best place! And ain’t I a woman? Look at me! Look at my arm! I could have ploughed and planted, and gathered into barns, and no man could head me! And ain’t I a woman? I could work as much and eat as much as a man—when I could get it—and bear the lash as well! And ain’t I a woman? I have borne thirteen children, and seen them most all sold off to slavery, and when I cried out with my mother’s grief, none but Jesus heard me! And ain’t I a woman? Sojourner Truth, “Ain’t I a Woman?” 1851 Women’s Convention, Akron, Ohio

A critical white feminist lens is broadly defined as “an antiracist transformation of white feminist theory [to be used] to expand the scope of feminist thought to critically consider whiteness and its privileges by blending aspects of critical white studies and feminist theory to examine power relationships through and intersectional lens” (Mcfadden 2017, p.  244). As white anthropologists and feminists explore the power relationships of the Victorian era, to uncover the ways in which science, social performance, class, and identity intersect to construct the “normal white” female body is to engage a critical white feminist lens that also employs a structural violence framework. The very act of examining Victorian era norms is a form of structural violence. But research such as this shines a light on racist and privileged frameworks and offers an opportunity to rethink how bodies have become defined as normal or deviant and how these determinations have been accepted without questioning. By not questioning the role of the cultural performance of gender against the backdrop of race means that we reproduce antiquated ideas of which bodies are valued, versus which ones are not. A critical white feminist lens requires us to “address the interconnectivity of racial and gender privilege and oppression” (McFadden 2017, 244). The Victorian era construction of the proper and appropriate female is at the center of rethinking what is meant when female bodies are privileged or marginalized. Corset use, and subsequent tight-lacing, served to disable the white female body while also amplifying what was seen as deviance in the form of mobility and resilience of non-white female bodies. These dramatically different set of behaviors (weak and sick versus strong and healthy), as highlighted in Sojourner Truth’s speech in 1851, served to enable systems of oppression and violence and supported racist narratives within science and anthropological discourses on human variation and difference. In the case of female bodies, white females were seen as more evolved and therefore privileged, but we need to understand who was scripting this narrative and to what end this narrative continues to be reproduced as truth. The challenge in engaging a critical white feminist model of inquiry means that as white-feminist scholars we need to grapple with the ways in which the structural violence of the Victorian era policed female bodies, as it constructed the “normal white female” as evolved and civilized, above all others (except white men). We

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need to consider how our own positionality as women, anthropologists, and researchers has reproduced these same ideas, instead of disrupting colonial practices. By failing to recognize how white, European-centric, historic essentializing of race was girded by white women who participated as the social and political order dictated while also serving to enforce white supremist ideas is to ignore the privilege that comes with being a white woman, is to ignore our role in shaping how we read bodies within these Victorian scripted norms, and is to ignore that this further marginalizes women of color as deviant and devalued. Our challenge is to disrupt and rethink historical race science and subsequent racial underpinnings that persist today; by looking closely these practices become visible in their influences, yet remain invisible because we are not interrogating these past (and current) practices. Science, and anthropological inquiry, cannot be absolved of their roles in othering while protecting white female bodies. We need to recognize that medicine has a culture of its own – one built on oppression – one that needs to be rethought, and the evidence needs to include the lived experiences, as well as the cultural frameworks that people bring with them. The intertwining of a critical white feminist lens and structural violence theory requires the rethinking of power relationships and to consider the intersectionality of lived experiences: “…whiteness should be understood here as an invisible and influential racial category, with implications of power, dominance, and normativity. Because the causes and effects of whiteness are rarely explored, the work of critical white theorists is necessary for understanding the hidden mechanisms and dynamics of our racialized society” (McFadden 2011, p.2–3). Chronic stress may in fact be an entry point for bioarchaeologists to rethink the underlying issues that impact individuals over long periods of time and to consider the cultural practices that are revealed when we consider the intersectional experiences of all individuals. But to understand what bodies from the past reveal about their time and place requires not only self-reflection but the hard work of recognizing our positionality alongside new heuristic contexts to understand the ways in which “normal” and “deviant” are culturally constructed and historically contingent and reproduced.

Conclusions Tight-lacing is an example of a cultural practice that creates chronic stress, disability, and immobilization of white female bodies and has produced the social/behavioral expectations of femininity, ultimately constructing the normal, white female. This practice, with its biological consequence, was used as a means to situate the white female body within the sociopolitical space of the community and science. But, bodies that are bound are helpless, fragile, sick, and unable to participate on an equal playing field with the unbound, strong, healthy bodies of men. Binding is structural violence, embedded in dominant and sociopolitical cultural traditions and social ideologies, normalized by the community, making females sick and disempowered.

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The practice of tight-lacing and the historic documents that discuss its use offer us an example of the ways that the body can be a transcript of the behavior, attitudes, and conditions that the sociopolitical frameworks require the individual to perform. In turn these systems act to discipline, to control, and to delineate boundaries (elite or common, marriageable or not) within communities. For many cultures, females tend to be the bearers of debilitating body modifications, the consequences of which are long term and can result in lifelong physical stress. Steeped in social meaning while also inhibiting the role of females within their community, these same markers in life may not be visible in death. Thus, we need to employ new models with which to examine the past – models that are inclusive of all data (archaeological, biological, ethnographic) – and we must move beyond traditional interpretations of ill health for females, going beyond reproductive stressors if females die young and age-related changes, if they live to old age. We need to ask what else puts females at risk for ill health. Rigid rules around sexuality? Heavy workloads? Cultural practices? Sociopolitical performance of the body? Engaging a critical white feminist lens, as I consider the role of corset use as a tool of structural violence, opens the door to see the way in which white females have participated in and been protected by science. My focus on tight-lacing serves to amplify only one aspect of how Victorian performance of beauty is deeply rooted in the structural violence associated with colonial praxis of racialized science. The tight-laced Victorian, white, middle- to upper-class female  – delicate and overly emotional and in need of help – shapes a narrative that continues to inform the ways in which females, all females white, black, or brown, across the globe are measured. This historic framing has become embedded and invisible as we have bought into the idea that females are weaker, less able, and problematized by their biology, without considering what is at the roots of these biologically deterministic ideas. In addition, white female bodies are missing from our research collections, and it is from this perspective that I have been shifting my exploration of females in the past, looking for opportunities to study and explore the white, middle- and upper-class, Victorian era female skeletons,4 as these bodies are often not curated or collected – even in anatomical collections. The body reflects the social boundaries and cultural norms that impact how the individual succeeds in the sociopolitical arena, which is often authored by men (Blake 1994). The elite are the architects of the sociopolitical meanings of cultural practices in most communities across time and space, and they are responsible as well for constructing the consequences for deviance from the “normal” or “prescribed” archetype, which in turn is often deviant from the natural body (Reischer and Koo 2004). By framing how to look at these practices, Scheper-Hughes and Lock’s (1987) three bodies and Galtung’s (2002) triangle of violence, alongside the 4  I currently have an ongoing project aimed at documenting, through skeletal analyses, and archival records when possible, data on stature, metabolic diseases, and other pathologies, from females in England during the Victorian era (1820–1900). This project has met many obstacles as skeletal remains that fit our criteria are hard to find, which speaks directly to my argument that white, middle- and upper-class female bodies are protected and valued in a different way than other bodies.

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poetics of violence and a critical white feminist model, a new lens is offered here with which to begin to understand the individually lived experiences for females in the past and the implications of our embedded narratives on the present. What becomes evident as we unpack the ways in which female bodies are read in bioarchaeology is that researchers consistently reproduce the white female body as the universal transcript for how a normal female is expected lived and what their social and political experiences might be. As we develop new understandings, we need to be reminded that science can simultaneously reinforce and be molded by prejudice, and the whiteness of science and anthropological inquiries becomes an invisible and influential framework in universalizing the idea of “normal.” For female bodies, normal was structured on a Victorian ideal and repeatedly reinforced through the practice of tight-lacing against the backdrop of the constructions of gender identity, beauty, and fragility of females. Privileging the white female body highlights both white supremist and masculinist ideology and power and girds the structural violence used to maintain social control over all female bodies, reinforcing racist assumptions of normal and deviant. These are our current frameworks, and they need to be rethought and reconsidered as we read female bodies in the past and understand them across cultures and over time in the bioarchaeological record, as well as today.

References Barry, L. W. (1870). The freaks of fashion: With illustrations of the changes in the corset and crinoline, from remote periods to the present time. London: Ward, Lock, and Tyler. Blake, C. F. (1994). Foot-binding in neo-Confucian China and the appropriation of female labor. Signs, 19(3), 676–712. Comstock, J.  L. (1848). Outlines of physiology, both comparative and human: In which are described the mechanical, animal, vital, and sensorial organs and functions: Also, the application of these principles to muscular exercise, and female fashions and deformities: Intended for the use of schools and heads of families: Together with a synopsis of human anatomy. New York: Pratt, Woodford. Crutchfield, E. L. (1897). Some ill effects of the corset. Gaillard’s Medical Journal, 67(July), 37–14. Davies, M. (1982). Corsets and conception: Fashion and demographic trends in the nineteenth century. Comparative Studies in Society and History, 24(4), 611–641. Dowson, T. A. (2006). Archaeologists, feminists, and queers: Sexual politics in the construction of the past. InFeminist anthropology: Past, present, and future (pp.  89–102). Philadelphia: University of Pennsylvania Press. Farmer, P. (2004). An anthropology of structural violence. Current Anthropology, 45(3), 305–325. Foucault, M. (1990). The history of sexuality: An introduction. New York: Vintage. Frayer, D. W., & Martin, D. L. (2014). Troubled times: Violence and warfare in the past. Abingdon: Routledge. Galtung, J. (2002). Violence, war, and their impact: On visible and invisible effects of violence. Polylog. http://them.polylog.org/5/fgj-en.htm Geller, P.  L. (2006). Altering identities: Body modifications and the pre-Columbian Maya. In R.  Gowland & C.  J. Knünsel (Eds.), Social archaeology of human funerary remains (pp. 143–153). Oxford: Alden Press.

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Gibson, J.  W. (1903). Illus. InGolden thoughts on chastity and procreation (p.  107). Toronto: J. L. Nichols. Gibson, R. (2015). Effects of long term corseting on the female skeleton: A preliminary morphological examination. Nexus: The Canadian Student Journal of Anthropology, 23(2), 45–60. Gilman, S. L. (1985). Black bodies, white bodies: Toward an iconography of female sexuality in late nineteenth-century art, medicine, and literature. Critical Inquiry, 12(1), 204–242. Knudson, K. J., & Stojanowski, C. M. (2008). New directions in bioarchaeology: Recent contributions to the study of human social identities. Journal of Archaeological Research, 16, 397–432. Kunzle, D. (2006). Fashion & Fetishism: Corsets, tight-lacing, & other forms of body-sculpture. Charleston: History Press. Lewin, R. (1989). Human Evolution. Boston: Blackwell Scientific Publications. Lewis, J.  E. (2008). Identifying sword marks on bone: Criteria for distinguishing between cut marks made by different classes of bladed weapons. Journal of Archaeological Science, 35(7), 2001–2008. Lord, W.  B. (1868). The corset and the crinoline: A book of modes and costumes from remote periods to the present time. London: Ward, Locke, and Tyler. Loudon, I. (1997). Childbirth. In I. Loudon (Ed.), Western medicine (pp. 206–220). New York: Oxford University Press. Martin, D.  L. (1997). Violence against women in the La Plata River Vallet (A.D. 1000–1300). In D.  L. Martin & D.  W. Frayer (Eds.), Troubled times: Violence and warfare in the past (pp. 45–76). Amsterdam: Gordon and Breach. Martin, D. L. (2012). Taphonomic and skeletal indicators of captivity and violence in the Southwest (AD 1000–1300). Landscapes of Violence, 2(2), 2. Martin, D. L., Akins, N. J., Goodman, A. H., & Swedlund, A. H. (1995). Harmony and discord: Bioarchaeology of the La Plata Valley. Santa Fe: Museum of New Mexico Press. McFadden, C. (2011) Critical white feminism interrogating privilege, whiteness, and antiracism in feminist theory. HIM 1990–2015. 1159. https://stars.library.ucf.edu/ honorstheses1990-2015/1159 McFadden, C.  R. (2017). Reproductively privileged: Critical white feminism and reproductive justice theory. In L. Ross, E. Derkas, W. Peoples, L. Roberts, & P. Bridgewater (Eds.). Radical reproductive justice: Foundation, theory, practice, critique (pp.  241–250). Feminist Press at CUNY. McNay, K., Humphries, J., & Klasen, S. (2005). Excess female mortality in nineteenth-century England and Wales: A regional analysis. Social Science History, 29(4), 649–681. Ortner, D. J., & Putschar, W. G. J. (1981). Identification of pathological conditions in human skeletal remains. Washington, DC: Smithsonian Institution Press. Perez, V. R., Nelson, B. A., & Martin, D. L. (2008). A study of variations in human bone modification at La Quemada. InSocial violence in the prehispanic American Southwest (p.  123). Tucson: University of Arizona Press. Reischer, E., & Koo, K. S. (2004). The body beautiful: Symbolism and agency in the social world. Annual Review of Anthropology, 33, 297–317. Richardson, J., & Kroeber, A. L. (1940). Three centuries of women’s dress fashions, a quantitative analysis (Vol. 5, No. 2). Berkeley: University of California Press. Roberts, C., & Manchester, K. (1997). The archaeology of disease (2nd ed.). Ithaca: Cornell University Press. Scheper-Hughes, N., & Lock, M. M. (1987). The mindful body: A prolegomenon to future work in medical anthropology. Medical Anthropology Quarterly, 1(1), 6–41. Schiebinger, L. (1986). Skeletons in the closet: The first illustrations of the female skeleton in eighteenth-century anatomy. Representations, 14, 42–82. Schiebinger, L. (1993). Why mammals are called mammals: Gender politics in eighteenth-century natural history. The American Historical Review, 98(2), 382–411.

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Smith-Rosenberg, C., & Rosenberg, C. E. (1999). The female animal: Medical and biological views of woman and her role in 19th century America. In J. W. Leavitt (Ed.), Women and health in America (2nd ed.) (pp. 111–130). Madison: University of Wisconsin Press. Stacey, M. (2002). The fasting girl: A true Victorian medical mystery. New York: Jeremy P. Tarcher. Standen, V. G., & Arriaza, B. T. (2000). Trauma in the preceramic coastal populations of northern Chile: Violence or occupational hazards? American Journal of Physical Anthropology: The Official Publication of the American Association of Physical Anthropologists, 112(2), 239–249. Steele, V. (2003). The corset: A cultural history. New Haven: Yale University Press. Stone, P. K. (2001). Engendering violence: Reassessing the role of women in violent conflict in the past. Paper presented at the American Association of Anthropologists 100th annual meeting, Washington, DC, Abstract published. Stone, P. K. (2009). A history of western medicine, labor, and birth. In H. Selin & P. K. Stone (Eds.), Childbirth across cultures: Ideas and practices of pregnancy, childbirth, and the postpartum. New York: Springer. Stone, P.  K. (2012). Binding women: Ethnology, skeletal deformations, and violence against women. International Journal of Paleopathology, 2(2–3), 53–60. Stone, P. K. (Ed.). (2018). Bioarchaeological analyses and bodies: New ways of knowing anatomical and archaeological skeletal collections. New York: Springer. Stone, P.  K. (in press). Bound to please: The shaping of female beauty, gender theory, structural violence, and bioarchaeological investigations. In S.  Sheridan & L.  Gregoricka (Eds.), Purposeful pain: The bioarchaeology of intentional suffering. Cham: Springer. Walker, P. L. (1989). Cranial injuries as evidence of violence in prehistoric southern California. American Journal of Physical Anthropology, 80(3), 313–323. Whitehead, N. L. (2004). On the poetics of violence. Violence, 55–77.

Chapter 3

Embodied Discrimination and “Mutilated Historicity”: Archiving Black Women’s Bodies in the Huntington Collection Aja M. Lans

Skeletal Collections as Archives Dr. George Sumner Huntington (1861–1927) was the first professor of anatomy at the College of Physicians and Surgeons in New York City to require systematic dissection of cadavers during medical training. An advocate for comparative anatomy, Huntington amassed an extensive skeletal collection which originally consisted of the remains of some 3600 individuals who were dissected at the medical school between 1892 and 1920. During this time period, it was argued that the marginalized classes of society could repay their debts by having their corpses dissected and curated for the sake of medical knowledge. Therefore, the collection demographics are likely skewed toward individuals of low socioeconomic status. Many people in the collection were recent immigrants to New York City and the United States who had no relations to claim their bodies. Aleš Hrdlička, the father of American physical anthropology, would eventually secure the collection for transfer to the U.S. National Museum (present day Smithsonian National Museum of Natural History) during the 1920s, where the collection currently resides. Here, he valued its diversity, including a wide range of races and pathological conditions. Adding to their value, the remains were accompanied by records documenting the descendant’s age, sex, nationality, and cause of death. Throughout time, the remains have become increasingly fragmented, resulting in a collection of approximately 3070 partial skeletons and commingling of about 26% of the collection (Pearlstein 2015). Their ages at death range from 15 to 96 years, with birth years ranging from 1798 to 1901. Forty-three percent of the collection is classified as native-born Americans and further categorized as white or black; 52%

A. M. Lans (*) Department of Anthropology, Syracuse University, Syracuse, NY, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 L. A. Tremblay, S. Reedy (eds.), The Bioarchaeology of Structural Violence, Bioarchaeology and Social Theory, https://doi.org/10.1007/978-3-030-46440-0_3

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is comprised of immigrants, and the rest are of unknown origin. About 73% of the individuals are listed as male, while only 27% are female. Two hundred and eighty-eight of the individuals listed in the collection catalog are classified as “black” or “Negro,” of which 79 are women. Most of these women worked as domestics, lived in segregated neighborhoods, and died in almshouses and public hospitals. Many were recent migrants to New  York City, and their remains show signs of hard labor, with most dying of infectious diseases. While all of these women died in New  York City and were dissected at the College of Physicians and Surgeons, they had diverse life experiences. Some were lifelong New  York residents, while others had only been in the city for a few weeks or months. They were born at different times and in different places and under different sociopolitical contexts (Fig. 3.1). In this light, it would be inappropriate to treat these women as a “population.” Rather, the Huntington Collection as a site is better viewed as a “catchment zone” (Novak 2017: 239). Bioarchaeologists often simplify sites, including collections, and treat them as representative samples of past populations. While the Huntington Collection was only built over a 28-year time period, the actual lives of the individuals who became part of the collection span over a century. In order to not fall into the “fallacies of synchrony,” this research takes into account the various ways these women came to be members of the collection (Novak 2017: 239). Additionally, there are individuals listed in the Huntington catalog but whose remains are missing from the collection. Drawing on the work of Watkins and Muller (2015), I merge skeletal remains with their associated texts, which allows me to include women for whom skeletal remains are no longer present. Out of these 79 women, there are only skeletal remains for 65. While I may never know what happened to the 17 women whose remains are missing, they were originally considered to be part of this archive and should still be treated as such. Therefore, in

Fig. 3.1  Life spans of the black women in the Huntington Collection

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conjunction with skeletal remains, I also consider what can be found in municipal archives, libraries, and other repositories. This includes death certificates, census data, maps, and texts related to the institutions and neighborhoods these women interacted with. Skeletal collections should be considered another type of archive. At the time of its establishment, the Huntington Collection was curated for medical research and anthropological investigations establishing “normal” human variation. Importantly, this period also marks the emergence of physical anthropology as a discipline, with a focus deeply enmeshed in eugenic concerns, including the “normative” nature of white bodies (Caspari 2009; Hrdlička 1919). The bodies of “others” were therefore needed to define categories and types, including those of different races and nationalities. Furthermore, these identified skeletal collections have long been used to develop and refine forensic and bioarchaeological techniques such as estimating age, sex, and ancestry (see Henderson and Cardoso’s 2018 edited volume). More recently, bioarchaeologists in particular have begun to question the history of these collections, the ethics surrounding their establishment, and applying structural violence frameworks to explore the lived and postmortem experiences of violence inflicted upon the bodies of the marginalized (Watkins 2018). In addition to considering how structural violence and inequality might be reflected in the processes of dissection and curation (Nystrom 2014; Sappol 2002; Watkins 2018), I draw on the work of historian Marisa Fuentes (2016) in considering the silences and violence of archives. Fuentes (2016) argues that the objectification of black bodies and their reduction to objects was also transferred to archival documents. “Mutilated historicity” refers to the “violent condition in which enslaved women appear in the archive disfigured and violated” and “how their bodies and flesh become ‘inscribed’ with the text/violence of slavery” (Fuentes 2016: 16). I extend this concept in my study to include the disarticulated, fragmentary, and incomplete remains of black women who died in post-emancipation New York City. I also consider the construction of archives. Trouillot (1995) discusses the process of historical production and the making of archives in terms of silences; “the presences and absences embodied in sources (artifacts and bodies that turn an even into fact) or archives (facts collected, thematized, and processed as documents and monuments) are neither neutral or natural. They are created. As such, they are not mere presences and absences, but mentions or silences of various kinds and degrees” (Trouillot 1995: 48). Trouillot (1995) emphasizes that depending on context, some humans are considered to be more human than others. If black people were considered to be incapable of certain acts or thoughts, then those with the power to construct archives would tell black histories in a way that produced silences and recreated the ranking of humans in the historical narrative. One way to fill these silences and expose the violence that has been inflicted upon such bodies is to undertake subversive readings of various archives. I draw on a variety of archival and bioarchaeological methods to (re)articulate the bodies of the black women in the Huntington Collection in order to better understand their lived experiences and postmortem lives. I then reflect upon how their stories might contribute to our current understandings of race, gender, class, and place. In what

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follows, I consider how best to investigate these women and their archival traces to more fully understand the complexities of their lives and deaths.

Defining Black Women’s Bodies The body is a contested site of meaning, and the black body in particular has been defined by others in ways that fix blacks as childlike, inarticulate, and fit for manual labor (Peterson 2001). The traditional role of the enslaved as objects for study carried on after emancipation, making black bodies into objects suitable for medical demonstrations, dissections, and risky surgeries and experiments (Cooper-Owens 2017; Washington 2006). To put it simply, “the atmosphere created by racial inferiority theories and stereotypes, 246 years of black chattel slavery, along with biased educational processes, almost inevitably led to medical and scientific abuse, unethical experimentation, and overutilization of African-Americans as subjects for teaching and training purposes” (Byrd and Clayton 2000: 11S). For example, the bodies of enslaved black women were used to found modern obstetrics and gynecology, and yet to this day, there are discrepancies in maternal mortality rates between black and white women (Cooper-Owens 2017; Roberts 1997; Washington 2006). Finally, after death and dissection, many skeletons were kept to establish collections like Huntington’s, which would then be used to measure difference and reinforce racial hierarchies. Racialized science was used to contribute to ideologies about human difference and rationalize the inferior treatment of blacks based on their supposed lack of intelligence, morals, and animal-like physical features (Caspari 2009; Gould 1996[1981]; Smedley and Smedley 2012). These sorts of studies flourished in the nineteenth century, with emphasis placed on studies of skin color, hair length and texture, and anthropometry, especially of the head. Scientists claimed neutrality while their research fueled discriminatory public policy against blacks and other immigrant communities (Watkins 2012). The dissection and study of individuals such as those contained in the Huntington Collection was used to bolster these sorts of hypotheses, yet the scientist performing these acts and analyses did not see their work as unethical. The bodies of the black women in Huntington’s Collection were used first for medical study and then later transferred to become part of the Smithsonian’s anthropological collection. Hrdlička wanted the bodies for the explicit goal of measuring differences between races and defining what made individuals abnormal. The circumstances of these women’s lives and deaths, as well as their postmortem careers in dissection rooms and museum cabinets, reflect the condition of being poor and black in America during this time period. “♀ Negro” is written upon the bones of many of these subjects. What did it mean to be a female Negro? Who decided that the body being dissected and curated was a female Negro? How did medical doctors and students perceive the body upon death? Why was her body acceptable for dissection? Why was the body of a black woman, who society deemed inferior and

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other when compared to that of a white woman, still acceptable for scientific research (Cooper-Owens 2017)? Black women’s behavior has always been under intense scrutiny in the United States. How and why gender identities and roles have been ascribed to them throughout the nation’s history is an important topic of discussion. The objectification of black women began with chattel slavery (hooks 2015[1981]; Ramey Berry 2017; Roberts 1997; Spillers 1987). They were then made to assume what the white majority considered to be masculine roles when working in fields but also still performed domestic roles as nurses, cooks, seamstresses, and maids (hooks 2015[1981]). Women who worked in white homes were under surveillance and at risk of various forms of assault. The devaluation of black women also depreciated much of the work they were forced to perform, and hence women who worked as domestics and in the service industry were forced to live off of meager wages. Black women were also largely unable to fulfill the ideal roles of proper mothers, as they labored as slaves and after emancipation had to work outside of the home (Roberts 1997). Black women have long been denied their rights as mothers to their own children. Black women have historically had little autonomy over reproduction, as with slavery, their children were nothing more than property (Hunter 2017; Roberts 1997). An owner wanted to maximize an enslaved woman’s reproductive potential but at the same time extort as much physical labor out of her as possible. After emancipation, black reproduction came to be seen as unregulated and dangerous, passing on biological inferiority and dooming their children to lives of poverty and delinquency. Rather than being viewed as moral homemakers, black women were perceived as promiscuous and likely to have unjust run-ins with the law because of this (Hicks 2010). Various stereotypes were developed to define black women and reinforce their place within society. Roberts (1991, 1997) discusses the image of the “Jezebel,” a woman governed by sexual desire. This imagery appears as early as the 1700s to legitimize the rape of enslaved women. Unmarried black women, whether enslaved or free, who gave birth outside of marriage were considered Jezebels as well (Austin 1989). The irony, of course, is that there is a complicated history to the legal recognition of black marriages (Hunter 2017). Enslaved blacks’ unions were often informal, and it was not uncommon for families to be separated. Blacks had to fight for their marriages to be acknowledged even post-emancipation. In contrast, the image of the “Mammy” desexualizes black women. Patton (1999) argues that the image of the Mammy was created to interfere with black motherhood. The desexualized, often overweight image of the Mammy created a bond to the owner’s family while diminishing enslaved women’s ability to provide for her own children. After the American Civil War, this image became even more popular, making domestic labor a natural extension of black women’s identity (Harris-Perry 2011). And yet black women who worked outside of the home were pathologized and blamed for the ruination of the black family, which involved emasculating black men and raising children incorrectly (Hill Collins 2000; Spillers 1987). At the same time, they were viewed as less feminine because they left the domestic sphere for work.

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The concept of the masculinization of black women is another area of relevance. Black feminist scholar Cheryl Hicks (2010) argues that despite the history of sexual exploitation faced by black women and assumptions about their promiscuity, they were masculinized in certain contexts, especially when it came to the criminal justice system. Black women were seen as being more likely to behave violently and disorderly, although these actions were likely attempts to protect themselves from physical assault and attacks on their moral character by members of both black and white communities. Black women and recent immigrants were disproportionately arrested in turn-of-the-century New York City and were thus seen as unfeminine, criminal, and immoral by law enforcement. Much of society did not see them as worthy of protection, unlike middle- and upper-class white women who were perceived as fragile. The Cult of True Womanhood emerged during the early 1800s for middle- and upper-class white women (hooks 2015[1981]; Patton 1999; Welter 1966).1 This notion of a cult of true womanhood may be better viewed as an ideology that inscribed womanhood onto female bodies (Roberts 2002). In this context, it is relevant, as the ideal female body was white. The man of the family was supposed to be a worker and provider, who ventured out into the potentially corrupting world. A woman was meant to be a pure, pious homemaker who was inherently religious and raised the next generation of citizens. A mother and a nurturer, a woman stayed in her domestic sphere, performing morally uplifting tasks related to housework. Marriage was aspired to, as it improved her character. Black women who were migrants to New York City were considered pathological, as women should not be mobile and seek employment (Hicks 2010; Sacks 2006). Urban blacks were characterized aggressive and dangerous. Along with arguments over the validity of racial categories, this was also during a time period when phrenology was still seen as a valid field of scientific inquiry. Criminality was seen as immutable and hereditary, so there was no point in attempting criminal reform employment (Hicks 2010; Sacks 2006). Black women’s skin color and physical features also came to be associated with their being more masculine. One way this narrow view of womanhood has been justified is through the supposed demasculinization of black men and the image of the domineering black woman (hooks 2015[1981]; Sacks 2006). Since slavery, black women have been made to carry out chores that were typically seen as masculine and, after emancipation, worked outside of the home and never typified true womanhood (Crenshaw 1989; hooks 2015[1981]). There were concerns over young, single black women’s morality (Hicks 2010; Sacks 2006). As more of these women migrated to the city after emancipation, they grew to be a disproportionate demographic: young, single, and female. In 1900, there were 124 black females for every 100 black males (Sacks 2006). They often 1  Welter’s work has been criticized for focusing on a lifestyle that few women could attain, as well as lacking an appropriate theoretical analysis. However, in this case, her concept of true womanhood proves useful in illustrating how difficult it was for black women to achieve such ideals. See Journal of Women’s History 14:1, Spring 2002.

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struggled to find work and did not even know how to dress for the weather. This led to the formation of organizations like the Association for the Protection of Colored Women in 1905, which would meet incoming boats from the south and Caribbean to help women protect their morality and assist them in finding work (Sacks 2006). Archival research also indicates that blacks in New York City had a lower proportion of nuclear families (SenGupta 2009). It is likely that married women did not always live with their spouses, perhaps because of employment circumstances or disputes (Hicks 2010; SenGupta 2009). Men were also more likely to leave the city in search of work seasonally. However, in turning to the violence of the archive, we might consider that many black couples formed what SenGupta (2009:50) refers to as “communal” households. These households might have been formed based on extended kin or couples who chose not to marry. Such arrangements contributed to notions of the sexualized black woman and the overcrowding of predominantly black neighborhoods. Taking this social, political, and historical context into account, it is possible to more fully understand the experiences of the black women who are now part of the Huntington Collection. I turn now to three individual women who are archived within the collection to illustrate the violence they have been subjected to and to reflect upon the mutilated historicity that permeates the skeletal archive.2

Belle I begin with the remains of Belle or, as she has been labeled, specimen 319,432. In the Huntington Collection records, Belle is listed as a 27-year-old black female who died of phthisis at the Colored Home in the year 1900. At first glance, Belle seemed to have more data than many of the women in the database, including measurements of her body upon death. However, combining archives paints a very different story of Belle’s life, death, and curation. I first began to uncover Belle’s story by consulting her death certificate in the New York City Municipal Archives. Here I learned that Belle was married, from Virginia, and had resided in New York City for 2 years. She lived and worked as a domestic in a private home on the Upper West Side of Manhattan. She did indeed die of tuberculosis, which contributed to the deaths of over half of the black women in the Huntington Collection. Tuberculosis has, of course, been long studied by bioarchaeologists and has the potential to leave its mark on bone (Roberts 2011; Roberts and Buikstra 2003). It is also a commonly referenced in discussions of structural violence and diseases of poverty, much of which draws on the research of Paul Farmer (2003).

2  Only first names are used as per agreement with the Smithsonian. I argue for naming the dead as a form of restoring personhood to long objectified remains (Lans 2018; Novak 2014).

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However, nephritis, or inflammation of the kidneys, is also listed on Belle’s death certificate, as well as the death certificates of five other black women in the Huntington Collection. After considering the other contributing factors listed along with nephritis in the collection catalog, including tuberculosis, high blood pressure, and endocarditis, I suspect these women may have had lupus. Nephritis is one of the main symptoms of systemic lupus erythematosus, which is a highly racialized autoimmune disorder that disproportionately affects African Americans and women in particular (Williams et  al. 2016). The exact etiology of the disease is not fully understood, but the immune system creates autoantibodies that attack healthy cells (Norman 2016). Studies have linked health complications and mortality due to lupus to hypertension, stress, and environmental and socioeconomic factors (Williams et al. 2014; Williams et al. 2016). While mentions of the disease span as far back as the writings of Hippocrates, a definitive diagnosis was not available until the discovery of lupus erythematosus cells in 1948 (Norman 2016). There are many symptoms of lupus, but some of the most common include rashes, fever, inflammatory arthritis, serositis, and photosensitivity (Heinlen et al. 2007). It has also has psychiatric symptoms, including cognitive dysfunction, anxiety, and depression (Meszaros et al. 2012). Exact estimates of the amount of people affected by lupus are difficult to calculate. According to the CDC, an estimated 1.5 million Americans have some form of lupus. Incidence rates of the disease are known to be highest in women ages 15–44, and the illness raises the risk of heart disease, osteoporosis, and kidney disease. African American women are three times as likely than white women to have lupus (CDC 2018a; Fernandez et al. 2005). A study of the nationwide Medicaid community found the highest prevalence of lupus in the southern United States among those with the lowest socioeconomic status (Feldman et al. 2013). African American women on Medicaid had the highest prevalence of systemic lupus erythematous at 281.37–227.28 per 100,000 cases (Feldman et al. 2013). They also had the highest rates of lupus nephritis at 57.76–61.69 per 100,000 (Feldman et al. 2013). Given these high rates of lupus, it is not unlikely that the women in the Huntington Collection suffered from the disease, including Belle. Lupus is also closely linked to infection with tuberculosis in developing countries (Erdozain et al. 2006; Bhattacharya et al. 2017). Exposure to the tubercle bacillus does not necessarily mean one will develop active infection; it is a two-stage process (Narasimhan et al. 2013). Certain factors put individuals at risk for active infection, including poverty, race, sex, living conditions, malnutrition, homelessness, drug use, alcoholism, diabetes, and a compromised immune system due to infection with HIV/AIDS (Dyer 2010; Narasimhan et  al. 2013; Singer and Clair 2003). Lupus also compromises one’s immune system, and lupus sufferers who live in areas where tuberculosis is prevalent are more likely to develop active infection (Bhattacharya et al. 2017). Tuberculosis was the second leading cause of death in the United States during the year 1900, with a mortality rate of 194.4 per 100,000 (Linder and Grove 1947). Nephritis was the sixth leading cause of death in 1900 with a mortality rate of 88.6 per 100,000 (Linder and Grove 1947). The difficulty is that during this time

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period, the causes of kidney disease were not fully understood (Pal and Kaskel 2016). Nephritis can be caused by bacterial infections including typhoid, syphilis, and pneumonia, as well as viral infections such as hepatitis B, mumps, and measles (Tidy 2016). In contemporary populations, kidney disease is most common in individuals with diabetes and high blood pressure (Mayo Clinic Staff 2019). It is also commonly caused by autoimmune disorders such as lupus. When nephritis mortality was calculated my race beginning in 1910, nonwhites consistently had higher rates of mortality, a trend that remains to this day (Linder and Grove 1947; Mayo Clinic Staff 2019). We should also consider where Belle received care and eventually succumbed to her illnesses. She was a resident at the Colored Home from late July until her death in early September. The Colored Home was a benevolent society located on Murray Hill and run by patrician New York women (SenGupta 2009). These women considered themselves fulfilling their role as pious, domestic citizens. Initially, the benefactors wanted to cater to the worthy black poor, mainly elderly former slaves who were naturally dependent. This observation is elaborated in Mary W. Thompson’s 1851 publication, Broken Gloom: Sketches of the History, Character, and Dying Testimony of Beneficiaries of the Colored Home, in the City of New-York. The goal of the book, and the institution, she argues (1851:5), “…is to make known more extensively the character of the Institution on whose behalf these pages speak,--to prove its usefulness in carrying out the plan of benevolence in pursuance of which it was originally established, and which, in its operations thus far, has fully proved its utility and advantages, showing itself worthy the patronage and support of a benevolent and Christian public. The Institution not only provides protection and a peaceful home for the respectable, worn-out colored servants of both sexes of our city, by sheltering and sustaining them during the lingering days of declining life, but furnishes them in their last moments the consolations of religion.”

The book includes the stories of many former slaves and impoverished blacks, with names such as Blind Sophia and Old Sarah Henry. Poor Johnny was only 13 years old when he arrived at the home, suffering from scrofula of the hip. Despite his suffering, his “dark skin covered one of the most amiable and engaging spirits ever witnessed.” The stories all read similarly, with a poor black person working hard as a slave, coming to the home after fulfilling their duties and looking for a simple life with God before death. Eventually, the home was required to take in all poor blacks, not just the deserving. Many were young men and women, and the vast majority were from the south, primarily the states of Virginia, Maryland, and Kentucky (SenGupta 2009). SenGupta (2009: 123) concludes that these migrants were less rooted in local black communities and therefore more likely to need public assistance. Most were laborers who had suffered injuries or fallen ill, and many were unmarried black women. The Colored Home targeted women for moral regeneration (SenGupta 2009). The focus was on religious instruction and work while promoting self-sufficiency. The Home boasted about finding employment for their inmates, and so it is possible that many young black women viewed it as an employment agency. At least 11 of the

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black women in the Huntington Collection died at the Colored Home, Belle included. I was also able to locate Belle on the Twelfth Census of the United States taken June 5, 1900, just weeks before her arrival at the Colored Home. So far, Belle is one of only two black women in the Huntington Collection who I have been able to find documentation of somewhere other than the collection database and a death certificate. This speaks to the difficulties of genealogical research on black people in the United States, further complicated by the long history of chattel slavery. Belle resided with the family of a Scottish immigrant named John, who was a 54-year-old musician. His wife Anna was 50, sons Ronald and Henry were 27 and 20, and daughter Hope was 21. Belle is listed as a black servant born in Florida in June of 1876, but her age is listed as 23 or 24 because her exact date of birth was unknown. She is also listed as being able to read and write. But this document raises more questions than answers. Was Belle born in Virginia or Florida, and when? Was she 23, 24, or 27? Also, if she was married, where might her husband have been, as he is not a member of the household? Here, perhaps, the skeletal archive can fill in some of these silences. Belle’s skeletal remains consist of only the left side of her body, including her scapula, clavicle, os coxa, and long bones. According to the collection database, her stature was 165.4 centimeters at death, likely recorded during her dissection. Using the maximum length of her femur, 46.2 centimeters, and Trotter’s (1970)3 formula for African American females, Belle’s height is estimated at 165.096  ±  3.41 centimeters. Additionally, her tibia, fibula, and femur show a combination of active and healed periostitis. While bioarchaeologists often focus on potential skeletal markers of tuberculosis, in this case, it is important to keep in mind that lupus has been found to cause periostitis in some cases (Ahn et  al. 2007; Burson et  al. 1990; Lalani et al. 2004). But what about her age? It turns out that Belle’s remains may tell a different story when it comes to how old she actually was when she died. Lines of epiphyseal fusion are still faintly visible on her proximal tibia and iliac crest (Fig. 3.2). The proximal tibia typically fuses completely by age 17 in females (Baker et al. 2005; Scheuer and Black 2004). The iliac crest usually fuses by 23 years of age (Scheuer

Fig. 3.2  Photograph of Belle’s tibia taken by the author 3  See Watkins (2012) for an in-depth discussion of the role of race in the development of standards for skeletal data collection in early physical anthropology.

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and Black 2004). Her pubic symphysis is damaged, but the auricular surface of her ilium appears to belong to a very young person, perhaps even a late teen (Buckberry and Chamberlain 2002). While environmental factors and disease can affect growth, it seems to me that Belle may have been younger than listed on archival documents. However, given the history of the Huntington Collection, it is always a possibility that these remains belong to another individual. Taking everything we know about Belle based on her various archival traces, there are still many unanswered questions. Belle was not born in New York City but migrated north from either Virginia or Florida. Many young black women chose to migrate north in search of employment and to escape the Jim Crow south (Hicks 2010; Hunter 1997; Sacks 2006). But how old was she when she made this move, and how long had she suffered from tuberculosis and likely lupus? How long did she live with John, Anna, and their children, and at what point did she resort to seeking help at the Colored Home, or was she forced to? Finally, why did her remains go unclaimed? I have been unable to find any other archival traces of Belle that might tell us who her husband was or if she had other family. In this way, her story reflects the mutilated historicity of black women in the United States.

Annie Next, I turn to the remains of Annie, specimen 317,781. Annie was a lifelong resident of New York; however, I cannot find any documentary sources on her besides a death certificate. She worked as a domestic until her death in 1893 at the age of 19. Her last known address was the Colored Home, where she lived for a month until she passed away. Her cause of death is listed as puerperal eclampsia and asthenia, or in other words, she died due to complications of childbirth, including convulsions and general exhaustion. Medical professionals no longer use the diagnosis of puerperal eclampsia, but in the mid-1800s to the early 1900s, the diagnosis was extremely common (Brand 1902; Herman 1902; Steele 1872). Recent medical research focuses on the diagnosis and treatment of preeclampsia as a hypertensive, multisystem disorder of pregnancy, although the etiology remains unknown (Bell 2010). Preeclampsia is the presence of new-onset hypertension and proteinuria or other end-organ damage after 20 weeks gestation, while eclampsia is the development of grand mal seizures in a woman with preeclampsia (Phipps et al. 2019). Theories surrounding the cause of the disorder include an enlarged uterus, abnormal placental factors, and vascular disorders (Ahmed et al. 2016; Pauli and Repke 2015). Preeclampsia and eclampsia affect an estimated 4–5% of pregnant people worldwide, resulting in over 50,000 maternal deaths a year, with high rates in African American women (Phipps et  al. 2019). The risk for developing preeclampsia is influenced by genetic predisposition, smoking, number of pregnancies, maternal age, preexisting hypertension, diabetes, chronic kidney disease, and obesity (Mol et al. 2016; Phipps et al. 2019). A father whose birth was complicated by preeclampsia is at risk of fathering a pregnancy with the same complications.

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Heritability is estimated at about 55% with both maternal and fetal contributions to risk. The only definitive treatment is delivery of the fetus (Phipps et al. 2019). References to eclampsia date to as early as the fifth century BCE (Bell 2010; Phipps et al. 2019). Throughout the eighteenth and nineteenth centuries, many theories were proposed to explain the onset of convulsions during and after childbirth, and effort was put into identifying symptoms that a woman might have such complications before it was too late. Some thought living in large cities and towns contributed to risk and that pressure was being put on the uterus (Bell 2010). Others focused on cerebral congestion, emotional stimuli, variations in the atmosphere, and toxic elements (Bell 2010). Treatments included bloodletting, the use of opiates, and hastening of delivery (Bell 2010). As doctors focused on preventative measures, they monitored for symptoms earlier in pregnancies including albumin in the urine, headaches, loss of vision, pain in the stomach, and edema (Bell 2010). Evidence points to Annie’s remains being highly desirable to anatomists and medical doctors. During this time period, physicians were at a loss for what caused eclampsia and were attempting to link it to other medical conditions, including renal disease and lesions on the brain (MacDonald 1878). “For many reasons, an opportunity to examine the brain of a puerperal patient dying of eclampsia is not an occurrence of every day, and it consequently requires the time to collect the necessary material” (MacDonald 1878: 232). MacDonald (1878) goes on to say that he was fortunate enough to obtain the brains of two women who died from puerperal convulsions and that he and other doctors examined these women’s brains and kidneys. In both cases, the doctors attributed the kidneys to causing eclampsia and then convulsions resulting in changes to the brain. MacDonald (1878) describes pregnant women vomiting for extended periods of time and then convulsing at intervals. Typically, the cervix would be dilated gradually, and attempts made to remove the unborn child. Postpartum hemorrhaging sometimes occurred, and convulsions would continue even after childbirth, often resulting in death (MacDonald 1878). We now know that women who survive preeclampsia often suffer lifelong consequences, including hypertension, heart disease, and stroke (Phipps et  al. 2019). They are also at higher risk for end-stage renal disease. The children born of women who are afflicted by preeclampsia may also be at risk (Phipps et al. 2019). They may suffer from neonatal respiratory distress syndrome, bronchopulmonary dysplasia, high blood pressure, increased body mass index, stroke risk, and lower cognitive functioning (Goffin et al. 2018; Mol et al. 2016; Phipps et al. 2019; Pinheiro et al. 2016; Tuovinen et al. 2014). While Annie did not survive her traumatic delivery, I have located the birth certificate for her male child. I am unsure of what happened to this child, as no father is listed and Annie was single. Perhaps if he survived, he was sent to the Colored Orphan Asylum, which was established in Manhattan in 1842 to minister to destitute black children (SenGupta 2009). Annie’s death brings to mind the ongoing discrepancies in motherhood mortality in the United States, where black women are disproportionately at greater risk of dying during childbirth (D’Alton et al. 2019). Currently, pregnancy-related mortality has been steadily rising in the United States, and most recently, 18 out of 100,000 live births result in pregnancy-related deaths (CDC 2018b). However, while the

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mortality rate is only 12.4 deaths per 100,000 live births for white women, it increases to 40 deaths per 100,000 live births for black women and 17.8 deaths per 100,000 live births for women of other races (CDC 2018b), a clear example of racially driven structural violence. This discrepancy in motherhood mortality has a long history in the United States. The Bureau of the Census began collecting detailed information regarding infant and motherhood mortality by state in 1915 (Linder and Grove 1947; Fig. 3.3). Rates of eclampsia have also varied based upon race throughout the United States history. Deaths attributed to “the puerperal state” actually rose from 13.4 per 100,000 in 1900 to 15.1 per 100,000 in 1940 (Linder and Grove 1947). Differences by race were not recorded until 1910, but we see a similar trend (Fig. 3.4). Preeclampsia remains a leading cause of maternal, fetal, and neonatal mortality (Ghulmiyyah and Sibai 2012; Mol et al. 2016). Rates of preeclampsia remain significantly higher among black women and the impoverished in the United States (Breathett et al. 2014; Caughey et al. 2005; Lo et al. 2013; Steegers et al. 2010). This speaks to wider concerns over disparities in obstetric outcomes between women of different races, including not only maternal mortality but also the prevalence of preterm births, fetal growth restriction, fetal demise, and inadequate prenatal care (Bryant et al. 2010). Annie’s brief life, the circumstances surrounding her death, and her various traces in archives all reflect mutilated historicity. All that remains of Annie in the

Fig. 3.3  Maternal mortality rates in New York, 1915–1940. (Data from Linder and Grove 1947)

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Fig. 3.4  Puerperal deaths in United States, 1910–1920. (Data from Linder and Grove 1947)

skeletal archive is her left clavicle, radius, and ulna. While there are no signs of pathological conditions or remnants of her traumatic death on these remains, they reflect the silences of the archives and the long history of the objectification of black women. Her body was likely valued for what it might reveal about eclampsia. Yet despite the use of black women for medical experimentation and research on obstetric issues, they still suffer the highest motherhood mortality rates in the nation (Cooper-Owens 2017; Washington 2006).

Johanna Finally, I consider what can be known about Johanna, a 35-year-old woman from British Guiana who died of pneumonia at Bellevue Hospital in 1895 after residing in New York City for only 3 weeks. Everything I know about Johanna comes from her death certificate, as her skeletal remains are no longer part of the Huntington Collection. Yet there is still much to be said about her short life. To begin with, I am including Johanna in a study about black women. Her death certificate categorized her as black, as does the collection catalog. I am considering her part of the larger group of black ethnics, but whether or not she would consider herself “black” or similar to African Americans, I am unable to definitively answer. More recent studies of black ethnics have found that many dark-skinned people are completely aware of the stigmatization and discrimination that those deemed

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African American face, and so they maintain certain aspects of their African and Caribbean identities to set themselves apart upon immigrating to the United States (Greer 2013). However, Johanna’s last known address puts her in the Tenderloin neighborhood of Manhattan. The area was also known as Negro Bohemia and was home to blacks from a variety of backgrounds and professions. It was a red-light district and had the greatest concentration of saloons, brothels, dance halls, and gambling parlors in the city (Elsroad 2010). There were a large number of black prostitutes and also black-­ run establishments that ignored the conventions of racial segregation (Gilfoyle 1992). Because of this, it was an area where black women were often assumed to be prostitutes and were at risk for run-ins with the law (Hicks 2010). The neighborhood came to represent the white fear of race mixing and was known as Satan’s Circus by reformers (Anderson 1982; O’Malley 2018). The “Tenderloin” name supposedly comes from police captain Alexander “Clubber” Williams who was thrilled when transferred to the 29th Precinct in 1876 and said “I’ve been having chuck steak ever since I’ve been on the force and now I’m going to have a bit of tenderloin” (Gilfoyle 1992: 203). The police were willing to accommodate the spread of prostitution in exchange for extortion payments from both legitimate and illegitimate businesses in the area (Burrows and Wallace 1998; Elsroad 2010). Around this time, most police officers were Irish American and tended to harass blacks, Jews, and other new migrants. Perhaps one of the most fascinating bits of information we can glean about Johanna’s life comes from her occupation, which was listed as “museum freak.” In general, there were five types of human anomalies that worked as museum freaks (Stulman Dennett 1997). There were natural freaks born with physical or mental deformities, self-made freaks such as tattooed people, novelty artists with freakish performances such as snake charmers, non-Western freaks such as “savages” from Africa, and fake or gaffed freaks who faked freakishness such as Siamese twins who were not actually attached. I believe that Johanna was a travelling performer, perhaps at dime museums, which were very popular during this time period, especially in New York City (Stulman Dennett 1997). Their roots can be found in Cabinets of Curiosity, often owned by wealthy white men throughout American history. However, after the American Revolution, such collections were sometimes opened to the public in order to make money and preserve artifacts (Stulman Dennett 1997). These types of businesses expanded during the mid-1800s with the growth of urban landscapes as they provided cheap entertainment that appealed to diverse audiences. Johanna would have worked during the peak of the dime museum era, which spanned from 1880 to 1900 (Stulman Dennett 1997). Dime museums contained acts such as freaks, magicians, and variety artists. Most acts would only stay a maximum of 6 weeks in order to keep exhibits exciting and new for visitors (Stulman Dennett 1997). They would perform on average 10–15 times a day. Some, like Huber’s Museum on 14th Street in New York City, provided low-cost lodging for their acts. However, smaller museums were more able to abuse and overwork performers while withholding their earnings (Stulman Dennett 1997).

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Exhibiting individuals considered freaks and abnormal served to exaggerate bodily differences and solidify concepts of what was considered normal (Martin 2002; Stulman Dennett 1997). Witnessing the exotic helped individuals to reaffirm their own status, especially in rapidly growing urban landscapes where many aspired to normalcy and whiteness. Adding to this, we might consider the history of exhibiting black bodies for entertainment purposes, which began with enslavement (Jones Jr 2013). Naturalists, scientists, showmen, and sideshows displayed black bodies for centuries (Martin 2002). The bodies of albinos were of particular interest, as they did not fit into tidy racial categories. But by putting such people on display, the role of black bodies as property and things was reinforced (Martin 2002). Nevertheless, it would be wrong to assume that all museum and sideshow performers were exploited. Some spectacle performances can be acts of resistance, community building, and identity formation (Jones Jr 2013). Performers could find camaraderie and form bonds among one another (Stulman Dennett 1997). There were also many individuals who gained celebrity status as freaks and earned high wages. Additionally, the audience for such spectacles was extremely diverse, especially in urban areas like New York City (Fig. 3.5). However, the ties between science and studies of the abnormal cannot be ignored. Medical journals during this time period regularly published case studies of individuals with deformities and abnormal anatomy (Kochanek 1997). There was also overlap between these scientific discussions and portrayals of spectacular bodies in popular culture. Medical doctors provided empirical and factual definitions of the abnormal, contributing to the spectacle of those considered to be freaks (Kochanek 1997). The bodies of the abnormal were highly desirable to anatomists and early physical anthropologists as reflected in the work of men like Hrdlička (1897, 1919). Johanna died at Bellevue Hospital. Bellevue was New York City’s public hospital, and it could not turn anyone away, including blacks. It was also a hospital that young medical students competed to intern at, for there was no shortage of patients, and it was affiliated with the College of Physicians and Surgeons (Oshinsky 2016). Johanna died of pneumonia, an infectious disease and leading cause of death during this time period (Linder and Grove 1947). She was dissected upon death and

Fig. 3.5  A want ad for “living curiosities” and “freaks of nature” from the January 1895 New York Clipper

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accessioned into the Huntington Collection, but her final resting place remains a mystery. If Johanna was considered to be a natural freak or to represent the exotic, perhaps her remains were prized for her abnormality. I cannot help but be reminded of Sarah Baartman. Known by many names including Sarah, Sara, or Saartjie Baartman as well as Hottentot Venus, she was taken from Africa and exhibited around Europe for about 5 years until her death in 1815 (McKittrick 2010). It took a 10-year campaign for her remains to be repatriated from the Museum of Natural History in Paris to South Africa, which finally happened in 2002. However, McKittrick urges us to consider the “creatively scientific possibilities with which Sarah Baartman has posthumously provided us” (2010: 113). We can move past the Eurocentric conceptions of science that have been used to define black femininity to generate new creative space. I hope to accomplish this by considering the lives of women like Johanna. Finally, it is vital that scholars consider the representation of people with disabilities in museums (Sandell et al. 2005). Most objects associated with people with disabilities in museums, including human remains, relegate them to three roles: nameless beggars and asylum residents and patients, heroes who have overcome disability, and freaks who fall outside of the range of normal human appearance (Sandell et  al. 2005). Johanna has been labeled a freak on her death certificate, which reflects the violence inflicted upon black women’s bodies in the archive. However, we need not continue the marginalization of her in death if we reconsider the archive and challenge the construct of normalcy.

Conclusion The mutilated histories of the black women in the Huntington Collection reflect the many intersections of oppression that black women have faced throughout the United States history. Their disarticulated, incomplete, and in some instances altogether missing remains are the result of lives and deaths structured by inequality. While the dissection of individuals including Belle, Annie, and Johanna was rationalized by the professionalization of the medical field, the bodies under scrutiny were not from the classes of society who would benefit from these scientific endeavors. After death and dissection, their skeletons were kept to establish collections, which could then be used by men like Hrdlička to measure difference and reinforce racial hierarchies. Now, it is possible for scholars such as myself to undertake subversive readings of skeletal archives. By combining the skeletal archive with documentary information, it is possible to (re)articulate the lives of women like Belle, Annie, and Johanna. The only pieces of archival documentation that all of these women have in common are death certificate and a record in the Huntington Collection database, documents for which they had no say in their production. However, with detailed historical context and theoretical concepts such as mutilated historicity, researchers can better represent the histories of marginalized people.

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Bioarchaeologists in particular must contend with the racist history of the field of physical anthropology and consider whether or not our research continues to perpetrate violence against the dead (Watkins 2018). The meanings and usages of identified skeletal collections are subject to change, and it is up to bioarchaeologists to become more ethical researchers. While I do not want to continue to objectify the black women in the Huntington Collection, I wonder if not telling their stories would be an even more violent act, which would maintain archival silences and leave their bodies incomplete and mutilated.

References Ahmed, A., Rezai, H., & Broadway-Stringer, S. (2016). Evidence-based revised view of the pathophysiology of preeclampsia. In S. Islam (Ed.), Hypertension: From basic research to clinical practice (pp. 355–374). Cham: Springer. Ahn, J.  K., Lee, Y.  S., Chung, H.  W., Cha, H.-S., & Koh, E.-M. (2007, December). Periosteal reaction in systemic lupus erythematosus. Joint, None, Spine: Revue du Rhumatisme, 74(6), 650–652. Anderson, J. (1982). This was Harlem: A cultural portrait, 1900–1950. New  York: Farrar Straus Giroux. Austin, R. (1989). Sapphire bound! Wisconsin Law Review, 3, 539–555. Baker, B. J., Dupras, T. L., & Tocheri, M. W. (2005). The osteology of infants and children. College Station: Texas A&M University Press. Bell, M.  J. (2010). A historical overview of preeclampsia-eclampsia. Journal of Obstetric, Gynecologic & Neonatal Nursing, 39(5), 510–518. Bhattacharya, P. K., Jamil, M., Roy, A., & Talukdar, K. K. (2017). SLE and tuberculosis: A case series and review of literature. Journal of Clinical and Diagnostic Research, 11(2), OR01. Brand, G. H. (1902). The Treatment Of Puerperal Eclampsia. The British Medical Journal, 1(2148), 509–510. Breathett, K., Muhlestein, D., Foraker, R., & Gulati, M. (2014). Differences in preeclampsia rates between African American and Caucasian women: Trends from the national hospital discharge survey. Journal of Women's Health, 23(11), 886–893. Bryant, A. S., Worjoloh, A., Caughey, A. B., & Washington, A. E. (2010). Racial/ethnic disparities in obstetric outcomes and care: Prevalence and determinants. American Journal of Obstetrics and Gynecology, 202(4), 335–343. Buckberry, J. L., & Chamberlain, A. T. (2002). Age estimation from the auricular surface of the ilium: A revised method. American Journal of Physical Anthropology, 119(3), 231–239. Burrows, E. G., & Wallace, M. (1998). Gotham: A history of New York City to 1898. New York: Oxford University Press. Burson, J. S., Graña, J., Varela, J., Atanes, A., & Galdo, F. (1990). Laminar periostitis and multiple osteonecrosis in systemic lupus erythematosus. Clinical Rheumatology, 9(4), 535–538. Byrd, W. M., & Clayton, L. A. (2000). An American health dilemma: Volume one a medical history of African Americans and the problem of race: Beginnings to 1900. New York: Routledge. Caspari, R. (2009). 1918: Three perspectives on race and human variation. American Journal of Physical Anthropology, 139, 5–15. Caughey, A. B., Stotland, N. E., Washington, A. E., & Escobar, G. J. (2005). Maternal ethnicity, paternal ethnicity, and parental ethnic discordance: Predictors of preeclampsia. Obstetrics & Gynecology, 106(1), 156–161. Centers for Disease Control and Prevention. (2018a). Lupus in women. Last modified October 17, 2018. https://www.cdc.gov/lupus/basics/women.htm

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Chapter 4

Embodying Industrialization: Inequality, Structural Violence, Disease, and Stress in Working-Class and Poor British Women Sarah Mathena-Allen and Molly K. Zuckerman

Introduction Between 1750 and 1850, the progressive industrialization and urbanization of the United Kingdom (UK) dramatically changed the landscape, socioeconomics, and social conditions of both urban and rural environments. Prior to this period, most of the population lived in smaller settlements with less than 5000 people and was predominantly agrarian, relying upon the use of agricultural products and animal husbandry (Wrigley 2013). Yet the UK’s industrial revolution had its roots within the economic systems of its global trading and colonial empire, including its participation in the Atlantic slave trade, in the eighteenth and nineteenth centuries. British colonies served as a source of raw materials and markets for manufactured goods and enabled the UK’s increasing industrial technological advancement. But with the abolishment of the Atlantic slave trade in 1807 and the abolishment of legal enslavement in most British colonies in 1833, new sources of exports for the global trade market and resources for workers within internal markets became needed (Landers et  al. 1993; Daunton 1995). As the UK came to rely less on its sugar-producing colonies in the Caribbean (Mintz 1986), it began to invest in increased production of manufactured goods, such as textiles, glassmaking, and iron, during the second wave of industrialization in the 1830s. Due to the consequent increased demand for an able-bodied workforce in these new large-scale production centers, urban migration increased to urban centers of manufacturing like London, Manchester, S. Mathena-Allen (*) Department of Anthropology, University of Massachusetts Amherst, Amherst, MA, USA e-mail: [email protected] M. K. Zuckerman Department of Anthropology and Middle Eastern Cultures, Mississippi State University, Mississippi State, MS, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 L. A. Tremblay, S. Reedy (eds.), The Bioarchaeology of Structural Violence, Bioarchaeology and Social Theory, https://doi.org/10.1007/978-3-030-46440-0_4

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Liverpool, and Glasgow, which swelled the populations of these cities (Floud and Harris 1996). Contemporaneously, new agricultural technologies enabled increased agricultural productivity, and consequent food surpluses, although the variety of these products was limited (Daunton 1995). Economic changes led to increased wages through most of the period of industrialization but with internal complexity in this overall trend; as women entered the workforce in increasing numbers through the nineteenth century, overall wages dropped, suggesting that women were paid less than men (Steckel and Floud 2008). The overall increase in wages was also countered by increases in the cost of living, including food and housing, for consumers in almost every societal class (Floud and Harris 1996). In addition, social and economic changes in the mid-nineteenth century created a laissez-faire social practice wherein the poor were deemed an elastic labor pool, or an easily replaceable, unskilled labor force, which led to increased labor mobility and displacement of workers, as well as a decreased presence of workhouses for accommodation and employment of the very poor (Rosen 2015; Wohl 1983). Overall, these changing economic structures increased economic inequality both between and within societal classes in the UK. As urban areas became increasingly crowded, unsanitary, and disease ridden, public health reformers in the UK instigated a vocal and contradictory sociopolitical discourse on health, emphasizing both social responsibility and the economic need to improve the health of the laboring population, particularly for women (Brown 2006). On one side were paternalistic views of poor and working-class women. These are evident in contemporary imagery of the poor and working class, such as in Gustave Dore’s engravings (see Fig. 4.1) in the Illustrated London News. These and similar images were employed to motivate legislation, promote social responsibility, and reflect the perceived squalor and wretchedness of working-class and poor neighborhoods. They frequently focused on the lives of working-class and poor women and their children, with the women depicted as unable to care for themselves and in need of social support from the middle and upper classes in the form of poorhouses, institutionalized health care, and middle-class charity visits. On the other side, as women increasingly entered the workforce, considerable social anxiety emerged regarding the potential “harm” of working-class women to their children and to society through perceived increases in sexual promiscuity and maternal neglect (Malone 1998). Due to rising infant and child mortality, increasing maternal mortality, and sociocultural values regarding the management of women’s bodies through both medical and cultural norms (Stone 2012), eighteenth- and nineteenth-­ century reformers called to institutionalize and regulate women’s bodies through legislation and the medical and public health systems (Wohl 1983). Public health usually relies on a biomedical approach, focusing on the role of biological factors in contributing to rates of disease frequencies in populations and the pathophysiology of disease and using biochemistry to assess “healthiness” in individuals (Dechlin and Carter 1994). However, when studying population-level patterns of health in past societies, biomedical approaches are arguably less useful. This is because the biomedical approach in public health is largely very descriptive (Hens and Godde 2008) and because it minimizes the role of sociocultural

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Fig. 4.1  Dudley Street, The Seven Dials, 1872, by Gustave Doré. This engraving depicts a busy street scene in Seven Dials, Covent Garden. Destitute children litter the street, blocking the way of an approaching carriage, and small shops line the right of the street, with shoes laid out around the openings to the cellars below houses (In: London: A Pilgrimage. Wood engraving on paper. Image source: The British Library)

contributions to disease (Armelagos 2003). Consequently, an approach that allows for the embodiment of inequality is arguably much more beneficial for understanding health disparities in the past (Krieger 2005). Specifically, embodiment refers to the production of lived bodies through cultural practices and representation (Van Wolputte 2004). Incorporating inequality into this involves following the principle that bodies are produced and constituted through their social identities (Agarwal and Glencross 2011), meaning that skeletal markers of poor health, such as infectious disease, can be interpreted as being reflective of the power dynamics that shape biological and social circumstances over the life course (Knudson and Stojanowski 2008; Nystrom 2011; Zuckerman et al. 2014). In turn, while populations on the receiving end of inequality, such as women, the poor, and other

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marginalized populations, may be obfuscated or invisible in the historical record, their lived experiences can be reconstructed through skeletal material (Grauer 2003; de la Cova 2010). This is particularly true for highly historically contextualized bioarchaeological research, which is especially well suited to reconstructing the changing health experiences of socially marginalized working-class populations, which are otherwise markedly absent in the historical record (Grauer 1995; Herring and Swedlund 2003). Employing embodiment and narrowing to urban areas of the UK during the mid-nineteenth century, the social concerns over working-class and poor women’s bodies that were held by contemporary public health officials cannot be simplistically viewed as benevolent actions designed to improve the overall health and lives of the working population. Instead, these concerns must be placed within the context of contemporary ideologies; historians have demonstrated that for the eighteenth and nineteenth centuries, the body should be viewed as being constituted through the outcomes of political, economic, and social forces (Foucault 2012). According to Foucault (1977), these comprised productive and repressive forces or techniques of power. Productive techniques constitute bodies and subjectivities through “work” on the body, generating bodies capable of specific societal functions, such as participation in an increasingly industrial workforce. Repressive techniques limit the behavior of the individual. Applied to the skeleton, activity markers and other indicators of repetitive behavior could be interpreted as evidence of productive techniques; the effects of repressive techniques could be detected in evidence of disease, trauma, stress, and other failures of cultural buffering (Zuckerman et al. 2014). The development of medical and public health institutions facilitated these techniques, allowing the body to become entangled and marginalized within systems of power (Foucault 2012). Existing historical records do indicate that inequality and structural violence played a critical role in the marginalization and institutionalization of working-class women’s bodies, creating health disparities between the socioeconomic strata, especially in rates of morbidity and mortality. However, there is very limited direct biological evidence of the biosocial outcomes for working-class women that were produced by the interplay of embodied inequality and structural violence—manifesting as increased allostatic load—and public health policies and practices remain limited. Here, allostatic load is defined as the “wear and tear” that the body experiences when repeated allostatic responses, including the release of stress hormones (e.g., cortisol), are activated during stressful situations (McEwan and Stellar 1993). Structural violence is difficult to define but is understood here as systematic adversity and the denial of materials required for health, well-being, and survival to the poor and marginalized; embodied, structural violence results in disease, stigmatization, and death (Farmer 2004). Taking a life-course approach, this chapter seeks to address this gap through examining relationships between allostatic load, reconstructed here through oral stress indicators (i.e., linear enamel hypoplasias, dental caries) and disease conditions (infectious (i.e., syphilis, tuberculosis), noninfectious (i.e., osteoarthritis, scurvy, rickets/osteomalacia)), in an aggregate sample of skeletons estimated as adult females (N  =  316) (≥18  years) that have been recovered

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from seven postmedieval cemeteries in and outside of London that represent low to high socioeconomic status (SES) communities. This chapter addresses three questions: (1) Do differences in evidence of allostatic load vary by geographic location—in London or outside of the city? (2) Do relationships exist between evidence of allostatic load early in life and disease conditions, infectious and noninfectious, later in life? (3) Lastly, does evidence of allostatic load vary relative to SES?

Background I ndustrial Landscapes and the Institutionalization of Public Health Urban areas in the UK were dramatically impacted by the diverse changes that industrialization caused in urban landscapes, as well as the subsequent impact that these ecological shifts had on health outcomes among all social strata. Diverse lines of evidence, however, show that health risks from industrialization were disproportionately born by the poor (Newman and Gowland 2017; DeWitte et  al. 2016). These changes included inadequate housing and sanitation; pollution of air, water, and food; increased population density; long working hours in often unsafe work conditions (Engels 1845; Gowland and Newman 2018); and inadequate nutrition, all of which were exacerbated by inadequate urban infrastructure (Steckel and Floud 2008). As workers moved into industrializing urban areas, factory owners built tenement housing that was commonly overcrowded and of poor quality (Engels 1845). In addition, the housing was frequently close to factory sites and other employment centers, exposing its occupants to poor air quality from both domestic and industrial smoke. Industrial smoke and other forms of industrial air pollution, such as coal dust, also negatively impacted working conditions inside of factories (Rosen 2015). And when combined with narrow streets and alleys with poor ventilation, overall poor air quality, and increased time spent indoors in factory work, this increased air pollution has been implicated in the increased amount of metabolic disorders, specifically vitamin D deficiency documented in children (i.e., rickets) and reproductive age women (i.e., osteomalacia) evident in both the historical and skeletal record (Wohl 1983; Lewis 2002; Sherman 2006). Exposure to toxicants in both industrial and domestic settings, such as lead exposure from sources as diverse as food contamination (e.g., milk), air pollution, and lead-glazed ceramics, also likely increased overall mortality and morbidity (Millard et al. 2014). Within urban communities, increased population density, exacerbated by overcrowded housing, also led to repeat epidemics of infectious disease, ranging from cholera and diphtheria to tuberculosis and smallpox (Roberts and Cox 2003). Industrialization also drove nutritional adequacy, particularly for the working class and poor (Engels 1845), as it produced a heavy reliance on high-calorie but nutrient-poor foods, such as sugar and coffee (Mintz 1986). The consequent malnutrition exacerbated all of

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these intersecting conditions within industrial landscapes, reducing immunological competence and increasing the risk of comorbid conditions among urban populations. While these diverse features of industrial landscapes negatively impacted morbidity and mortality across demographic groups, diverse lines of evidence show that they were particularly detrimental for the health and growth of urban children, especially infants (Newman et  al. 2019). Importantly, child health, especially infant health, can be informative about maternal health, shedding light on the health impacts of industrialization on reproductive age women. Historical and bioarchaeological evidence reveals that in the mid-nineteenth century, more than one-third of all deaths in major urban areas, such as London, were among those less than five years of age. Bioarchaeological analyses of subadults under the age of five from the mid-eighteenth to mid-nineteenth centuries also reveal high rates of various growth deficiencies and metabolic conditions, such as vitamin C deficiency (i.e., scurvy), that are indicative of both suboptimal infant health and nutrition and maternal health and nutrition, especially among the poor (Newman et al. 2019). Some of this can be attributed to shifts in infant feeding practices, specifically early cessation of breastfeeding, that were driven by women’s increasing participation in the workforce (Newman et al. 2019). Women who returned to work soon after birth experienced worse maternal health while also leaving their infants exposed to greater risk of malnutrition and infectious disease due to early cessation of breastfeeding (Newman and Gowland 2017). By the late nineteenth to early twentieth century, these conditions, especially for infants, had become a major focus of public health policies and interventions. But these practices, such as campaigns to reduce infant mortality through the delivery of uncontaminated dairy products to urban areas, were entangled within complex economic and social conditions (Wohl 1983). Working-class women faced contradictory discourses, with societal pressure upon them to work outside of the home and provide for their families through paid labor, but they were also ideologically held responsible for the well-being of their children and faced intense blame for infant mortality, especially when it occurred under the supervision of non-maternal caretakers (Wohl 1983; Reynolds 2011; Clark 2013). The Rise of Public Health  The rise of public health in the UK is tied to the early understandings of health, medicine, and social welfare. It is also tied to a changing mixture of local- and state-level involvement in public health-related legislation and interventions. Until the late nineteenth century, there were few state-level public health interventions in large part because of the conservative view that a centralized government should not maintain an active role in the lives of the British people but that instead social responsibility should fall upon local organizations and towns (Hamlin 1998). The first state-level involvement did not occur until 1662, with the 1662 Poor Reform Act (or Settlements Act). This legislation relegated the responsibilities of the poor and working class to individual towns and parishes, such as through the creation of workhouses, which reflected contemporary beliefs among social and welfare reformers that providing work was the best way to combat rural

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poverty (Rosen 2015). Unlike almshouses, which typically catered to the elderly and disabled, workhouses served individuals from a variety of demographic groups throughout the seventeenth to nineteenth centuries (Tomkins 2004). Nevertheless, historical records indicate that workhouse tenants were typically women and children. At the Oxford workhouse, for instance, adult women made up 41% of the population while men accounted for only 12% (Tomkins 2004). Records suggest that workhouse conditions were unsanitary, featuring bed-sharing, crowding, and high rates of epidemic disease (Tomkins 2004; Rosen 2015). The state’s role in maintaining social welfare increased again in 1665, with the Great Plague of London, which caused greater concern for the living conditions and health of the urban poor and the first call for a health council to manage public health in cities, including London (Rosen 2015). Further state-level involvement in public health, however, would not occur until the nineteenth century (Rosen 2015). Institutional health care for the poor and working class, though, did increase in the eighteenth century, though it remained limited for much of this period. Much of this was linked to workhouses; individuals in the workhouse system typically received care from small, parish-run infirmaries attached to the institution (Holden et al. 2009). Hospitals also increased in number during this time period, driven in large part by urban workers who did not qualify for parochial assistance. By 1797, seven public and private hospitals had been built in London alone, and by 1860, more than 100 provincial hospitals had been built in England (Rosen 2015). Most of these were private, founded by reformers and physicians (Holden et al. 2009), and were supplemented by public dispensaries, many of them oriented toward mothers and children; by 1840, more than 100 dispensaries for special infant care, maternal care, and related needs had opened across England (Rosen 2015). Unfortunately, both the hospital and dispensaries suffered from high rates of infectious diseases and low hygiene. They also operated within a strict moral economy of values for “legitimate and deserving needs” for the poor and working class. Specifically, contemporary social and moral values, particularly in the Victorian era (AD 1837–1901), emphasized that the benefits of social assistance and public health should be reserved for the “deserving” and “qualified” poor, particularly those that were free of any moral or economic failings (Eden 1928; Holden et al. 2009; Sheetz-Nguyen 2012). For instance, patients often needed to provide letters of recommendation on their qualifications before receiving care (Holden et al. 2009). This practice intersected with gendered ideologies and prejudice against working-class and poor women in negative ways; unemployed women, unwed mothers, and prostitutes were typically unable to secure such a letter, which severely restricted the care and monetary assistance available to them (Sheetz-Nguyen 2012). Economic constraints could exacerbate this structural inequality for poor and working-class women; at donation-based hospitals, for instance, such as the Newcastle Infirmary, women with the pox but without a letter could receive care only if it did not interfere with other patients’ access to care. But until 1885, men with the pox and without a letter could receive care, regardless of how it affected access (Holden et al. 2009).

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In the nineteenth century, state-level involvement in social welfare programs and public health reforms increased once again, driven by an intersection of responses to epidemics in urban areas with an increasing need for an able-bodied industrial labor force (Rosen 2015; Hamlin 1998; Wohl 1983). For instance, an 1834 amendment to the Poor Law restricted the ability of parishes to support any “able-bodied” poor. Rosen (2015: 111) argues that this change was tied both to increasing urbanization and the rise of the free market economy in the aforementioned second wave of industrialization but also the increasing necessity for public health measures in response to epidemics in increasingly crowded urban areas. McCoy (2017: 652) argues that due to the roots of public policy in sanitation, even after the mid-­ nineteenth-­century acceptance of germ theory, state- and community-level British officials holistically conceptualized public health as being fundamentally related to working conditions and social problems. Consequently, public health officials tended to view certain subpopulations, namely, the poor and working-class women, as being more “predisposed” to disease, such as cholera, because of their exposure to harsh working conditions, unclean domestic and work environments, and poverty. Their views also derived from the social mindset that public health problems were inherently correctable through medical treatment and interventions in social welfare (Hamlin 1998), meaning that poor health and welfare among these populations could also be attributable to their “laziness” and unwillingness to work (Holden et al. 2009). However, the poor sanitary conditions, including in housing, food sanitation, and air and water quality, represented the greatest threat to working-class health. State-­ level involvement in sanitary reform greatly increased in the mid-nineteenth century, largely through major new legislation. This shift was driven by cholera epidemics in the 1830s (Hamlin 1998; Sherman 2006), by Enlightenment principles, and by the progressive involvement of a growing middle class in social conditions and welfare reforms, which was motivated by both secular and religious concerns (Rosen 2015). Simultaneously, the shift was also driven by a variety of publications on living conditions of the working class and urban poor in the UK, particularly those focusing on women and children’s living conditions, ranging from Dickens’ fictions (Litsios 2003) to those more explicitly oriented toward social reforms for the poor and working class, such as Chadwick (1842) and Engels (1845). For instance, Chadwick (1842) and his subsequent work as a commissioner of the General Board of Health greatly contributed to the creation of the Public Health Act in 1848. This Act was the first broad measure aimed at improving the living and social conditions of the working class and poor, including improved water treatment and provision and waste removal (Rosen 2015). The Act was, however, highly controversial and unpopular because of the aforementioned conservative view (Hamlin 1998). As a result, it was not renewed until 1858, and widespread acceptance of the sanitary measures included in the Act did not occur until 1875 (Rosen 2015).

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 ealth and the Female Skeleton in the Industrialization H of the UK Human skeletons can serve as an important source of evidence for interpreting relationships between public health policy, urbanization, industrialization, and structural violence, and their biosocial effects on population-level health in the past, especially for populations that are underrepresented in historical records (e.g., DeWitte 2014; Zuckerman 2014; DeWitte et al. 2016; Roberts et al. 2016). The few studies assessing female and women’s health within this dynamic have generated diverse findings. For example, DeWitte (2014) used skeletal evidence to generate demographic and biological profiles of pre-industrial and industrial populations in London in order to understand how mortality and frailty, or an individual’s relative risk of death, changed with industrialization. Analysis of this particular dynamic requires the use of skeletal data because while adequate historical data on health and mortality is available for industrial populations, comparable data is not available for the pre-industrial period (DeWitte 2014). DeWitte  (2010) found that while pre-­ industrial males and females had an equivalent risk of death, mortality risk was lower for females than males in the industrial period. Historical records have shown similar excess male mortality with industrialization, which is potentially attributable to social factors such as accidents at work (Vallin 1991). Indeed, Gage (1994) proposed that the declines in overall mortality that occurred toward the end of industrialization in the late nineteenth and early twentieth century in the UK (i.e., second epidemiologic transition) (Zuckerman 2014) were associated with increased sex differentials in mortality that favored women. In DeWitte’s sample, she proposed that this mortality differential might relate to the higher infectious disease burden that characterized industrial (vs. pre-industrial) London. Males carry a higher overall mortality risk—including from infectious disease—than do females due to innate biological differences, such as from the immunomodulatory effects of circulating sex steroid hormones (Fish 2008). Correspondingly, industrializing London’s burgeoning infectious disease burden could have more strongly affected the health and mortality risks of males than females (DeWitte 2014). Other works have assessed stature, generated from skeletal material, to explore this dynamic. Stature is a highly sensitive measure of biosocial conditions including environmental quality, nutritional status, and biological well-being during growth and development (Stinson 2000). It can be reconstructed from skeletal data as well as from height records, but like mortality data, very little historical data on stature is available for the pre-industrial period (Koepke 2016). Koepke and Baten (2005) assessed skeletally estimated stature for all of Europe in the two millennia preceding the eighteenth century and found that male and female stature roughly tracked each other into the eighteenth century, including in Central and Western Europe (e.g., England). This suggests roughly equal biosocial conditions in the pre-­ industrial period for males and females. Galofré-Vilà et  al. (2018) also assessed skeletally estimated stature in England in the last two millennia but were able to extend their analysis into the nineteenth century. They found that stature in males and females declined after 1650, likely in response to increased work intensity,

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child labor, and rising social inequality with industrialization. Stature further declined from the mid-eighteenth to mid-nineteenth centuries, which is consistent with the findings of most studies of height records (e.g., Galofré-Vilà et al. 2018; Meredith and Oxley 2014) and was likely a response to poor environmental quality and declining dietary adequacy in urban areas (Galofré-Vilà et al. 2018). Studies of height records have been able to further explore the role of gender, and gender discrimination, within this decline. They have found that English women’s stature declined markedly in the early nineteenth century, more so than it did among English men, and among both rural and urban populations (Nicholas and Oxley 1996). They have also found that industrialization affected women’s health and well-being very early in their lives, and its negative impacts extended to their children. For instance, among mid-nineteenth-century textile workers, girl’s stature was significantly less than that of boys, which has been attributed to manifestations of contemporary gender bias (Horrell and Oxley 2016). Girls had to do more arduous domestic work alongside their factory work than did boys or, potentially, girls were more likely than boys to be put into factory work below the legal age limit (Horrell and Oxley 2016). Studies of poor and working-class women’s heights also show that their involvement in industry (rather than home-based production) negatively impacted their stature as well as that of children in their household, suggesting that the nutritional resources available to them became scarcer and of poorer quality with industrialization, especially during the early nineteenth century (Nicholas and Oxley 1996; Horrell and Oxley 2012). Lastly, while studies directly linking industrialization, labor, and skeletal stressors are rare, Roberts and colleagues (Roberts et al. 2016) reported a case of possible “phossy jaw,” or osteonecrosis of the mandible that is typically caused by exposure to industrial phosphorus during matchmaking, in an eighteenth- to mid-nineteenth-­ century subadult skeleton from an urban industrial sample in the UK. Matchstick making was an industry often associated with women and girls, and cases of phossy jaw in young female matchstick makers can be found in the historical record, but sex could not be estimated in this case. In the aggregate, these studies of skeletal material show that industrialization in the UK had diverse but generally negative effects on health and well-being, especially for poor and working-class women.

Inequality, Structural Violence, and Health Violence within human societies takes on many manifestations and meanings, from the direct—such as physical assault and warfare—to the indirect and often invisible forms of structural violence. Although definitions vary, structural violence refers to the limitations in access to resources, both economically and socially, that limit individuals from reaching their full biological, economic, and social potential and that increases their risk of suffering from poor health, injury, and even death (Galtung 1969; Farmer 2004, 2009). These injustices and inequalities become normalized and ubiquitous through systemic conditions of racism, sexism, and

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classism within economic, political, and cultural processes and institutions that are continuously reshaped and realigned for the reproduction of hegemonic power over marginalized “others” (Farmer 2004). Through strategic uses of nonlethal harm, including limiting access to health care, inadequate housing, and exposure to environmental toxins and hazards, the “status quo” of these inequalities can have multigenerational impacts through both biological (e.g., epigenetics, developmental pathways) and social mechanisms (Elbert and Schauer 2014). For example, Shackel (2018) proposed that overall poor health in contemporary communities in Appalachia can be connected to the structural violence—specifically low wages, inadequate nutrition, poor working conditions, and substandard housing—committed against their late nineteenth-century working-class forbearers. Although structural violence likely existed in some phases of the premodern period, modern capitalistic practices, rooted in the development of industrialization, brought with it new means of categorizing and maintaining relations of power to serve the socioeconomic and sociopolitical needs of states (Anglin 1998). Industrialization and its subsequent impacts on the politico-economic structures of states has allowed inequality and structural violence to become normalized and ubiquitous among populations living at the margins of state and capitalistic power, with limiting effects on the potential impacts of medical and social reform (Farmer et al. 2006). Critiques of structural violence analysis argue that this lens on inequality and injustice renders marginalized individuals invisible, homogenizes experiences of violence, and lays culpability not on individuals or groups that propagate the oppression but upon the “invisible hand” of institutions (Benson 2008; Price 2012). Instead, by placing individuals at the epicenter of the “fault lines” from which the goods, resources, and individuals move to form socioeconomic and cultural power, the previously invisible lines used to maintain particular power through social values and degrade others can be made visible (Anglin 1998; Nordstrom 2009). However, privileging the narrative of marginalized individuals in the past can be difficult. Historical records for marginalized groups, such as women and the poor, can be limited or invisible within the historical record or obfuscated by the political motivations of those in the dominant class who created the records (Grauer 2003; Herring and Swedlund 2003). Bioarchaeological analyses can address these limitations and can reverse the analytical lens of violence, placing individuals at the epicenter (Nordstrom 2009) and creating a productive middle ground between the concept of structural violence and critiques. In particular, biocultural approaches to bioarchaeological analyses of violence have emphasized the complex interactions between social behaviors, power dynamics, and violent encounters between populations (Martin et al. 2010; Martin and Harrod 2015). Yet limiting bioarchaeological analysis to patterns of skeletal evidence of violence-related trauma (e.g., fractures) prohibits interpretations of systemic violence and privileges direct violence over structural violence within past cultural systems (Stone 2012). Consequently, researchers have developed models for incorporating the analysis of structural violence into bioarchaeological analysis (i.e., Klaus 2012); these suggest that direct violence is only one aspect of systems of violence that were present in the past. Instead, framing the

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analysis of skeletal markers of allostatic load within their politico-economic, historical, and ethnographic contexts can help to address the synergistic relationships between systems of unequal power dynamics and the body’s physiological response. Drawing upon biocultural bioarchaeological frameworks that emphasize the links between disease morbidity and social status (e.g., Larsen 2015), the bioarchaeology of social identities (Agarwal and Glencross 2011), and direct relationships between political economies and health (Goodman and Leatherman 1998; Goodman and Martin 2002), Klaus (2012: 35) argues that differences in health outcomes evident within skeletal assemblages represent forms of violence and the effects of productive and repressive forces. However, Klaus cautions that the concept of structural violence is not suitable for all past populations. Specifically, the lens of structural violence is most applicable under certain conditions including; within Western European and Euro-American societies, within hierarchical social systems, are considerate of other forms of violence and power dynamics, reflective of the agency of marginalized peoples, and entrenched with historic and archaeological environments (Klaus 2012: 35–37). Bioarchaeological analyses of inequality and structural violence relative to industrialization can be used to comprehend relationships between productive and repressive forces, politico-economic systems that control health and health care, and their impact on the body. Public discourses on health, particularly in the face of epidemics—such as cholera epidemics in the 1830s in the UK—are often couched in specific linguistic and social ideologies that determine who has access to care (Farmer et al. 2006) or which individuals represent a threat to the body politic by their inability or refusal to participate socially as “sanitary” citizens (Briggs 2003). Although research on the structural dynamics of inequality and health typically focuses on modern westernized societies, these dynamics have their roots within the industrialized moral economies and ideologies of the seventeenth to nineteenth centuries. Such bioarchaeological analyses can also address variation within experiences of violence along the intersection of identities, such as class and gender. Price (2012: 11) argues that considerations of gendered violence suffer from an overarching homogenization of experiences of it as domestic violence and the assumption that “all domestic violence is the same.” To avoid this problem, these bioarchaeological analyses must also consider the myriad ways in which the biosocial production of differential health outcomes also occurs at these intersections. Bioarchaeological research over the past three decades has increasingly addressed gender relative to health (Hollimon 2011), but structural violence relative to class and gender is a comparably new but promising focus. For example, Stone (2012) explores how “chronic violence” against women, such as tight lacing (e.g., corsetry) in Western societies in the nineteenth century, might be investigated bioarchaeologically in order to reconstruct indirect modes of patriarchal control of women’s bodies in stratified societies in the past. Research such as this encourages researchers to consider evidence of indirect violence alongside direct violence and attend to how multiple intersecting identities can produce differential vulnerability to structural violence and productive and repressive forces and the complex patterns of health differentials that this can create.

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This chapter seeks to use this perspective to address gaps in our understanding of the variation in allostatic loads among women with regard to geographic location and socioeconomic status as working-class women became increasingly entangled within the institutionalized power of public health initiatives.

Materials and Methods Oral and Skeletal Markers of Stress and Disease To address the relationships between the increased allostatic load associated with industrialization, SES, and geographic locations, several disease conditions and oral indicators of stress were examined. These include infectious diseases, specifically tuberculosis (TB) and acquired syphilis, and noninfectious disease, specifically scurvy (Vitamin C deficiency), osteomalacia and rickets (Vitamin D deficiency), and osteoarthritis. This study utilized an overall health approach in order to address allostatic load over the life course, doing so by examining several disease conditions to assess aggregate risk of poor health over the life course rather than exploring the etiology of single disease and its impact on health (Goodman and Leatherman 1998; Armelagos and Swedlund 1990; Larsen 2015). To address the role of risk of increased allostatic load over the life course in the sample, two oral stress indicators, dental caries and linear enamel hypoplasias (LEH), both of which have been associated with elevated risk of disease morbidity and overall mortality (Armelagos et al. 2009; DeWitte and Bekvalac 2010), were also examined.

Infectious Diseases Importantly, TB, a primarily respiratory infection that was commonly caused by Mycobacterium tuberculosis and Mycobacterium bovis in the eighteenth to nineteenth centuries, and syphilis (e.g., the pox), a sexually transmitted infection caused by Treponema pallidum pallidum, were extremely common infectious diseases in the industrializing UK (Lönnroth et al. 2009; Roberts and Cox 2003). Furthermore, recent immunological studies of the pathophysiology of TB and syphilis infections have shown that persistent infection with these conditions—to active stage in TB and tertiary stage in syphilis, respectively—is associated with an inadequate immune response during the early stages of infection and consequent inability to eliminate the pathogen through bacterial clearance (Carlson et  al. 2011; Kaufman 2001). Importantly, active stage TB and tertiary stage syphilis are the phases of these conditions that generate distinctive skeletal lesions (Hackett 1975; Ortner 2003). Therefore, the presence of skeletal lesions associated with syphilis and TB can be interpreted as evidence of an inadequate immune response during the early stages of infection (Zuckerman 2017). In addition to being a key feature of poor overall

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health, inadequate immune responses, including against pathogens, are one of the long-term manifestations of allostatic load, particularly that experienced during early life (Danese and McEwen 2012).

Noninfectious Diseases Scurvy and Rickets/Osteomalacia  Scurvy, caused by deficient levels of Vitamin C, and rickets and osteomalacia, which are caused by Vitamin D deficiency in subadults and adults, respectively, were extremely common metabolic diseases in industrializing urban populations in the UK (Roberts and Cox 2003). Importantly, both are also highly informative for reconstructing overall health, and environmental and nutritional quality. Vitamin D deficiency is primarily attributable to ultraviolet radiation exposure from sunlight, rather than nutritional deficiency (Holick and Chen 2008), whereas scurvy derives from dietary inadequacy (Maggini et al. 2010). In addition to producing rickets in sub-adults, which can have negative mechanical consequences, and exacerbating the risk of fractures and osteoporosis in adults, Vitamin D deficiency has been associated with increased risk of common cancers, autoimmune diseases, hypertension, and infectious diseases in both adults and subadults (Holick and Chen 2008). Especially in sub-adults, Vitamin C deficiency is associated with inadequate immune responses, such as against respiratory infections, and diverse delays in cognitive and physical development that can have lifelong negative impacts on health (Maggini et al. 2010). OA  Osteoarthritis, which comprises focal, progressive loss of articular cartilage leading to direct bone-on-bone contact and consequent degeneration of joint surfaces and their margins, represents a pattern of responses to various factors, including genetic, environmental, and behavioral causes (Larsen 2015). It is cumulative across the life course, reflecting joint loading and associated damage, and is therefore informative about workload and activity (Larsen 2015). In modern societies, OA carries substantial societal and individual costs, as it is the leading cause of chronic disability in older adults (Zhang and Jordan 2010). Large-scale analyses of OA in European industrializing populations have shown overall higher levels of OA in males than females but decreased levels of OA in the industrial than agrarian, pre-industrial period (Williams et al. 2018). Oral Stress Indicators  In assessing the relationship between early life allostatic load and later life health outcomes, LEH and caries are particularly informative (DeWitte and Bekvalac 2010). LEH are horizontal or pit enamel defects that can occur during enamel formation (Hillson 1996, 2008; Larsen 2015). Several physiological stressors, such as malnutrition or infectious disease, can influence the formation of these defects, and because of this, they are considered to be nonspecific indicators of physiological stress during growth and development (Goodman and Rose 1991). Caries form due to demineralization of the hard tissues in a localized region of the teeth due to long-term presence of oral bacteria on the enamel surface (Larsen 2015). Caries can also form as a result of the body’s inability to control the

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proliferation of the cariogenic oral bacteria, reflecting an inadequate immune response (Acs et al. 1999). Here, the co-occurrence of frequencies of LEH and caries was systematically evaluated to assess overall health from early life development (i.e., formation of LEH in permanent dentition) into adulthood (i.e., formation of caries) using a life history perspective. This approach can be used to address the co-occurrence of pathological changes due to specific diseases and/or nonspecific stress indicators (Mathena and Zuckerman 2017).

Skeletal Samples The aggregate skeletal samples for this study derive from seven cemetery sites across the UK. The samples were chosen based upon the geographic location of the site, the availability and preservation of the skeletal material, and the SES of the community(ies) associated with the cemetery. All of the sites included within this study date to the postmedieval period, dating to the seventeenth to nineteenth centuries. Sample sizes included in this study and their demographics can be seen in Table 4.1.

Table 4.1  Demographics and sample sizes

Site location Coronation Street (CS) Coach Lane (COL) St. Benet Sherehog (ONE94) Chelsea Old Church (OCU00) St. Bride’s Lower Churchyard (FAO090) Cross Bones (REW92) St. Thomas’s Hospital (NLB91) Total

Early adult females (18–35 years) 9

Older adult females (≥36 years) 19

Adult females (≥18 years) 2

0

7

0

15

16

0

13

46

2

1770– Primarily poor 120 1849 to low SES

24

92

5

1800– Poor to low 1853 SES 17th. Mass graves C

26

3

22

1

40

15

21

4

316

79

223

14

Number of individuals Community associated with included in the Date study (n) (AD) the cemetery 1816– Pooz to middle 30 1855 SES 1711– Poor to middle 7 1857 SES 1666– Affluent to 31 1849 middle SES 1712– Primarily 1842 higher SES

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Skeletal Samples Outside of London Coronation Street (CS)  This cemetery is located in Newcastle upon Tyne, a major industrial center for coal and shipping. A total of 204 individuals were recovered from a parish churchyard of the Church of St. Hilda, between 1816 and 1855, and was associated with a poor to middle SES community. Coach Lane (COL)  An MNI of 236 individuals, with several hundred disassociated human remains, were excavated from the Society of Friends burial ground, which was in use by a poor to middle SES community between 1711 and 1857.

Skeletal Samples from Inside London Chelsea Old Church (OCU00)  This cemetery served a predominantly higher SES community that lived on the outskirts of London in Chelsea between the eighteenth and nineteenth centuries. It was excavated in 2000, yielding 198 individuals for analysis (Bekvalac and Kausmally 2008). St. Bride’s Lower Churchyard (FAO090)  This cemetery was one of the largest in London and served a primarily low SES community representing the Bridewell workhouse, Fleet prison, and the surrounding neighborhood. Excavation generated 544 individuals from this site for analysis (Miles and Conheeney 2005). Cross Bones (REW92)  Although the Cross Bones burial ground existed since the middle of the eighteenth century, the 148 individuals excavated and recovered likely date to between 1800 and 1853. The cemetery served the low SES and poor community of St. Saviour Southwark parish as a pauper’s cemetery (Brickley et al. 1999). St. Benet Sherehog (ONE94)  Dating to the primarily sixteenth and seventeenth centuries, the 231 individuals derive from the affluent to middle SES community of the St. Benet Sherehog parish in London (Miles and White 2008). St. Thomas Hospital (NLB91)  A total of 193 individuals were analyzed from three mass burial trenches at the site, all of which were associated with the nearby St. Thomas Hospital. The graves, dating to the seventeenth century, are likely epidemic or pauper’s graves.

Methods Osteological and paleopathological inventories of the samples included in this study from CS and COL were conducted by the first author, while data from these inventories for the other samples (ONE94, OCU00, FAO090, REW92, NLB91) were

4  Embodying Industrialization: Inequality, Structural Violence, Disease, and Stress… Table 4.2 Observed health sample

oral

LEH and caries present CS COL ONE94 OCU00 FAO090 NLB91 Total

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Sub-sample (n) 30 7 4 38 58 23 160

derived from the Museum of London’s Centre for Human Bioarchaeology’s (CHB) WORD (2016) database. In all cases, data recording, including age and sex estimation, followed Powers (2012). Only individuals estimated as being female (i.e., female, probably female) and eighteen years of age or older were included in the sample. Following Powers (2012), disease conditions and oral stress indicators were scored as being present or absent in each individual, but rickets and osteomalacia were combined into one variable. Additionally, an aggregated subsample of individuals (n = 160), from all but REW99, with LEH and caries (Table 4.2) was used to test whether associations existed between these indicators, combined and separately, and infectious (syphilis, TB) and noninfectious disease conditions (scurvy, rickets/osteomalacia) using odds ratios (Sattenspiel and Slonim 2012). Chi-square tests (p ≥ 0.05) were run in SPSS 25© to address associations between geographic locations (London, outside of London) and disease conditions in each population and between SES and disease conditions (tuberculosis and syphilis) in a subsample of the sites (CS and FAO090, FA0090 vs. OCU00, CS and OCU00) (e.g., Figure 4.3a, b). When samples sizes dropped below five, a Fisher’s exact test (p ≥ 0.05) was used to assess significance.

Results The overall frequencies of disease conditions and oral stress indicators within all of the samples can be seen in Fig. 4.2, which shows that the highest frequencies of disease conditions were found in the cemeteries from outside of London. For statistical analysis, frequencies of noninfectious diseases (rickets/osteomalacia, scurvy, OA) and infectious diseases (TB, syphilis) were combined due to small sample sizes. The results of Fisher’s exact and chi-square are seen in Table 4.3. They show that infectious diseases did not reach significance for any site-specific test, although frequencies of TB and syphilis were higher in lower SES populations as seen in Fig. 4.3a, b. However, results were significant when comparing CL, OCU00, and FAO90, which suggests that differences in geographic location—London vs. outside of London—were associated with higher frequencies of noninfectious conditions outside of London. The results of the odds ratios are in Table 4.4. Results of

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Fig. 4.2  Frequencies of disease conditions (noninfectious (scurvy, rickets/osteomalacia), tuberculosis, syphilis, total infectious disease (syphilis, tuberculosis)) and oral stress indicators (LEH, caries)

Table 4.3  Chi square results p (≥.05) CS/OCU00 CS/FAO CS/REW FAO/OCU00

a

Trauma 0.04 0.681 0.385 0.025

OA 0.013 0.003 0.227 0.757

Syphilis 0.205 0.51 NA 1

Tuberculosis Frequencies

TB 0.549 0.494 0.322 1

b

Scurvy 0.032 0.03 0.5 NA

LEH 0.297 0.03 NA 0.4

Caries 0.07 0.98 NA 0

Rickets 0.467 0.114 1 0.312

Syphilis Frequencies CS vs FA0090 60

120 50 100 40 Count

Count

80 60

30

40

20

20

10

0

FAO

OCU00 Site

Tuberculosis: combined ((M.tuberculosis/bovis)/brucellosis) (0= no/1 =yes) 1 0

0

CS

FAO Site

SYPHILIS(0--no/ 1--yes) 0

1

Fig. 4.3  Frequencies of tuberculosis (a) (FAO vs. OCU00) and syphilis (b) (CS vs. FAO)

4  Embodying Industrialization: Inequality, Structural Violence, Disease, and Stress… Table 4.4 Disease risk relative to oral stress indicators

Disease risk relative to oral stress indicators Non-infectious disease/LEH & caries Non-infectious disease/LEH Non-infectious disease/caries Infectious disease/LEH & caries Infectious disease/LEH Infectious disease/caries

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Odds ratio 0.7 1.15 0.3 6.15 2.81 5.02

the odds ratios tested for the subsample with oral stress indicators suggest that individuals with both oral indicators, LEH and caries, have a six times greater risk of developing an infectious disease. Results also suggest that individuals with LEH are at a slightly increased risk—approximately one time greater—for developing a noninfectious disease.

Discussion The results from this study suggest that despite the role of public health initiatives in the eighteenth and nineteenth centuries, which were intended to minimize overall mortality and morbidity and improve health among the poor and working class of the UK, working-class and poor women in and outside of London were extremely vulnerable to dynamics of power within the industrializing nation. Frequencies of oral stress indicators, which are indicative of early life and later life physiological stress when combined, were high across all of the subsamples but particularly for samples from outside of London. These findings, while specific to adult females, are consistent with bioarchaeological analyses of subadult health during industrialization (Newman et al. 2019). Many of these have found high frequencies of oral stress indicators in subadults from urban and rural populations, with rural assemblages often manifesting greater evidence of early life stress (Gowland et al. 2018). Overall, individuals in this sample therefore represent those who shared these stressful early life experiences but who were somewhat more resilient than their subadult peers and managed to survive into adulthood. Further investigation of this dynamic, however, awaits an analysis including subadults and male adult skeletons from the same samples. At the same time, the findings that presence of LEH, and the presence of both LEH and caries, is associated with much greater risk of noninfectious and infectious diseases, respectively, does not merit much further analysis. These findings are highly consistent with those of a small but growing number of studies in bioarchaeology (e.g., Armelagos et  al. 2009) and a vast body in life course and social epidemiology (Charles et al. 2016). These have found that early life experiences of physiological stress, such as that indicated by LEH, especially when paired with continued stress into adulthood, such as that indicated by caries, greatly

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predispose individuals to noncommunicable diseases, such as cardiovascular disease (Barker 2012), and some chronic infectious conditions, such as syphilis (Zuckerman In press). The findings here show that the effects of early life stress on adult health outcomes, well recognized in modern industrial and postindustrial populations, have roots that extend back into the allostatic load that poor and workingclass women experienced at the very beginning of industrialization. For all of the samples, infectious disease was common, except for individuals from St. Benet Sherehog, who did not show any evidence of syphilis or TB. These high frequencies of infectious disease are consistent with historical evidence of the high infectious disease burden that characterized industrializing urban areas in particular, and within them, poor and working-class populations especially (Roberts and Cox 2003). But the absence of these conditions in the St. Benet Sherehog sample sheds special light upon this finding. Miles and Conheeney (2005) noted that skeletons from this site yielded extremely low frequencies of syphilis when compared to other contemporary assemblages. They proposed that this may be attributable to overall immunological competence within the living population of St. Benet Sherehog, which, given its high SES, would have had adequate diets and low exposure to stressors (Miles and Conheeney 2005). Indeed, given that persistent syphilis and active stage TB have been associated with inadequate immune responses during early infection, the frequency of these conditions within the middle SES to poor samples relative to the high SES assemblage in this study is likely indicative of chronic stress (Zuckerman In press) and allostatic load in females in the former— especially poor and working class—communities and its relative absence in the more privileged and buffered former. Indeed, sites characterized by low SES yielded the highest frequencies of infectious and noninfectious disease and OA. As discussed above, historical records of the living and working conditions for poor and working-class individuals suggest that industrialization placed them at increased risk of disease and environmental hazards. Despite social values that suggested middle to low SES women should assist in providing for their families, there were limited in their economic and social opportunities. As the abovementioned studies of stature reveal, women’s participation in the workforce impeded their access to adequate diets, with negative effects on their biological well-being, evident in their short stature (Nicholas and Oxley 1996; Horrell and Oxley 2012). Here, this dynamic seems to be evident as well, manifesting as scurvy, rickets, and osteomalacia. Additionally, while frequencies of OA declined in Europe with both males and females with industrialization, the high frequencies of OA in the samples may be evidence of the physical strain that the double burden of labor—domestic as well as industrial—that working-class girls and women endured (Horrell and Oxley 2016) but that their male coworkers did not. Women who were not able to adequately participate in the industrial workforce may also have been compelled to find alternative means of economic support. Historical records indicate that especially among the limited to unskilled labor force, many women who were fired from servant positions or factory work may have turned to prostitution, even if only temporarily (Walkowitz 1982). This may have rendered them more susceptible to infectious diseases, especially syphilis (Walkowitz 1982),

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and other stressors, including psychosocial stress, which potentially increased their allostatic load. In turn, this may have been exacerbated by the limitations on access to health care imposed by the contemporary social and moral values that emphasized that social assistance and public health, including institutional care, should be reserved for the “deserving” and “qualified” poor and typically not for unemployed women, prostitutes, or women with “the pox” (Sheetz-Nguyen 2012), which may have included some of the females in the samples analyzed here. When tested for geographic location, significant differences were found for OA and scurvy and LEH, indicating that the effectiveness of public health measures was uneven across the UK. Specifically, as defined and reconstructed in this study, poor and working-class women outside of London were at a slightly higher risk for increased allostatic load over their life course, ranging from early life stress to nutritional deficiencies and physical strain. This may be attributable to the physical landscape of industrialization; although London was the center of some manufacturing, most of the UK’s industrialization came from outside London (Daunton 1995; Wrigley 2013). Bioarchaeological analyses of subadult health have shown, for instance, that the biosocial impacts of industrialization on children’s health were experienced throughout the UK, in both rural and urban areas (Gowland et al. 2018). Urban centers in both the northern and southern parts of the UK were also negatively affected, with some urban populations outside of London experiencing higher levels of metabolic disease than those in London (Newman et  al. 2019). Indeed, Lewis (2002) has argued that industrialization, not urbanization, was more damaging to subadult health, especially for noninfectious disease risk, meaning that living in an intensively urban area like London did not represent the highest contemporary health risk. Due to the limited archival records associated with most of the samples, this study is limited in addressing associations between geographic location, health, and allostatic load over the life course. But historical records evidence high rates of rural-urban migration during industrialization in response to economic pressures (Daunton 1995). And while large urban centers in the UK, such as London, were epicenters of eighteenth- and nineteenth-century public health and hygiene improvements, few studies of these improvements—and their effects on health—have been conducted for communities outside of these centers, such as those from which Coach Lane and Coronation Street derive (Hamlin 1998; Rosen 2015), leaving little for comparison. Analysis of additional samples from outside London may prove fruitful for more comprehensively understanding the role that location played in the health of poor and working-class women during industrialization.

Conclusion Untangling dynamics of power and their insidious, direct impacts upon the body represents a significant challenge to past studies of the complex socioeconomic and cultural impacts of public health and hygiene legislation. Studies of present-day health initiatives have greatly emphasized this relationship (e.g., Shackel 2018), but

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they remain under-evaluated in bioarchaeological analyses, including those of industrialization in the UK. Yet institutionalized health care remains one of the most critical tools for enabling and reinforcing the “status quo” of structural violence (Farmer et al. 2006). As this study emphasizes, women, especially those of the poor and working classes, were especially vulnerable to those dynamics in the UK in the eighteenth to nineteenth centuries. Recovering their lived experiences enables a reconstitution of their agency and disrupts the “status quo” of their experiences within the nexus of violent politico-economic systems by placing them, as individuals, at the epicenter of harm. It also generates not just bodies that mean but meaningful bodies that can contribute to our understanding of the embodied experiences of inequality and structural violence across time (Zuckerman et al. 2014). Acknowledgments  Thanks go to Petra L. Banks, Michelle L. Davenport, and Ryan J. King for their assistance with coding some of the data employed here. This research was supported by the National Science Foundation grant: NSF #IIA-1261172.

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Chapter 5

Patriarchy in Industrial Era Europe: Skeletal Evidence of Male Preference During Growth Sarah Reedy

Introduction Institutionalized forms of inequality can cause undue harm, stress, and even premature death by avoiding the basic needs of people within a society (Galtung 1969). Those who are in the lowest classes and rungs of society’s ladder are those who suffer the most. There are multiple ways discrimination can manifest itself through classism, sexism, racism, and ageism. In this chapter, I will explore the inequalities experienced by children growing up in the stressed conditions of Industrial Era Europe (eighteenth to twentieth centuries). The industrialization of cities is often a drawn-out and multivariate process that encompasses complex social and political changes. In Europe this process is often credited as a time of development, innovation, and economic growth. While these may be true, it was also a time of vast urbanization, pollution, hard labor, distinct social classes, poor nutrition, and disease (Thompson 1963; Hobbs et  al. 1999; Cardoso and Garcia 2009; DeWitte et  al. 2015; Leatherman and Jernigan 2015; Hughes-Morey 2016). It is under these conditions that childhood growth can be negatively impacted. Industrialization is a complex process and often includes changing political structures and rapid urbanization leading to increased disease burden and overcrowded and poor living conditions, yet often leads to eventual economic growth for rising middle classes. The people living during the Industrial Era of Europe experienced such conditions and the majority of the populace lived in conditions of inequality, rising costs, declining wages, malnutrition, and extremely poor, overcrowded living conditions (Thompson 1963; Webster 1975; Szreter 1988, 2004; S. Reedy (*) Department of Sociology, Anthropology, and Criminal Justice, Quinnipiac University, Hamden, CT, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 L. A. Tremblay, S. Reedy (eds.), The Bioarchaeology of Structural Violence, Bioarchaeology and Social Theory, https://doi.org/10.1007/978-3-030-46440-0_5

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Hobbs et  al. 1999; More 2000; Johnson 2006; Cardoso and Garcia 2009). Many people, especially those of the lower classes, were exposed to harsh working conditions, heavy pollution, lack of health care, and poor sanitation increasing their risk for developing various diseases like tuberculosis, cholera, rickets, and typhoid (Thompson 1963; Wohl 1983). Just like industrialization, the growth and development of human children is also a complex process. Children’s growth is a reflection of the environment. Under good conditions, children grow and develop to their full genetic potential. However, stressed conditions leading to malnutrition, disease, starvation, overcrowding, and hard labor often lead to stunting, decreased muscle mass, failure to thrive, and increased risk of death (Stini 1969; Van Gerven and Armelagos 1983; Tanner 1989; Eveleth and Tanner 1990; Bogin 1999; Cameron 2002; Lewis 2002; Cardoso 2005; Cardoso and Garcia 2009; Hughes-Morey 2012). Children are considered the most fragile members of society (Tanner 1982; Van Gerven and Armelagos 1983; Goodman et  al. 1984; Schell 1989; Bogin 1999; Cameron 2002). Their skeletal remains can help us understand how poor conditions differentially influenced health between social classes and sexes. While all children can be negatively impacted by poor environmental conditions, boys1 may exhibit a greater disadvantage. Under conditions of stress, boys often show more evidence of stunted growth, decreasing the sexual dimorphism (i.e., differences between the sexes) in height of an adult population (Stini 1969; Roede and van’t Hof 1978; Oyhenart 2006). Buffa et al. (2001) discovered that girls are adapted to reserve nutritional components, like fat and protein, during growth (for use during pregnancy and nursing), buffering them during times of stress. However, patriarchal practices of the Industrial Era often resulted in preferential treatment of boys and men gaining them better access to nutritional foods within the household (Horrell and Oxley 2012). In analyzing children’s skeletal remains, there can be many challenges such as establishing sex and age. Industrial Era Europe provides a unique opportunity to gain this information in the form of cemetery documents for each of the individuals within their samples. This allows us to analyze boys and girls separately, a variable often indistinguishable in juvenile skeletal remains, as well as know the cause of death and even their family’s social status making comparisons within and among populations possible. This chapter explores how the stressed environmental conditions of the Industrial Era of Europe, such as changing political structures, infectious diseases, overcrowding, poor sanitation, malnutrition, patriarchy, and low socioeconomic status, impacted growth and sexual dimorphism through comparisons of three Industrial Era subadult samples with varying socioeconomic status (SES).

1  Here I use the gendered terms “boys” and “girls” rather than the biological terminology “male” and “female” typically used in scientific writing to demonstrate that, in life, these children were impacted by the gender ideologies of their cultures, which often led to differential treatment and ultimately inequality.

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The interpretation of structural violence among past populations can be challenging. Industrial Era European skeletal remains offer a unique opportunity to compare the bodies of those individuals to written, historical records due to the vast historical literature and cemetery samples available for research. Here, I interpret the consequences of the rapid changing political and social systems, such as the process of industrialization and patriarchal norms that impacted the daily needs and living conditions of the populace, specifically those most vulnerable, on the growth and development of children during this time.

Changing Political Structures and Industrialization I use three skeletal samples from London (England), Bologna (Italy), and Lisbon (Portugal) for this analysis. These remains are those of people who lived during the height of their population’s industrial growth. Each of these cities experienced rapidly changing political systems resulting in inequity for the majority of their residents. The tolls of rapid population growth, increased risk of infectious diseases, and poor sanitary and living conditions can be seen on the skeletal remains of the most vulnerable individuals of society, children. Historical records help paint the picture of the day-to-day experiences of these populations and can help interpret the analyses of their skeletal remains. Below is a brief historical review of the industrialization process each of the cities used in this project.

London The skeletal sample from London is from the Spitalfields Coffin Plate Skeletal Collection. It includes people from the Spitalfields district and dates to 1729–1859. The Spitalfields district had an influx of immigrants fleeing religious persecution from France in the early to mid-eighteenth century. Silk and weaving manufacturing increased at this time allowing some wealth and industry into the district (Molleson and Cox 1993). This collection is made up of members of the Christ Church in Spitalfields, all of whom were buried in the private family vaults of the crypt. Records show that most individuals buried in the crypt were from middle to upper classes, with occupations such as craftsmen, surgeons, stockbrokers, and merchants, and many of them were estate owners (Cox 1996; Lewis 2002). They are described as relatively wealthy which most likely buffered them from hardship, food shortages, and rising costs of living (Molleson and Cox 1993; Nitsch et al. 2011; Hughes-­ Morey 2016). During the seventeenth and eighteenth centuries, increased wages, economic growth, and wealth meant increased population growth and urbanization. Consequently, with increased population came poor environmental conditions, competitive and ultimately decreased wages, and severe food shortages especially

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among the working classes (Schwartz 1985; Molleson and Cox 1993). After a typhus epidemic in Manchester public, campaigns for better public health became more prominent (Douglas et al. 2002). In eighteenth-century London, infant mortality rates were as high as 30% with smallpox and whooping cough killing most children, even among the wealthy (Douglas et al. 2002). The Marine Society and the Royal Marine recruitment data show that those born before 1800 were often severely stunted (Molleson and Cox 1993). Typically urban children grew taller than rural children; however the opposite was true in nineteenth-century England despite social status suggesting English industrialization was extremely stressful in terms of morbidity and mortality, especially in children (Tanner 1982). This is further supported with rising mortality rates and overall decreases in height, as well as increases in diseases, population, and pollution (Komlos 1993; More 2000; Mays et  al. 2008; Bengtsson and van Poppel 2011). From 1600 to 1900, thick layers of smoke and smog often sat atop London’s industrial sectors due to the use of coal and steam-powered factories and transportation (More 2000). The smoke pollution in addition to the growing buildings and narrow streets is associated with increased cases of rickets and other nutritional deficiencies (Molleson and Cox 1993; More 2000). With increasing population growth in the 1820s and 1830s and a collapse in small, local governments, London experienced a shortage of clean water and failing sewage facilities, a decrease in smallpox vaccinations, increases in overcrowded housing, and rampant infectious diseases such as tuberculosis, typhus, and typhoid (Woods and Woodward 1984; More 2000; Johnson 2006). The “Great Stink” of 1851, when raw sewage flowed directly into the Thames River (a source of drinking water for many) causing multiple cholera epidemics, propelled public health as a priority improving sanitary conditions (Johnson 2006; Daunton 2014; Frerichs 2016). These improvements led to decreasing mortality rates, especially among infants (Szreter 1988).

Bologna The skeletal sample from Bologna is part of the Frassetto Skeletal Collections and dates from 1880 to 1935. It is housed in the Museum of Anthropology at the University of Bologna in Italy. During this 55-year period of time, Italy experienced rapid political changes from a parliamentary oligarchy, to Mussolini’s fascist regime, to a republic with a parliamentary democracy (Webster 1975; Cardoza 1982; Hobbs et al. 1999). Bologna became competitive for their agricultural, engineering, silk, cotton, tobacco, steel, chemical, automotive, packaging, and meat industries increasing the economic growth, urbanization, and living standards for a growing middle class (Webster 1975; Vaccaro 1980; Cardoza 1982; Capecchi 1997; Forgacs 1990; Bosworth 2013).

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In 1883–1914 Bologna’s socialist mayor provided public housing, public access to education and the university, rising incomes, and assistance programs improving social conditions (Vaccaro 1980; Capecchi 1997). Between 1900 and 1914 alone, Bologna saw a population increase of 30% (Vaccaro 1980). Despite standards of living improvements and a rising middle class in the late nineteenth century, Mussolini’s regime (1925–1945) created very poor conditions and rising unemployment forcing most laborers to work additional hours and days to survive (Capecchi 1997). The individuals housed in this skeletal collection were primarily middle to low classes (Mariotti et al. 2015). According to the records of the individuals interred in this sample, roughly 30% of the adult men were factory workers, 20% worked in trade professions, while another 20% were police, military, businessmen, or retired professionals. Women, on the other hand, were overwhelmingly (70%) labeled as domestic workers and 20% as laborers. Domestic workers may mean working for other families or for their own as stay-at-home wives and mothers, and it may also mean that they worked for the weaving industry, but from their home. Italy was largely influenced by the Catholic church and maintained a strong patriarchal culture where women and children were considered inferior and submissive and treated harshly (Krause 1999; Rahikainen 2004; Bosworth 2013). Their work was largely undervalued in the society and within the home despite their importance in textile manufacturing (Kertzer and Hogan 1989; Capecchi 1997; Krause 1999, 2005, 2007). Many women worked throughout their pregnancies potentially impacting their health and that or their infants, which may be a factor in the 40–47% infant mortality rate in 1910 (Klusener et al. 2014). Rising population growth led to poor living conditions and increased risk of infectious diseases such as the Spanish flu, tuberculosis, and cholera, as well as malnutrition leaving the poorest and most vulnerable at greater risk of morbidity and mortality (Bosworth 2013). The increasing unhappiness of the population ended with labor strikes resulting in civil unrest for the fascist regime. At this point the governmental shift toward a republic with a parliamentary democracy allowed more modern standards of education, industrial growth, and literacy, as well as higher wages and shorter working hours (Forgacs 1990).

Lisbon The skeletal sample from Lisbon dates to 1805–1975 and is housed in the National Museum of Natural History in Lisbon, Portugal. During this time conditions in Portugal were very poor with consistently changing political systems and late industrial development. Portugal was ruled by a monarchy until the Napoleonic invasions in 1807, pushing the country into civil war until the twentieth century. At this time Portugal developed into a republic state, but with a weak capitalist system (Cardoso 2005; Oliveira and Pinho 2010). In 1933 Portugal fell under the longest standing dictatorship of all Europe with Antonio de Oliveira Salazar. The political instability

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of this time resulted in very poor conditions with most of the population living in poverty. Eventually, strong social movements led to a military coup in 1974 resulting in a democratic system that allowed conditions to ultimately improve (Giner 1982; Cardoso 2005; Stolz et al. 2013). Because of the changing political systems and poor conditions, industrial growth was slow to develop. Most industry consisted of textiles, metalworking, cork, ceramics, and tobacco (Reis 2004; Cardoso 2005). The labor force comprised of large numbers of women and children, with women earning the least (Reis 2004). Like Italy, Portuguese families were largely Catholic and patriarchal with children and wives under the father’s authority (Pina-Cabral 1992). People fled to the city center of Lisbon tripling the population size resulting in increases in infectious diseases and an infant mortality rate of 30–40% (Reis 2004, 2009; Cardoso 2005; Cardoso and Garcia 2009; Oliveira and Pinho 2010; Da Silveira et al. 2013; Klusener et al. 2014). In 1920 life expectancy was as low as 30–40 years and half of all children died before the age of 15 years (Cardoso 2005). Portuguese stature declined by 10% over the course of the nineteenth century (Stolz et  al. 2013). During Salazar’s regime (1933–1974), Portugal became one of the poorest countries in Europe. Food, housing, sanitation, education, and healthcare were largely unavailable to most of the working class population. These conditions were further exacerbated by World War II, leaving over half of the population in poverty (Giner 1982; Cardoso 2005; Stolz et al. 2013). It was not until after a military coup in 1974 that conditions started to improved. Family incomes increased allowing them more access to nutritional food and healthcare, as well as better public health polices improving sanitary and living conditions throughout the city (Cardoso 2005, 2006, 2008; Cardoso and Garcia 2009). Military data shows that between 1902 and 2000, men’s height increased 8.93 cm, with most improvement occurring after the 1970s. During the time when the individuals of this skeletal sample were living, Portugal was considered one of the poorest European nations with some of the highest infant and overall population mortality rates and shortest populations. The Salazar dictatorship resulted in some of the poorest living conditions in all of Europe. The individuals comprising these samples are described as primarily low SES especially given the fact that they are interred in this collection in the first place. In Portugal, it is common for people to be buried in graves for 5 years and then exhumed so the burial plot can be reused. Family members must pay a fee to place their loved ones in more permanent graves or mausoleums. When the family cannot pay these fees, the skeletal remains are placed in communal graves and incinerated, or the National Museum of Natural History collects them for research (Cardoso 2005), which indicates that these individuals’ families could not afford more permanent burials.

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Inequality (Status, Childhood, and Patriarchy) Most Europeans depended on wage labor, with those often competing with the development of new technologies (Webster 1975; Hobbs et al. 1999). Men, women, and children worked 10–15  h/day in order to survive. This work was often in factories and brutal, both from the manual labor and the rough treatment from managers (Hobbs et al. 1999; Rahikainen 2004). Social historians report that during the Industrial Era children in parts of England started working in factories by age 6  years (Thompson 1963; Cox 1996; Lewis 2002), children in Portugal by age 10 (Goulart and Bedi 2007; Cardoso and Garcia 2009), and children in Italy by age 12 (Kertzer and Hogan 1989; Rahikainen 2004). In Italy, children likely earned higher wages than their mothers. In poverty conditions, as long as they earned money for the family, children were sent to work (Cunningham and Viazzo 1996). In the eighteenth and early nineteenth centuries in England, women’s and children’s wages were often not recorded as part of household earning in census data (Humphries 2010; Goose and Honeyman 2013; Humphries 2013). Similarly, women and children’s living and household expenses are often underrepresented in historical research (Humphries 2013) vanishing them from much of history. Though women worked long days outside of the home, they were still expected to complete household duties and bear the burden of raising children. Tanner (1982) describes how many nineteenth-century European women worked in laborious conditions throughout their pregnancies. Household income and food allocation were often the responsibility of the mother. Horrell and Oxley (2012) explain that women would often “self-sacrifice” and then allocate food to her children depending on how their contributions to the household were valued (Horrell and Oxley 2012). However, daily food intake is challenging to evaluate in living populations, and it is even harder to interpret food intake from past populations when relying on written records, many of which leave women and children out entirely. But, some records do show us women and young children were most often given grain-based foods, potatoes, and tea, while men and adolescent boys received bread, meat, dairy, and beer, all of which had higher nutritional values (Humphries 2013). This male preference doesn’t just end with food, but is also accounted for in greater female infanticide (Voland et al. 1997) and less time breastfeeding female infants (Humphrey et al. 2012). During the nineteenth century medical professionals began to document the need for social welfare laws to improve the conditions for the public (Tanner 1982; La Berge 2002). Many started to compare the growth of children working in factories to those not working, finding that children who labor had suffered growth insults (Tanner 1982). By 1901 it was largely illegal for British children under the age of 12 years to work in factories, a law that likely influenced other nations, such as Italy and Portugal. With harsh working conditions and a lack of good, nutritious food, poor children were already disadvantaged, but added to this was the surge in

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urbanization, and living conditions became increasingly cramped and polluted as population size increased (Engels 1958; Thompson 1963; Johnson 2006). The impact of these societal stressors is evident in height data and skeletal remains. For example, Horrell and Oxley (2012) found that the nutritional quality of food decreased with a growing reliance on grains and more processed foods. As a result diseases like rickets, scurvy, and tuberculosis became more prevalent, especially among women and children, and even more so in those living in urban settings. Skeletal research provides another means of testing inequality for the purpose of interpreting structural violence and the impacts of environmental stress and malnutrition. Mary Lewis (2002) found that children from the Industrial Era of London had higher frequencies of linear enamel hypoplasias (LEHs,) dental caries and abscesses, cribra orbitalia, and stunted height compared to those from the medieval period suggesting that living conditions declined during the Industrial Era. Similarly, Cardoso and Garcia (2009) found more evidence of stunted height in Industrial Era adults from Lisbon, Portugal, than those from the medieval period. Mariotti et al. (2015) also discovered high rates of infectious diseases in individuals from a nineteenth-century Bologna, Italy, skeletal sample. While that research points to the Industrial Era specifically, those who were more vulnerable, such as females and the poor, were even further disadvantaged. Poor children from eighteenth- to nineteenth-century England were more likely to die than those from higher status families (DeWitte et al. 2015). Hughes-Morey (2016) found that low status females were more stunted and had the highest risk of mortality during Industrial Era London given the preferential treatment for male children and the added stress of low social status.

Childhood Growth (Normal vs Stressed and Sex Variation) Under normal, healthy conditions, boys and girls follow similar growth trajectories until the adolescent growth spurt. At this time, girls typically grow and mature at a faster rate. Boys experience a longer period of overall growth, typically resulting in higher height and weight values (Tanner 1989; Bogin 1999; Cameron 2002). During early childhood growth, children are some of the most vulnerable members within a population, with their growth as a reliable indicator of the overall health status of a population (Tanner 1982; Schell 1989; Bogin 1999; Cameron 2002; Leatherman and Goodman 2005). If environmental conditions are poor (such as those described in the Industrial Era), they may experience stunting and increased risks of morbidity and mortality (Stini 1969; Tanner 1989; Eveleth and Tanner 1990; Bogin 1999; Cameron 2002). While this can negatively impact all children, boys may be at an increased risk. Since the 1950s, research has consistently shown that girls likely have an adapted response to stressed conditions through the storage of fat and protein for later reproductive demands, resulting in their overall increase in body fat compared to boys (Greulich 1951; Stini 1969, 1972, 1978, 1980; Roede and van’t Hof 1978; Brauer

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1982; Wolfe and Gray 1982; Hierneaux 1985; Stinson 1985, 1992, 2000; Tanner 1989; Eveleth and Tanner 1990; Pucciarelli et al. 1993; Buffa et al. 2001; Oyhenart 2006). This “female buffering” allows girls to continue growing while boys may experience more stunting (Stini 1978, 1980; Wolfe and Gray 1982; Buffa et  al. 2001). Girls typically survive better during times of stress and are more likely to experience catch-up growth than boys (Greulich 1951; Stini 1969, 1972; Tanner 1989; Eveleth and Tanner 1990). In such stressed conditions, when boys experience more stunting, morbidity, and mortality than girls, it reduces the overall sexual dimorphism in adult stature of the population, a trend that has been witnessed in living populations and measured in skeletal remains (Stini 1969; Roede and van’t Hof 1978; Brauer 1982; Hierneaux 1985; Pucciarelli et al. 1993; Oyhenart 2006; Cardoso and Garcia 2009). For example, Garvin and Ruff (2012) found that individuals from lower SES backgrounds growing under conditions of stress had decreased body size dimorphism. Cardoso and Garcia (2009) found that adult dimorphism in height is decreased in an Industrial Portuguese sample that shows significant levels of environmental stress, while a medieval Portuguese sample exhibits increased dimorphism in height. DeWitte (2010) discovered that men from medieval London had an increased risk of mortality compared to women. This research suggests that while all individuals may suffer similarly in the same poor environmental conditions, females may be more resilient when exposed to stressful conditions. On the other hand, as mentioned previously, these Industrial Era societies were largely patriarchal, thus leading to “cultural buffering” of males in the form of preferential treatment for wage earning and food. This cultural buffering could potentially mask the positive effects of biological buffering in females (Stinson 1985; Hughes-Morey 2012). It is not well understood how the effects of biological buffering and cultural buffering interact or interfere with each other. However, it is well understood that political and economic factors heavily influence one’s access to proper nutrition; therefore growth represents a potential measure of the economic contribution to societal needs (Norgan 2002), which can allow us to consider interpretations of social status and gender inequality in the bioarchaeological record. One way to do this is through measuring stunting. When medical professionals of the nineteenth century became aware of the negative impacts of poor nutrition during childhood, they started to take note of height as a proxy for health (Norgan 2002), a practice that is still performed today. A child is considered to have low body weight, be stunted in height, or wasted (weight for height) when they are ≤2 z-scores below the mean of the population (Bogin 1999; Cameron 2002). At this score, if the child is not properly treated, can face multiple poor health outcomes for the rest of their life. Children can face malnourishment during fetal development if the mother lacks access to healthy foods. This often leads to babies born with low birthweight. Known today as Barker’s fetal programming hypothesis, or more commonly as Developmental Origins of Health and Disease (DOHaD), such early growth and developmental delays can result in long-term health consequences such as immune function impairments that can cause greater susceptibility to infectious diseases,

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decreased cognitive abilities and muscle mass, as well as a greater risk of morbidity and mortality throughout life (Barker and Osmond 1986; Barker et al. 1989; Stinson 1992; Barker et al. 1993; Haas 1998; Kuzawa 1998, 2005; Barker 2007; Armelagos et al. 2009; Wadhwah et al. 2009). Low SES and poverty are likely the largest contributors to malnutrition, with those suffering having little access to high quality and quantity foods, higher susceptibility to disease through poor living conditions, and higher risk of infectious diseases from a weakened immune system. This becomes a populational problem common in today’s developing societies, very similar to those of Industrial Era Europe being used in this research. Only if conditions improve can children experience “catch-up” growth, defined as rapid growth velocity in height or weight in a short period of time (Eveleth and Tanner 1990; Bogin 1999; Cameron 2002). However, the timing, severity, and duration of the growth insult can all determine the extent of this growth catch-up (Eveleth and Tanner 1990; Bogin 1999; Teranishi et al. 2001; Cameron 2002; Agarwal 2016). Improvements to environmental conditions at the population level can improve the growth status of children and are reflected in positive secular trends (Johnston 2002). Most developed nations have indeed experienced an increase in height over the last 50–100 years, but prior to this many European populations declined in height from the eleventh to nineteenth centuries suggesting very poor living conditions during industrialization (Johnston 2002). Having reviewed the stressed environmental conditions of the Industrial Era of Europe, including the detriments to women and children through patriarchal practices, the impacts of poor environments on childhood growth, and how boys and girls respond differently under stress, the skeletal remains from that time present us with an excellent opportunity to study how boys and girls respond to such conditions differently.

Hypotheses and Goals This study aims to investigate the impact of social inequality and structural violence during the growth process when environmental conditions are poor. Are children from poor families and cities more likely to exhibit stunting than those from higher social status families and cities? Are girls biologically buffered against poor conditions or are cultural buffers, privileged to males in these patriarchal societies, offering them better potential for growth than their female counterparts? Given that poor environmental conditions can lead to stunted height, I test the following three hypotheses: first, the majority of children from the Industrial Era will exhibit shortened femur lengths relative to a healthy reference sample; second, children from the lower SES will be more stunted than those from middle and high SES; and third, boys will be more stunted than girls especially in the lower SES sample.

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Materials The samples used to test these hypotheses are (1) the Luis Lopez skeletal sample from Lisbon, Portugal; (2) the Spitalfields Coffin Plate Skeletal Collection from London, England; and (3) the Bologna Skeletal Collection from Bologna, Italy. In order to test for stunting, these samples will be compared to a modern, healthy living reference sample, (4) the Denver Growth Study from Denver, Co. The Denver Growth Study (DGS) was a longitudinal growth study of living children from Denver, Colorado. These were primarily middle to upper class children living between 1927 and 1967. They are used here to represent children growing under healthy, normal conditions ideal for reaching full growth potential (Maresh 1955; McCammon 1970; Ruff 2003). Radiographic images were taken of each child every 6 months providing femur images that can be measured for comparative research like this (Maresh 1955; McCammon 1970). Each of these skeletal samples comes from cemeteries with written records indicating sex and age, houses large numbers of juvenile remains, represents those living during the height of their city’s industrialization, and represents a different socioeconomic status making them ideal for this research. Research performed on these samples already indicates many of the individuals display skeletal stress, while the children from the Luis Lopez and Spitalfields collections are stunted in height compared to medieval skeletal samples from similar geographic locations (Lewis 2002; Cardoso and Garcia 2009). A historical review of each of these populations is described in the background above. Each sample also represents a different SES. The Spitalfields sample includes individuals from middle to upper class backgrounds (Molleson and Cox 1993), the Bologna sample contains those from middle to low SES (Mariotti et al. 2015), while the Luis Lopez collection primarily consists of those from very low SES (Cardoso 2005). Table 5.1 displays the sample size distribution over age groups for each of these samples.

Table 5.1  Sample sizes separated by age groups and sex

Sample Luis Lopez Spitalfields Bologna Total

Age groups 0–1 years Boys Girls 5 0 15 12 10 11 30 23

2–5 years Boys Girls 7 8 13 7 12 11 32 26

6–12 years Boys Girls 7 9 2 2 4 6 13 17

13–18 years Boys Girls 14 12 2 7 6 6 22 25

Total 62 60 66 188

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Methods Statistical analyses were performed using Microsoft Excel and SPSS statistical software, version 23 from IBM. Only well-preserved individuals with documented sex and age were used. Diaphyseal femur length, without epiphyses, was measured via osteometric board or spreading calipers for individuals between 0 and 12 years of age, and total femur length, with epiphyses, was measured with an osteometric board for all individuals with epiphyses from age 13 to 18 years (following Buikstra and Ubelaker 1994). Left femora were used, except in cases where they were not available, then the right was used. This project divides the children into four age groups that reflect typical developmental markers like tooth eruption, growth spurts, and fusion of long bones. They are defined as follows: infant (0–1  year), young child (2–5  years), older child (6–12 years), and adolescent (13–18 years). These groups are used to compare children of similar ages to each other. Z-scores were calculated and used to determine if the Industrial Era children were stunted compared to those from the DGS. Z-scores were calculated within sex and age groups; if these measured −2 standard deviations (SD) below the mean of the reference sample mean, they were considered stunted, while 3 SD or more below the reference was considered severely stunted (World Health Organization Working Group 1986; Leatherman and Goodman 2005; Cardoso 2005; Cardoso and Garcia 2009; Leatherman et al. 2010). Femur length means and standard deviations by sample, sex, and age group are listed in Table 5.2. Because the DGS dataset is based on radiographs, a correction for image parallax was made using a formula by Ruff (2007). The DGS data were recorded in centimeters and were converted to millimeters for comparison. Skeletal growth profiles (SGPs) within and between samples by sex were created by plotting age at death against the percent of adult femur length achieved to determine if boys’ femur lengths were more negatively impacted than girls (Lewis 2002; Cardoso 2005). Values for adult height achieved were calculated from adult femur

Table 5.2  Femur length means (mm) for boys and girls by sample Low Age groups Infants 0–1-year-olds Young children 2–5-year-olds Older children 6–12-year-olds Adolescents 13–1- year-olds

Sex Male Female Male Female Male Female Male Female

N 5 0 6 8 7 9 11 11

Mean 142.16 NA 201.42 195.63 290.86 294.06 431.86 398.00

Middle St. Dev. 12.82 NA 33.85 25.94 48.28 37.64 29.17 36.46

N 7 9 7 8 3 6 5 6

Mean 124.43 112.22 160.79 170.63 269.33 244.17 416.60 403.50

High St. Dev. 18.49 17.10 14.96 37.27 23.76 38.98 32.51 8.55

N 7 6 8 3 2 1 1 7

Mean 116.98 114.25 172.50 158.83 262.00 310.50 453.00 398.00

St. Dev. 19.93 24.91 16.25 21.83 86.27 NA NA 22.07

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measurements from these samples (Ruff et al. 2012; Agostini 2017). This was done given the fact that all three samples span large time periods, are made up of native born and immigrants, and witnessed many changing political-economic situations all of which can cause tremendous variation within a skeletal sample. Mann-Whitney U tests of femur length regression residuals were used to test for statistically significant variation between boys and girls within each sample and age group (Schillaci et al. 2011). These are nonparametric tests of means between two independent populations or subgroups, each with multiple individuals, with ordinal or continuous data that are not distributed normally or have small sample sizes, as is the case with these samples (Laerd Statistics 2013). It is important to note that the boys and girls within each of these samples, especially those from London who come from the same church congregation, do not necessarily represent independent samples. However, this is the best test for comparing boys to girls within samples, so results must be taken with caution.

Results Z-scores for each sample can be seen in Table 5.3. Relative to the DGS, over half of the Industrial Era children did have stunted femur lengths. However, the middle SES sample from Bologna exhibits overall more stunting than the lower and upper SES samples. When analyzed by sex, boys in the upper SES sample do exhibit more stunting than girls, but girls from the lower and middle SES samples display a greater percentage of stunting than boys. Figures 5.1, 5.2, and 5.3 display z-scores of mean diaphyseal and total femur length of boys and girls from each SES group. The young and older children from the skeletal samples display shorter femur length for age compared to infants, a result that is also visible in the SGPs of diaphyseal and total femur length. Males from the middle SES become shorter by age 4 and remain the shortest, while the low

Table 5.3  Percent of stunted diaphyseal femur length by sample and sex. Lower and middle SES girls exhibit more stunting than any other group Z-score Lisbon (low SES) boys Normal (Z > −2.0) Stunted (Z  −2.0) Stunted (Z  −2.0) Stunted (Z  −2.0) Stunted (Z  −2.0) Stunted (Z  −2.0) Stunted (Z 16 years of age)

Table 6.3  Demographic paleopathology frequencies

7 (6%) 17 (5.5%)

4 (7%) 2 (4%)

Osteomyelitis 4 (4%)

47 (50%) 122 (54.5%)

30 (61.2%) NA

0 1 (0.3%)

1 (2%) 0

Enamel hypoplasiasa Treponematosis NA 0

2 (2%) 3 (1%)

1 (2%) 0

Tuberculosis 0

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Fig. 6.5 Hyperostosis frontalis interna (HFI) of an ambiguously sexed middle-to-old adult from burial location 407. (Photo credit: Erin Chapman)

osseous change was hyperostosis frontalis interna (HFI), with 18% (n  =  11) of  females displaying this change and 5% (n  =  6) of  males. Interestingly, 22% (n = 11) of ambiguously sexed adults were also diagnosed as having HFI (Fig. 6.5). Many of these ambiguously sexed individuals with HFI were likely female, but due to hormonal changes associated with menopause, they were unable to be differentiated based on cranial criteria alone. Three individuals had probable tuberculosis: two males and one female. However, this likely underrepresents the actual number. The frequencies for these pathologies were either similar within the new and old sections of the cemetery or too small of a sample to state any temporal relationship.

Discussion: Whose Heterotopia? A diversity of residents and patients sought different forms of relief at the ECPH complex during its operation. Many of the deceased in the ECPH cemetery were likely residents of the poorhouse and/or the insane asylum. Many also died while seeking/receiving care for disease or injury at the hospital. Some were born at the poorhouse. Some came to the ECPH as foundlings. For all of these people, the ECPH complex was a heterotopia, a real place that was like a societal counter-site that sequestered them from the rest of society. The interpretation of the ECPH as a heterotopia requires the integration of paleodemography and paleopathology data with a careful examination of the roles of social identities in society’s perception of welfare worthiness. This approach can help us to understand whether society perceived

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particular people, at the time of their deaths, as in a state of crisis, deviancy, or possibly both. Based on age and disability, cultural violence determined who was in crisis and worthy of social welfare and who was deviant and a financial and social burden. In NYS, society viewed pauper children below the age of 16 as in a state of crisis. These children, with proper training, had the potential to end the cycle of poverty. Historical records, specifically the Keeper of the Poorhouse reports, are congruent with the skeletal data. Births, infant presence and infant mortality remained a constant in the ECPH complex throughout its existence. According to historical records (Keeper’s Reports 1857–1920) and statistical analysis of the cemetery map, more infants below the age of 2 years old died and were interred in the last few decades of the institute’s operation (1890s to 1900s). This is likely to be associated with the increased numbers of foundlings that died at the ECPH during this time period. It is possible that this increase is attributable to the Panic of 1893 and the subsequent economic depression that affected the United States working class, including those in Buffalo, NY (Rezneck 1953). However, additional historical research may reveal other causes for this demographic shift. The small number of skeletal remains associated with individuals aged 2–16 years old impedes any valid statistical analysis. However, their paucity supports poorhouse removal of these children from the institution. NYS initiated the indoor relief system, in part, as an effort to educate healthy and intelligent pauper children in crisis. Yet, it was apparent that the poorhouse did not adequately educate children in Christian values and a work ethic that supported the nationalist agenda nor did it end the vicious cycle of hereditary pauperism. Children remained in a crisis state inside of the poorhouse. Therefore, the government increased efforts to swiftly remove children via adoption or transference to orphanages. While the poorhouse served as a heterotopia of crisis for some children, it was a heterotopia of deviance for other children. The Children’s Law stipulated that only healthy and intelligent children between the ages of 2 and 16 would be removed from poorhouses. A child deemed to “…be an unteachable idiot, an epileptic or paralytic, or be otherwise defective, diseased, or deformed…” may have been confined to the poorhouse (An Act To Provide for the Better Care of Pauper and Destitute Children 1875). NYS made a distinction between healthy children who were fit for society and unhealthy children who were unfit (Muller 2017). The poorhouse served as a heterotopia of deviance for this latter category of child who was disabled by an ideology – a cultural violence – that fixated on identifying the unworthy poor. Children in crisis may be largely absent from the ECPH cemetery. Healthy children would have been placed with families or sent to orphanages. Children for whom the poorhouse was a heterotopia of deviance are likely those found within the cemetery. The infant and child skeletons excavated may be associated with children who died at the Erie County Hospital. The majority of infants died during the perinatal period and may have been premature, small for gestational age, malnourished in utero, etc. Other children may be individuals who were impaired (i.e., possessed tangible indications of disease, mental illness, or physical impairment), disabled by their society (Muller 2017), and confined to the poorhouse. Bioarchaeological analysis of the skeletal remains of infants and children indicates the presence of severe and chronic

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physiological stress. Bony evidence of malnutrition, metabolic disturbances, and infectious disease were present among these skeletal remains. The skeletal remains from location #204 may represent a child who was considered deviant. This skeleton presents with severe systemic disease, likely congenital syphilis (active destructive lesion to the horizontal plate of the palatine bone, mulberry molars, Hutchinson’s incisors), as well as comorbid metabolic disease, evidenced by extensive microporosity and formative and destructive lesions throughout the skull. It is unlikely that poorhouse officials would have adopted out this child or sent them to an orphanage. The Keeper of the Poorhouse Reports indicated that throughout the entire history of the poorhouse, more adult males than adult females sought relief. Therefore, it is not surprising that, according to these same records, more adult males than adult females died at the ECPH. It is also the case that more males than females were disinterred from the ECPH cemetery in both the old and new sections of the cemetery. The disparity between the number of males and females living in and dying at the poorhouse may relate to contemporary gender roles (Katz 1986). The vast majority of poorhouse inmates were members of the working class. Intake records indicate that most men were unskilled laborers and most women were listed as having no occupation. Women did work, but this does suggest that paid labor was rare. This led to a vulnerability for women, especially those widowed or abandoned by their husbands. This is particularly the case when these women had children. Structural violence against women in the industrial complex meant that their laboring role as domestics in the household hindered their ability to earn wages and support themselves and their children in the absence of men (Smith 1895). While women entered the poorhouse less frequently than men, they did so at younger ages than men. On the other hand, men were able to avoid the poorhouse until later in life. Older women were more likely to be cared for by their family, since they could still contribute domestically to a household. Smith (1895) explained that it was a moral offense to not care for one’s mother, since society suppressed her earning potential in earlier years. Older men had the opportunity to earn and save their wages and were viewed as less useful for domestic tasks (Smith 1895). Thus, men were cared for less often than women due to their diminished labor contribution (Katz and Stern 2008). Katz (1986) also addressed that considerably high numbers of poorhouse inmates lacked an extensive social support system. Many were unmarried and childless. Therefore, many elderly entered the poorhouse because there were no kin or kith to care for them. Determining which adults fell into specific heterotopia categories of crisis or deviancy can be difficult if no osseous or mortuary signs of difference are observable. Antemortem trauma was present in approximately one-third of the adults who had at least 75% of their appendicular skeleton present. There was a gender bias, in which males had a higher prevalence of antemortem trauma than females. This could be attributed to the contemporary gender-based occupational roles, with men having industrial jobs and women having domestic roles. Most traumatic injuries involving one of the limbs would render a man at least impaired and if not disabled, unable to make a living wage. Thus, men would be considered in a state of crisis if they are seeking relief after a disabling injury. If the severity of the injury rendered

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them no longer able to earn a wage, e.g., leg amputation, this would move them into the deviance realm particularly if it was a disfiguring injury. Other osseous signs of difference showed that approximately a quarter of individuals had active and/or healed visceral rib lesions. While these types of lesions have multiple possible etiologies, we can glean that while these individuals were residing at the ECPH, they had some type of respiratory irritation. This pathology, unless paired with other traces of an individual’s life, cannot pinpoint if they were in crisis or deviance but does tell us something about the non-survivors. Also, non-specific physiological stress indicators such as periostitis and enamel hypoplasias inform us about morbidity but are not specific enough to reveal the life events leading to these stresses. There are more specific pathologies that can be attributed to socially stigmatized perspectives and identify that individual as in a state of deviance for this time and place. For example, the person exhumed from location #174 was a young adult female. Most of her long bones displayed diffuse nongummatous osteoperiostitis. This, coupled with stellate scarring and caries sicca of the ectocrania, indicated that she had tertiary treponematosis, probably venereal syphilis. Society would likely have identified this woman as socially and biologically deviant; thus, she would have experienced the ECPH as a heterotopia of deviation. Individuals with HFI experienced the ECPH as a place of both crisis and deviance, since this osseous change primarily occurs in older or elderly individuals. Lastly, for those three individuals who had probable tuberculosis, they would have been in crisis seeking relief from the poorhouse unless they acquired the infection while in the ECPH. NYS deemed that children were in a state of crisis within the poorhouse. In response, healthy children were removed from poorhouses only for many to be institutionalized in orphanages. Likewise, NYS made great efforts to extract the mentally ill from poorhouses. Reformers believed that the mentally disabled in these new asylums would be admitted, treated, cured, and released. Instead, and similar to the unfulfilled expectations of the poorhouse, rates of institutionalization rapidly rose, costs were overwhelming, and custodial care became the norm. Katz (1986:106) affirmed that “the state had neither moved mental illness from under the mantle of welfare nor transformed the quality of care. Rather, it shifted its location and perhaps its style.” NYS did not deinstitutionalize the mentally ill but moved them to asylums designed specifically for the chronically insane. It may seem ironic that particular groups of individuals were identified as being in crisis in the poorhouse, only to be sequestered to separate heterotopias of deviation. Yet as Katz (1986:xi) appropriately noted, “[t]ime and again, welfare has been extended or redesigned to promote social order by appeasing protest or disciplining the poor.” Efforts to create a salubrious environment for the masses, an act of bio-power to let live (Foucault 1990:136), require the creation of heterotopias of deviance. This further supports Samuels’ (2010) affirmation that heterotopias materialize as society aspires toward utopia. Bioarchaeological analysis of demography and pathology of the ECPH skeletons complicates our understanding of the poorhouse as a heterotopia. Vital to this analysis is the discrepancy between the poorhouse as crisis and poorhouse as deviance as viewed through the lens of the poor versus the lens of those in power. Foucauldian heterotopias are framed by societal measures of crisis or deviancy. Society’s

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rhetorical cultural violences, e.g. hereditary pauperism, as created, propagated, and enacted by those in power, led to the structural violence of institutionalization. Counter to the cultural violence disseminated by the State, the majority of poorhouse residents were members of the working class. They wanted to work. They were temperate. They were literate. They did not inherit pauperism from their parents. For many, underemployment or periodic episodes of unemployment induced destitution. This resulted from a reliance on seasonal work and fluctuating demands of the labor market (Katz 1986). This is evident in the Intake Records of the ECPH that document the presence of able-bodied men seeking relief, particularly during the winter months when the availability of construction and outdoor work diminished significantly in Buffalo, NY.  Indirectly, the absence of these wages led to destitution not just for men seeking work but for their families as well. Nineteenthcentury poorhouses, asylums, and other rurally emplaced total institutions functioned as heterotopias and created heterotopias of the urban centers with which they were associated.

 onclusion: The Violent Inscription of Human Bodies C at the ECPH A nuanced approach to ECPH history reveals the temporal transformations in social identity that altered perceptions of individual worthiness of social welfare. These perceptions, in turn, affected the function of the poorhouse as heterotopias of crisis and/or deviation for a person depending on their socially ascribed identities. In this cultural violence, those in crisis were considered worthy of social welfare, while the deviant were an economic and social drain on society. The ECPH was an Other space that isolated impoverished people in industrial-­ era NYS. It housed Others in crisis, deviant Others, and those who were considered both in crisis and deviant. Healthy children were present in the poorhouse for the entirety of its history. Their stay, whether in the hospital or the poorhouse, was intended to be temporary – a short departure from mainstream society before they resumed public life with adoptive families or moved on to other heterotopias, e.g., orphanages. NYS kept disabled children, those deemed unhealthy or unintelligent, inside of the poorhouse or transferred to another heterotopia of deviance, such as an asylum for idiot children. Mentally disabled adults, considered deviant, would similarly be transferred to asylums. Many physically disabled adults and the elderly were considered to be in a state of temporary crisis, while their bodies healed from injury, disease, and/or malnutrition. Yet, they also may have been considered deviant as their inability to work – their idleness – was detrimental to society. Some physically disabled adults in the ECPH were regarded as particularly deviant. NYS believed that these poor produced or exacerbated their destitution and physical impairment, be it malnutrition, disease, or injury, by evil indulgences, e.g., alcohol use, extramarital sexual behavior, and laziness.

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A bioarchaeological approach that incorporates a diachronic analysis of social reform policy, institutional practice, and social identities is necessary in order to tease apart the complexities of institutionalization. This historical contextualization reveals the cultural violence that justified the ECPH as a heterotopia. This heterotopia, in turn, enacted utopian  social policies and furthered structural violences by sequestering the unworthy poor from the rest of society. These dynamic social processes did not end with the commencement of the poorhouse. Interrogation of poorhouse transformation from a catch-all indoor welfare facility to one that provided relief for the aged and infirm illuminates the various movements in its history. These include removal of the blind and deaf, followed by the mentally disabled, the healthy children, and, finally, the able-bodied. Such movements and the cultural violences that facilitated them affected institutionalized bodies in the industrial-era. The excavated portion of the ECPH cemetery is a burial space for the very young (infants less than 2 years old), the disabled, and the elderly and infirmed, mirroring the transformation of the poorhouse itself. Acknowledgments  We are grateful to the editors for inviting us to contribute to this volume and the previous AAPA symposium, as well for their feedback during the drafting stages. We also thank the anonymous reviewer for providing us with areas for improvement. The first two authors also extend their gratitude to Dr. Joyce Sirianni and Dr. Doug Perrelli for the invitation to participate in the Erie County Poorhouse Bioarchaeology Project and for their continued support.

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Chapter 7

Norway’s Industrial Beginnings: New Life Challenges, Recurring Poverty, and the Path to Tukthuset, Oslo House of Corrections Gwyn Madden and Rose Drew

Introduction Tukthuset, the workhouse in Oslo, Norway, opened in 1741 (Harby 1990: 7). To walk through the doors of 33 Storgata, Oslo, was to relinquish all personal control. Clothing was replaced by industrial garb. Families were separated by sex and age, inmates were hidden behind imposing walls. They could not leave at will; not even those who entered freely. In 1807, visiting officials called the conditions under which they lived “appalling” (Oslo City Archives). For some, this may have hastened death and in many cases their only crime was being poor. The role of poorhouse, workhouse, and low-security prison were interchangeable: vagrancy, “sexual deviancy,” unemployment, disability, and minor crimes could be punishable by 6 months incarceration; and indeed begin or accelerate a downward spiral of health leading ultimately to their death. Any unclaimed bodies were then potentially available to be used as cadavers for surgical practice or anatomical studies. Despite provisions for these anatomical remains to ultimately be interred, few seem to have been. Their unmarked graves were removed for the development of a new police station. Only a small plaque with erroneous dates on the outside of a restaurant remains as their monument. This type of structural violence goes beyond that inflicted upon the living to where the memory is tarnished or erased altogether (Halling and Seidemann 2017). The development of a new roadway in association with the new police station occurred in the spring of 1989. This roadwork led to the rediscovery of Tukthuset Workhouse, Oslo, Norway. Archaeologists called to inspect remains found on the G. Madden (*) Grand Valley State University, Allendale, MI, USA e-mail: [email protected] R. Drew Department of Archaeology, University of Winchester, Winchester, UK © Springer Nature Switzerland AG 2020 L. A. Tremblay, S. Reedy (eds.), The Bioarchaeology of Structural Violence, Bioarchaeology and Social Theory, https://doi.org/10.1007/978-3-030-46440-0_7

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worksite determined them to be human. Upon a search of the historical records, the forgotten cemetery associated with Tukthuset Workhouse (1741–1938) was found. Norwegian archaeologists were given 18 days to excavate an area approximately 50 m square (Harby 1990:6) during which time they located 23 graves they identified as the “discrete burial” series. However, the slow nature of archaeological collection did not meet the needs of the developers, who blocked further scientific excavation. Over the course of several months, more remains were gathered by road workers as they excavated an area 30 m long by 5 m wide (Harby 1990:6). Sellevold, Harby and other members of the archaeological team occasionally visited the site to collect remains located by workers; these remains are referred to as the “Veivesenets folk” (roadwork folk) series. Eight other graves or assemblages collected by the team were labeled the F series. Between November 27–29, 1989, Sellevold and the original archaeological crew returned and hurriedly excavated the last 33 graves which are identified by the date of excavation. According to Harby (1990:6), due to a lack of time and money only scattered notes and photographs were taken, few of which remain today. While the number of boxes has been recorded, not all boxes are accounted for based on the numbering system. Many boxes held multiple individuals, although 88 held mostly complete individuals. Two boxes labeled “AI Mat” are believed to represent anatomical materials (AI series) used in the education of physicians at the University of Oslo alone (Sellevold 1990: 1). Two additional series of remains, 4000 and 7000, were accessioned into the Schreiner Collection before the 1989 excavation, and are associated with Tukthuset. “Krimmefeng” or “jailed criminal” was written in ink on the 4000 series skulls and labeled on the boxes. Schreiner archives verify the 16 individuals in the 4000 series are associated with “Storgaten 33,” from the “women’s prison burial site,” which were excavated and subsequently given to the University of Oslo, Anatomy Institute in March 1939 for curation (Schreiner Collection Archive; translated by R Drew, Sept 2018). The only identification for the 7000 series is the label “Tukthuskirkegarden” (Tukthuset church garden) written on the boxes. The location of the Tukthuset cemetery was noted on M.S. Døderlein’s map from 1769 and Patroclus Hirsch’s map from 1794 (Harby 1990:6), unavailable today. At some point in time, the cemetery was moved from its original location near the center of the workhouse precinct to the northwest corner of the facility. Anders Daae wrote: “For the sake of convenience and in order to save expenses in the town’s churchyard, a separate churchyard was built in Tukthuset, close to the large backyard. By the end of the 1770s, the churchyard was moved to the furthest part, its southwest corner. In 1808 it was expanded with a piece of Inspector’s Garden.” It was this “new” cemetery from which these remains originate. (Harby 1990:6)

Sadly, it is not uncommon for location information about burials to be lost as new buildings are erected, cemeteries moved, and maps mislaid or poorly preserved (Fowler and Powers 2012b:79). Traditionally, excavation is thought of as digging in the earth, although it could also be thought of as digging through boxes when assessing collections. The

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collection, transportation, storage, and later handling of remains are continuing factors in taphonomic change, tied to current cultural standards. At times, information is held by only a few individuals; easily lost, forgotten, or never written up. Additionally as researchers’ study remains it is not uncommon for samples to be taken with little to no record of the work done, thus permanently altering the sample. This paper will focus on anatomical specimens labeled as “AI” as well as those individuals in the remaining burials that show potential use as anatomical specimens. The remains will be discussed in regards to their use as anatomical specimens, and the burial, excavation, and post-excavation taphonomy, all of which have shaped interpretations of the remains.

Tukthuset Tukthuset was built in Oslo, Norway (Fig. 7.1) between 1738 and 1741, constructed by royal decree to be used as a workhouse and jail (hf.uio.no). Tukthuset was in use from 1741 to 1938 housing individuals who had entered voluntarily due to poverty, or sentenced to terms of stay for offenses such as petty theft, prostitution, being mentally ill, lazy, or simply having nowhere to go (Kvaal et al. 1994; Hals 2010). Between the years 1780 and 1830, Tukthuset became a co-ed minimum security

Fig. 7.1  Tukthuset Workhouse, Oslo, Norway, Worm-Peterson (1910)

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prison, open to all ages. Contemporaries to those housed at Tukthuset believed that those entering the workhouse were those “whose characters are suspicious, whose morals are bad, who have no settled reputable means for a livelihood” (Wallis Herndon and Challu 2013; 70). Disease has also been considered a major factor for entry to workhouses (Wallis Herndon and Challu 2013). Tukthuset was similar to poorhouses, almshouses, and orphanages throughout Europe; it was a place where marginalized public poor and disobedient people were sent by the local authorities. Those who were sick, old, or bedridden were “cared for” while the remaining members carried out labor. Inmate’s bodies, unclaimed by family, were buried in the Tukthuset cemetery. As an additional factor of social differentiation, the contemporaneous Anatomisk Institutt (AI) was permitted from 1811–1820 to study the remains of up to 20 individuals from Tukthuset per year (Holck 1990; Kvaal et al. 1994). Christiania Tukthus, or the House of Correction, existed to contain and control the poor of Southern Norway for just under 200 years. It was hypothesized that most of these “poor” individuals would show indicators of skeletal evidence of impoverished childhoods and/or impoverished adulthoods. The evidence for impoverishment being presence and prevalence of trauma, congenital disorders, vitamin deficiency disorders, infectious disease processes, and non-specific indicators of stress. Furthermore, it would be expected that evidence of medical studies like full-­ thickness cuts, incomplete cut marks, or craniotomy would be found on a small portion of these individuals. Taken together the two types of evidence would represent an example of structural violence; practices built into societal systems that allow harm to come to those in the population with the least access to resources while suppressing the visibility of inequalities and individual’s potential agency (Farmer 2009).

Materials and Methods In this study, individual remains used by the University of Oslo for anatomical study (AI) are the focus, with a brief comparison to the total Tukthuset cemetery population (n = 309). This cemetery assemblage consists of a mix of primary and secondary burials. Individuals buried in the Tukthuset churchyard may have been disturbed by subsequent burials, used as anatomical and surgical cadavers, and subjected to non-scientific excavation. The authors observed the entire collection from 2009–2017 to determine the biological profile, number of individuals present, trauma, disease, and non-specific indicators of stress present. This is the first comprehensive study beyond basic age and sex estimates for the site report (Sellevold np; Sellevold 1990). A total of 162 boxes were examined and while some held mostly complete individuals many held just a skull, a few long bones, a mix of elements and were comprised of multiple individuals. The remains were also observed for cut or sawn elements suggestive of use as anatomical specimens, autopsied individuals, or dissected individuals. Adult

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age, sex, and individual completeness estimations were based on the guidelines established in Brickley and McKinley (2004) and Buikstra and Ubelaker (1994). Age categories were created as follows: child (0–9 years), juvenile (10–17 years), young adult (18–35  years), adult (35–50  years), older adult (over 50  years), and unidentifiable. All skeletal materials were observed macroscopically to record general pathology following Brickley and McKinley (2004) and Buikstra and Ubelaker (1994) including trauma, congenital disorders, vitamin deficiency disorders, infectious disease processes, and non-specific indicators of stress. Non-specific indicators of stress observed include linear enamel hypoplasia (LEH), periosteal inflammation (periostitis), and osteomyelitis. Transverse lines or pitting on the dentition characterize LEH, representative of physiological stress from prenatal development to 15 years of age (Goodman et al. 1993; Hillson 1996; Larsen 1997). Anterior dentition is preferable when observing LEH, though teeth are frequently lost/disassociated or broken during excavation and storage, as well as being “lost” to mechanical processes during mastication. In this paper, LEH was observed on incisors and canines for distinct individuals (differentiated mandibles and maxillae) that showed one or more LEH.

Periostitis The periosteum is a dense, fibrous membrane that surrounds all bone surfaces except synovial joints; the internal surface is lined with bone-forming cells. Periostitis, a chronic periosteal reaction, instigates abnormal bone growth due to disturbances in or insults to the periosteum. Periosteal reactions can be caused by trauma, infection (Ortner 2003; Mann and Hunt 2005; Lewis 2007) and metabolic conditions (Brickley and Ives 2008). Periosteal reaction is not considered a disease (Ortner 2003; Brickley and Ives 2008), but if the abnormal bone growth is a response to infection, it can be termed periosteal inflammation (Ortner 2003: 206). New bone first manifests as disorganized fiber-like (“woven”) bone and can accumulate as plaques or spicules; with healing the new bone can be remodeled into layers of undulating, irregular bone (Ortner 2003; Mays 2010).

Osteomyelitis Osteomyelitis is caused by opportunistic bacteria that invade the marrow space of bones, which instigate bone and tissue destruction, repair, and the discharge of necrotic tissue and pus. Macroscopically this presents as diffuse periosteal destruction, new bone formation, and large perforating erosions of subchondral bone (Aufderheide and Rodriguez-Martin 1998; Ortner 2003: 180–183; Mays 2010:

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179–181; Waldron 2009). Chronic osteomyelitis can be diagnosed by expanded shafts, highly irregular bone deposits, drainage canals, and segments of isolated necrotic bone (sequestrum) resulting from a restricted blood supply. The bacteria move throughout the medullary canal causing lytic destruction but can also instigate internal bone growth, possibly to restrict the spread of infection (Ortner 2003, p.185).

Other Disease Processes Disease patterns presented here include possible evidence for rickets, tuberculosis, and syphilis. Rickets and osteomalacia are caused by a deficiency in Vitamin D during the ossification process (Mann and Hunt 2005). Rickets, which develops in juveniles, is seen as flaring of the metaphyses, and bowing or deformity of bone shafts which can persist into adulthood (Aufderheide and Rodriguez-Martin 1998; Mays 2010). Rickets was recorded as presence or absence of flared metaphyses and bowing of the long bones for juveniles. Osteomalacia (the adult-onset form of Vitamin D deficiency) may present as slight deposition of periostitis on the long bones, light pitting/increasing porosity on the cranial vault (Ortner 2003), reduction in overall weight, and angulation/kyphosis of the sacrum (Ortner 2003; Aufderheide and Rodriguez-Martin 1998). Osteomalacia and osteoporosis, which develop as a consequence of aging, are very difficult to differentiate (Aufderheide and Rodriguez-­ Martin 1998:309; Brickley and Ives 2008). Macroscopic observation alone does not provide enough information to distinguish between the two adult disorders. While not a part of this research, radiographs and histology carried out in the future may aid in their differentiation; however, here they are identified together as osteomalacia and osteoporosis.

Tuberculosis Tuberculosis is a pyogenic mycobacterium that is highly contagious and most easily spreads through infected droplets inhaled into the lungs. Vertebrae and ribs are the skeletal elements most commonly affected (Waldron 2009: 90–93), with vertebrae predominantly affected on the anterior aspect (nearer to the ribs) of the bodies. Vertebrae were macroscopically inspected for presence/absence of woven or sclerotic bone, lytic lesions (Dangvard Pedersen et al. 2019; Mariotti et al. 2015:400), anterior collapse and kyphosis for potential tuberculosis (TB) diagnoses (Ortner 2003, 231–232; Dangvard Pedersen et al. 2019). Bone loss in vertebral bodies can be so severe as to cause collapse of the spine in a sharp angular kyphosis, termed “Pott’s disease” (Waldron 2009, p.94). Identification of TB lesions on the ribs was made following Santos and Roberts (2001), Matos and Santos (2006), and Nicklisch et  al. (2012). Signs of new bone formation, nodules, and a streaky appearance potentially associated with TB were recorded as present/absent on the visceral

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surface of the ribs, along with location on the shaft. Evidence of these morphological changes on the ribs is typically near the neck and extends onto the shaft when associated with TB. Presence/absence of periostitis was observed on mostly complete individuals with “extra-spinal” bones as suggested by Spekker et al. (2018, p.352) in diagnosing pre-antibiotic TB cases.

Syphilis Syphilis, a bacterial infection, was observed as elevated plaque on the periosteal and cortical long bone shafts, particularly in the tibia, clavicle, and forearms (Hackett 1976; Ortner 2003; Powell and Cook 2005). It is expected that more than one bone will present a lesion, therefore a number of bones should show modification for a diagnosis of syphilis (Marden and Ortner 2011). Tertiary syphilis often presents as osteomyelitis without sequestrum and can include medullary obstruction, gummata, expanded bone shafts, hypervascularization (vessel impressions), and joint destruction with erosive arthropathies (Hackett 1976; Ortner 2003; Powell and Cook 2005). Following Mosher et al. (2015), lesions will be identified as pathognomonic, indicative, and consistent with the disease. Pathognomonic lesions were identified as those on the crania (e.g., caries sicca). Marden and Ortner (2011:24) state an affected clavicle is also a hallmark of syphilis. Saber shin, described as fusion of subperiosteal new bone to cortical bone observed on the anterior surface of adult tibiae (Ortner 2003: 294), along with “cavitating nodal lesions” (Marden and Ortner 2011) is strongly indicative of the disease. Identification of periostitis on more than one long bone, periosteal changes to the ribs and naso-palatal area can be used together to diagnose an individual with lesions consistent with syphilis (Mosher et al. 2015). Bone is limited in its response to infection and injury causing overlapping indicators for TB and syphilis: bone can be destroyed, deposited, or there can be variation and mixture of these processes (Waldron 2009: 19). The latter of these changes is most commonly due to repair and remodeling following tissue destruction. In both diseases, periosteal new bone can form, although bone loss with little repair is more common in TB (Waldron 2009). Bone deposits associated with TB are found on visceral rib surfaces (Matos and Santos 2006), and in younger individuals, as symmetrical, widespread periosteal bone inflammation, termed pulmonary hypertrophic osteopathy. In treponemal disease (syphilis), periosteal new bone accumulates on skeletal elements with little tissue overlay, such as the tibia, bones in the forearm, the clavicle, and the skull (Ortner 2003; Waldron 2009). Lytic lesions associated with syphilis include destruction of the nasal aperture and erosive lesions termed “gumma” that affect skin and bone (Waldron 2009), causing medullary canals to be exposed directly to bacteria and potentially instigating osteomyelitis. Due to these similarities and the commingled nature of about two-thirds of the collection, although individuals were surely affected by the disease, the specific bacteria are not currently discernible and the lesions will be described more than diagnosed.

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Due to the commingled nature of the remains, only healed fractures were recorded, by bone, position on the bone, age, sex, and fracture type using macroscopic observation. Healing was observed as presence of woven bone in the early stages through completely remodeled cortical bone (Ortner 2003; Mays 2010). Molecular studies to seek tuberculous DNA, isotopes, and possibly syphilis are ongoing with an international team. Results of these studies will appear in future publications, as well as a full description of the total Tukthuset cemetery population.

Results From the two boxes labeled AI, 446 skeletal elements were observed with a minimum number of individuals noted as nine. Individuals across the life course were present including one child, two young adults (one male), two adult males, one adult female, and three older adults. Of the elements present, 170 were modified by sawing, hesitation marks, or mostly sawn through and then snapped to complete the break. See Figs. 7.2 and 7.3. In some cases, sawn and snapped segments refitted. Also present were 276 unmodified bones. Approximately half of the 446 bones present belonged to two individuals, the child and a robust young adult male. At least three additional bones distributed throughout other boxes show sawing or hesitation marks. These include a sawn tibia in V28, a large triangular wedge cut out between the posterior parietals and occipital on 7281 (skull held together with wire; cut piece is not present), and a craniotomy in Grave 12. For the total population, 308 individuals were identified: 192 were adult and 38 were under the age of 18 years. Seventy-nine of the 192 individuals were female and 113 were male. An additional 77 individuals were recorded as unidentifiable for age

Fig. 7.2  Sawn/anatomical dissection of two thoracic vertebrae joined by ossified tissue. Note the fused vertebrae were further dissected

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Fig. 7.3  Hesitation marks on rib (AI Materials)

and sex. These totals include remains marked AI that represent a minimum number of nine individuals. The predominant pathologies observed in the sawn/modified materials are spinal osteoarthritis and osteoporosis. Sixteen ribs and two thoracic vertebrae with TB are the only exceptions (Table 7.1). The elements retained for study that lack evidence of surgical practice or anatomical dissection (Table 7.2) have evidence consistent with osteoarthritis in arms, legs, shoulders, and knees as opposed to mostly in the spine in the modified materials. Also seen in the unmodified elements are healed fractures in arms, legs, hip, and foot; 10 fractures total. Forty ribs in the non-­ modified group have evidence of disease or disorder; only 19 do in the modified group. Only fragments of cranium were present in the AI materials, the one left maxillary fragment was sawn approximately in half in the transverse plane. All of the individual’s teeth had been lost long enough prior to death to allow time for the alveolar (gum) bone to become completely resorbed; LEH could not be observed. A facial abscess was also present near the canine. In the total population 45 mostly complete cranium were present, combined with maxillary and mandibular fragments for a total of 107 dental arcades of which 56 discrete individuals displayed LEH.

Periostitis In the AI collection, three tibiae, four fibulae, and one clavicle have lesions consistent with chronic periosteal inflammation. For example, one pair of tibiae in the middle third of the shafts have long, narrow, undulating sclerotic deposits on the lateral aspects. The left tibia has two distinct vascular impressions within this deposit; the right tibia has one vessel impression. In the wider Tukthuset assemblage there are 29 boxes with elements showing evidence of chronic periostitis, with 19 cases in fairly complete individuals. One adult male, V1, has widespread periosteal new bone formation consistent with

Bone Vertebrae: Cervical Thoracic Lumbar Ribs Cranial Clavicle Sternum Manubrium Sacrum Femur Tibia Total modified

17 68 5 57 3 2 4 6 3 4 1 170 3

36

2

38

18

3

31

6

3

Healed Snapped fracture

2 8

Hesitation Sawn marks

40

4

2

6 26 2

Osteophytic lipping

3

3

2

2

Ossified Eburnation cartilage

17

2 15

18

16

2

2

2

Osteoporosis TB Spondylolysis

Table 7.1  Tukthuset cemetery AI individual elements observed with modification, by modification type and pathology present

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Bone Number present Healed fracture Osteophytic lipping Eburnation Enthesopathy/ossified ligaments Osteoporosis TB Periostitis Vertebrae 15 Ribs 82 10 5 25 Clavicle 7 1 1 1 Scapula 5 5 1 Humerus 6 1 5 2 1 Ulna 6 1 5 2 Radius 6 3 2 Os Coxae 3 1 Femur 2 2 2 Patella 4 3 2 Tibia 5 2 1 1 2 Fibula 6 1 4 4 Hand 65 4 Foot 64 1 Total modified 276 20 26 2 14 7 25 7

Table 7.2  Tukthuset cemetery AI individual elements observed with no modification by pathology present

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pulmonary hypertrophic osteoarthropathy; another individual, young adult female 4383, has bilateral periostitis on the upper humeri and scapulae.

Osteomyelitis None of the 446 elements in the AI collection show any indication of osteomyelitis. Three individuals from the general Tukthuset population have pyogenic bone infection, including localized bone destruction, drainage cloacae, and abnormally expanded bone. Two possibly associated elements, a left humerus and right clavicle with lytic lesions, shaft expansion, and drainage canals are observed in Grave 1 of the “discrete burial series”, a box with commingled remains of at least four individuals.

Rickets None of the skeletal elements in the AI collection have the bowed long bone shafts associated with rachitic deformity. None of the ribs have abnormal superior-inferior warping also considered an indication of the disorder. Mild to moderate bowing of lower long bones was observed throughout the wider collection. One box from the larger population is labeled 28 Nov 1989 Kasse 2 and contains remains from at least eight individuals. Of these remains, long bones from at least three individuals display mild rachitic bowing. At least 25 individuals in the total Tukthuset population have femora and or tibiae with mild shaft curvature.

Tuberculosis In the AI collection, two thoracic vertebrae and 16 ribs displayed potential signs of tuberculosis. The thoracic vertebrae showed typical TB associated pyogenic canals in the bodies while the ribs presented with nodules, striations, and new bone formation. In the Tukthuset population including the 9 individuals from the AI collection, up to 42 individuals or 14% of the population displayed potential evidence for TB.

Syphilis Macroscopic evidence of syphilis was not observed in the AI materials. Twelve individuals in the general Tukthuset sample show bony change related to syphilis.

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Discussion Skeletal Indicators of Dissection and Disease No teeth were present in the AI materials for comparison with the total population. Fifty-six of 107 individuals with assessable dentition in the non-AI burials displayed at least one LEH lesion, suggesting the possibility that 15% of the population would have been at higher risk for diseases and a reduction in longevity (Larsen 1997: 50). While LEH does not cause disability it represents moments of acute stress in childhood health that later plays into adult health issues. One pathology will often cause a decrease in health, which can create the potential for synergy with other pathologies, further increasing the likelihood to be affected by more disease processes. Another theoretical approach suggests that individuals who do not display LEH are healthier; fewer than 10% of individuals from developed nations have hypoplasias, which are far more common in “disadvantaged subgroups” (Larsen 1997:50). It is interesting to note that the majority of those under 18 years of age in the cemetery did not have LEH implying they were not subject to nutritional deprivation or physiological stress earlier in life. However, as death occurred prior to maturation it suggests that these individuals were not osteological “survivors.” Trauma can also be a differential diagnosis for LEH. The sawn, and thus modified, AI sample shows no evidence of periostitis while the unmodified sample presents eight cases on long bones. Periostitis was observed in 29 individuals of the general Tukthuset sample suggesting low-level infectious processes were in action. Three individuals in the general Tukthuset sample showed the more serious osteomyelitis; two males and one individual of unidentifiable sex. No cases were noted in the AI individuals. Osteomyelitis often develops as the result of an open wound (Aufderheide and Rodriguez-Martin 1998: 175). It could be assumed that wounds were cared for scrupulously as only three individuals of 308 suffered from osteomyelitis. However, individuals with the less serious periostitis may have gone without treatment or had more limited treatment affecting their overall health and survival. Ultimately, these individuals may have died prior to developing more serious bony responses to infection. This is illustrative of the “osteological paradox,” the concept that rampant bone disease indicates a survivor, whereas those with poor immune systems or acute disease die with unblemished bones (DeWitte and Stojanowski 2015). No individuals within the AI sample displayed rickets while 26 presented rickets in the long bones of the general Tukthuset sample. Of these 26, three females show what may be either osteoporosis or osteomalacia along with evidence of healed fractures. During the Industrial Revolution, more people of all ages spent their lives working indoors in factories, decreasing the natural ability to obtain Vitamin D from the sun’s rays. Winters in Norway were also very cold requiring individuals to bundle up, covering most of the skin, thus reducing their ability to obtain Vitamin D from the sun (Ortner 2003). Rickets deformities observed in the adult sample were not active pathology; childhood bowing had not been completely remodeled and

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thus erased from the long bones (Brickley et  al. 2010:64). Aufderheide and Rodriguez-Martin (1998) state that while it is difficult to differentiate osteomalacia from osteoporosis, both are associated with increased incidence of fracture. Bowing seen in rickets, especially the tibia, could be misdiagnosed as saber shin observed in syphilis (Aufderheide and Rodriguez-Martin 1998). It could be assumed that because sea mammals and fish provide adequate dietary Vitamin D, rickets would be nearly absent in Norway (Brickley et al. 2005) a country with easy access to the sea, although inmates at Tukthuset may have previously lived in rural land-locked areas not close to those sea resources. When admitted to Tukthuset they were likely fed soups and gruel, the latter ideally created from equal parts flour or oats, and water (Higginbotham 2013: 61, 171), as they were the most inexpensive food available, offering little to no dietary Vitamin D. Contemporary English poorhouses located in cities also offer examples where individuals were regularly served gruel, bread and cheese, rice and potatoes (Higginbotham 2013: 34; Shields Wilford and Brittney 2018: 29). Poverty was actually considered to be caused by poor diet (Riddervold and Ropeid 1984). It has been stated that in lieu of food, which would provide necessary nutrition, people would consume tobacco, coffee, and sugar as stimulants to aid them in making it through the workday (Hutchison 2011). Reports often contained opinions regarding the eating behavior of the poor, such as: “If their money was spent on bread instead of tobacco, they would not suffer such poverty as many do” (Hutchison 2011:160). Ironically the “poor” used the stimulants like all social classes to put in a longer workday.

Tuberculosis Researchers have observed a range of 1–4% skeletal lesions in populations where tuberculosis was present (Aufderheide and Rodriguez-Martin 1998; Ortner 2003: 228), representing only a small portion of those affected. Using a modern population in Italy, Mariotti et  al. (2015:392) found that of 64 individuals with known cases of TB, 71.8% displayed some skeletal change. Population density (Stone et al. 2009; Geber 2013) and low socioeconomic status are associated with TB (Mariotti et al. 2015). The low socioeconomic status of the TB group studied by Mariotti et al. (2015) is comparable to Tukthuset. The study of autopsies in European centers in the early 1800s shows almost 100% presence of TB (Aufderheide and Rodriguez-­ Martin 1998: 130). Two thoracic vertebrae and 16 ribs in the AI group displayed possible evidence for TB, for an MNI of two. Forty-two individuals or 13.6% of the general Tukthuset sample, showing possible evidence of tuberculosis, would be the absolute minimum number of individuals suffering from the disease in the total population. See Fig. 7.4, top image. According to Holck (1990), church records indicate that many Tukthuset residents died of tuberculosis. Differential diagnosis of rib lesions includes pulmonary disorders, while for vertebrae, cancers, fractures, osteomyelitis, and other

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Fig. 7.4  Top image: left rib with spiculated new bone on inner surface, AI series. Bottom image: right tibia, anterior view with healed gumma circled in red, with detail view, same tibia, of gumma

disorders (to a lesser degree) may be misdiagnosed as TB (Aufderheide and Rodriguez-Martin 1998:140–141). The Monroe County Almshouse (MCA) in New York, in use from 1826 to 1930s, reflects similar trends to Tukthuset. MCA began with only 35 individuals but rose to a population high around 5100. Of those housed at MCA death records indicate that 47% of women and 28% of men died from tuberculosis (DiGangi and Sirianni 2017:156). On September 7, 1741, Tukthuset opened with 13 women and 6 men (Harby 1990: 8) but increased to 700 over time. Only three cranial elements were present in the AI material. The single maxilla did not show evidence of infection, which can appear as bony spicules and plaques in the sinuses (Liebe-Harkort 2012). However, 14 individuals were identified in the general Tukthuset sample with chronic infection in the maxillary sinus. Only maxillary sinuses that were broken or sawn were observable, so this number is a low estimate. The major cause of bony spicules is considered to be pollution (Liebe-­ Harkort 2012), found more commonly in compact urban areas (Roberts 2007). It has been noted that generally poorhouses and prisons were not well-ventilated allowing contagion to spread (DiGangi and Sirianni 2017; Ignateiff 1978). Environmental pollution within the home may have been from smoking or cooking fires, while outside the home individuals working in factories, especially textiles,

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were likely affected by industrial pollution. Liebe-Harkort (2012:395) suggests that malnutrition would also have played a role in the development of spicules in the maxillary sinus, as malnutrition decreases the effectiveness of the immune system. Chronic maxillary sinus infection, in an environment of increased malnutrition, pollution, and compact living, mirrors the environment in which tuberculosis is known to thrive.

Syphilis In syphilis, bony change occurs during the tertiary stage, but only 15–40% of syphilitic individuals reach this stage (Zuckerman 2017). Of those individuals who do reach the tertiary stage only 10–20% show associated skeletal change (Zuckerman 2017; Walker et al. 2015; Resnick and Niwayama 1995). Of the 12 individuals with syphilitic bone lesions in the general population, gummata and undulating and fusiform tibial shafts, ulnae and radii are the few potential indicators of syphilis in this collection (Hackett 1976; Waldron 2009:106). See Fig. 7.4, bottom image. No cases of caries sicca, considered pathognomic for syphilis, were observed. As less than one-third of the remains are relatively complete, a more definitive diagnosis is problematic. All individuals presenting possible evidence in the Tukthuset population display lesions either indicative or consistent with syphilis. Differential diagnoses for syphilis include tumors and infection (Aufderheide and Rodriguez-Martin 1998:163–164). It is said, many of the females in Tukthuset were guilty of the “crime” of “sexual deviancy”, and “lechery” or “promiscuity”; and were likely prostitutes (Hals 2010: 9–12). Six of the 12 cases of syphilis were female. Multiple sex partners increase the risk of infection (Attwood 2016). In 1860 a new law was created allowing for doctors to supervise prostitutes, issuing an official “visitation card” if the individual was disease free. Prior to 1887 prostitution was legal with “official houses” where visitation was carried out, but after 1887 prostitution was made illegal (Fyrand and Granholt 1994:216). Legal work for lower-class females was limited to either being a servant, or hard agricultural labor (Dahlström and Liljestrom 1983). Some women may have had little choice. This historic evidence suggests that syphilis would be present in this Tukthuset population.

Fractures Fractures observed in the AI remains were well healed suggesting that individuals likely received some care during the healing process. Ten fractures were found on unsawn ribs and 3 on sawn ribs; ribs are by far the most fractured bone type in the AI material. Seven long bones, one foot bone, and an os coxae presented healed fractures in the unsawn material. Only one of these bones, a left radius, could be

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sexed as probable male. This particular individual has more skeletal elements present than any other of the AI specimens. Additional sawn bones with healed fractures included 3 thoracic vertebrae of a total 68 modified thoracic. A total of 25 AI elements exhibit healed fractures out of the MNI of nine. An additional 47 healed fractures, lacking signs of obvious bone infection, were observed in the non-AI group, representing 15% of the individuals identified in the total population. Twenty-five healed fractures were observed for males, 18 for females, and 4 in individuals of unknown age/sex. Males presented the only three nasal fractures in the total population as well as two mandibular fractures. Nasal and mandibular fractures are strongly associated with interpersonal violence (Lovell 1997: 166). Two female radii showed healed fractures with an additional female that had both the radius and ulna fractured. This compares to one radial fracture for males. Fractures of the lower arm bones are generally caused by a fall or defense of bodily attack (Lovell 1997: 160–161). Feet in both sexes showed a number of fractures; three in females and seven in males. Watkins’ (2012:38) observations of poorhouse inmates of the Montague Cobb collection show males and females with dissimilar numbers of fractures, 21 and 11 respectively. Compared to the Montague Cobb collection the general Tukthuset sample shows more individuals with fractures and females closer in number of fractures to males. Differences between the sexes have been used to suggest potential differences in cultural context/activity as women generally show fewer fractures than men (Watkins 2012). To some extent fractures affect an individual’s ability to actively participate in a society that offered mostly hard labor for the lower working class, especially for women (Dahlström and Liljestrom 1983) and would have limited their ability to work while the fracture was healing. Spondylolysis, fracturing of the pars interarticularis, considered to have both genetic and environmental components, is present in 4–8% of individuals in modern populations (Aufderheide and Rodriguez-Martin 1998: 63). Two lumbar vertebrae of indeterminate sex from two individuals presented spondylolysis in the sawn AI sample, one identified as L5 and the other an indeterminate vertebral number. In the general Tukthuset cemetery sample, unilateral spondylolysis was present in one individual, with bilateral occurring in five individuals; two of the bilateral cases also displayed spondylolisthesis. While spondylolysis is observed more often in males (Aufderheide and Rodriguez-Martin 1998: 63), in this sample five were female and one was male; one of each sex also presented with spondylolisthesis. The environmental component is suggested to be work requiring greater flexibility in the spine which results in microtrauma to the pars interarticularis separating it from the vertebral body. If the microtrauma affects both sides of the pars interarticularis the body and arches are no longer joined, which may result in spondylolisthesis. No longer anchored to the arches, the vertebral body can slip anteriorly causing pressure on the spinal cord, potentially resulting in neurological issues. The healed fractures in this assemblage lack infectious response, which suggests the inmates received adequate care. In addition, few fractures are unreduced; that is, most were splinted or permitted to heal without undue movement of the afflicted area. It is therefore probable other disorders also received adequate care, rather than

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the afflicted being treated with utter disregard, despite their circumstances. But, this remains speculative. While the pattern and appearance of skeletal anomalies can provide clues to the possible diagnoses (Waldron 2009: 21), the diagnosis of disease is most accurate with complete skeletal remains, as bone is limited in its response to insult. In the case of Tukthuset less than 1/3 of the individuals were complete enough to see these patterns and make more solid diagnoses. “Care” can also be inferred from the burial treatment after death. Based on the burials excavated academically, each grave contained a coffin; the graves were not intercutting (Harby 1990). After the bulk of the Tukthuset churchyard was thought cleared, remains were gathered by road workers, with archaeologists only able to monitor the commercial development, once their allotted time for academic excavations had passed (Harby 1990). As numerous studies show, remains excavated hurriedly and collected by construction workers (Murray and Perzigian 1995), the gathering and deposition of a large number of AI bones together, and bones buried randomly in the graves of others all decrease the possibility of making accurate diagnoses of diseases and disorders. It is difficult to tell a life story from a single bone; for example, one box contained five right femurs and nine left femurs. As Halling and Seidemann (2017:179–180) state when discussing Charity Hospital remains in New Orleans, “Instead of ancestry, the unifying characteristics of the groups represented by the skeletal material…seems to have been poverty.” It seems the same unifying principle was at play in Tukthuset.

Social Upheaval at the Time of Tukthuset In 1741 the population of Norway was 611,300; by 1801 it was 882,800. Continuing this trend, by 1850 the population was 1,391,100, and by 1900 it was 2,118,000 (Lahmeyer 2014), most of whom lived in cities, including Oslo. As seen in other countries, people flooded into urban areas during the Industrial Revolution (Huey 2001; Moring 2008; Spencer-Wood 2001), and during embargoes in the Napoleonic Wars looking for work. As a consequence of British naval blockades, entire villages starved to death. Additionally, Norwegian trade was greatly restricted due to Denmark imposing heavy tariffs, trade restrictions, and considerable import duties. From 1740 to 1742, there were a series of crop failures and widespread disease. Due to the deficit of economic growth and industry, Norway fell into a depression (Gjerset 1915) which resulted in more individuals lacking the resources to survive. Not all who fled to the cities were successful in their endeavors, leading some to Tukthuset. However, returning to their rural community was likely not an option as a household sufficiently stressed to send an individual away to work in the first place would not be able to reintegrate a returnee. This would have left a number of individuals without a way to secure food and shelter, leading to an increase in the number of those in need. Norway had around 10 workhouses in the 1890s; Oslo Tukthuset was the largest (Ulvand 2012) followed by workhouses in Bergen, Khristiansand, and Trondhjem.

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According to Ulvand (2012:31), “By the mid-1880s, about 1100 persons out of a population of 2 million were detained annually, and of these 700 were detained in the capital.” By 1851, life expectancy in Norway was 49.51 years (O’Neill 2019). It has been stated that older individuals without family support were often sent to the workhouses (Higginbotham 2013). A life expectancy of 49 years fits well with the demographic data from the cemetery that shows the majority of the inmates were between the ages of 35 and 50 years at death. While 35–50 years is not considered old today, at that time fewer individuals lived beyond this age range. During the 1800s, Norway was one of the least developed countries in Europe (Wientzen 2015:209). After the 1870s, the economy in Scandinavia shifted from an agrarian economy to a more commercial one, during which time the poor were pushed off of their land (Moring 2002). This not only encouraged movement to large cities, but it is estimated that 250,000 people left Norway by the 1880s (Wientzen 2015:211). Ulvand (2012) states that at the workhouse in Bergen individuals between 30 and 59 years of age were overrepresented, mostly single able-bodied men. The workhouse in Trondheim had a population similarly aged to that in Bergen (Ulvand 2012). Women entering the workhouse were generally younger than their male counterparts, their desperation possibly due to loss of a male breadwinner in addition to having young children needing support (Moring 2008). The Norwegian workhouse was populated in a singularly distinct fashion. Prior to establishment of the Vagrancy Act in 1900, policemen were given the power to place any individual thought to be a drunk or vagrant in the workhouse for up to 6 months with no trial. Although individuals were required to be at least 15 years of age to be “sent” to the workhouse (Ulvand 2012), records indicate that a boy of 6 years was once sent to the men’s dormitory, a child was observed in the AI materials, and infants are included in the total population. It was not uncommon for an individual to be sentenced to the workhouse when there was not enough evidence to support a criminal claim by the police (Ulvand 2012). Neighbors and families are said to have used the police against each other, indirectly participating in “a structurally violent social order” (Klaus 2012:31). The system of caring for the elderly broke down when large numbers of people moved to the cities. In rural areas it was generally the son’s responsibility to care for his parents in old age, as the new holder of the land title (Moring 2002; Nystedt 2002). In urban areas adult children gave money to their widowed mother; in many cases daughters (unmarried or widowed themselves) or other relatives lived together for support in old age. An alternate source of income to keep widows from the poorhouse was to take on boarders. Data suggest that most of the women in poorhouses were unmarried, or widowed with no children to rely on in old age (Moring 2008). Nystedt (2002) found that women were twice as likely as men to become widowed during this period in Sweden. One likely reason fewer women ended up in the workhouse is that widows were seen as “the deserving poor” and were paid poor relief (Schmidt 2007:276). All of the workhouses were built according to models used in Denmark, especially the Children’s House in Copenhagen established in 1605. The Victorian ideal

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was that good rules of conduct should be acquired by inmates through hard work (Geber 2013; Harby 1990). Structurally, many workhouses were constructed to look like middle-class housing or even palaces (Spencer-Wood 2001). The layout of the Oslo Tukthuset followed a common European building pattern with “outbuildings behind and perpendicular to the main building in order to surround a square, central courtyard” (Spencer-Wood 2001:118). Tukthuset was modern for its time, the largest structure in the city since the building of the cathedral, completed in 1699 (Harby 1990:7). It has even been said that when King Carl Johan looked beyond Christiania (Oslo) from Ekebergåsen for the first time, he believed that Tukthuset was the royal residence (Harby 1990:8). Placement of the poor inside such imposing structures distanced the reality of poverty, thus easing consciences and suggesting society was taking care of those in need. H.M. Stanley, an inmate in St. Asaph Union Workhouse in England stated the situation aptly, “The aged poor and superfluous children of that parish are taken, to relieve the respectabilities of the obnoxious sight of extreme poverty and because civilization knows no better method of disposing of the infirm and helpless than by imprisoning them within its walls” (Higginbotham 2013:34). From 1837 Tukthuset made woollen garments for the inmates sentenced for 3 months or more. They were given black and white clothing meant to last for 2 years: for women a sweater, skirt, cloth shirt and stockings; for males knitted sweatshirts, long trousers, and a woollen hat (Harby 1990:12). Again H.M. Stanley attributed this giving of clothing to the inmates as a way to make them indistinguishable, thus inciting no interest in particular individuals (Higginbotham 2013:34) at the same time normalizing the inmates’ suffering (Klaus 2012). For many, even hard labor may have been seasonal, providing support for individuals for only a few months per year (Nystrom 2014; Wallis Herndon and Challu 2013; Moring 2008; Grauer et al. 1998; Sutter 1995). Recurrence of residency at many workhouses was part of the coping strategy (Moring 2008; Watkins 2012) along with frequent moves and relying on social groups (Wallis Herndon and Challu 2013:62). As one example, two Norwegian brothers had 75 separate stays at the workhouse, ranging from 1 to 6 months each (Ulvand 2012). Workhouse inmates were considered worse than criminals, being given no financial support when their term was up (Ulvand 2012). As the number of terms spent at a workhouse increased, the length of time between returns to the workhouse decreased (Ulvand 2012).

Dissection as Further Punishment Typically there were 2–13 anatomical students per year at the Anatomisk Institutt, which created a requirement for up to 20 cadavers a year from 1814 to 1820 (Holck 1990: 75). This suggests that up to 140 individuals from Tukthuset may have been subjected to dissection studies during that period. Use of remains for anatomical learning did not stop at the poorhouse/workhouse/almshouse, but also included

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other institutions such as hospitals, houses of correction, and prisons (Spencer-­ Wood 2001:116). Only nine individuals from Tukthuset were observed in the sample marked AI which suggests not all of the dissected remains were reburied. Vertebrae, including the sacrum, present the largest number of post-cranial bones modified at 93 individual elements. While Flies et al. (2017) found no evidence of pathology in the remains modified at Copenhagen Hospital, there are a number of pathologies displayed in the modified remains at Tukthuset. Arthritic change was the most common AI pathology in the modified (40) and unmodified (26) bones at Tukthuset. Tuberculosis was the second most common AI pathology in modified (18) and unmodified (25) remains, almost exclusively observed on the ribs, although such evidence suggests only consistence with the disease. Individuals at Copenhagen Hospital may not have survived long enough for pathological change to be seen on the bone. At Tukthuset it is obvious many individuals lived for long periods of time despite disease processes affecting their bodies. In the AI sample, more elements lack any observable evidence of sawing, hesitation marks, and snapped-off breaks, than have such marks (Tables 7.1 and 7.2). This may be idiosyncratic or may suggest the two types of elements were studied for different purposes. Unmodified (e.g., lacking saw marks) bones may have been retained to investigate differences in age and sex-related morphology, pathologies, and phenotypical differences or disorders that would be obvious in the living. On the other hand, modified bones may have been kept as anatomical specimens. Recent research suggests that differentiating between autopsy, dissection, surgical training, or creation of anatomical specimens can be proposed but is not completely functional (Dittmar and Mitchell 2015; Flies et al. 2017; Nystrom 2014). For example, there are four sternum present in the Tukthuset remains that were sawn vertically which has been suggested to represent autopsy specifically of the heart (Flies et  al. 2017); although it could also be assumed that the sawn sternums were the result of dissection. Two sawn clavicles may represent opening of the thorax for dissection (Fowler and Powers 2012b). Three of the AI cranial elements display saw marks: one left maxilla, one frontal-­ temporal piece displaying two hesitation marks, and one temporal-occipital piece with the mastoid process sawn off. Only one individual, not found with the AI material, showed a horizontal circumferential craniotomy. Flies et  al. (2017) found a cranium with a horizontal craniotomy and an additional horizontal saw mark through the maxilla superior to the alveolar portion attributing it to the category of anatomical specimen. The sawn maxilla from Tukthuset is a single maxillary bone sawn through the sinus. While there are similarities between the maxilla found at Tukthuset and by Flies et al. (2017), they are not similar enough in nature to identify the Tukthuset maxilla securely as an anatomical specimen. Grave 12 presents the only craniotomy found. This individual is an adult male with evidence of Klippel-Feil Syndrome type II (Barnes 1994) and TB in the form of serpens endocranium symmetrica as described by Hershkovitz et  al. (2002). Presence of disease in Grave 12 suggests that an autopsy may have been performed; however, while no fragmented remains are associated with this individual (Nystrom

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2014) to aid in the identification of dissection versus autopsy, there is evidence of a drop of red dye suggestive of dissection (Dittmar and Mitchell 2016; Mitchell 2012). Craniotomy of only a single individual is striking in comparison to the 61 craniotomies seen in the Newcastle Infirmary burial ground (Chamberlain 2012:17), only one of which showed cranial lesions similar to that seen in Grave 12. However, there were few complete and fragmented crania, which may be the result of decapitation and use of the skull for teaching purposes (Fowler and Powers 2012b). Mann et al. (1991:110) discuss the presence of sawn and snapped femora in Maryland and conclude that if there was no trauma or infection associated with such cuts they point to surgical practice. None of the Tukthuset femora, either sawn or sawn and snapped, show evidence of trauma or infection, suggesting they were used in surgical practice. Tukthuset is not alone in the manner of collection, or form of deposition. The Albany Almshouse Cemetery (AAC), located in New York and in use from 1826 to 1926, was excavated in 2002 in work performed by both archaeologists and commercial construction crews (Solano 2006). At the AAC, burials were found deposited in a variety of methods: in coffins and without, stacked on top of one another, and remains from more than one body in one coffin. Seven single boxes believed to have held anatomical specimens used by the Albany Medical College, beginning in 1894, were also buried in the cemetery (Solano 2006). In the Newcastle infirmary burial ground pieces from dissections were found in complete burials, and in one instance a stone slab was placed with a dissection to imitate total body weight (Chamberlain 2012:21). According to Chamberlain (2012), only a few pieces of the clothing in which individuals were buried have been found; no other artifacts were associated with the cemetery. The Royal London Hospital at Whitechapel also showed a lack of grave goods, except for one copper ring (Fowler and Powers 2012b:82). In a few Tukthuset graves there have been redundant, isolated bones that do not seem to belong to any of the individuals. It is hypothesized that these bones, after use by the anatomy students, were discarded into a currently open grave, for reburial with another deceased individual (Fowler and Powers 2012a). The same treatment is noted for skeletal material from the Copenhagen Hospital cemetery in use 1842–1858 (Flies et al. 2017). According to Fowler and Powers (2012b), “sham” burials, coffins filled with sawdust, were present in the St. Thomas Hospital, London cemetery. Several of the boxes from Tukthuset also displayed sawdust or wood shavings. However, Harby (1990) states that it was common to place bodies on wood shavings, possibly for their absorption qualities. Flies et al. (2017: 1012) go so far as to suggest for the Copenhagen Hospital cemetery “it seems reasonable to assume that many of the corpses and body parts represent human remains supplied for dissection and surgical training.” At Newcastle Infirmary body parts used in dissection were found in large charnel pits, while at the Royal London Hospital Whitechapel the remains were also found in wooden coffins with occasional pieces of additional individuals (Fowler and Powers 2012b:83). Burial on workhouse or hospital grounds along with evidence of dissection and placement of individual bones within intact burials are all factors in

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establishing these individuals as set apart from normal acceptable members of society. As seen at other workhouses (Flies et al. 2017), noted in historic documents, and based on remnants of coffin parts occasionally found in the Tukthuset collection, it can be seen that individuals buried here were generally given a proper cultural burial. The coffins at Tukthuset were shaped, with one trapezoid making up the superior end of the coffin and another trapezoid at the inferior. The bodies were commonly laid on their backs in the extended position with the hands either folded or placed resting one on each side of the pelvis, although the position was not uniform (Harby 1990:12). The anatomical specimens at Tukthuset were found in a large, wooden box (Berit Sellevold, personal communication, May 2015). Proper burial at least offered a touch more respect than placement of anatomical specimens in a privy/latrine at the end of their use life, as seen elsewhere (Blakely and Harrington 1997; Mann et al. 1991). Fear of dissection was so prevalent in Victorian England that people would hold “funeral raffles” in an attempt to assure their remains would not be dissected (Hurran 2011); winners having been given a paid funeral. While eventual burial of the AI bones was commendable, it must not be forgotten that dissection, seen at the time as degradation of the deceased, was also acceptable because these poorest of the poor had no voice to refuse (Hildebrandt 2010). The institution carried forward the individual’s “living identity” in such a way that the memory of them was further defamed, through the mutilation and display of their physical remains (Nystrom 2011). Tukthuset is not the only cemetery where human remains were used as learning tools for anatomical students. Other cemeteries in the US and UK suggest that what truly linked all of these individuals was being poor and disenfranchised (Nystrom and Mackey 2014; Hodge 2013; Watkins 2012; Crist and Crist 2011; Nystrom 2011; Davidson 2007; Museum of London Archaeology 2006; Chamberlain 1999; Blakely 1998; Blakely and Harrington 1997; Council for British Archaeology 1997; Phillips 1997; Grauer and McNamara 1995; Higgins and Sirianni 1995; Angel et al. 1987). Across Europe and North America from the 1600s to early 1800s, it was common for executed individuals to be used for anatomical training (Halpern 2007; Larsen 2002; Mitchell 2012; Nystrom 2014). Dissection/autopsy of the bodies has been considered an additional punishment in death. Following this line of reasoning, the individuals buried in the workhouses were also punished even after death, but in their case for being poor. Use of workhouse remains for dissection has been referred to as structural violence, the institution and society responsible for desecration of the “body” even in death (Nystrom 2014). According to Larsen (2002:197) during this period throughout Europe, including Norway, the “Poor who were sick, frail or disabled were entitled to support, but the attitudes against people who were able and had the capacity to work were rather harsh.”

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Concluding Remarks Workhouses became locations for those able but not employed to live and work as a form of punishment, following general European sentiment regarding the poor (Huey 2001:125; Shields Wilford and Brittney 2018: 10–11). Indeed, the workhouse punishment for vagrancy was in force as recently as 1970 (Klause 2012). The adoption of forced labor to produce economically important goods such as rasped wood for dyeing, tobacco for trade and use, and textiles, emerged simultaneously to the growth of African chattel slavery throughout the Americas and the Caribbean, as home-grown European free labor. Indeed, with villeinage re-established in Denmark in the early 1700s by Christian VI, peasants between age 14 and 40 were not permitted to leave their estates, could be punished by the estate owner at will, and have been described as “white negro slaves” (Gjerset 1915; Rozbicki 2001). It could be said that individuals in the workhouse were at the end of the road in terms of their ability to survive. The inmates were required to carry out work for the governing body of the workhouse, “teaching” them how to work but for no wages (Spencer-Wood 2001). The word “inmate” itself suggests that these individuals were criminal by societal standards. While the workhouse may have been less than ideal, it represented the minimal care offered by society (Watkins and Muller 2015). It is likely that inmates had positive and negative feelings regarding the workhouse as it aided in sustaining life, but among dehumanizing conditions. As in many countries, Norwegian laws regarding the dead deal sporadically with how disturbed graves are handled. The Norwegian cultural heritage law of 1978 includes language on treatment of graves before 1536. In 1897 it is said that the church required only that, “When the cemetery is closed, it must remain consecrated for at least 40 years after the last funeral” (Harby 1990). This practice is still in use. Therefore after 40  years, if the burial is post 1536, there are no specific requirements for the treatment of burials. Progress continues and with it construction revealing remains from numerous cemeteries with no requirement for archaeological excavation. The 1989 excavation of Oslo’s Tukthuset churchyard was an exception to this practice. By 1990 no listings of these vulnerable cemeteries remained, so it is likely that additional cemeteries have been, and will continue to be, disturbed with no documentation of the site. An archaeological excavation can be done only once. Undocumented sites are likely to be lost forever (Harby 1990:14), and so those buried within. In the case of Tukthuset, remains were modified due to autopsy and dissection, the removal of remains by roadworkers, and likely curatorial practice, increasing the difficulty in estimating age, sex, and pathological processes. Memories of Tukthuset slowly vanished from the minds of Oslo’s citizens. Today all that is left of Tukthuset is a 100 meter long brick wall left after demolition, albeit with a plaque. Sadly the well-meaning commemoration states erroneously that the workhouse closed in 1838 and yet also that it became an all-female prison in 1880; the workhouse closed in 1938. In observing the individuals at Tukthuset we show the value of understanding scientifically educational remains and the history of the

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workhouses which could be thought of as a way to uplift the status of those treated so poorly in life and death. Workhouses are an example of failed integration of all classes of individuals into society, and as more research is carried out on workhouses the experience of these individuals is becoming entrenched in the history of us all. Hurran (2011:66) states that “The dissected body has a narrative and that the individual medical histories can be reconstructed to reveal broken lives on a scale little appreciated.” Due to the commingled nature of many individuals at Tukthuset, it is extremely difficult to draw out individual narratives. However, uniting the evidence from these remains allows them to once again be heard, and together these voices tell of life and death for the poor at Tukthuset. Rothman (1987:11) rightly states “We cannot understand the contemporary crisis around poverty in general, and homelessness in particular, if we do not appreciate the dynamics in the rise and, more or less, fall of the almshouse.” What of the future? Relating the history of the workhouses to the general public is desperately needed to take our current knowledge outside of the discipline. As data collection came to an end, the remains were at last accessioned into the Schreiner collection. Per Holck, curator of the remains for over 20 years, patiently waited throughout years of sporadic analysis for these anthropological observations to finally be complete. Recently however, novice staff, with little understanding of the various excavation series developed during the summer and fall of 1989, randomly renumbered boxes, out of order and out of series: thus adding a new layer of uncertainty and invisibility to their otherwise unknown provenience.

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Chapter 8

A New Division of Labor? Understanding Structural Violence Through Occupational Stress: An Examination of Entheseal Patterns and Osteoarthritis in the Hamann–Todd Collection Anna Paraskevi Alioto

Introduction Understanding the past is a recurring question within American society and culture. Recent studies have approached this question by using multiple lines of evidence from different disciplines in conjunction with the historical records to reanalyze lived experiences. In the past few decades alone, there has been a surge of studies examining and understanding the hidden histories of marginalized groups such as Native and African Americans  (Barber &  Berdan 1998; Blakey 2001; Harrod &  Crandall 2015; Nicholas 2008; Turner &  Andrushko 2011). Ultimately, these studies center on the incorporation of new research techniques and perspectives in order to create a clearer picture of these individuals and cultures, especially when the historical record is incomplete. While such studies have integrated different lines of evidence from disciplines such as history, cultural anthropology, and sociology, there has been limited research conducted using techniques and methods in biological anthropology in conjunction with historical analysis to reconstruct the past (Foster et al. 2012). This is especially true for studies which seek to understand whether and/or how structural violence is observed on the human skeleton. The purpose of this research is to test whether entheses and osteoarthritis can be used to examine occupational stresses within a structural violence framework. Entheseal changes (also known as musculoskeletal markers or MSMs) refer to the sites on the bone where muscles or ligaments attach, and osteoarthritis denotes a joint disease which reduces the cartilage and allows bones to rub together thereby wearing down the joints (Benjamin et al. 2006; Larsen 1997). Based on previous understandings regarding structural violence and occupational stresses, this study A. P. Alioto (*) Western Michigan University, Kalamazoo, MI, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 L. A. Tremblay, S. Reedy (eds.), The Bioarchaeology of Structural Violence, Bioarchaeology and Social Theory, https://doi.org/10.1007/978-3-030-46440-0_8

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seeks to create a connection between structural violence, economic/class opportunity, and bioarchaeology (Benson 2008; Nystrom et al. 2011). The Hamann–Todd Collection, consisting of individuals who lived in Cleveland, Ohio at the turn of the twentieth century, was utilized to understand how entheseal changes could be examined within this framework to provide a clearer understanding of the impact of occupational and activity stresses on marginalized populations. To accomplish this, the study tested for possible disparities over time (1913–1935) and two different factors, namely immigrant status and biological affinity, which are two examples of known marginalized groups during the Industrial Period according to historical sources and previous studies (de la Cova 2010a, b).

Industrial Era Cleveland (1880–1920) In order to reconstruct activity and labor patterns in early twentieth century Cleveland, it is crucial to understand the history regarding the labor and manufacturing industries as well as the population movements and their corresponding social and cultural spheres. At the turn of the twentieth century, Cleveland, like other northern cities, was enjoying a period of industry and expansion. Prior to this time, Cleveland had already started industrial growth and expansion with the creation of highways, railroads, and canals to connect the Great Lakes and increasing production of iron to use in manufacturing (Rose 1950). By 1860, Cleveland was a predominantly heavy industry city with little to no commerce in agricultural products (Van Tassel & Grabowski 1987; Rose 1950). The Civil War increased Cleveland’s iron industry and by 1880, iron accounted for about 20% of Cleveland’s manufacturing  (Rose 1950). Another contribution to Cleveland’s industrial growth occurred in the 1880s with the creation of new industries such as petroleum, chemicals for refineries, and automobiles in which Cleveland boasted three of the earliest manufacturers of gasoline, electric, or steam-powered cars (Van Tassel &  Grabowski 1987; Miller & Wheeler 1997). Cleveland’s age of rapid industrial growth peaked around 1930, when it was second only to Detroit among American cities in the number of workers employed in industry (Van Tassel & Grabowski 1987; Rose 1950). Since Cleveland had a diverse industrial economy around the turn of the twentieth century, different labor forces (contingent on skill sets) developed throughout the city. Cleveland’s early laborers can be traced to the building of the Ohio and Erie Canal, which began construction in 1825 and demanded a lot of unskilled labor (Rose 1950). As a result of  Cleveland’s industrial increase, social and economic gaps between skilled and unskilled laborers began to widen as labor unions were formed among the skilled laborers as they had the economic advantage to do so while the city’s unskilled laborers did not (Van Tassel & Grabowski 1987; Miller & Wheeler 1997). In the 1870s and 1880s, there were at least ten different types of industrial

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unions in the city, and when the economic recession of 1873–1878 shook the economy, the number of union activities and labor strikes increased due to the economic pressure (Van Tassel & Grabowski 1987). Some of these protests were successful, such as the major strike at the Cleveland Rolling Mills in 1882, which resulted in unionization of 80% of the workforce, resulting in higher wages for the workers (Van Tassel & Grabowski 1987; Rose 1950). By the end of the 1880s, life improved for Cleveland’s workers, however the tension between the unions and the corporations never completely went away. The most important trend that occurred out of these labor movements was the development of a working class that shared similar goals and values. This would even transcend the ethnic and religious barriers between different groups of people as America fell into the Great Depression (Van Tassel & Grabowski 1987).

Great Migration and African-Americans As industry expanded toward the end of the nineteenth and the beginning of the twentieth centuries, there was an abundance of lower skilled labor in American cities. Soon after, America’s rural poor, along with formerly enslaved African-­ Americans who engaged in seasonal agricultural work, began to move to the northern cities, a shift known as the Great Migration (Van Tassel &  Grabowski 1987; Rose 1950). One of these northern American cities was Cleveland in Cuyahoga County, Ohio. Despite the new labor opportunities, discrimination and segregation followed African-Americans northwards. In Cleveland, the most serious economic discrimination was that very few African-Americans were permitted to work in industry, even though Cleveland was a heavily industrialized city (Van Tassel & Grabowski 1987). African-Americans were not hired in the steel mills and foundries that had become one of the most important industries in Cleveland. This prejudice was often found in labor unions which usually excluded African-American workers  and therefore,  oftentimes blocked  them from economic mobility. As a result, by 1910, only 10% of Cleveland’s African-Americans were skilled laborers (Van Tassel & Grabowski 1987). The period of 1915–1930 was an era of both progress and difficulties for African-­ Americans. The industrial demands and the decline in immigration due to World War I created an increased opportunity for African-American labor, which prompted more individuals to head north looking for jobs (Van Tassel  & Grabowski 1987; Rose 1950). Because of these economic opportunities, a distinct African-American middle class rose; however discrimination and segregation still existed. For example, African-Americans were still sequestered in the Central Avenue ghetto despite obtaining and living with different levels of economic and financial stability (Van Tassel & Grabowski 1987; Miller & Wheeler 1997).

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Second and Third Waves of European Immigration While African-Americans and rural Americans migrated from the South to the North to take advantage of the unskilled and skilled labor jobs available in Cleveland, Europeans from southern and eastern Europe also traveled to America’s industrial cities due to poverty and political unrest within their home countries. Early immigration waves to Cleveland during the mid-nineteenth century originated from countries such as Ireland, Britain, and Germany. These immigrants were utilized to help construct the Ohio and Erie Canal near Cleveland, which allowed the city’s economic potential, especially in mercantile endeavors, to grow and made the city more attractive to other groups of immigrants (Van Tassel &  Grabowski 1987; Rose 1950). By the 1870s, European migration continued from Germany, Great Britain, and even increased from Ireland. However, the most diverse and substantial European immigration to Cleveland occurred around 1870–1914 and was coined the “New Migration” as  many southern and eastern European immigrant families began to migrate and many of them settled in Cleveland (Van Tassel & Grabowski 1987). This large movement was the result of land shortages in home countries, liberal emigration policies, increased military conscription, poverty, and even persecution (Van Tassel & Grabowski 1987; Rose 1950). Some of these groups included Italians, Austro-Hungarians, and Greeks. The influx was so great that the city used some of its police officers, stationed around the city, to count and assist new arrivals (Van Tassel & Grabowski 1987). Because Cleveland industrialized at a slower pace than other cities such as Chicago and Detroit, the city received more “new immigrants,” in later decades than the others. Therefore, immigrant communities and institutions, such as churches and benefit organizations to help immigrants, arose in Cleveland later than in other cities (Van Tassel & Grabowski 1987). As a result, immigrants, at first, did not have the resources to find higher levels of occupations such as white-­ collar cleric positions and would have to rely on the menial labor jobs that offered work on a sporadic schedule such as day laborers. During World War I, new immigration came to a standstill in Cleveland due to increased tensions with Europe which oftentimes resulted in increased suspicion of immigrants, especially those who home countries were the United States’ enemeies (e.g. Austria-Hungary and Italy) (Van Tassel & Grabowski 1987). In addition, the federal government passed restrictive legislation such as the National Origins Act of 1921 (1924) that prohibited large-scale immigration from southern and eastern Europe, among other “undesirable” populations, such as East Asians, Arabs, and Africans, and provided restriction quotas for different ethnic groups (Van Tassel &  Grabowski 1987; Miller &  Wheeler 1997). After that, very little immigration took place in Cleveland until after World War II.

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Cleveland and Cuyahoga County Occupations Circa 1900 In order to understand and discern possible activity stresses and patterns from the Hamann–Todd Collection, it is crucial to understand Cleveland’s geographic and economic landscape. By 1900, Cleveland was well on its way to becoming one of the top industrial cities in the United States. The development of new industries along with the increasing population from the south and Europe created a diverse  blend of occupations at all social and economic levels  (Van Tassel &  Grabowski 1987). At the beginning of the twentieth century, Cleveland had a population of 876,050 and Cuyahoga County (where Cleveland is situated) had a population of 1,412,140 (U.S.  Census Bureau  1900,  1999). Cuyahoga Cleveland was divided into several townships, and the city of Cleveland was comprised of 42 wards (U.S. Census Bureau 1900, 1999). Similar to other urban centers in the North, the outlying townships had different occupations than those who lived in Cleveland and even different wards, within the city, had different occupations and diverse groups of people. Since the occupations for the Hamann–Todd Collection are unknown (as of now), the following section details some of the types of occupations that individuals  from the collection could have had in Cleveland  based on the 1900 Federal Census. A sample of at least 50 occupations was collected from different wards of the city as well as the outlying townships. For each city ward and/or township, the name of the occupation, the number of individuals, the gender of the individuals, and the amount of skill and force that went into the job, based on Villotte et  al. (2010), were collected in order to get an understanding of what types of occupations were prevalent during the Industrial Age in Cleveland. Villotte et al. (2010) created four occupation groups based on the type of labor (manual versus nonmanual) and the amount of force applied. Group A included nonmanual workers who do not engage in forceful activities such as storekeepers, policeman, and landowners. Group B included individuals who participated in manual but nonforceful occupations such as shoemakers, tailor, weavers, and home servants. Group C included manual workers who carried heavy loads or were involved in forceful tasks. Example include carpenters, masons, rural workers, butchers, and steelworkers. Lastly, Group D were manual, unskilled, and forceful laborers such as foot soldiers, day laborers, and unskilled workers (Villotte et al. 2010). These groups were utilized in this study as a way to understand the types of entheseal and occupational stresses individuals may have experienced based on their (possible) occupations. Because of this, it is likely that the numbers of each type of occupation present could give a generalized idea of the amount and frequency of occupation stress to be expected in the skeletal sample, especially regarding Group D, which were typically the occupations of those in the lower classes. These groups were then utilized in conjunction with scored entheses to get a clearer picture regarding labor, occupation, and stress. Table 8.1 lists the top five occupations for both males and females based on the westside of Ward I and  Ward IX, both of which are in Cleveland (U.S.  Census

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Table 8.1  Top Male and Female Occupations from Cleveland Wards I and IX, circa 1900 (U.S. Census Bureau 1900) Occupation Rank Tally Sex Race Immigrant? Place of Birth Sampled Occupations circa 1900 from Cleveland City Ward I (Westside) Day laborer 1 77 M CAU. Yes Ireland, Italy, Russia, Poland, Austria, Hungary, Assyria Tailor 2 9 M CAU. Yes Italy, Bohemia (Czech Republic) Candymaker 3 7 M CAU. Yes Greece, Romania Clerk 4 6 M CAU. Yes/No Ohio, Germany, Ireland Teamster 5 5 M CAU. No Ohio, Wisconsin Waiter 5 5 M 4 CAU/ 1 AFR. Yes/No Italy, Virginia, Germany, New York Sewer 1 3 F CAU. Yes/No Ohio, Russia (factory) Tailor 1 3 F CAU. Yes Italy, Bohemia (Czech Republic) Washwoman 3 2 F CAU. Yes/No Michigan, Ireland Bookkeeper 4 1 F CAU. No New York Cook 4 1 F AFR. No Ohio Sampled Occupations circa 1900 from Cleveland City Ward IX Steel laborer 1 15 M CAU. Yes/No England, Pennsylvania, Ireland, Ohio, Austria, Wales Machinist 1 15 M CAU. Yes/No Germany, Ohio, England, Ireland, Pennsylvania, Wales Day laborer 3 6 M CAU. Yes/No England, Ireland, Ohio Blacksmith 4 5 M CAU. Yes/No Scotland, England, Isle of Man (Great Britain), Ohio Iron molder 4 5 M CAU. Yes/No England, Ohio, Ireland, Michigan Boarding 1 2 F CAU. Yes/No Ireland, Ohio house Servant 1 2 F CAU. No Ohio, New Jersey Saloon 3 1 F CAU. No Michigan keeper Day laborer 3 1 F CAU. Yes Ireland Machinist 3 1 F CAU. Yes Wales Storekeeper 3 1 F CAU. No Ohio

Bureau 1900, 1999). In this study, there was a focus more on Cleveland’s city wards rather than the townships, as most individuals from the Hamann–Todd Collection were from the city. The sample demonstrates that most of the work for males dealt with some form of manual or industrial labor in addition to other skilled manual labor activities such as carpentry. The occupation of “Day Laborer” was particularly high, a total of 77 individuals which fits into the historical evidence for immigrant laborers at this time (U.S. Census Bureau 1900). In other words, many lower-class individuals, who were usually immigrants, would work in the less-skilled, higher

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stress occupations. For females, the top-ranked occupations were more domestic work such as house servants and skilled trades such as dress makers. It is noted, however, that there is a smaller frequency of individuals who worked in different occupations. It is likely that this is related to the fact that either most females did not have recorded  occupations at that time and unemployed domestics or, the more likely scenario, that there were many different types of occupations a female could work which would account for low numbers per each one. Based on Villotte et al. (2010), the top occupations for males indicate both skilled and unskilled labor with high workloads and force, which would subsequently create higher stress at entheseal attachment sites. For females, the pattern is a little different in which they were engaged more in unskilled and skilled nonforceful labor which could create less stress on entheses and joints compared to males. As mentioned previously, there are fewer African-Americans who held the top five jobs in these wards. The fact that African-Americans, for the most part, could not hold industrial jobs is proven true when examining the census records. Instead, according to this snippet of occupations, African-Americans seemed to work in the food industries e.g., as waiters and cooks (U.S. Census Bureau 1900). In addition, the low frequency of African American can also be attributed to the segregation regarding housing and therefore census collection.

Background of the Hamann–Todd Osteological Collection The Hamann–Todd Collection is one of the few cadaver collections in the United States that offers a glimpse of late nineteenth and early twentieth century urban life. It is comprised of over 3000 individuals, who died from 1911 to 1938, and represents some of the marginalized groups of Cleveland and the surrounding Cuyahoga County, Ohio (Cobb 1935). Individuals from this collection are mostly European-­ Americans along with African-Americans, but there are smaller samples of other groups such as Asian-Americans and Hispanic-Americans. The individuals who became a part of this collection either donated their bodies, could not afford burial, or were found on the streets (Hunt & Albanese 2005; de la Cova 2010a, b). Therefore, many individuals were picked up from hospitals, asylums, and poorhouses and represent the lower classes and fringes of society. The majority of European-Americans were foreign-born immigrants and their immediate first-generation descendants, while most of the African-Americans were individuals who migrated from the south as a part of the Great Migration (Cobb 1935). Table 8.2 lists general demographic information from the Hamann–Todd collection which demonstrate the social and economic trends in Cleveland (Cobb 1935). The sample size, n = 1177, represents those individuals that have a place of birth, age, and cause of death in associated documentation (Cobb 1935). Because the Hamann–Todd Collection represents many lower class and marginalized individuals who often worked in unskilled occupations, the collection can be used to loosely trace economic and social trends in Cleveland at the beginning of the

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Table 8.2  Demographic Composition of the Hamann–Todd Collection based on Migration Patterns, Birthplace, and Age (Cobb 1935) Demographics of the Hamann–Todd Collection: Migration Patterns Great “New” Immigrants: Migrations “Old” Migration: Immigrants: Southern/Eastern AfricanEuropeans Northern/ Americans Western Europeans Austria, Hungary, Georgia, Germany, Countries/ Alabama, Ireland, Great Czechoslovakia States of South Origin (most Britain Carolina numerous) Number of ≈172 ≈247 ≈284 Individuals ≈20.9% ≈24.1% Percentage of ≈14.6% Collection (n = 1177) Demographics of the Hamann–Todd Collection: Birthplace and Age American-born: AmericanBirthplace ForeignEuropean-Americans born: born: AfricanEuropeanAmericans Americans

Number of 431 Individuals Percentage of ≈36.9% Collection (n = 1177) Age Total population Median Age

≈45 years

American-born: European Individuals and Others Ohio, New York, Pennsylvania

≈474 ≈40.3%

292

447

Miscellaneous: Foreign-born AfricanAmericans, AsianAmericans etc. 7

≈25.0%

≈38.0%