Examining Reactive Arthropathy in Military Skeletal Assemblages: A Pilot Study Using the Mass Grave Assemblage from the Battle of Towton (1461)

Meghan Elizabeth Banton

doi:10.5334/pia.466

Abstract

Military personnel are often subjected to physical exertion, sleep deprivation, deficient diets, overcrowding, and stress. All of these influences are capable of compromising the immune system’s ability to ward off disease-causing bacteria, thus explaining why the historical narrative of war is frequently accompanied by reports of death and suffering due to epidemics of infectious diseases. Historically some of the most common infections included: diarrhoea, dysentery, typhoid fever, gonorrhoea, and streptococcal tonsillitis. The bacteria which cause these diseases are also capable of triggering arthritis. When an arthritic condition is triggered by an infectious microbe it can broadly be referred to as “reactive arthropathy,” of which the spondyloarthritides (SpAs) are of great interest. Since the bacteria associated with these arthritic conditions are responsible for the epidemics which have plagued combatants for centuries, it is reasonable to assume that reactive arthropathy was present in past military populations. This assertion can be tested through a prevalence study of military related skeletal assemblages. To test the methodology and gain preliminary results for this research project, a pilot study was carried out using remains from the 1461 Battle of Towton. The methodology was deemed to be sound and the statistical results, while not significant, were promising.

Highlights

The physical exertion, sleep deprivation, deficient diets, and stress which combatants are subjected to reduces the ability of their immune system to ward off infectious organisms (Ekblom et al 2011)
The SpA skeletons shared characteristics commonly observed in Reactive Arthritis (ReA), but not to the extent that they fulfilled all of the criteria needed to meet the ReA operational definition
They provided enough evidence to strongly suggest the pattern of the condition’s course had it been able to continue its development. Though they cannot be categorized as ReA, the amount of supporting evidence indicated that some informal categorization beyond the general SpA classification should be used

Summary

Introduction

The physical exertion, sleep deprivation, deficient diets, and stress (both environmental and mental) which combatants are subjected to reduces the ability of their immune system to ward off infectious organisms (Ekblom et al 2011). Diseases that were commonly found among past combatants included diarrhoeal diseases, venereal diseases, and laryngopharynx infections (Smallman-Raynor and Cliff 2004) These conditions are frequently triggered by bacteria, including: (diarrhoeal) Salmonella enteritidis, Campylobactera jejuni, Yersinia enterocolitica, Shigella dysenteriae, Shigella flexneri, Escherichia coli, Salmonella typhi, Clostridium difficile, (venereal) Neisseria gonorrhoeae, Chlamydia trachomatis, (laryngopharynx) Streptococcus pyogenes, and Streptococcus pneumoniae (Carter 2010; Chandran and Raychaudhuri 2010; Ehrenfeld 2012; Hannu 2011). These bacteria are known to be arthritogenic, meaning they are capable of triggering an arthritic reaction. Of the various forms of reactive arthropathy, the spondyloarthritides (SpAs) are of great in relation to past military populations since they are linked to the bacteria previously mentioned as common among past combatants; Reactive Arthritis (ReA) is associated with the diarrhoeal and venereal bacteria and Psoriatic Arthritis (PsA) with streptococcal bacteria (Barton and Ritchlin 2005; Carter 2010; Chandran and Raychaudhuri 2010)

Methods

Results

Conclusion