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From the 'Cemetery to Clinic' team

Introduction

Welcome to the JISC-funded project 'From Cemetery to Clinic': Digitised pathological data from archaeological leprous skeletons. This project was set up to create a unique interactive resource on the pathological manifestations of leprosy (Hansen's disease) in skeletons excavated from the Medieval leprosarium of St. James and St. Mary Magdalene, Chichester in Southern England in 1986-87 and 1992 by Chichester District Archaeological Unit. The leprosarium was founded circa 1118 AD to care for eight leper brethren and was used as a leprosarium until at least 1418. Of the 384 individuals excavated a minimum of 75 individuals show skeletal lesions which are likely to have been due to leprosy. The Chichester collection is the only large scale excavated and published archaeological assemblage of leprosarium patients in the UK, and one of a handful worldwide. None of the child skeletons from Chichester had definitive skeletal evidence for leprosy, and therefore this archive is only concerned with adult skeletal material.

The chronic infectious disease leprosy is a devastating and debilitating condition involving pathological changes to the upper jaw (rhino-maxillary syndrome), resorption of bones of the hands and feet (including knife-edge remodelling of metatarsals and concentric remodelling of phalanges), secondary infectious involvement of the tibiae and fibulae (periostitis), and remodelling of the hand phalanges caused by fixed flexion of the fingers (volar grooves due to claw-hand deformity). As a treatable condition it has largely been eliminated in the developed world. A digitised archive of 400 historic clinical x-radiographs taken of living leprous patients in Ethiopia 30 years ago provides additional context.

By combining new clinical descriptions alongside the 3D data, this resource offers the opportunity to inspire an emotional response, understand past human experiences, and offer people the chance to come face-to-face with the realities of the disease and how people in the past may have responded to the social stigma of the disease. The following 3D digital archive preserves fragile dimensional information that is otherwise under threat from attrition through handling and is aimed as a virtual training and research tool for clinicians, human osteologists, archaeologists and the wider public.