Spital Square

The Spital Square site, previously referred to as ‘St Mary Spital’ (Thomas et al. 1997) is situated on the northern side of Folgate Street in North East London. It was home to the Augustinian priory and hospital of St Mary Spital, of which it was one of the largest in Medieval England.

Serious excavation of the site was carried out between 1985 and 1989 by the Museum of London in preparation for redevelopment of the area (Thomas et al. 1997).

During this time a total of 126 human skeletons were recovered from four distinct sections of the site and were retained for analysis (Site codes: NRT85, NRF88, SPQ88 and SSQ88). For the purposes of this summary the data for all four sections has been grouped.

Nine skeletons (SSQ88) were recovered from the priory, dated 1197-1235. Although ten graves were identified during the excavation, one had only a small number of disarticulated bones suggesting a prior exhumation.

A total of 15 individuals (SPQ88) were recovered from the first phase of the infirmary hall/ chapel dating between 1280 and 1320.

A total of 102 sets of remains were recovered from the hospital cemetery, dated 1235-1280, and consisted of 54 (NRT85) individuals from the North section and 45 (NRF88) from the South. Although they were recovered during two separate excavations both sub groups can be linked archaeologically and osteologically. All the graves were aligned east-west.

Data entry for this site is ongoing.

Methods

Non-metrics and dental measurements were not recorded for sub adults on this site.

Preservation

Overall the quality of the bone was good and the majority of individuals were more than 50% complete.

Preservation N= %
Good 123 99.2
Medium 1 0.8
Poor 0 0

Table 1 Skeletal preservation

Chart of skeletal completeness from medieval spital squareFigure 1 Skeletal completeness (N=124)

Demography

A total of 124 individuals have presently been analysed, comprising 43 males, 23 females and 42 sub-adults. Of all adults, the single largest group was the 36-45 year age category, accounting for 67% of the adult population. The combined male to female ratio for the site was almost 2:1 but was higher in the 18-25 (8:1) and 36-45 (9:1) categories, however, females outnumbered the males by 3:1 in the mature adult demographic.

There was an unusually high representation of sub-adults recovered from Spital Square, accounting for approximately one third of the burials. The majority died during adolescence; however, approximately 24% were aged between 6 and 11 at the time of death.

Chart of skeletal age from medieval spital squareFigure 2 Age distribution (N=124)

Age N= %
Perinatal 1 0.8
1-6 month 0 0.0
7-11 month 0 0.0
1-5 years 5 4.0
6-11 years 10 8.1
12-17 years 20 16.1
18-25 years 19 15.3
26-35 years 14 11.3
36-45 years 28 22.6
>46 years 9 7.3
Adult 12 9.7
Sub adult 6 4.8

Table 2 Age distribution (N=124)

chart of adult male and female distribution from medieval spital squareFigure 3 Adult male and female distribution (N=82)

All adults % Male % Female %
18-25 years 19 23.2 12 27.9 5 21.7
26-35 years 14 17.1 7 16.3 5 21.7
36-45 years 28 34.1 20 46.5 7 30.4
>46 years 9 11.0 2 4.7 6 26.1
Uassigned Adults 12 14.6 2 4.7 0 0.0
Total 82 43 23

Table 3 Male and female distribution by age in the adult population

Stature

Stature, calculated using complete femora, indicated that both males and females were of average height when compared to individuals from other British medieval populations (Roberts and Cox).

Sex Avg_stat SD VAR MIN MAX N
Female 161.1 5.8 34 159.0 170.4 10
Male 169.5 4.8 23.3 161.1 178.7 20
Unsexed 0

Table 4 Stature estimation from femoral length

Pathology

The Spital-Square population reflected a typical medieval pathological pattern with high numbers of trauma and infection. 19.5% of the adult population suffered some form of trauma and although more individual cases were recorded among men, women had a higher prevalence of healed fractures. 17% of the adult population exhibited some form of infection, including 1 case of tuberculosis, while 14% of sub-adults had non-specific infections.

Of further interest is a case of Osgood-Shlatter's disease and a probable case of Keinbocks disease.

Pathology table for Spital Square (Word 88kb)

Vertebral Pathology

Vertebral pathology was consistently higher among females except in the case of schmorl’s nodes, of which there were almost double the prevalence in males.

All adults Male Female
N n % N n % N n %
Osteoarthritis 62 6 9.7 37 3 8.1 19 3 15.8
Osteophytosis 62 31 50.0 37 19 51.4 19 11 57.9
IVD 62 32 51.6 37 20 54.1 19 11 57.9
Schmorl's nodes 62 31 50.0 37 24 64.9 19 6 31.6
Fusion 62 4 6.5 37 2 5.4 19 0 0.0

Table 5 Distribution of vertebral pathology by sex in adults with one or more vertebrae present

Dental Pathology

Dental analysis revealed a, perhaps not unexpectedly, high prevalence of calculus across the population, however, more unusual were the levels of caries, enamel hypoplasia and periodontal disease. A particularly high prevalence of hypoplasia was recorded among the females of the population which may be indicative of social segregation.

Caries Calculus Hypoplasia Periodotitis Periapical lesions
N n % N n % N n % N n % N n %
Male 30 15 50.0 30 29 96.7 30 16 53.3 30 27 90.0 30 7 23.1
Female 16 8 50.0 16 16 100 16 13 81.3 16 14 87.5 16 7 43.8
All adults 48 25 52.1 48 47 97.9 48 31 64.6 48 42 87.5 48 14 29.2
Sub adults 26 8 30.8 26 22 84.6 26 17 65.4 26 7 26.9 26 1 3.8

Table 6 Distribution of dental pathology in sub adults and adults

Discussion

Medieval Spital Square represents a stratified population from an early medieval Augustinian priory and hospital. This assemblage provides an ideal sample for comparative study with other British medieval populations and populations from continental hospitals of a similar period. Furthermore, this site may benefit from a more detailed analysis of the individual sub sections outlined above, particularly those pertaining to the infirmary cemetery.

Excavations carried out on Medieval Spital Square

1-3 Norton Folgate, E1
Sitecode: NRT85

4-12 Norton Folgate, E
Sitecode: NRF88

38 Spital Square, E1
Sitecode: SSQ88

4 Spital Square, E1
Sitecode: SPQ88

Recorded by J. Bekvalac, L.Cowal, T. Kausmally, R. Mikulski