AAP 369 090151534 An examination into the treatment of individuals with physical deformities and how this has changed through time. Reconstruction of Viste Boy Barber and Tveit. 2011 Dissertation Supervisor: Dr. Andrew Chamberlain An examination into the treatment of individuals with physical deformities and how this has changed through time. Abstract This dissertation provides a study of the ways in which individuals with physical deformities have been treated throughout time, from the pre-historic to the pre-modern period. Using a combination of primary written sources, museum exhibitions, secondary written sources and media, it shows that while individuals were treated without much differentiation throughout the pre-historic period, the adoption of religion, writing and changing social values altered this. The deformed came to be viewed as either an embodiment of evil, or as a source of religious power. In every instance they were singled out, whether they were treated preferentially or not. The preference for a ‘perfect’ physical specimen continues to this day. The discussion concludes with points for further research. Acknowledgments I would like to thank my dissertation supervisor Andrew Chamberlain, and my personal tutor Pia Nystrom, for guiding me through this work and Suzanne Woods and Caitlin Nagle for proof-reading it. I would also like to thank the friendly staff at the National Fairground Archives and the Royal College of Surgeons for their help in finding research material. Contents Introduction_______________________________________________________________4 Background_______________________________________________________________5 Analysis__________________________________________________________________8 Prehistory_________________________________________________________________8 The Mediterranean_________________________________________________________13 Bronze Age_______________________________________________________________16 Iron Age__________________________________________________________________19 Egypt____________________________________________________________________23 The Middle Ages___________________________________________________________26 Post-Medieval to the Modern Age______________________________________________30 Evaluation_______________________________________________________________36 Conclusion_______________________________________________________________39 Bibliography_____________________________________________________________40 Introduction This paper is a discussion on the treatment of individuals, or groups of individuals, who suffered from physical deformities at some point during their lives. It aims to discover whether or not the type of treatment they received, both in a medical sense and a cultural one, has changed through time and whether this is linked to changes in social structure, technological advances and social reform. A final goal is to determine whether or not we, as Westerners, are correct in the assumption that treatment of these individuals is better today than it ever was in the past. Only individuals with physical deformities will be included in the study, in other words those with skeletal abnormalities visible in the archaeological record or those with notable physical impairments depicted in written or artistic sources. There are several reasons for this, most pertinently the fact that this is what is most obvious within the archaeological record. Another reason is so that the research criteria is not too wide given the length of this paper. Although those with a physical disability aren’t solely among the disadvantaged, we could extend this group to include the blind and death, those suffering from chronic disease of the soft tissues, the brain damaged and even the very impoverished, but their skeletons leave us with no clues as to the nature of their impairments (Waldron. 2000). Such individuals may also have been treated in a different way to those with purely physical deformities. It must be noted however that the types of disabilities often overlap, for example an individual with microcephaly will also have a reduced mental capacity (Oxford Concise Medical Dictionary. 2007), but it is the physical aspects of the condition on which the paper will focus. It may also be true that the deformity may not be disabling. Viste Boy, a fifteen year old from the Norwegian Stone Age had scaphocephaly, or boat-head, but such a condition does not impair brain or motor functions, and he was otherwise strong and healthy (Barber, cited by Okstad. 2011). The origin of the deformity will only be considered in the context of how that individual is treated. In other words, the deformity may be congenital or due to illness, an accident or a battle wound but its origin will only be noted if it appears that individuals with similar abnormalities are being treated differently. In order to get a complete overview of the changing attitudes towards disabled people, the paper will look at cases from prehistory, such as the examples of Neanderthal compassion found at Shanidar Cave up until the nineteen fifties, and the start of modern history (Trinkaus. 1978, Crubezy and Trinkaus. 1992). This will allow me to utilise archaeological research alongside primary and secondary written sources and exhibitions such as those found at the Hunterian Museum at the Royal College of Surgeons in London and Sheffield’s National Fairground Archive. There will also be the opportunity for me to research different aspects of media portrayal, for example in works like Tod Browning’s 1932 film, ‘Freaks,’ and David Lynch’s ‘The Elephant Man.' This in turn leads on to the final point of discussion within the paper, that of the portrayal of disabled individuals in the archaeological record. There are some academic papers on this subject, most notably the work of Cross (1999), Waldron (2000), Hupert (2000), and Sullivan (2001). My goal then is to collate this research and determine whether it is our own prejudices that prevent us from correctly representing the past disabled, or whether preservation of remains differs due to treatment of the remains of the individual as an outcast. Background Throughout history the deformed have been segregated and pushed to the boundaries of society. In almost any culture we can find an individual, or group of individuals whose personal traits or attributes have led them to become excommunicated from the group’s normal way of living. The reasons why the disabled are often singled out for this purpose are manifold, perhaps on the most basic level because they deviate from what we consider to be the norm on a primitive scale; their very body is not what it should be. Linked to this are our own intrinsic conceptions about beauty and wholeness, along with the fact that such a person may not be able to contribute in the same way to society as a whole. This concept of a disabled person as a drain on resources could be considered to have been more pertinent in the past, when survival was dependant on what each person could produce than it is today. But when such a person requires assistance in their day-to-day lives feelings of resentment on the part of the carer may have been stirred ways that are still echoed in our society. Consider the attitudes of some Western individuals to those who cannot support themselves and must rely on ‘tax payer’s money,’ for survival. We think of ourselves as a forward moving and advanced society, and yet it has not been a straight forward journey from prehistoric people without compassion to today’s politically correct culture. Indeed, we find a great deal more fluctuation than one might think in the treatment of people with deformities, for example the woman found at Dolni Vestonice had severe skeletal deformities in her limbs, face and back and yet she had reached adulthood and was buried in a rich grave filled with ochre and beads (Formicola et al. 2001). Meanwhile in the one hundred or so years that elapsed between the publication of Victor Hugo’s The Hunchback of Notre Dame in 1831 and Paul Gallico’s The Snow Goose in 1940 we find absolutely no difference in the treatment of Quasimodo and Rhayader, both gentle and talented men who are shunned and isolated due to their hideous appearance (Hugo. 1993, Gallico.2001) Whilst both are works of fiction it is undeniable that their representation of such treatment would have reflected what would have happened to such people that the time. Viste Boy is another good example. Due to his dating at around 7,500 years ago, the assumption was made that he would have been sickly due to his scaphocephaly, but he was in fact robust and healthy. A second claim was that his close-set eyes and protruding jaw marked him as a criminal or outcast, not a rich man (Okstad. 2011). While the latter prediction may well be true, we have no evidence to support either theory. It is interesting to note how quickly our minds jumped towards the idea that he was a criminal given both his skeletal abnormality and, without putting too fine a point on it, that he was rather ugly. Our assumption too was that his deformity would have prevented him from leading an active and healthy life style. The criteria given for exclusion in any society is fluid rather than static. It is not a modern concept nor is it linked, as was previously suggested, to literacy, complex societies, or state organisation; it must arise from specific cultures (Hupert. 2000). To take a modern example, when an eight-legged baby girl was born to a poor family in Bihar, India, she was believed to be the re-incarnation of the goddess Lakshmi and was worshipped as such by the villagers. When doctors heard of her condition they immediately wanted to operate and remover her parasitic twin, and yet if the same child was born in Ancient Rome, she would most likely have been thrown in the River Tiber after birth (Blumberg. 2009). Not only do the boundaries which exclude shift both temporally and spatially, those who were once excluded can become the accepted, whether because they have altered, or because the society has. Whether or not they can successfully reintegrate back into society is dependent on many factors, but is often visible in the archaeological record as segregation within cemeteries (Hubert. 2000). What this paper aims to find out is how and why different individuals were excluded from their social groups and how this has changed throughout time. Analysis Prehistory The notion that life in prehistory was ‘nasty, brutish and short,’ has prevailed throughout archaeology even to this day. On the surface, it seems to be a reasonable assumption, particularly concerning the lives of the disabled. Mobile hunter gatherer economies would have been dependant on the physical activity of their members. It has been suggested that disabled people could only have been supported after the development of agriculture and the establishment of a stable food resource (Roberts. 2000). This is mirrored during the Industrial Revolution, in which production was once again dependant on an individual’s yield; disabled people became less tolerated and laws were passed in order to restrict their lives (Roberts. 2000). Yet there are examples of individuals who must have been cared for as they attained a degree of age alongside chronic disabilities or deformities. One example is an adolescent from the Late Upper Palaeolithic, found in Italy, who suffered from acromesomelic dyplasia, a form of dwarfism. This would have left him with a height of approximately 110-120 cm and restricted movement, particularly at the elbows. And yet this individual survived for almost two decades despite his reduced ability to participate in subsidence or economic activities and the difficulty he must have had navigating the landscape. He must, therefore have been supported by the other members of his group (Frayer et al. 1987). The Upper Palaeolithic site of Dolni Vestonice contained the burial of DV15, a young adult female with a variety of skeletal defects (Formicola et al. 2001) These include enamel hypoplasia, asymmetrical curvature and shortening and angular deformities of the femora, a diaphyseal deformity of the distal right humerus, a fracture on the left ulnar and asymmetry between the length of the forearms (Trinkaus et al. 2001). Despite this however, DV 15 also displays a level of hypertrophy to the limbs which is average to high for an Early Upper Palaeolithic person. Moreover the severe osteoarthritis found in the upper limbs suggests a wear pattern caused by the repetitive carrying or dragging heavy loads (Trinkaus et al. 2001). This would not only be in keeping with the mobile nature of these Pavlovian populations, but the healthy bone tissue shows no evidence of atrophied limbs that result from misuse. Therefore we must concur that DK 15 contributed in some way to the social group, most likely through the carrying or dragging of heavy bags with a straps or handles as this corresponds to the osteoarthritis seen on the middle finger and ethnographic evidence of carrying methods in similar societies (Trinkaus et al. 2001). Not only does the maturity of this individual indicate care and support, the skeletal remains also prove that she was an active member of society. An important point to note about the Dolni Vestonice burial is its rich and elaborate nature. The two male adolescents buried alongside DV 15 have pendants carved from ivory and carnivore teeth, while DV15 lay under several mammoth scapulae with cut marks on them (Gamble. 1999). All three lay in different positions, DV15 faced upward while one of her companions had his arms outstretched as if to cover her. All three had their heads and pelvic area covered in ochre. The burial also contained stone tools, ivory beads and shell ornaments. The bodies were covered with branches which were set alight and then covered quickly with earth to prevent the bodies from burning (Gamble. 1999). The burial, grave goods and funerary ritual combine to make something out of the ordinary and this, coupled with the deformities found on the skeleton on DV 15 suggest not disadvantageous, but preferential treatment at the hands of her peers. Either way she has been grouped for a rich burial, ‘regardless of whether the perception is negative or positive, the perception nevertheless serves to separate and distinguish people with disabilities from those who lack them,’ (Covey. 1998: 25). The burial at Dolni Vestonice is mirrored in the linking of physical deformity, young, mixed sex individuals and unusual funerary behaviour by the double child burial from Sunghir, Russia (Formicola and Buzhiloza. 2004). This Mid Upper Palaeolithic site contained a long, shallow grave in which a twelve to thirteen year old boy and a nine to ten year old girl were placed supine and head to head. Again the bodies were covered with red ochre, and accompanied by thousands of ivory beads, probably attached to clothing, as well as mammoth tusk spears, ivory daggers, pins, pendants and animal carvings, antler rods and hundreds of perforated vulpine canines (Formicola and Buzhiloza. 2004). The position, grave goods and double child skeletons make this burial unique without considering the girl’s underlying pathological conditions. Her femora are short and bowed, most likely due to a congenital bowing of the long bones, or CBLB. Like DV 15 she was robust and healthy regardless of her condition and the similarities between the two contemporary sites suggests a link between abnormality and sophisticated ritual and Fig 1. The Double Burial at Sunghir. Hitchcock.2012 symbolism throughout the Upper Palaeolithic (Formicola and Buzhiloza. 2004). This is repeated at Neolithic sites such as the Tomb of the Eagles on Orkney. Of the eighty five people found buried in the Isbister Cairn, a higher number of people than would normally be expected had a hip and cranial abnormalities. Four bodies showed deformed hips, a condition which only affects one in 25,000 people nowadays. Many would have suffered neurological impairment due to cranial deformity (Towrie. 2001). While we cannot rule out the possibility that certain deformities were more prevalent in the past than they were today, the human body is fairly uniform and as these are not bacterial or viral infections we would generally expect the spread to be the same. It was suggested that Isbister may have been a ritual centre for those singled out by their deformity. Another theory is that the grave site was especially for those who had died ‘unacceptable’ deaths, those who were murdered, died in an accident or were foreigners. This is supported by forty per cent of the bodies having trauma wounds (Towrie. 2001). In this case, the linking between the deformed and the unacceptable is clear, and both are being singled out. Inbreeding is another possibility, which could potentially explain the high instances of certain skeletal abnormalities. If the human body is said to be uniform, can the same be said for human compassion? Jane Hupert theorises that past societies may not have had the need for compassion, and therefore did not display it, and that their pain thresholds may have been higher (Hupert. 2000). While such statements may be impossible to prove or disprove, even amongst Neanderthal populations we can find evidence of compassion. The Near Eastern Neanderthal found at Shanidar in Iraq and dated to 73-40,000 years ago displayed several skeletal abnormalities. These include a withered clavicle, scapula and humerus, osteomyelitis of the clavicle, fractures of the humerus and the amputation of the distal humeral epiphysis, right forearm and hand. There were also wounds on the body and cranium, and the individual suffered from degenerative joint disease alongside the curved and asymmetric limb bones (Crubezy and Trinkaus. 1992). His limb abnormality appears not be congenital, but concurrent with an injury to his left eye socket; a blow to the left side of his brain could have disrupted the blood flow to, and paralysed, his right arm. This loss of nervous stimulation would lead to very rapid atrophy (Trinkaus. 1978). His right foot displayed severe arthritis (Trinkaus. 1978). He also suffered from hyperostoic disease, a condition which causes the spontaneous enlargement of the outer layer of bone (Crubezy and Trinkaus. 1992, Oxford University Press. 2007). While traumatic injuries are not uncommon in skeletons from this time, Shanidar 1 displays an impressive array of traumatic and degenerative conditions which would have impaired his life in the Neanderthal period. This male was between thirty-five and forty years at his death, a reasonable age for any individual during the Middle Palaeolithic, let alone one with such crippling skeletal deformities. Again we must infer that some help was on hand to allow this individual to survive. Disability may arise for several reasons, due to a congenital disorder, illness or trauma and in some cases medical intervention. The Neolithic site at Buthier-Boulancourt contained the body of a man who had survived a deliberate amputation. An elderly man, he suffered from osteoarthritis, visible on his vertebrae, lower limbs and feet, along with lesions and nodes on his spine. His teeth had fallen out during the course of his life, and he suffered from infected gums (Buquet-Marcon et al. 2009). Most notably however his left arm was incomplete from the forearm down, and the humerus was missing the distal end. It displayed an unusually straight edged surface, with a clean cut at the epitochlea. The sharp cut and robustness of the bone suggests trauma, rather than disease, and a new layer of cortical bone had formed on top, which shows healing (Buqet-Marco et al. 2009). It was suggested that the original trauma partially severed the forearm and the amputation took advantage of this. The man lived several months or even years after the surgery, judging by the thickness of the cortical bone (Buquet-Marcon et al. 2009). His grave goods of a polished schist axe and a large flint are unknown for the Buthiers-Boulancourt area, and the grave is deeper than its contemporaries. This high status individual not only survived an attack and an amputation, but was not excluded from his group (Buquet-Marcon et al. 2009). It is clear from these examples then that the disabled were at least tolerated during the Prehistoric period. In many cases we see them attain great age, and in others they are given elaborate burials. But this period of time was much less complex in terms of social structure, ritual and theology than the one which followed it and in many cases we will see the link between the differential treatment of a disabled individual and religious and social taboos. The Mediterranean By the 17th-16th Century BC we see for the first time examples of disability being used as art, with the Boxing Boys, a wall painting found in Akorotiri on the Greek island of Thera. Depicted is a combination of, ‘structural anatomical adjustments which are diagnostic of spondylolisthesis…the forward slippage of one of the lumbar vertebrae,’ (Mitchel. 2006: 22). It was suggested that the artist used a live subject as a model, due to the accuracy of the portrayal, making this the earliest recorded effort of a sports induced injury. Paintings on the adjoining walls depict wild goats with ‘swayback,’ a similar skeletal deformity (Winkelman and Moore. 1942, Mitchel. 2006). This is the first time we see skeletal abnormalities being used to create something aesthetically pleasing and suggests those afflicted were honoured and not vilified. This may be due, however, to the nature of the injury, as sport was considered an important part of Greek society, and such injuries may have been considered as badges of honour, rather than as a disfigurement. Indeed, despite the Classical Greek predilection for the perfectly proportioned human body to assume their distaste for anything less than flawless would be mostly incorrect. While this is not to say that physical disability went unnoticed, it was seen more as an individual problem, examined on a case-by-case basis by the local community, rather than a wide-scale medical one (Rose. 2006). Indeed it is important to remember that both the Classical forge Gods, Hephaestus and Vulcan, were lame, most likely a reflection of the smiths at the time, who were often lame due to their using arsenic to alloy copper. We can find more examples of individuals with severe deformity reaching maturity despite their needing assistance in their day-to-day living. The remains of a mature male aged 45-50 years suffering from Madelung’s deformity were found in a collective grave known as the ‘Giant’s Tomb,’ in Donori, Sardinia, dating to the Bronze Age. Both his forearms were affected by the condition; they were significantly shortened with bowed radii. Despite a plethora of other osteological abnormalities along the forearms and degenerative lesions across his whole body, the man Fig 2. The difference between the man’s shortened limbs (A) and a regular man’s (B) Canci et al. 2002 had developed muscular insertions and slight osteoarthritis on his left hip similar to the lower limbs seen on other skeletons on the site. He must have led an active life within the society, despite the deformity to his upper-arms (Canci et al. 2002). However by the Greek Iron Age we find examples of disabled individuals being outcast, and buried as such. Burial UV-19: la was an inhumation in a well located on the North Slope of the Acropolis. In an area not noted for its burials, and buried in a fashion previously unrecorded for this period was a middle-aged male with evidence of severe cranial trauma, which would have caused neurological impairment, and a broken back-bone alongside well-developed tendons on the knees and hips: a disabled but active man. The body was laid contracted on a stone slab with no grave goods except a single cup; there are pottery fragments throughout the deposit dating it to the Early Geometric period, although the style of inhumation is unknown for this time (Little and Papadopoulos. 1998). As the body arrangement precludes his falling into the well and dying, he must have had a deliberately unusual burial. Although shaft burials of this type were common during the Bronze Age, these are always multiple internments, often with animals which highlights the strangeness of burial UV-19:la. Yet these shaft burials were not normal for that time either, leading the man to be dubbed a social outcast, or ‘deviant social persona,’ (Shay 1985, cited by Little and Papadopoulos. 1998). Although it is difficult to ascertain the man’s exact status, whether ‘man-handled stranger, prisoner or slave,’ (Smithson, cited by Little and Papadopoulos. 1998) the likelihood that he suffered from aphasia, that is a difficulty with communication, or epilepsy lead us to believe that his simple and unusual internment was a representation of his outcast status (Little and Papadopoulos. 1998). Further examples of the attitude towards the deformed in Greek culture come from their literature, art and politics. The preference for a sound and physically perfect body is emphasised in Hesiod’s, ‘Works and Days,’ and Plato’s, ‘Laws,’ as well in Classical sculptures depicting perfect, symmetrical bodies. Aristotle even proposed a law that would prevent parents from rearing deformed children, while in Sparta parents were legally obliged to abandon all deformed infants, reflecting their views that deformities were an expression of the Gods’ anger (Sullivan. 2001) It was required that person have no physical blemishes before they could hold a religious post. Those with severe physical deformities, such as dwarfism, were tolerated for amusement by their ‘owners.’ The Romans took this one step further by using deformed slaves for entertainment, even to the extent that a separate agora had to be built for their sale (Sullivan. 2001). They considered the birth of a deformed child portentous; hermaphrodites in particular were considered an ill-omen. Both Plato and Cicero deemed the physical condition as mirroring that of the soul, implanting a deep-seated fear of the deformed into Grecco-Roman culture (Sullivan. 2001). Again we must emphasise the nature of the deformity as being key in the treatment of the individual. The Boxing-Boys were probably painted due to their injury being sports related, and therefore not due to invoking the Gods’ wrath: ‘while the ancient Greeks and Romans placed a high priority upon the care of those injured and subsequently disabled in battle, they were enthusiastic advocates of infanticide for sickly or deformed children,’ (Barnes. 1991: 2). Hephaestus was married to the beautiful Aphrodite, suggesting that talent or fame could overcome the obstacles of a person’s poor appearance. Bronze Age With the transition from the lithic era to the Bronze Age came a more complex social system allowing for the trade and diffusion of resources and ideas, along with the beginning of written history (Bray and Trump. 1973). When studying the treatment of disabled individuals this gives us two important points to note. Firstly that our analyses need no longer be limited to skeletal evidence alone, but begins to extend across the spectrum of the written world and secondly, that with a more complex society comes a greater variety of consequences for those born or later disabled. Evidence of compassion in the Bronze Age comes from a barrow in Buckinghamshire, England. One adult male, the third in a series of five burials, was laid in a plank lined pit covered with a wooden lid, alongside two flint knives and a pair of red deer antlers (Anderson. 2002). At some point, late in life, his tibia had been badly fractured as the result of a blunt trauma most likely caused by a heavy object dropping on the outer side of the leg or knee, displacing a fragment of the lateral tibia. Although healed the torn ligaments would have left him unstable and with restricted movement of the knee. His gait would have been awkward, with his knee slightly rotated, and his foot sticking out. This lead to stress on the right side of the pelvis, of the sort normally seen only on people of more advanced age, and then equally on both sides of the body (Anderson. 2002). The individual would have been immobile for a time while his leg was splinted, suggesting he would have had assistance in feeding himself, while his unusual gait would have disadvantaged him in such a society. However his burial in the centre of a primary barrow, with high quality grave goods mark him as man of status, a status which he did not lose through his disability (Anderson. 2002). While this example of compassion suggests that people with disabilities were well cared for in Bronze Age societies there are several important points to note. The first is that it is difficult to determine the position held by the person at birth of prior to their becoming disabled. It is likely the wealthy would have had access to better treatments than the poor. Secondly if the deformity was present at birth then the child may have been killed; the bones of children are much harder to find in the archaeological record as they do not preserve as well and are often buried apart from other grave sites. Another important facet of this investigation is whether or not the person attained high status because of their disability. It may have lent them status, but it also becomes the defining fact about them, ‘Disabled people are often thought of primarily in terms of their disability, just as sexual preference, gender or ethnicity becomes the defining factor in perceiving another person,’ (Davis. 2002 cited by Shipper. 2006). This is mirrored within the Bible, a text notable for its scarcity of physical description, and yet the character of Mephisobeth is described as ‘lame,’ every time his character appears (Shipper. 2006). In Leviticus, text is devoted to a description of the ‘physical and mental perfections deemed necessary for all aspects of religious ritual,’ (Lev. 21. 16-20) and only recently have people with learning difficulties been allowed to take Mass within the Catholic Church (Barnes. 1991). In the Sumerian myth of Enki and Ninmah the disabled are allotted particular tasks, again being singled out as different, although holding prominent positions (Shipper. 2006). Another Bronze Age case, that of a woman buried in Jericho, highlights this point. Buried with a rich assortment of grave goods, but also her wooden crutch, even in death she was presented as needing assistance (Cartwright et al.2009). It has been argued that the scarcity of evidence of disabled people from this period has more to do with the modern stereotypes of excavators than a lack of representation. The site of Lachish in the Southern Levant revealed a small bronze statuette of a naked man in a house adjacent to the Fosse Temple. Dating to the Late Bronze Age, the statue is missing parts of the right arm and left leg. Although the arm appears to have snapped off, the leg is fashioned into a rounded stump, suggesting it was made to look deliberately like a severed limb (Tubb. 2000). The statuette could be a votive item, intended to look like the supplicant, but is very well made compared to similar items from the period. Therefore its maker must have been a wealthy, and important, disabled man (Tubb. 2000). While site reports often detailed dental anomalies or arthritis such observations are rarely made in a social or demographic context. The assumption is made that any such individuals would automatically be disadvantaged (Tubb.2000). Further problems arise when we consider preservation in the archaeological record. A child who is disabled due to a fracture may grow into adulthood with no pathological traces on their bones (Waldron. 2000). The skeletons of young children normally leave fragmented evidence at best, and if they were disposed of at birth due to a deformity it is unlikely they would have been given a formal burial. What evidence we do have of the Bronze Age is that people who became disabled later in life either obtained, or did not have to relinquish their high status, but what became of babies with neo-natal conditions is not yet known. Iron Age Fig 3. Representation of the second individual showing the bones present (in grey) and those with pathological lesions (black). Tayles and Buckley. 2004 An Iron Age burial in a valley of the River Mun, in Thailand contained a sample of 120 individuals, three of whom had skeletal deformities. A young male, aged between sixteen and twenty was buried with four pottery vessels, a fish skeleton and the ulna of a deer. His hands, feet, tibiae and fibulae, sternum and face all display pathological bony changes. An older male was buried in a cluster of five individuals, along with a layer of pig foetuses. He too had lesions, suggestive of leprosy or psioratic arthritis, although leprosy is more probable. The third individual, a young woman, was buried in the same cluster. She displayed lesions on her vertebrae diagnostic of tuberculosis or nonspecific osteomyelitis, with tuberculosis the most likely disease. Although other individuals in the burial display some minor pathological lesions, these three individuals are by far the worst affected (Tayles and Buckley. 2004). But one is buried singly with an assortment of grave goods, while the other two are intermingling with unaffected individuals. The burial site contains graves filled with rice, bronze and iron ornaments and tools, glass, precious metals and stones, status symbols that were, ‘Concentrated in the graves of certain individuals implying a socially complex society,’ (Tayles and Buckley. 2004: 254). The first individual appears to be unaffected by his crippling disease in terms of status. The other two individuals could be looked at in one of two ways; either their disease was a contributing factor to their low status burial or, given the conclusions drawn from the first individual, it was unrelated. This suggests that the disease alone was not enough to wreak changes in their social status and therefore that such individuals were not treated differentially. Fig. 4 Reconstruction of the vertebral column and rib cage of the women suffering from congenital scoliosis. Murphy. 2000 Another example of a communal burial as a possible representation of acceptance comes to us from the Aymyrlyg complex in South Siberia. Out of the 800 individuals retrieved from the cemetery, a high number of individuals suffered from developmental defects, while others suffered as a result of illness. Two individuals displayed hypoplastic mandibles. A young woman aged 25-35 suffered from severe scoliosis twisting her lower thoracic region 90o to the right and the upper thoracic region 30o to the right. Her gracile skeleton and poorly developed muscle markings suggest she was immobile; it is likely she was at least partially paraplegic due to the reduced diameter of her eighth to twelfth vertebral foramina. Not only would she have needed constant care, her body would have been obviously and severely deformed and it is likely she also suffered from congenital heart disease, undescended scapulae and abnormalities of the genito-urinary tract and the thumb (Murphy. 2000). The cranium of a young child is indicative of hydrocephaly as well as a meningocele on the frontal bone on the line of the metopic suture. Not only would this protrusion be vulnerable to trauma and infection, the hydrocephaly would at best cause headaches and a lack of concentration and at worse impair gait, cause mental abnormality and a loss of balance (Murphy. 2000). Two females suffered from dysplasia and congenital dislocation of the hip, which would have left them with a Trendelenburg gait, a distinctive limp. Five examples were recorded of slipped femoral capital epiphyses, a condition common in overweight adolescents who achieve later sexual maturity. It leaves the affected leg shortened and rotated, with a loss of flexibility in the hip and pain upon moving (Murphy. 2000). An instance of clubfoot was also noted. Polytrophic defects included a case of neurofibromatosis in a 25-30 year old female, resultant in darkened spots and tumours on the skin, lesions on internal organs and the absence of part of the sphenoid bone. The grossly enlarged and deformed left orbit on this woman, along with a slightly enlarged right orbit and abnormal nasal morphology would have left her with restricted eye movements and possible loss of vision, proptosis (a popped eye) and facial hemi-hypertrophy (Murphy. 2000). Further facial abnormalities were visible on a juvenile possibly suffering from Goldenhar syndrome. The left side of his face was hypoplastic, while his right hand molars displayed more extensive attrition than those on the left, suggesting he could only use that side to chew. Goldenhar syndrome may also cause mental retardation, deafness and eye defects; only his cranium was available for research making a full diagnosis impossible (Murphy. 2000). A final individual suffered from frontometaphysal dysplasia, leaving him with abnormally coarse facial features: an enlarged brow, widely spaced eyes and general facial asymmetry, along with possible deafness and poor vision. The majority of these individuals would not have had these conditions visible at birth, and it is suggested this is why they were allowed to live and develop as part of the society rather than being killed at birth. There is no evidence on site for infanticide regarding deformed neo-natals but as discussed earlier lack of evidence is not indicative that it was not done. The semi-nomadic lifestyle of the community means that some effort must have been devoted to helping these individuals; the woman with scoliosis in particular would have been practically immobile. One point to note is, despite their being buried together, the child with Goldenhar syndrome and the male with frontometaphysal dysplasia had diseases which cannot be biologically related. Therefore it is likely that their inclusion together is linked to their social status as diseased individuals. This is a practice mirrored in many ethnographic studies, in which any individuals deemed as ‘different,’ for whatever reason are buried together, but separate or differently from the rest of the group. The fact that these two individuals were buried alongside several others suggests that they too were subject to social taboos which are not visible skeletally (Murphy. 2000). It would appear from this site that disabled people were, at the very least, tolerated and assisted allowing them to reach maturity (in most cases) and cope with the demanding lifestyle. However the nature of the burial tells us that they were still being marked out as different in some way, although whether this is ameliorative or pejorative is impossible to tell at this site. Egypt By contrast in Ancient Egypt deformity was certainly viewed favourably, even so much as representing divine benevolence (Sullivan. 2001) Indeed, it was proclaimed by Pharoah Amenemope, ‘Do not laugh at a blind man, nor tease a dwarf, nor cause hardship for the lame,’ (Schipper. 2006:63). In fact the physical evidence we have shows that even some of the Pharaohs themselves were disabled; the body of Thutmoses IV had a pelvic tilt due to a sustained fracture, while Siptah’s mummy is indicative of polio, with shortened limbs on the left side but hyperextension of the left ankle and foot (Schipper. 2006). Schipper suggests the reason they are not represented as deformed in contemporary artworks is because their ruling while deformed was not popular, and at odds with how a king should look (Schipper. 2006). But this is at odds with the rest of the evidence presented for Egypt, in which disability is consistently associated with ritualistic and religious excellence; some of the Egyptian deities such as Bes and Hapi were themselves deformed. As religion is often key to the way in which a culture treats their disabled, so this may be the reason why it was so tolerated and even venerated at this time. Dwarves in particular were venerated during this period, with many holding high positions and awarded rich burials. The dwarf Seneb (VIth Dynasty), known as the ‘Prophet of Cheops and Buto,’ and buried at the royal necropolis at Gizah, was associated with his own individual cult worship. Khemhotpe was the ‘Keeper of the Royal Wardrobe,’ while figurines and statues such as the one of Djeho on a XXXth Dynasty sarcophagus cement their exalted position. They were accorded their own niche in society, not only because of their religious associations and craft culture, but because they were viewed as being liminal. They were neither children nor properly adult, belonging to both the human realm and the animal one, interchangeable with pets. Cluster tombs of dwarves at the Giza necropolis suggest they may have been regarded as a separate social group (Jeffreys and Tait. 2000). While achondroplasia appears to be the most common form of dwarfism, accounting for the condition of the dwarves in the tomb of King Semerkhet, many types of skeletal dyplasia are in evidence at this time. The Badarian skeleton and the dwarf from the tomb complex of King Wadj both had short-limbed dwarfism, while two humeri from early Dynastic Egypt display evidence of mucopolysaccharidoses. A child burial dating to 1000 BC is a rare example of osteogenesis imperfect, in which the bones are small and brittle and the skull bulges at the sides (Kozma. 2008). The female foetus thought to be the daughter of Tutankhamun and his sister Ankhesenamun, displays scoliosis, spina bifida and Sprengel deformity (Kozma. 2008). These deformities which may have been the product of incest, which was a common practice for rulers at this time. As incest often results in genetic abnormalities, did this then breed a tolerance amongst the people of Egypt when their very rulers bred deformed children? Medicine was a subject studied in Ancient Egypt, with the first schools of medicine set up in temples that used a mystical approach alongside a scientific one. Deformities are not mentioned on any medical papyri, presumably because such conditions could not be cured (Nunn. 2002, Mitchel. 2006). Skeletal evidence, however, proves the prevalence of conditions such as achondroplasia and hydrocephalus, for which we have no written evidence. A case of the latter can be viewed on a skeleton of a man in a Roman era cemetery, with a skull 66cm in circumference, in contrast to an average 55cm. His left side was also underdeveloped, with his right arm overdeveloped, suggesting he relied on a crutch. This is reflected by the stela of Intef, in which a crutch is depicted as being lodged under the right arm (Nunn. 2006). Fig. 5: The Stela of Intef (12th Dynasty) showing crutch usage. Nunn. 2006 Another example of deformities being depicted in Egyptian art is a statuette from 4000-3400 B.C., which depicts a figure suffering from Pott’s disease. This is a form of tuberculosis which attacks the back-bone and leaves the victim with a hunch-back, a common disease during this period (Peltier. 1993, Oxford Concise Medical Dictionary. 2007). Other examples include a Royal Doorkeeper depicted on the Steal of Roma with a wasted and shortened leg and a Vth Dynasty official portrayed on the temple of Raneferef at Abu Sir as a hunchback (Sullivan. 2001). However again we see a correlation between the reason behind the disability and the type of treatment afforded to the individual; catching a contagious or infectious disease such as leprosy could result in banishment from the community. Those with ‘noble,’ deformities, that is those that are incurable and present during birth, or those whose conditions resulted from a traumatic accident were not treated badly. In contrast conditions which develop after birth, such as tuberculosis, deformity of the limbs, genital hypertrophy or distended abdomens, are depicted as being synonymous with non-elite rank and activities, and the individuals suffering from them are often depicted as emaciated, suggesting they had little wealth. We must also be careful in according Egypt the status of a nation forgiving of disability, as many of the features observed on mummified bodies thought to be pathological are now known to be as a result of the binding process, and therefore would have had absolutely no impact on the individual’s status and subsequent burial (Jeffreys and Tait. 2000). The Middle Ages As we move forward into the Medieval period, we can see quite a dramatic shift in the general attitude towards people with disabilities. Although this may be due in part to the wider variety of evidence available to us in this later time, we begin to see the disabled portrayed as negative stereotypes in various texts and it is clear that religion now has a more profound impact on the way people are being treated. At this time too came a deeper seated fear of that which was different, whether physically, religiously or racially; depictions of Ethiopians at the Vezelay Abbey in France are deformed and pig-snouted, displaying a link between difference and horror (Sullivan. 2001). Deformity was directly associated with evil and witchcraft; deformed children were thought to be the products of a mother’s intercourse with Satan, or due to their parents dabbling in the black arts (Barnes. 1991). A tradition of changelings, healthy babies that were replaced with deformed ones by the Devil, can be found as far back as Neolithic Ireland, with separate ‘cillin,’ burials for these children, often in sites already associated with the otherworldly (Finlay. 2000). In all cases physical or mental impairment was thought to be the result of divine intervention for wrongdoing. Martin Luther proclaimed the Devil lived inside any deformed child, and recommended killing any cases. Despite this however, any disabled who lived were shunted alongside similarly disadvantaged groups, such as the elderly and poor, in relying on the charity of the church, even most hospitals followed an ecclesiastical, not a medical approach, in caring for their patients (Barnes. 1991). There was some division between hospitals as to whom they would admit, St John’s Hospital in Cambridge would refuse entry to pregnant women, lepers, wounded people, cripples and the insane, while the San Iacopo a Sant’ Eusebio and Sant’ Antonio hospitals in Florence treated the incurably ill exclusively. Many hospitals forced the patients to leave once their condition had been at least partially cured, the Helig Geist Spital, Frankfurt, sent people away as soon as they were able to walk (Metzler. 2011). Others were kept as ‘idiots,’ for the amusement of rich families, in the assumption that those with a physical deformity would also be mentally disabled (Barnes. 1991). Disability was directly related to sinful behaviour even if it was not produced as an act of God. Medieval texts such as the Canterbury Tales suggest that blindness in a man could occur as a direct result of his lust for a desirable woman. This ‘deformity,’ was then passed on to his wife in the form of a pregnancy. The fear of siring a monstrous child was rife (Pearman. 2010). Neo natal-deformities were believed in some cases to be caused by maternal impression, that what a woman looked at during her pregnancy was reflected on her baby, but was more likely caused by incorrect swaddling (Stevenson. 1992, Metzler. 2006). This is reflected in Medieval art, in contrast to the smooth proportions seen in Classical sculpture, art in the Middle Ages reflects an obsession with the twisted and macabre. Even in the case of Christ himself, for example Cologne Cathedral’s Gero Crucifix, his body is deformed and agonised. In this case the physical deformity is at odds with Christ’s spiritual perfection, but it reflects the association between deformity and the ‘original sin’ cast upon the human race after its corruption in the Garden of Eden (Sullivan. 2001). Conversely however it was believed that in the afterlife, all physical imperfections would vanish, only those wounds gained in the pursuit of righteousness, such as the scars of a saint, would remain (Metzler. 2011). In this way the impairment could be viewed as an ordeal, which the person must overcome before their resurrection. Additionally the disabled could be seen as disassociated from their physical form, as this was only going to be reshaped in Heaven, perhaps leading to harsher treatment because of their incorporeal status. Disability was an almost limbo like state, in which the individual was neither truly healthy, nor sick; accordingly medical texts give over little information on those whose conditions could not be cured. In fact instances of the disabled were only properly recorded in depictions of miracles, as an advertisement for the cure (Metzler. 2011) The segregation of the disabled, not just in hospitals and alms houses, but as separate communities within residential areas occurred, although whether this is due to physical appearance alone, or the associated loss of family and income that placed them alongside other marginalised groups is unknown (Metzler. 2006). Written texts confirm this, ‘These beggars, prostitutes, thieves, cutpurses…these disabled and sick, real or simulated, these blind men and prostituted women constituted, in certain town quarters, virtual world’s unto themselves, cohesive communities with their own laws and languages, their own leaders,’ (Stiker. 2002: 66). Lepers in particular would constitute their own economy, so often were they were refused entrance to alms houses, in the belief that they spread diseases. Like the fools of rich houses, the disabled were often permitted to live on the edge of society as a kind of entertainment, or charitable cause, cared for but without acceptance (Stiker. 2002) Fig. 6 The Biddenden Maids Anderson. 2006 It is clear then that there was a dramatic shift in the treatment of the disabled as we pass through the Middle Ages, from one of apparently complete tolerance and even reverence, to one in which they are pushed to the boundaries of society. While the onset of Christianity can be linked directly to the cause of this, it is important not forget the differentiation between the types of disability. As mentioned above lepers were subject to particular rules, while the blind were often treated reverentially, due to their connections with the Gospels (Stiker. 2002). A final case, in the village of Biddenden, proves an unusual point, which will be expanded on further as we reach the era of the human freak show. In 1100 the conjoined twins Mary and Eliza Chulkhurt were born. They are depicted as being fused at both pelvis and shoulder, although his is actually impossible; it is more likely they were fused at the pelvis alone and walked with their arms around each other’s shoulders as twins conjoined in this way often do. After their death, a supplement of cheese, bread and beer was given every year to the poor in the lands they owned, as per their wishes. Today they are still celebrated for their generosity in the form of decorated pastries. In their lives the woman were lauded as much for their generosity, as for their unusual physicality, but was that merely due to their wealthy status? (Bondeson. 2004). Although the celebration of ‘freaks’ such as these is a growing trend after the Middle Ages, the underlying financial status of the person in question can never be underestimated. The Early Renaissance period saw a switch in the way deformity and sin were associated, particularly in Italian art. The condemned humans in Signorelli’s The Damned Cast from Hell are portrayed as Classically beautiful, while an old man with rhunophyma is lovingly depicted alongside his grandson in Ghirlondaio’s An Old Man and his Grandson. A boy with Down’s syndrome is depicted happily riding a donkey in Di Cosimo’s The Discovery of Honey (Sullivan. 2001). However this association between deformity and beauty was short-lived, Classical standards of beauty returned with the High Renaissance with the work of Michaelangelo and Leonardo Da Vinci. Deformity was once again associated with sin and corruption by the end of the Renaissance, with Bronzino’s Allegory of Venus using deformity as a metaphor for madness (Sullivan. 2001). In theology debate began to rage about the place of the deformed in society, and what truly could constitute humanness, and thus who could receive the sacrament. As the Bible states that man is made in God’s image, so too was put forth the theory that the Bible supports prejudice against the deformed, and the deformity must be a result of God’s wrath (Sullivan. 2001) Post-Medieval Towards the end of the Middle Ages there was a shift in attitude towards the physically impaired. Charity was given less indiscriminately, institutions became more selective and laws were passed to prevent begging and vagrancy. As the work load increased and the number of able workers decreased due to famine, warfare and plague, there was a reduction in the segregation of the disabled. Specific jobs, such as gleaning, were solely the property of the physically impaired (Stiker. 1999, Mezler. 2006, 2011). Although this did, in turn, lead to an increase in work related injuries and illnesses, the arrival of ‘public health’ and compensation for limbs damaged in the course of work aimed to counteract this. Along with an increase in the mutilation of bodily parts as punishment, the physical body was no longer viewed as intangible, and could therefore be given a monetary value. (Mezler. 2011). Along with the Industrial Revolution, this social transformation, with the increase in transport links and its desire for organised leisure led to the creation of venues solely for the purposes of entertainment. This led to the rise of the ‘freak show,’ culture, in which those with severe deformities were paraded in front of the public for their amusement. Alongside magicians and illusionists, these shows were a staple of the Victorian era. Those with genuine physical deformities, most notably ‘Siamese,’ twins and dwarves, nestled against those whom had purposefully altered their bodies, ‘self-made freaks,’ such as tattooed men, or unusually fat women (Toulman. 2006, Kembar. 2007). There was no clear boundary of what defined the freak; a baby who had been eaten by a horse was exhibited by Tom Norman (Kembar. 2007). The living freak, however, was always centre stage, normally a conjoined twin (Toulman, 2006, Kembar. 2007). Freaks of nature such as these were contrasted with freaks of culture, or ethnic freaks. Here the emphasis was on foreignness, representative of Britain’s supremacy and racism at that time. The relationship between freaks was emphasised; marriages between midgets were popular, as was the juxtaposition between the fat lady and the skeleton man. The stress placed on their otherness served to reassure the onlookers that what they saw was a novelty and a distraction, far removed from the inclusiveness of their gender, class or race (Kembar. 2007). In this all the onlookers were equal, and above those whom they viewed which gave them a sense of belonging. Fig. 7. General Tom Thumb entertains Queen Victoria and Prince Albert. National Fairground Archives. 2012 While some of these so-called freaks were treated poorly and subject to harsh medical testing, in the case of Joseph Merrick, more commonly known as the Elephant Man, many thrived under these unusual conditions. Dwarf ‘Major Mite,’ owned his own showroom, thirteen shops in London, five in Nottingham and three in Stratford-Upon Avon, whilst ‘General Tom Thumb,’ was privileged enough to visit Queen Victoria and Prince Albert. In fact many dwarves were employed in royal service around this time, mirroring the pattern in Ancient Egypt (Toulman. 2006, Kembar. 2007). Another notable case is that of sideshow performer Schlitzie, who had microcephaly, who came to public attention through Todd Browning film, ‘Freaks.’ A popular attraction at a variety of circuses, when his legal guardian George Surtees passed away Schlitize was committed to a hospital. After a period of deep unhappiness there he was recognised by sword swallower Bill Unks, who convinced the hospital he would be better off working as a freak again. They conceded, and Schlitizie spent his final years happily performing (Pednaud. 2012). In this case it is clear that although the hospital may have been giving Schlitize the best medical attention, he was only really happy when performing. Indeed, Pednaud argues that the freak-shows were not exploitation as most, if not all, of the people on display chose to exhibit themselves in such a way and share their gifts with the world (Pednaud. 2012). But in the case of Schlitzie, who as a result of his microcephaly had the cognitive abilities of a four year old, could such a choice really be made? It would perhaps seem more likely that while the individual may have enjoyed the performance, they would have had scant choice of an alternate career. The case of Joseph Merrick highlights this. His severe deformities led him to seek a life in the sideshow business, as his appearance and lameness meant he could do little else. Accounts show he was not particularly well treated there, as it was widely understood that he was an imbecile. When forcibly removed from the circus, on the grounds his display was immoral, he was set upon by an angry mob and saved only through his association with doctor Frederick Treves. While Treves offered him proper lodgings and treated him with dignity he was still an object of display, except that his clientele was now the upper class, and not those that had paid to see him in a cage (Treves. 1954). Seemingly our obsession with difference was too great to acknowledge that fact that Merrick was an intelligent, articulate person; if anything this just served to highlight the bizarre nature of his condition. Treves also took the opportunity to study him medically, as was becoming more common at the time. Scientific improvements and an increase in the number of medical museums meant that the physically deformed were not just freaks, but objects to be studied. John Hunter, one of the eighteenth century’s most prolific collectors of medical anomalies, established a collection of over 14,000 items by his death in 1793 (Alberti. 2011) Of these pieces, two shed a particular light on the treatment of people with physical deformities at that time. The first is the body of Charles Byrne ‘The Irish Giant,’ whose 7ft 7inch skeleton currently resides in the Hunterian Museum. It was purchased by Hunter for the sum of £500, despite Byrne’s wish to be buried at sea (Alberti. 2011, Pers. Visit. 2011). Having been stared at for the entirety of his life, he wished for some level of anonymity in death. Instead Hunter treated his body like an object of study, rather than in accordance with his Byrne’s own desire, disregarding his rights of burial in the quest for scientific knowledge. Fig. 8 The Skull of the Two-Headed Boy of Bengal Pednaud.2012. The second is that of the so-called, ‘Two Headed Boy of Bengal.’ Born into the poor farming village of Mundul Gait in Bengal in May 1783, his life was almost immediately cut short as his mid-wife attempted to destroy him in a fire. The condition known craniophagus parasiticus meant he had a second head growing on top of his first, ending in a neck-like stump. Although the second head would, at times, appear to cry, smile and suckle independently of the main head, it was underdeveloped, and did not appear to sleep. He received a great deal of attention for his condition, but the only medical examination he was given was when he died at the age of four, from a cobra bite (he was otherwise healthy in nature). Despite being buried near the Boopnorain River, outside Tumloch, the grave was robbed by a Mr Dent, a salt agent for the East India Company and the skull was passed on to the Hunterian Museum (Bondeson. 2006, Pednaud. 2012). This provides us with an interesting scientific case; the boy was the earliest recorded example of craniopagus parasiticus and appeared to thrive despite his twin. In today’s society the head is always removed when the condition occurs. Moreover it displays another lack of medical scruples concerning the bodies of the deformed. While it should be pointed out in Hunter’s favour that he collected a wide variety of medical curiosities, such as the healthy foetuses of women in different stages of pregnancy, there is still the tendency to treat the individual as an object, either to be gawped at while alive or dissected when dead. Alberti notes how one specimen, originally that of a Mrs P, a fifty-two year old woman from London becomes simply ‘RCSHC/P998,’ a sample of ulcerated oesophagus. She is no longer a product of her own personality, but that of the cancer that killed her, a specimen and not an individual (Alberti. 2011). This is indicative of treatment at the time, in which the burials of individuals were violated for research, in death as in life only their deformity and not truly a person. This was a period in which disability was truly realised as a concept, and while the advances in medicine were a boon to those with less severe deformities, the inherent concepts of those who were different as the ‘depraved’ or the ‘feeble-minded,’ still remained. With asylums and hospitals now in place, the disabled could effectively become invisible, either locked away or left begging on the streets. The identities of empire and race were being constantly threatened by this degeneration of the human body (Turner. 2011). This came to a head with the appropriation of eugenics, particularly by the Third Reich, leading to deaths of several thousand individuals with a physical or mental illness. Nazi society believed such individuals were unworthy to live; art depicting the deformed was destroyed or placed alongside pictures of physically deformed individuals to convince the population that they were flawed and unhealthy (Sullivan. 2001). This leads us into today’s society, in which physical perfection is one again considered the pinnacle of attractiveness. While we would consider ourselves, as a Western society, to be forgiving and caring towards those with deformities, it is true that we parade them on the television and the internet in a not dissimilar way to the Victorians and their human freak shows. Just because we aren’t standing in front of the person in question, we are still judging them and evaluating their contribution to society based on their appearance alone. In prehistoric times we may have been more apt to look over this simply because there was more work to be done. Or perhaps it is a product of our society and not our consciousness that leads us to define a person by their physical differences. Evaluation Throughout the prehistoric period we find examples of individuals who must, at the very least, have been tolerated by their social groups. Many have attained some degree of age, while others show clear wear marks and muscle growth which means they must have contributed to their society. In a time in which strength and mobility are key to survival this may seem quite unusual and yet, what reason would these communities have to shun the individual based on their appearance? Without scriptures to tell them to fear the unknown or philosophies to praise the perfect, it can be almost assumed that life at the time, consumed as it was by subsidence, simply did not have time in it for prejudice of this sort. Indeed, we find examples of disabled people with particularly rich burials, such as that at Dolni Vestonice, suggesting that status could be gained regardless of disability. This is not to say we do not find burials, such as those at the Tomb of the Eagles, in which disabled people have been lumped together with the murdered or foreigners, but this seems to have more to do with the nature of their death than the way they lived in life. From these examples it would appear that while disability was not necessarily a barrier to succeeding in life, an individual’s status and position had more to do with the way they were viewed by their society. However it is important to note that this is not conclusive. There are several reasons that we are unable to find the bodies of those that were poorly treated, because they were not buried or because their more fragile bones have disintegrated. This is particularly true of children, whose bones are harder to find in any case, and without any writings to detail whether or not there was a policy of destroying deformed children at birth, we cannot make any assumptions. When writing does become common place, we can view such laws as those passed in Sparta, demanding the destruction of deformed children at birth. The depictions of Classical beauty at this time firmly suggest that disability was now viewed as something to be shunned. Although this could also be true of prehistory, we know then at least that disabled people were allowed to integrate into society at large. We do find examples of compassion towards the deformed during the Bronze Age, with barrow tombs and rich burials ascribed to some individuals. Yet, here too come the beginnings of an emphasis on defining the person by their disability, burying people alongside their crutches for example. While this is neither positive nor negative in the strictest sense, it takes away from the individuality and personality of that human and describes them only as their illness. Moreover we find no written descriptions at this time from people who are themselves disabled. This can be viewed in one of two ways, that the disabled were not taught to write, because they were thought stupid or not to have anything worth recording, or that we are only viewing society through the eyes whose documentations have survived. Therefore we must look to first hand evidence such as burials to gain a more rounded view. The Iron Age gives us both the disabled buried as outcasts and in communal internments, which suggests acceptance. Again this may be down to the status of the individual, or their family, rather than the disability itself. In Egypt however we can see a clear tolerance, even preference, for those with physical deformities. Dwarves were thought to have mystical powers and held many prominent positions, while those born into royal families also showed signs of congenital disease, possibly as a result of inbreeding. In a culture in which several of the Gods were also deformed, the Egyptians showed a surprising amount of reverence for those around them. As the pharaoh was meant to be the human representation of Amon Re, so too the Gods were shaped into images as deformed as their worshippers, thus breeding a tolerant culture. In contrast throughout the Medieval period it was religion that dictated deformity to be a thing of evil, a representation of God’s wrath, and people were treated accordingly. Although the disabled could seek alms at the door of the church, they were resigned to life as an outcast unless, in the case of the Biddenden Maids, their deformity was so unusual that curiosity overrode religious fervour, and the individual, or twain in this case, became celebrated. It should be noted that while the Biddenden Maids were born into a wealthy family, this fascination for extreme deformity continued well into the Victorian period. By this time the deformed had a choice, to beg on the streets as the invisible, or become hyper-visible, with a life in the public eye. While many of these so-called ‘freaks,’ were treated well and enjoyed their work, it was a simple choice between that or extreme poverty. Disability only became an entity in this period. No word exists prior to the sixteenth century and charities and hospitals began appearing to treat those afflicted, and yet even today, we find ourselves drawn to the deformed or unusual, although it is now in the form of media rather than the travelling circus. Disability is not an unchanging human condition that is common to all cultures. It evolves alongside the society and its values, making it difficult to judge exactly how it was viewed in the past. With the human record often scant and written accounts under bias it is impossible to say with certainty how disability was viewed at a singular point in time. The individual, their condition, their manner of acquiring it and their familial status must all be taken into account. It is clear, however those who are different have always been treated differentially, whether in a positive or negative light, and it is within the human nature to at least observe that which is different to us. Conclusion When I began researching this dissertation my assumption was, like many Westerners, that the treatment of deformed individuals in the past would only ameliorate through time. Instead my research has brought me to conclude that in a world without religion, the written word, indeed what we might call culture, there was no apparent difference in the way in which disabled people were treated. Of course, this is not to say that their disability was not noticed or accounted for, but rather that they were accepted as part of the group, and given such work as they could perform. I disagree with the assumption that people in the past had no need for compassion, as I believe this to be a constant, for would those without compassion allow individuals with severe deformities to live to any age? I perceive that the onset of religion, and in particular Christianity, skewed this compassion in the view that deformity was a punishment for disobedience, despite the fact that this is at odds with Christianity’s preaching of tolerance. While we cannot expect people not to be shocked or curious by those with an appearance different to their own, it is human nature to be curious, it is imperative to know that as few as one hundred years ago it was common place for the deformed to be chained and displayed for our own amusement. So while treatment of the deformed has not worsened since then, it is not a gradual or general improvement throughout time, instead dependent on the society, religion and, most pertinent of all, the individual and the deformity in question. Bibliography Alberti. S. J. M. M. 2011. Morbid Curiosities: Medical Museums in Nineteenth-Century Britain. Oxford: Oxford University Press Anderson. T. 2002. Healed Trauma in an Early Bronze Age Human Skeleton from Buckinghamshire, England. International Journal of Osteoarchaeology. Vol. 12. 220–225 Barnes. C. 1991. A Brief History of Discrimination and Disabled People. Disabled People in Britain and Discrimination: A Case for Anti-Discrimination Legislation. India: C. Hurst and Co. Bondeson. J. 2006. The Two-Headed Boy and Other Medical Marvels. New York: Cornell University Press Blumberg. M. S. 2009. Freaks of Nature and What They Tell Us about Development and Evolution. Oxford: Oxford University Press Browning. T. 1932. Freaks. (DVD) California: Warner Home Video Buquet-Marcon. C, Charlier. P and Samzun. A. 2009. A possible Early Neolithic amputation at Buthiers-Boulancourt (Seine-et-Marne), France. Antiquity. http://antiquity.ac.uk/projgall/buquet322/ (Last accessed 7th May 2012) Canci. A, Marini. E, Mulliri. G, Usai. E, Vacca. L, Floris. G and Tarlia. S. M. B. 2002. A Case of Madelung’s Deformity in a Skeleton from Nuragic Sardinia. International Journal of Osteoarchaeology. Vol. 12. 173–177 Cartwright. C, Ward. C, Tubb. J and Delaunay. H. 2009. The Middle Bronze Age Furniture from Tomb P19 at Jericho: Wood Identification and Conservation Challenges. The British Museum Technical Research Bulletin. Vol 3. 111-120 Covey. H. 1998. Social Perceptions of People with Disabilities in History. Springfield: Charles. C. Thomas Publications. Cross. M. 1999. Accessing in the Inaccessible: Disability and Archaeology. Archaeological Review from Cambridge. Vol. 15 (2) 7-30 Crubezy. E and Trinkaus. E. 1992. Shanidar 1: A Case of Hyperostoic Disease (DISH) in the Middle Palaeolithic. American Journal of Physical Anthropology. Vol. 89 (4) 411-420 Finlay. N. 2000. Outside of Life: Traditions of Infant burial in Ireland: From Cillin to Cist. World Archaeology. Vol. 31 (3) 407-422 Frayer. D. W, Horton. W. A, Macchiarelli. R and Mussi. M. 1987. Dwarfism in an Adolescent from the Italian late Upper Palaeolithic. Nature. Vol. 330 (6143) 60–62 Formicola. V, Pontrandolfi. A and Svobonfa. J. 2001. The Upper Palaeolithic Triple Burial of Dolni Vestonice: Pathology and Funerary Behaviour. American Journal of Physical Anthropology. Vol. 115 (4) 372-379 Formicola. V and Buzhilova. A. P. 2003. Double child burial from Sunghir (Russia): Pathology and Inferences for Upper Palaeolithic Funerary Practices. American Journal of Physical Anthropology. Vol.124 (3) 189–198 Gallico. P. 2001. The Snow Goose and the Small Miracle. London: Essential Penguin Gamble. C. 2000. The Extension of Social Life 60,000 -21,000 years ago. The Palaeolithic Societies of Europe. Cambridge: Cambridge University Press Hubert. J. 200. The Complexity of Boundedness and Exclusion in Madness, Disability and Social Exclusion: The Archaeology of Difference ed. Hubert. J.1-9. Oxon: Routledge Hugo. V. 1993. The Hunchback of Notre Dame. Hertfordshire: Wordsworth Classics Hunterian Collection, The. 1799-Ongoing (Exhibition). London: Royal College of Surgeons (Visited May. 2011) Jeffreys. D and Tait. J. 2000. Disability, Madness and Social Exclusion in Dynastic Egypt in Madness, Disability and Social Exclusion: The Archaeology of Difference ed. Hubert. J. 87-96. Oxon: Routledge Kembar. J. 2007. The Functions of Showmanship in Freak Show and Early Film in Early Popular Visual Culture. Vol. 5 (1). Oxon: Routledge Kozma C. 2008. Historical review II: Skeletal dysplasia in ancient Egypt. American Journal of Medical Genetics Part A (146A) 3104–3112 Little. L. M and Papadopoulos. J. K. 1998. A Social Outcast in Early Iron Age Athens. Hesperia: The Journal of the American School of Classical Studies at Athens. Vol. 67 (4) 375-404 Lynch. D. 1980. The Elephant Man. (DVD). London: Optimum Home Releasing Metzler. I. 2006. Disability in Medieval Europe: Thinking About Physical Impairment During the High Middle Ages, c. 1100-1400. Oxon: Routledge Metzler. I. 2011. Disability in the Middle Ages: Impairment at the Intersection of Historical Inquiry and Disability Studies. History Compass. Vol. 9. 45–60 Mitchel. J. 2006. Deformity in the ‘Boxing Boys,’ in History of Medicine. New York: Target Health Inc Murphy. E. M. 2000. Developmental Defects in Iron Age Siberia in Madness, Disability and Social Exclusion: the Archaeology and Anthropology of Difference ed. Hupert. J.60-81. Oxon: Routledge National Fairground Archive. 1996-Ongoing. (Exhibition) Sheffield: Western Bank Library (Visited January 2012) Nunn. J. F. 2002. Ancient Egyptian Medicine. London: Red River Books Okstad. 2011. Coming Face-to-Face with an Ancient Human. http://www.uis.no/research/article58004-51.html (Last accessed 26th January 2012) Oxford University Press. 2007. Oxford Concise Medical Dictionary Oxford: Oxford University Press Pearman. T. V. 2010. ‘O Sweet Venym Queynte!’ Pregnancy and the Disabled Female’s Body in the Merchant’s Tale in Disability in the Middle Ages: Reconsiderations and Reverberations ed. Eyler. J. R. 25-39. Surrey: Ashgate Publications Pednaud. J. T. The Human Marvels. http://thehumanmarvels.com/ (Last accessed 26th April 2012) Peltier. L. F. 1993. Orthopaedics: A History and Iconography. California: Norman Publishing Roberts. C. A. 2000. Did they take sugar? The use of skeletal evidence in the study of disability in past populations in Madness, Disability and Social Exclusion: The Archaeology of Difference ed. Hubert. J. 46-60. Oxon: Routledge Rose. M. L. 2006. The Staff of Oedipus: Transforming Disability in Ancient Greece. Michigan: University of Michigan Press Schipper. J. 2006. Disabilities Studies and the Bible: Figuring Mephisobeth into the David Story. New York: T & T Clark International Stevenson. I. 1992. A New Look at Maternal Impressions: An Analysis of 50 Published Cases and Reports of Two Recent Examples in Journal of Scientific Exploration Vol. 6 (4) 353-373 Stiker. H. J. 2002. A History of Disability. Michigan: University of Michigan Press Sullivan. R. 2001. Deformity-A Modern Western Prejudice with Ancient Origins. Proceedings of the Royal College of Physicians of Edinburgh. Vol. 31. 262-266 Tayles. N and Buckley. H. R. 2004. Leprosy and Tuberculosis in Iron Age Southeast Asia? American Journal of Physical Anthropology. Vol. 125. 239–256 Toulman. V. 2006. ‘Curious Things in Curious Places,’ Temporary Exhibition Venues in the Victorian and Edwardian Entertainment Environment in Early Popular Visual Culture. Vol. 4 (2) Oxon: Routledge. 113-139 Towrie. S. 2011. Tomb of the Eagles Remains Paint a Darker Picture of Neolithic Orkney at Orkneyjar: Orkney Archaeology News. http://www.orkneyjar.com/archaeology/2011/03/16/tomb-of-the-eagles-remains-paint-a-darker-picture-of-neolithic-orkney (Last accessed 21st February 2012) Treves. F. 1954. The Elephant Man and Other Reminiscences. Toronto: Library of the Academy of Medicine Trinkaus. E. 1978. Hard Times Among the Neanderthals. Natural History. Vol. 83. 58-63 Trinkaus. E, Formicola. V, Svoboda. J, Hillson, S. W and Holliday. T. W. 2001. Dolni Vestonice 15: Pathology and Persistence in the Pavlovian in Journal of Anthropological Science. Vol. 28 (12) 1291-1308 Tubb. J. N. 2000. Two Examples of Disability in the Levant in Madness, Disability and Social Exclusion: The Archaeology of Difference ed. Hubert. J. 46-60. Oxon: Routledge Turner. A. 2011. Disability & the Victorians: Confronting Legacies. http://www.disabilityhistory.co.uk/node/130 (Last accessed 27th April 2012) Waldron. T. 2000. Hidden or Overlooked? Where are the Disadvantaged in the Archaeological Record? In Madness, Disability and Social Exclusion: The Archaeology of Difference ed. Hubert. J. 29-46. Oxon: Routledge Warwick. B and Trump. D. 1973. A Dictionary of Archaeology. London: The Penguin Press Winkelman. N. W and Moore. M. T. 1942. Progressive Degenerative Encephalopathy Occurrence in Infancy, with Antenatal Onset Stimulating ‘Swayback’ of Lambs: Report of a Case. Archives of Neurology and Psychiatry. Vol.48 (1) 54-71. Images Cover Photograph: Barber. J and Tveit. T. 2011. Face-To-Face with an Ancient Human on Science Daily. http://www.sciencedaily.com/releases/2011/10/111020084819.htm (Last accessed 25th January 2012) Fig1. Hitchcock. D. 2012. A Burial at Sunghir,,USSR. http://donsmaps.com/sungaea.html (Last accessed. 7th May 2012) Fig 2. Canci. A, Marini. E, Mulliri. G, Usai. E, Vacca. L, Floris. G and Tarlia. S. M. B. 2002. The marked shortening of the right forearm of Donori man (A) in comparison to a normal upper limb(B) in A Case of Madelung’s Deformity in a Skeleton from Nuragic Sardinia. International Journal of Osteoarchaeology. Vol. 12: 173–177 Fig 3. Tayles. N and Buckley. H. R. 2004. Diagrammatic representation of individual 2, showing bones present (in gray) and those with pathological lesions (black) in Leprosy and Tuberculosis in Iron Age Southeast Asia? American Journal of Physical Anthropology. Vol. 125:239–256 Fig 4. Murphy. E. M. 2000. Reconstruction of the vertebral column and rib cage of the Hunno-Sarmatian period woman with congenital scoliosis due to multiple unilateral hemimetameric hypoplasia in Developmental Defects in Iron Age Siberia in ed. Hupert. J. Madness, Disability and Social Exclusion: the Archaeology and Anthropology of ‘Difference.’ Oxon: Routledge Fig 5. Nunn. F. J. 2006. The Stela of Intef (12th Dyasty) showing his use of a staff as a crutch, exactly as suggested by Derry (1912-13) from an examination of a skeleton belonging to the skull shown in fig 4.9 (British Museum) in Medicine in Ancient Egypt. Red River Books: London Fig. 6. Anderson. E. J. 2006. The Biddenden Maids. http://www.phreeque.com/mary_eliza.html (Last accessed 7th May 2012) Fig. 7. Courtesy of the National Fairground Archives, Western Bank Library Sheffield. South Yorks. S10 2TN. General Tom Thumb and Queen Victoria (Last accessed January 2012) Fig 8. The Two headed Boy of Bengal. Pednaud. J. T. The Human Marvels. http://thehumanmarvels.com/ (Last accessed 26th April 2012) 090141534/AAP396 Page 44 of 44