Possible scurvy in the prisoners of Old Quebec: A re-evaluation of evidence in adult skeletal remains

Scurvy is known to have been present in many past communities but recognising the condition in adult skeletal remains poses significant challenges. Fifty skeletons of Protestant prisoners who died between 1746 and 1747 were excavated in 1986-1987 from the walls of Old Quebec, Canada. Documentary sources indicate scurvy was present, and those considered the most likely candidates (n=9) were selected for re-evaluation using recently published macroscopic diagnostic criteria. Cranial porosity, hypertrophy and periosteal new bone formation (PNBF) were compared. The non-specific nature of skeletal changes in adult scurvy has a considerable effect on the potential to suggest a diagnosis. It is conceivable that all individuals had scurvy close to the time of death, but just two displayed probable evidence of scurvy and a further two had possible evidence of scurvy. Remaining cases had insufficient evidence for diagnosis. Although not straightforward, significantly more information was obtained by combining the results of the three types of pathological changes considered. Recent work has highlighted the difficulties of using PNBF in paleopathology, but careful evaluation of location and approximate stage of healing at the time of death contributes useful information that can be used to indicate level of disease burden and possible co-occurrence of conditions.