As we enter the final few months of the Putting Flesh on the Bones project, our team has been busily cataloguing and repackaging the Calvin Wells Palaeopathology Archive. This has left time for the blog. However here is a recent feature about the collection and project on the popular website and Twitter sensation #FolkloreThursday
Sophie Whyatt is a postgraduate at the University of Bradford studying Forensic Archaeology and Anthropology BSc (Hons). Sophie joined the ‘Putting Flesh on the Bones’ project in January 2018 after completing a five-month placement in the Anatomy Department at the RJAH Orthopaedic Hospital. Her main interests are a combination of Anatomy, Osteology and Forensic Anthropology. During her placement Sophie catalogued and digitised Calvin Wells’ extensive collection of archaeological and clinical radiographs.
The process of using x-rays to view the internal form of an object, or radiography, was discovered by the German physicist Wilhelm C. Roentgen in 1895. The potential medical application of the technique was immediately apparent and within months was being used for diagnosis across Europe and the United States. An early pioneer in applying radiography to palaeopathology was Calvin Wells’ former teacher of anatomy at UCL Elliot Smith, who is recorded as making x-rays of the mummy of Thutmose IV in Cairo in 1904. By the time Wells emerged as a prominent palaeopathologist in the early 1960s the technique had been long ignored within the discipline.
In his article The Radiography of Ancient Bones for the journal ‘X-Ray Focus’ (1964) Wells outlined the main benefits of using the technique in palaeopathology. This included the ability to examine structures within the bone, to confirm or make diagnoses which could not be made from visual examination, and in the examination of mummies, as it would prevent damage from handling. Wells enthusiastically incorporated the technique into his own practice, going as far as to purchase a portable x-ray machine of his own. In his own cavalier fashion Wells kept the device in one of his outbuildings with no concern for health and safety. It is likely that many of the archaeological radiographs in the archive collection were produced by this machine.
Here are two radiographs from the Calvin Wells archive which demonstrate the value of applying radiography to palaeopathology:
Figure 1 (above) gives an example of Polyostotic fibrous dysplasia revealed by a radiograph. Given that the bone has the appearance of several different diagnoses, a radiograph is required to identify a specific pathology
Figure 2 (right) is a radiograph of a femur which shows with a lesion resulting from scurvy, a diagnosis which would be impossible to identify from the naked eye alone.
My primary role on the Putting Flesh on the Bones project has involved digitising the 709 archaeological and clinical radiographs in the Calvin Wells Archive. This is a necessary task as radiographs are particularly prone to deterioration, and digital copies will ensure that they are accessible to future generations of researchers. The digitisation process involves scanning each radiograph using a specialised scanner and then adjusting the images using Photoshop. In the case of the clinical radiographs it was important for me to redact any personal information, such as the patient’s name, age and hospital number. Like health and safety regulations, Calvin Wells did not anticipate future data protection legislation!
In addition to working on the radiographs, I helped transcribe Wells’ unpublished skeletal reports, list his several hundred offprints and library books, and continue cataloguing his extensive transparency collection. Once catalogued and available to researchers, I think the collection will have a considerable influence on the understanding and development of palaeopathology.
‘Not all evidence is in bones’; Calvin Wells is quoted as saying in a 1966 article in the American arts magazine Horizon. He asserts that ‘ancient disease and injury have often been faithfully recorded in works of art…sometimes the skeletal material supplements the artistic’. It’s evident that Wells invested a considerable amount of research into the artistic representation of injury, disease and medical treatment throughout history. Most of Wells’ published work on the subject focuses on anthropological artefacts from African, East Asian or Pre-Columbian tribes and societies. However, Wells, who resided in both East Anglia and the French Pyrenees, was also interested in how European artists and craftsmen captured the history of human illness and medicine in various traditional artistic mediums.
St. Mary’s Church in Bury St. Edmunds, Suffolk, is the third largest parish church in England and has one of the most renowned ‘angel roofs’. Fashionable between 1395 until the English Reformation, angel roofs are elaborately carved church ceilings and remain the largest surviving body of English medieval woodwork. Only 170 angel roofs remain today, with the majority located in East Anglia. The angel roof at St. Mary’s was commissioned to mark the marriage of Henry VI and Margaret of Anjou, and the cherubim are said to represent the Royal couple. Alongside the large ‘demi-angels’ are hundreds of smaller-scale carvings. In 1964 the East Anglian photographer Hallam Ashley undertook a photographic study of these figures, which inspired Wells to write an accompanying article.
In the article 15th-Century Wood-Carvings in St. Mary’s Church, Bury St. Edmunds Wells writes that the church roof is ‘adorned with some of the finest woodwork to have survived the vandalism of Cromwell’. The most interesting aspect of the carvings is that ‘many have some relationship to disease or medicine’ and those that have no direct medical link may have been indirectly influenced by the proximity of several hospitals’. Bury St. Edmunds was a medieval centre for infirmaries, which served both large monastic and secular populations. In some carvings the references to medical treatment is explicit.
The carving on the left is a doctor with a uroscopy flask. Uroscopy was the historic medical technique of examining a patient’s urine for symptoms of disease, and was common practice up until the 17th-century. In this carving Wells notes that the doctor is tilting the flask forward ‘as though debouching its contents over the congregation’. The more ecclesiastical carving on the right is an angel with a pestle and mortar which were common tools for preparing ‘plants and fruits which figured prominently in the herbals and leech-lore of the Middle Ages’.
Elsewhere Wells identifies wood-carvings with more ambiguous links to medieval medical practices.
The horn of the unicorn (pictured left) was a valuable ingredient in an ancient ‘material medica’, the substances used in the composition of medicine. The 15th-century physician James Primrose wrote that ‘unicorn horns…are thought to be the prime antidote for all’ and offered the user ‘renewed strength and vigour’. The horn of this mythical creature, which was in fact narwhal tusk, came to symbolize quackery and fake medicine by the 17th-century.
The carving of the monkey (picture right) is indicative of medieval scepticism of the medical profession. Wells notes that the carving of a primate in a collar and chain holding a uroscopy flask is a ‘disrespectful gibe caricaturing the physician as an ape – a motif that is found elsewhere in medieval carvings’.
Henry VI’s Ear
“My life is spent studying the evidence for disease in ancient bones and early works of art, so I was delighted to receive your letter”
The above quotation is Wells’ response to the German folklorist Ellen Ettlinger, who was seeking a medical diagnosis for the aforementioned Henry VI. In researching an article about religious representations of Henry VI being invoked as a saint, Ettlinger came across a curious pair of stained glass windows in King’s College Chapel Cambridge.
In this detail from a stained glass window dated 1525 (above left), Henry VI has a ‘curious right-ear – like a question mark’. In a later 19th-century copy (below), the king has a ‘very distinctly deformed right ear’. It had been recorded that Henry suffered a neck wound at the first Battle of St. Albans (1455) and Ettlinger was curious as to whether this was the cause of the deformation.
Wells relished medical puzzles such as this, and wrote Ettlinger a lengthy and detailed letter of reply. In his opinion it was ‘unlikely that the arrow wound at St. Albans would have produced a lesion of the ear’ as ‘wounds of the neck had a strong tendency to be either trivial or lethal’. Wells’ assertion was that the deformed ear in the 1525 portrait was pseudopathological, which is to say that although there is the appearance of disease none is actually present. After examining similar examples, Wells observed that anatomically incorrect ears were a common feature in artwork of the period. The Victorian craftsman who made the 19th-century copy most likely thought the inaccuracy was intentional and reproduced it. As an exercise in diagnostic thinking, Wells supposed that if the deformity was indeed intentional then Henry VI likely had an epithelioma, or ‘rodent ulcer’. Ellinger agreed with Wells’ first conclusion on the grounds that an image created to promote the cult of Henry VI would unlikely portray the saint suffering from such a temporal affliction.
Among the artwork and objects Wells examined for ‘glimpses into the ailments of ancient people’ were coins, pottery, wax seals, and even fabric. In Bones, Bodies and Disease Wells asserts that the Bayeux Tapestry provides a unique medical record of the battle wounds and fatalities suffered during the Norman conquest of England. One of Wells’ preferred medical artefacts were votive images. A votive, or ‘ex-voto’ is an offering to a saint or divinity given in fulfilment of a vow, or in gratitude or devotion. One of the most common types are ‘ex-voto anatomica’, which are modelled on parts of the human body. In 1977 Wells collaborated on an article with renowned archaeologist T.W. Potter which involved the analysis of a sample of 8,000 terracotta ex-voto anatomica excavated at a healing sanctuary at Ponti de Nona near Rome.
The ex-voto excavated at Ponti de Nona included many types of body parts, including heads, limbs and internal organs. In his report Wells noted that feet were the most common, making up some 40% of the entirety of ex-voto excavated. One explanation for the prevalence of a particular body part may have been because worshippers in that location were more likely to suffer from injuries or diseases specific to that certain part of the anatomy. For example Wells observed that Ponti de Nona was surrounded by rural farming communities whose members would have been predisposed to injuries of the legs and feet. Based on analysis of the remaining ex-votos, Wells postulated that people of Ponti di Nona also suffered from arthritis, migraines, gonorrhoea, and dermatological conditions. In the article Wells defended the limitations of diagnosing illness in terracotta artefacts writing ‘it is better to infer a range of possibilities than retreat into a safe but unhelpful silence, making no attempt to interpret these interesting objects’.
Medical and scientific knowledge has developed significantly since the 1970s, meaning interpretation of visual arts is no longer such a valuable tool for palaeopathological research. However, Wells always asserted that artwork was just one of many sources of evidence to be used in combination or in lieu of skeletal evidence. In this respect Wells saw artists and craftspeople as early clinical observers, providing a description or record of pathological conditions long before doctors. Whereas human remains are generally buried or cremated, artwork is treasured, preserved and put on display. As a doctor and art lover Wells would no doubt have identified with the famous Hippocratic saying ‘Ars longa, vita brevis’ (Art is long, life is short).
1966. Calvin Wells ‘Ancient Aches and Pains’ in Horizon (Summer) pp.114-120
1965. Calvin Wells ’15th-Century Wood-Carvings in St. Mary’s Church, Bury St. Edmunds’ in Medical History 9 pp.286-288
1973. Ellen Ettlinger ‘Notes on a Woodcut Depicting King Henry VI Being Invoked as a Saint’ in Folklore, Vol.84, No.2 (Summer) pp.115-119
1985. T.W. Potter & Calvin Wells ‘A Republican Healing Sanctuary at Ponte Di Nona Near Rome and the Classical Tradition of Votive Medicine’ in British Journal of Archaeology Volume 138. pp.23-47
In assessing Calvin Wells’ contribution to the study of palaeopathology, it’s worth noting that he only committed himself full-time to the discipline in later life. At the age of 62 when many are settling into retirement, Calvin started to forge his legacy as a world renowned palaeopathologist. In the 30 years preceding this period Calvin worked primarily as a General Practitioner diagnosing disease and injury in the living. Completing his medical studies at University College London, Dr Wells served in the Royal Medical Corps for six years before setting up a general medical practice in Norwich city centre. According to reminisces of his wife Freddie, it was she who ran the business side of things while Calvin spent much of his work week motoring around the Norfolk countryside visiting his rural patients. Aside from Calvin’s student memoirs, there is very little archive material from his time in the medical profession. This is one of many factors which make this specimen report and accompanying photographs from 1957 among the more unusual items in the Calvin Wells Archive Collection.
Sebaceous horn (1957)
Sebaceous horn (1957)
Sebaceous, or cutaneous, horns are a rare condition and this particular case is even rarer considering the extent to which the tumour developed before being excised. Medical doctor and palaeopathologist Keith Manchester states that it is the largest specimen he’s encountered and makes a comparison with the case of Madame Dimanche. Also referred to as Widow Sunday, Madame Dimanche (pictured right: From Bailey and Love’s Textbook of Surgery, 1932) was a 76 year-old watercress seller from early 19th-century Paris. Over the course of six years, a 25cm sebaceous horn grew from her forehead before being removed by the famous French surgeon Joseph Souberille. Calvin’s patient was far more affected by her condition in the sense that it prevented her from forming any romantic relationships. There is added poignancy in the fact that the condition is easily treated with a simple excision and skin graft. In a similar manner with which he would later interpret high drama in ancient bones, Calvin ensured to convey a glimpse of humanity in this specimen report.
Published in 1964 as volume 37 of Thames & Hudson’s landmark archaeology series Ancient People and Places, Calvin Wells’ Bones, Bodies and Disease is his most enduring work on palaeopathology. The series’ editor at the time was the distinguished archaeologist Glyn Daniel, who knew Wells personally but was taking somewhat of a risk commissioning him for such a major project. Up until this point Wells had published relatively little research besides a handful of skeletal reports focused mainly on excavations in East Anglia. However, letters from Daniel to Wells reveal that the editor was keen to meet the demand for archaeological literature which focused specifically on ancient disease, injury and medical treatment. As a general practitioner with a parallel career in palaeopathology Wells was the best, if not the only, candidate for the role.
With Bones, Bodies and Disease, Wells had ambitions to help popularise palaeopathology much in the same way Daniel, who was Television Personality of the Year 1955, had achieved with archaeology. In an interview for the BBC Home Service Wells stated that:
To the extent that Bones, Bodies and Disease was intended to make the study of ancient disease stimulating to the general reader Wells was remarkably successful. The book was warmly reviewed in national newspapers and magazines. East Anglia’s Eastern Daily Press stated that ‘to call it a thriller would not be out of place’ while the Liverpool Echo called it ‘a whodunit with a difference’. In the Irish Times the book was deemed ‘scholarly and strange’ with the clarification that it was ‘decorative and exact in scholarship’ with ‘wide and diverse appeal’. The Times Literary Supplement welcomed Dr Wells’ ‘exciting textbook of palaeopathology’ and the Economist confirmed that it contained ‘much to entertain and instruct the general reader’. Perhaps the most effusive review of this nature was by Jacquetta Hawkes in the Sunday Times who praised ‘Wells’ dedicated enthusiasm for his enthusiasm for his unusual subject, which has given vigour and vividness to his pen.’
It was not just in the popular press where Bones, Bodies and Disease received a positive reception, as several leading specialist journal and publications awarded the book favourable reviews. They included Science, the British Medical Journal, the Archaeological Journal, and the Pharmaceutical Journal. Writing in the Dutch archaeology journal Helinium the eminent Belgian physician Paul Janssens gave the work a glowing review, calling it a work of great value to archaeologists, medical doctors and the general reader.
The only exception to the largely enthusiastic response to Bones, Bodies and Disease appeared in the Museums Journal and was authored by Wells’ fellow palaeopathologist Don Brothwell. Instead of praising the accessibility or simplicity of the writing, Brothwell
saw the author as ‘underestimating the reading ability and intelligence of people most likely to read such books’. The second major criticism, possibly the sharpest blow to the self-confessed pedant Wells, was that the book suffered from vague and inaccurate referencing. Overall, Brothwell felt the book fell ‘below par’ of the usual standard featured in the ‘Ancient People and Places’ series. An infuriated Wells demanded the Museums Journal publish a letter of reply. In response to Brothwell’s criticism of the book’s simple style, Wells countered that there was ‘no virtue in turgid complexity’. To the second criticism that the work was poorly referenced Wells accused Brothwell of lacking the training and experience to make such judgements. Despite Glyn Daniel’s best efforts to broker peace between the two palaeopathologists, their relationship became acrimonious thereafter.
Leaving this negative exchange aside the publication of Bones, Bodies and Disease was a major turning point Wells’ career in palaeopathology and remains a central part of his bibliography. In addition to selling sufficiently well to merit a second print, the book was translated into numerous and has the remarkable honour of being the only general work on palaeopathology in the Portuguese language. Despite its age the publication continues to be cited in bioarchaeology research and literature, and has yet to be fully superseded by later works. As an introductory book to palaeopathology for the general reader it remains pertinent, cover many subjects still feature in public debates related to archaeology and anthropology.
1st edition with cover design by Satra Wells (1971)
Scientific Book Club edition (1972)
Given the legacy of Bones, Bodies and Disease it is surprising that Wells’ second and final book Man in his World made such little impact. Published in 1971 by John Baker Publishers Limited, Man in his World was an attempt by Wells to write an anthropological survey analysing 1 million years of human history and civilisation. The book was released with relatively little fanfare with none of the international publicity his first book received. A small review in The Sunday Times called the book ‘a terse and well informed impression’ let down by rather ‘stolid writing’. The review did praise the book’s illustrations, which were done by Wells’ daughter Satra . Despite the lack of coverage Man in his World achieved moderate success, and was later republished and distributed by the Scientific Book Club. Unusually the book was also published in Turkey where it appears to have sold well.
While only writing two books in his lifetime, Wells’ skeletal reports, journal articles and contributions of chapters to other publications means that he remains one of the most prolific writers on palaeopathology in the United Kingdom. Moreover as the Putting Flesh on the Bones project unlocks Wells’ archive we are finding considerably more writings not included in his official bibliography. These writings include unpublished work on palaeopathology as well as vast array of other subjects, including anthropology, history medicine, art history, and more. By unlocking the archive material we hope to give researchers the ability to reassess Calvin Wells’ ‘strange and scholarly’ life and work.
Bones, Bodies and Disease by Calvin Wells (London: Thames & Hudson, 1964)
Man in His World by Calvin Wells (London: Baker, 1971)
Review of Bones, Bodies and Disease by Don Brothwell in Museum Journal (vol. 64, no.4, March 1965, p.340-341)
Review of Bones, Bodies and Disease by R.J. Harrison British Medical Journal (9 October 1964, p.1245)
Review of Bones, Bodies and Disease by Paul Janssens in Helinium (Volume 9, 1964, pp.282-284)
Review of Bones, Bodies and Disease by T.D. Stewart in Science (07 Aug 1964: Vol. 145, Issue 3632, pp. 568-569)
Review of Bones, Bodies and Disease by Roger Warwick Archaeological Journal (1964: 121:1, pp. 215-216