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Leprosy can lead to blood depletion in Zn, Ca, Mg, and Fe and blood enrichment in Cu. In late medieval Europe, minerals were used to treat leprosy. Here, physiological responses to leprosy and possible evidence of treatment are investigated in enamel, dentine, and cementum of leprosy sufferers from medieval Denmark (n = 12) and early 20th century Romania (n = 2). Using SXRF and LA-ICP-TOFMS, 12 elements were mapped in 15 tooth thin sections, and the statistical covariation of paired elements was computed to assess their biological relevance. The results show marked covariations in the Zn, Ca, and Mg distributions, which are compatible with clinical studies but cannot be directly attributed to leprosy. Minerals used historically as a treatment for leprosy show no detectable intake (As, Hg) or a diffuse distribution (Pb) related to daily ingestion. Intense Pb enrichments indicate acute incorporations of Pb, potentially through the administration of Pb-enriched medication or the mobilization of Pb from bone stores to the bloodstream during intense physiological stress related to leprosy. However, comparisons with a healthy control group are needed to ascertain these interpretations. The positive correlations and the patterns observed between Pb and essential elements may indicate underlying pathophysiological conditions, demonstrating the potential of SXRF and LA-ICP-TOFMS for paleopathological investigations.

During the 12th and 13th centuries, numerous leprosy hospitals were founded in Europe. Given that leprosy was not considered infectious, this may reflect social dimensions of the disease. Aiming at exploring the impact of leprosy on medieval people and the organisation of the Danish leprosarium at Næstved, we reconstructed the diet of twenty patients using stable isotopes, and compared our results with relevant historical data. The isotope results revealed a terrestrial C3 diet with a small contribution of aquatic foods. Contrary to historical evidence of daily fish consumption in the leprosy hospital, only six individuals consumed relatively large amounts of freshwater fish. Leprosaria have been considered monastic institutions, and thus a varied diet, poor in aquatic protein, questions the monastic nature of the hospital and points to a social stratification. A multi-isotope analysis of a larger sample set would add to our understanding of the diet of the leprosy patients, as well as their treatment in the leprosarium.