Zoom into the image above about four times, and you’ll be able to see London Bridge Street properly. This was on the northern edge of St Thomas Hospital, a medieval hospital established for the relief of the poor and sick. One of only three hospitals to survive the dissolution of the monasteries, albiet with a short closure and a re-dedication away from St Thomas the Martyr to St Thomas the Apostle, the hospital came under threat by the construction of London Bridge Station in the mid 1800s. At Florence Nightingale’s suggestion the hospital moved to its current location just over a mile away in Lambeth, but the remains of the medieval and post medieval buildings were destroyed by 1864.

For many hospitals during this period, particularly those who dealt with the poor, the problem of disposing of bodies was accute. Although some were claimed by relatives, many lacked the funds to ensure burial and some were never claimed. Although hospitals could have agreements with local churches to use churchyards for burial of the unclaimed or destitute, payment would have to be made. As a result many hospitals kept their own graveyards, a concept that might seem strange to us but should be seen in light of the religious nature of hospitals during this time – the medieval tradition had been for all hospitals to be religious institutions, and this carried over into the post medieval period, with all having their own chapels, and some (like St Thomas) going on to become parish churches in their own right.

Whilst a number of the burial areas of St Thomas are known from cartographic sources, the large numbers of patients passing through the hospital and the pressure for space in this important trade area close to the Thames Southbank wharfs put constant pressure on the graveyards.

It is perhaps not surprising that a rescue excavation in 1991 under part of the large white building visible in the map above uncovered a previously unknown graveyard. What is perhaps more astounding is the sheer density of bodies recorded. In a 6m x 3m x 3m deep area, 277 bodies were recorded. What became clear was that the majority of these had been buried without coffins, covered by just a shroud held together with a pin. In addition many had been packed together in single mass graves, side-by-side and sometimes one on top of another. Graves pits had been cut into areas already full of bodies, with either none of the modern respect for those already buried or no prior knowledge of the locations of the burials.

One aspect of the burials highlighted by the excavators was the high incidence of syphilis infection, present in 13% of the analysed individuals. Whilst syphilis is familiar to us as a sexually transmitted bacterial infection, it can be passed from mother to child. It became known in Europe by the mid-15th century, but a cure wasn’t available until the advent of antibiotics in the early 20th century. Wikipedia gives a good description of some of the nastier results of syphilis, but suffice to say it modifies the bone structure as well as causing skin lesions and internal damage which can effect even the very young and could have been clearly visible.

As the excavators say here, the data tells us that living in the 17th century was highly risky, with childbirth causing a specific risk for young women. But of course, the big question is whether this was the site of a plague pit. Whilst we know that St Thomas was actively turning away those infected with the plague, it would have been difficult to spot all of those infected, and once infection became present in the hospital it seems likely to have been hard to control.

The question of whether this represents a plague pit affects how we interpret the evidence. If we look at the figures for syphilis infection, is the infection level of 13% a good representation of syphilis presence in the general population of the area or were people with syphilis, with its open sores and lesions, more susceptible to the plague? There are almost twice as many men as women in the analysed sample: does this mean that men were more susceptible to the plague then women?

If the burial represents a plague pit, then this explains satisfactorily to our modern sensibilities why there might be mass burials and disturbance of those already buried. However if this is not a plague pit, and the pressure of infected bodies created by the plague had not occurred, then why the mass graves, why the inter-cutting burial pits, the disturbance of the dead and the dumping of disarticulated bones? Was this the way that hospitals regularly treated the bodies of paupers?

Of course, this is just the surface – the more cemeteries that are uncovered, the more chance there is of answering these questions, and increasing our understanding of our ancestors. Perhaps of particular interest is how the attitudes to death may have changed. Either way, it’s worth remembering next time you walk around London Bridge railway or tube station that there’s probably still hundreds more burials just around the corner!

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