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Intestinal parasite infection and sanitation in medieval Leiden, the Low Countries | Antiquity | Cambridge Core

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Spatial patterns of service access in sixteenth-century Leiden; citation_author=Van Steensel, A.; citation_author=Nigro, G.; citation_publication_date=2020; citation_inbook=Economic inequality in pre-industrial societies: causes and effect; citation_firstpage=369"> <meta name="citation_abstract" content="In the absence of written records, disease and parasite loads are often used as indicators of sanitation in past populations. Here, the authors adopt the novel approach of integrating the bioarchaeological analysis of cesspits in an area of medieval Leiden (the Netherlands) with historical property records to explore living conditions. Using light microscopy and enzyme-linked immunosorbent assays (ELISA) they identify evidence of parasites associated with ineffective sanitation (whipworm, roundworm and the protozoan Giardia duodenalis)—at residences of all social levels—and the consumption of infected livestock and freshwater fish (Diphyllobothriidae, cf. Echinostoma sp., cf. 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Open</a></li><li><a href="/core/publications/collections/hemingway-letters" target="">Hemingway Letters</a></li><li><a href="/core/publications/collections/shakespeare-survey" target="">Shakespeare Survey</a></li><li><a href="/core/publications/collections/stahl-online" target="">Stahl Online</a></li><li><a href="/core/publications/collections/the-correspondence-of-isaac-newton" target="">The Correspondence of Isaac Newton</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Elements</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Explore</li><ol><!--[--><li><a href="/core/publications/elements" target="">About Elements</a></li><li><a href="/core/publications/elements/cambridge-elements-series" target="">Elements series</a></li><li><a href="/core/publications/elements/published-elements?aggs%5BopenAccess%5D%5Bfilters%5D=7275BA1E84CA769210167A6A66523B47&amp;aggs%5BproductTypes%5D%5Bfilters%5D=ELEMENT&amp;searchWithinIds=ECFD8F5C64F47F3F5A3D395C15B7C493" target="">Open access Elements</a></li><li><a href="/core/publications/elements/published-elements?aggs%5BproductTypes%5D%5Bfilters%5D=ELEMENT&amp;aggs%5BproductDate%5D%5Bfilters%5D=Last%203%20months&amp;searchWithinIds=ECFD8F5C64F47F3F5A3D395C15B7C493" target="">New Elements</a></li><!--]--></ol><!--]--><!--[--><li>Subjects (A-E)</li><ol><!--[--><li><a href="/core/elements/subject/Anthropology/2E44A5AF2838E017617A26DD79FAEAEE" target="">Anthropology</a></li><li><a href="/core/elements/subject/Archaeology/63A50B5368A9F97F8AA2D6AB965B5F4C" target="">Archaeology</a></li><li><a href="/core/elements/subject/Classical%20Studies/DDC63B7F5792FE2A95D1FB15F76E3F42" target="">Classical Studies</a></li><li><a href="/core/elements/subject/Computer%20Science/A57E10708F64FB69CE78C81A5C2A6555" target="">Computer Science</a></li><li><a href="/core/elements/subject/Drama,%20Theatre,%20Performance%20Studies/2825E4E39F2D641B36543EE80FB1DEA3" target="">Drama, Theatre, Performance Studies</a></li><li><a href="/core/elements/subject/Earth%20and%20Environmental%20Sciences/F470FBF5683D93478C7CAE5A30EF9AE8" target="">Earth and Environmental Sciences</a></li><li><a href="/core/elements/subject/Economics/FA44491F1F55F917C43E9832715B9DE7" target="">Economics</a></li><li><a href="/core/elements/subject/Education/550D00F8DF590F2598CF7CC0038E24D1" target="">Education</a></li><li><a href="/core/elements/subject/Engineering/CCC62FE56DCC1D050CA1340C1CCF46F5" target="">Engineering</a></li><!--]--></ol><!--]--><!--[--><li> Subjects (F-O)</li><ol><!--[--><li><a href="/core/elements/subject/Film,%20Media,%20Mass%20Communication/4B91F10E834814A90CE718E7831E492F" target="">Film, Media, Mass Communication</a></li><li><a href="/core/elements/subject/History/66BE42A30172E280FDE64F8EE2F485B0" target="">History</a></li><li><a href="/core/elements/subject/Language%20and%20Linguistics/140D314098408C26BDF3009F7FF858E9" target="">Language and Linguistics</a></li><li><a href="/core/elements/subject/Law/7C9FB6788DD8D7E6696263BC774F4D5B" target="">Law</a></li><li><a href="/core/elements/subject/Life%20Sciences/E044EF2F61B601378786E9EDA901B2D5" target="">Life Sciences</a></li><li><a href="/core/elements/subject/Literature/F2434ADC122145767C6C3B988A8E9BD5" target="">Literature</a></li><li><a href="/core/elements/subject/Management/0EDCC0540639B06A5669BDEEF50C4CBE" target="">Management</a></li><li><a href="/core/elements/subject/Mathematics/FA1467C44B5BD46BB8AA6E58C2252153" target="">Mathematics</a></li><li><a href="/core/elements/subject/Medicine/66FF02B2A4F83D9A645001545197F287" target="">Medicine</a></li><li><a href="/core/elements/subject/Music/A370B5604591CB3C7F9AFD892DDF7BD1" target="">Music</a></li><!--]--></ol><!--]--><!--[--><li> Subjects (P-Z)</li><ol><!--[--><li><a href="/core/elements/subject/Philosophy/2D1AC3C0E174F1F1A93F8C7DE19E0FAB" target="">Philosophy</a></li><li><a href="/core/elements/subject/Physics%20and%20Astronomy/DBFB610E9FC5E012C011430C0573CC06" target="">Physics and Astronomy</a></li><li><a href="/core/elements/subject/Politics%20and%20International%20Relations/3BF83347E5E456DAC34F3FABFC8BBF4E" target="">Politics and International Relations</a></li><li><a href="/core/elements/subject/Psychology/21B42A72BA3E4CB0E3315E5B1B71B07F" target="">Psychology</a></li><li><a href="/core/elements/subject/Religion/53E51D24FB488962B9364A2C4B45D1C3" target="">Religion</a></li><li><a href="/core/elements/subject/Sociology/0E2CD53A93003DF17E52D753F6E90683" target="">Sociology</a></li><li><a href="/core/elements/subject/Statistics%20and%20Probability/3150B8B0D1B0B4E8DC17EC9EDFD9CA26" target="">Statistics and Probability</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Textbooks</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Explore</li><ol><!--[--><li><a href="/highereducation/" target="">Cambridge Higher Education</a></li><li><a href="/highereducation/services/librarians/title-list" target="">Title list</a></li><li><a href="/highereducation/search?sortBy=publication_date&amp;aggs=%24productDate%24Last%25206%2520months%3Atrue%26Last%252012%2520months%3Atrue%26Last%25203%2520years%3Atrue%26Over%25203%2520years%3Atrue%3B%3B&amp;event=SE-AU_PREF" target="">New titles</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Collections</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Book collections</li><ol><!--[--><li><a href="/core/publications/collections/cambridge-companions" target="">Cambridge Companions</a></li><li><a href="/core/publications/collections/cambridge-editions" target="">Cambridge Editions</a></li><li><a href="/core/publications/collections/cambridge-histories" target="">Cambridge Histories</a></li><li><a href="/core/publications/collections/cambridge-library-collection" target="">Cambridge Library Collection</a></li><li><a href="/core/publications/collections/cambridge-shakespeare" target="">Cambridge Shakespeare</a></li><li><a href="/core/publications/collections/cambridgehandbooks" target="">Cambridge Handbooks</a></li><!--]--></ol><!--]--><!--[--><li> Book collections (cont.)</li><ol><!--[--><li><a href="/core/publications/collections/dispute-settlement-reports-online" target="">Dispute Settlement Reports Online</a></li><li><a href="/core/publications/collections/flip-it-open" target="">Flip it Open</a></li><li><a href="/core/publications/collections/hemingway-letters" target="">Hemingway Letters</a></li><li><a href="/core/publications/collections/shakespeare-survey" target="">Shakespeare Survey</a></li><li><a href="/core/publications/collections/stahl-online" target="">Stahl Online</a></li><li><a href="/core/publications/collections/the-correspondence-of-isaac-newton" target="">The Correspondence of Isaac Newton</a></li><!--]--></ol><!--]--><!--[--><li>Journal collections</li><ol><!--[--><li><a href="/core/publications/collections/cambridge-forum" target="">Cambridge Forum</a></li><li><a href="/core/publications/collections/cambridge-law-reports-collection" target="">Cambridge Law Reports Collection</a></li><li><a href="/core/publications/collections/cambridge-prisms" target="">Cambridge Prisms</a></li><li><a href="/core/publications/collections/research-directions" target="">Research Directions</a></li><!--]--></ol><!--]--><!--[--><li>Series</li><ol><!--[--><li><a href="/core/publications/collections/series" target="">All series</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Partners</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Partners</li><ol><!--[--><li><a href="/core/publications/publishing-partners/agenda-publishing" target="">Agenda Publishing</a></li><li><a href="/core/publications/publishing-partners/amsterdam-university-press" target="">Amsterdam University Press</a></li><li><a href="/core/publications/publishing-partners/anthem-press" target="">Anthem Press</a></li><li><a href="/core/publications/publishing-partners/boydell-brewer" target="">Boydell &amp; Brewer</a></li><li><a href="/core/publications/publishing-partners/bristol-university-press" target="">Bristol University Press</a></li><li><a href="/core/publications/publishing-partners/edinburgh-university-press" target="">Edinburgh University Press</a></li><li><a href="/core/publications/publishing-partners/emirates-center" target="">Emirates Center for Strategic Studies and Research</a></li><li><a href="/core/publications/publishing-partners/facet-publishing" target="">Facet Publishing</a></li><!--]--></ol><!--]--><!--[--><li> Partners (cont.)</li><ol><!--[--><li><a href="/core/publications/publishing-partners/foundation-books" target="">Foundation Books</a></li><li><a href="/core/publications/publishing-partners/intersentia" target="">Intersentia</a></li><li><a href="/core/publications/publishing-partners/iseas" target="">ISEAS-Yusof Ishak Institute</a></li><li><a href="/core/publications/publishing-partners/jagiellonian-university-press" target="">Jagiellonian University Press</a></li><li><a href="/core/publications/publishing-partners/royal-economic-society" target="">Royal Economic Society</a></li><li><a href="/core/publications/publishing-partners/unisa-press" target="">Unisa Press</a></li><li><a href="/core/publications/publishing-partners/university-adelaide-press" target="">The University of Adelaide Press</a></li><li><a href="/core/publications/publishing-partners/wits-university-press" target="">Wits University Press</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Services</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>About</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>About Cambridge Core</li><ol><!--[--><li><a href="/core/services/about/about" target="">About</a></li><li><a href="/core/services/about/accessibility" target="">Accessibility</a></li><li><a href="/core/services/about/crossmark-policy" target="">CrossMark policy</a></li><li><a href="/core/services/about/ethical-standards" target="">Ethical Standards</a></li><!--]--></ol><!--]--><!--[--><li>Environment and sustainability</li><ol><!--[--><li><a href="/core/services/about/environment-and-sustainability" target="">Environment and sustainability</a></li><li><a href="/core/services/about/reducing-print" target="">Reducing print</a></li><li><a href="/core/services/about/journals-moving-to-online-only" target="">Journals moving to online only</a></li><!--]--></ol><!--]--><!--[--><li>Guides</li><ol><!--[--><li><a href="/core/services/about/user-guides" target="">User guides</a></li><li><a href="/core/services/about/user-guides-and-videos" target="">User Guides and Videos</a></li><li><a href="/core/services/about/support-videos" target="">Support Videos</a></li><li><a href="/core/services/about/training" target="">Training</a></li><!--]--></ol><!--]--><!--[--><li>Help</li><ol><!--[--><li><a href="https://corehelp.cambridge.org/" target="">Cambridge Core help</a></li><li><a href="https://corehelp.cambridge.org/hc/en-gb/p/contact-information" target="">Contact us</a></li><li><a href="https://corehelp.cambridge.org/hc/en-gb/requests/new" target="">Technical support</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Agents</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Services for agents</li><ol><!--[--><li><a href="/core/services/agents/services-for-agents" target="">Services for agents</a></li><li><a href="/core/services/agents/journals-for-agents" target="">Journals for agents</a></li><li><a href="/core/services/agents/books-for-agents" target="">Books for agents</a></li><li><a href="/core/services/agents/price-list" target="">Price list</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Authors</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Journals</li><ol><!--[--><li><a href="/core/services/authors/journals" target="">Journals</a></li><li><a href="/core/services/authors/journal-publishing-statistics" target="">Journal publishing statistics</a></li><li><a href="/core/services/authors/corresponding-author" target="">Corresponding author</a></li><li><a href="/core/services/authors/seeking-permission-to-use-copyrighted-material" target="">Seeking permission to use copyrighted material</a></li><li><a href="/core/services/authors/publishing-supplementary-material" target="">Publishing supplementary material</a></li><li><a href="/core/services/authors/writing-an-effective-abstract" target="">Writing an effective abstract</a></li><li><a href="/core/services/authors/journal-production-faqs" target="">Journal production - FAQs</a></li><!--]--></ol><!--]--><!--[--><li>Journals (cont.)</li><ol><!--[--><li><a href="/core/services/authors/author-affiliations" target="">Author affiliations</a></li><li><a href="/core/services/authors/co-reviewing-policy" target="">Co-reviewing policy</a></li><li><a href="/core/services/authors/digital-author-publishing-agreement-faqs" target="">Digital Author Publishing Agreement - FAQs</a></li><li><a href="/core/services/authors/anonymising-your-manuscript" target="">Anonymising your manuscript</a></li><li><a href="/core/services/authors/publishing-open-access" target="">Publishing open access</a></li><li><a href="/core/services/authors/converting-your-article-to-open-access" target="">Converting your article to open access</a></li><li><a href="/core/services/authors/publishing-open-access-webinars" target="">Publishing Open Access - webinars</a></li><!--]--></ol><!--]--><!--[--><li>Journals (cont.)</li><ol><!--[--><li><a href="/core/services/authors/preparing-and-submitting-your-paper" target="">Preparing and submitting your paper</a></li><li><a href="/core/services/authors/publishing-an-accepted-paper" target="">Publishing an accepted paper</a></li><li><a href="/core/services/authors/promoting-your-published-paper" target="">Promoting your published paper</a></li><li><a href="/core/services/authors/measuring-impact" target="">Measuring impact</a></li><li><a href="/core/services/authors/journals-artwork-guide" target="">Journals artwork guide</a></li><li><a href="/core/services/authors/using-orcid" target="">Using ORCID</a></li><!--]--></ol><!--]--><!--[--><li>Books</li><ol><!--[--><li><a href="/core/services/authors/books" target="">Books</a></li><li><a href="/core/services/authors/marketing-your-book" target="">Marketing your book</a></li><li><a href="/core/services/authors/elements-user-guides" target="">Author guides for Cambridge Elements</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Corporates</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Corporates</li><ol><!--[--><li><a href="/core/services/corporates/commercial-reprints" target="">Commercial reprints</a></li><li><a href="/core/services/corporates/advertising" target="">Advertising</a></li><li><a href="/core/services/corporates/sponsorship" target="">Sponsorship</a></li><li><a href="/core/services/corporates/book-special-sales" target="">Book special sales</a></li><li><a href="/core/services/corporates/contact-us" target="">Contact us</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Editors</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Information</li><ol><!--[--><li><a href="/core/services/editors/journal-development" target="">Journal development</a></li><li><a href="/core/services/editors/peer-review-for-editors" target="">Peer review for editors</a></li><li><a href="/core/services/editors/open-access-for-editors" target="">Open access for editors</a></li><li><a href="/core/services/editors/policies-and-guidelines" target="">Policies and guidelines</a></li><!--]--></ol><!--]--><!--[--><li>Resources</li><ol><!--[--><li><a href="/core/services/editors/the-editors-role" target="">The editor&#39;s role</a></li><li><a href="/core/services/editors/open-research-for-editors" target="">Open research for editors</a></li><li><a href="/core/services/editors/engagement-and-promotion" target="">Engagement and promotion</a></li><li><a href="/core/services/editors/blogging" target="">Blogging</a></li><li><a href="/core/services/editors/social-media" target="">Social media</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Librarians</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Information</li><ol><!--[--><li><a href="/core/services/librarians/open-access-for-librarians" target="">Open Access for Librarians</a></li><li><a href="https://www.cambridge.org/core/services/open-access-policies/read-and-publish-agreements" target="">Transformative agreements</a></li><li><a href="/core/services/librarians/transformative-agreements-faqs" target="">Transformative Agreements - FAQs</a></li><li><a href="/core/services/librarians/evidence-based-acquisition" target="">Evidence based acquisition</a></li><li><a href="/core/services/librarians/ebook-news-and-updates" target="">ebook news &amp; updates</a></li><li><a href="/core/services/librarians/cambridge-libraries-of-the-world-podcast" target="">Cambridge libraries of the world podcast</a></li><li><a href="/core/services/librarians/purchasing-models" target="">Purchasing models</a></li><li><a href="/core/services/librarians/journals-publishing-updates" target="">Journals Publishing Updates</a></li><!--]--></ol><!--]--><!--[--><li>Products</li><ol><!--[--><li><a href="/core/services/librarians/cambridge-frontlist" target="">Cambridge frontlist</a></li><li><a href="/core/services/librarians/cambridge-journals-digital-archive" target="">Cambridge journals digital archive</a></li><li><a href="/core/services/librarians/hot-topics" target="">Hot topics</a></li><li><a href="/core/services/librarians/other-digital-products" target="">Other digital products</a></li><li><a href="/core/services/librarians/perpetual-access-products" target="">Perpetual access products</a></li><li><a href="/core/services/librarians/price-list" target="">Price list</a></li><li><a href="/core/services/librarians/developing-country-programme" target="">Developing country programme</a></li><li><a href="/core/services/librarians/new-content" target="">New content</a></li><!--]--></ol><!--]--><!--[--><li>Tools</li><ol><!--[--><li><a href="/core/eligibility-checker" target="">Eligibility checker</a></li><li><a href="https://www.cambridge.org/core/services/open-access-policies/read-and-publish-agreements" target="">Transformative agreements</a></li><li><a href="https://www.cambridge.org/core/services/librarians/kbart" target="">KBART</a></li><li><a href="https://www.cambridge.org/core/services/librarians/marc-records" target="">MARC records</a></li><li><a href="/core/services/librarians/using-marcedit-for-marc-records" target="">Using MARCEdit for MARC records</a></li><li><a href="/core/services/librarians/inbound-openurl-specifications" target="">Inbound OpenURL specifications</a></li><li><a href="/core/services/librarians/counter-report-types" target="">COUNTER report types</a></li><!--]--></ol><!--]--><!--[--><li>Resources</li><ol><!--[--><li><a href="/core/services/librarians/catalogues-and-resources" target="">Catalogues and resources</a></li><li><a href="/core/services/librarians/making-the-most-of-your-eba" target="">Making the most of your EBA</a></li><li><a href="/core/services/librarians/posters" target="">Posters</a></li><li><a href="/core/services/librarians/leaflets-and-brochures" target="">Leaflets and brochures</a></li><li><a href="/core/services/librarians/additional-resources" target="">Additional resources</a></li><li><a href="/core/services/librarians/find-my-sales-contact" target="">Find my sales contact</a></li><li><a href="/core/services/librarians/webinars" target="">Webinars</a></li><li><a href="/core/services/librarians/read-and-publish-resources" target="">Read and publish resources</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Peer review</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Peer review</li><ol><!--[--><li><a href="/core/services/peer-review/how-to-peer-review-journal-articles" target="">How to peer review journal articles</a></li><li><a href="/core/services/peer-review/how-to-peer-review-book-proposals" target="">How to peer review book proposals</a></li><li><a href="/core/services/peer-review/how-to-peer-review-registered-reports" target="">How to peer review Registered Reports</a></li><li><a href="/core/services/peer-review/peer-review-faqs" target="">Peer review FAQs</a></li><li><a href="/core/services/peer-review/ethics-in-peer-review" target="">Ethics in peer review</a></li><li><a href="/core/services/peer-review/online-peer-review-systems" target="">Online peer review systems</a></li><li><a href="/core/services/peer-review/a-guide-to-publons" target="">A guide to Publons</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Publishing ethics</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Journals </li><ol><!--[--><li><a href="/core/services/publishing-ethics/publishing-ethics-guidelines-journals" target="">Publishing ethics guidelines for journals</a></li><li><a href="/core/services/publishing-ethics/core-editorial-policies-journals" target="">Core editorial policies for journals</a></li><li><a href="/core/services/publishing-ethics/authorship-and-contributorship-journals" target="">Authorship and contributorship for journals</a></li><li><a href="/core/services/publishing-ethics/affiliations-journals" target="">Affiliations for journals</a></li><li><a href="/core/services/publishing-ethics/research-ethics-journals" target="">Research ethics for journals</a></li><li><a href="/core/services/publishing-ethics/competing-interests-and-funding-journals" target="">Competing interests and funding for journals</a></li><!--]--></ol><!--]--><!--[--><li>Journals (cont.)</li><ol><!--[--><li><a href="/core/services/publishing-ethics/data-and-supporting-evidence-for-journals" target="">Data and supporting evidence for journals</a></li><li><a href="/core/services/publishing-ethics/misconduct-journals" target="">Misconduct for journals</a></li><li><a href="/core/services/publishing-ethics/corrections-retractions-and-removals-journals" target="">Corrections, retractions and removals for journals</a></li><li><a href="/core/services/publishing-ethics/versions-and-adaptations-journals" target="">Versions and adaptations for journals</a></li><li><a href="/core/services/publishing-ethics/libel-defamation-and-freedom-of-expression" target="">Libel, defamation and freedom of expression</a></li><li><a href="/core/services/publishing-ethics/business-ethics-journals" target="">Business ethics journals</a></li><!--]--></ol><!--]--><!--[--><li>Books</li><ol><!--[--><li><a href="/core/services/publishing-ethics/publishing-ethics-guidelines-books" target="">Publishing ethics guidelines for books</a></li><li><a href="/core/services/publishing-ethics/core-editorial-policies-books" target="">Core editorial policies for books</a></li><li><a href="/core/services/publishing-ethics/authorship-and-contributorship-books" target="">Authorship and contributorship for books</a></li><li><a href="/core/services/publishing-ethics/affiliations-books" target="">Affiliations for books</a></li><li><a href="/core/services/publishing-ethics/research-ethics-books" target="">Research ethics for books</a></li><li><a href="/core/services/publishing-ethics/competing-interests-and-funding-books" target="">Competing interests and funding for books</a></li><!--]--></ol><!--]--><!--[--><li>Books (cont.)</li><ol><!--[--><li><a href="/core/services/publishing-ethics/data-and-supporting-evidence-books" target="">Data and supporting evidence for books</a></li><li><a href="/core/services/publishing-ethics/misconduct-books" target="">Misconduct for books</a></li><li><a href="/core/services/publishing-ethics/corrections-retractions-and-removals-books" target="">Corrections, retractions and removals for books</a></li><li><a href="/core/services/publishing-ethics/versions-and-adaptations-books" target="">Versions and adaptations for books</a></li><li><a href="/core/services/publishing-ethics/libel-defamation-and-freedom-of-expression" target="">Libel, defamation and freedom of expression</a></li><li><a href="/core/services/publishing-ethics/business-ethics-books" target="">Business ethics books</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Publishing partners</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Publishing partners</li><ol><!--[--><li><a href="/core/services/publishing-partners/publishing-partnerships" target="">Publishing partnerships</a></li><li><a href="/core/services/publishing-partners/partner-books" target="">Partner books</a></li><li><a href="/core/services/publishing-partners/ebook-publishing-partnerships" target="">eBook publishing partnerships</a></li><li><a href="/core/services/publishing-partners/journal-publishing-partnerships" target="">Journal publishing partnerships</a></li><!--]--></ol><!--]--><!--[--><li>Publishing partners (cont.)</li><ol><!--[--><li><a href="/core/services/publishing-partners/journals-publishing" target="">Journals publishing</a></li><li><a href="/core/services/publishing-partners/customer-support" target="">Customer support</a></li><li><a href="/core/services/publishing-partners/membership-services" target="">Membership Services</a></li><li><a href="/core/services/publishing-partners/our-team" target="">Our Team</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Open research</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Open access policies</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Open access policies</li><ol><!--[--><li><a href="/core/services/open-research-policies/open-research" target="">Open research</a></li><li><a href="/core/services/open-research-policies/open-access-policies" target="">Open access policies</a></li><li><a href="/core/services/open-research-policies/cambridge-university-press-and-plan-s" target="">Cambridge University Press and Plan S</a></li><li><a href="/core/services/open-research-policies/text-and-data-mining" target="">Text and data mining</a></li><li><a href="/core/services/open-research-policies/preprint-policy" target="">Preprint policy</a></li><li><a href="/core/services/open-research-policies/social-sharing" target="">Social sharing</a></li><!--]--></ol><!--]--><!--[--><li>Journals</li><ol><!--[--><li><a href="/core/services/open-research-policies/open-access-journals" target="">Open access journals</a></li><li><a href="/core/services/open-research-policies/gold-open-access-journals" target="">Gold Open Access journals</a></li><li><a href="/core/services/open-research-policies/transformative-journals" target="">Transformative journals</a></li><li><a href="/core/services/open-research-policies/green-open-access-policy-for-journals" target="">Green Open Access policy for journals</a></li><li><a href="/core/services/open-research-policies/transparent-pricing-policy-for-journals" target="">Transparent pricing policy for journals</a></li><!--]--></ol><!--]--><!--[--><li>Books and Elements</li><ol><!--[--><li><a href="/core/services/open-research-policies/open-access-books" target="">Open access books</a></li><li><a href="/core/services/open-research-policies/gold-open-access-books" target="">Gold open access books</a></li><li><a href="/core/services/open-research-policies/green-open-access-policy-for-books" target="">Green Open Access policy for books</a></li><li><a href="/core/services/open-research-policies/open-access-elements" target="">Open access Elements</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Open access publishing</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>About open access</li><ol><!--[--><li><a href="/core/services/open-access-publishing/open-research" target="">Open research</a></li><li><a href="/core/services/open-access-publishing/open-access-week" target="">Open Access Week</a></li><li><a href="/core/services/open-access-publishing/open-access" target="">What is open access?</a></li><li><a href="/core/services/open-access-publishing/open-access-glossary" target="">Open access glossary</a></li><li><a href="/core/services/open-access-publishing/open-access-myths" target="">Open access myths</a></li><li><a href="/core/services/open-access-publishing/hybrid-open-access-faqs" target="">Hybrid Open Access FAQs</a></li><li><a href="/core/eligibility-checker" target="">Eligibility checker</a></li><!--]--></ol><!--]--><!--[--><li>Open access resources</li><ol><!--[--><li><a href="/core/services/open-access-publishing/open-access-resources" target="">Open access resources</a></li><li><a href="/core/services/open-access-publishing/benefits-of-open-access" target="">Benefits of open access</a></li><li><a href="/core/services/open-access-publishing/creative-commons-licenses" target="">Creative commons licences</a></li><li><a href="/core/services/open-access-publishing/funder-policies-and-mandates" target="">Funder policies and mandates</a></li><li><a href="/core/services/open-access-publishing/article-type-definitions" target="">Article type definitions</a></li><li><a href="/core/services/open-access-publishing/convert-your-article-to-open-access" target="">Convert your article to Open Access</a></li><li><a href="/core/services/open-access-publishing/open-access-video-resources" target="">Open access video resources</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Open research initiatives</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Research transparency</li><ol><!--[--><li><a href="/core/services/open-research-initiatives/transparency-and-openness" target="">Transparency and openness</a></li><li><a href="/core/services/open-research-initiatives/open-practice-badges" target="">Open Practice Badges</a></li><li><a href="/core/services/open-research-initiatives/oa-organisations-initiatives-and-directories" target="">OA organisations, initiatives &amp; directories</a></li><li><a href="/core/services/open-research-initiatives/registered-reports" target="">Registered Reports</a></li><li><a href="/core/services/open-research-initiatives/annotation-for-transparent-inquiry-ati" target="">Annotation for Transparent Inquiry (ATI)</a></li><!--]--></ol><!--]--><!--[--><li>Journal flips</li><ol><!--[--><li><a href="/core/services/open-research-initiatives/open-access-journal-flips" target="">Open access journal flips</a></li><li><a href="/core/services/open-research-initiatives/oa-journal-flip-faqs" target="">OA Journal Flip FAQs</a></li><!--]--></ol><!--]--><!--[--><li>Flip it Open</li><ol><!--[--><li><a href="/core/services/open-research-initiatives/flip-it-open" target="">Flip it Open</a></li><li><a href="/core/services/open-research-initiatives/flip-it-open-faqs" target="">Flip it Open FAQs</a></li><!--]--></ol><!--]--><!--]--></ol><!--]--><!--[--><li>Open access funding</li><ol><!--[--><!--]--></ol><ol><!--[--><!--[--><li>Open access funding</li><ol><!--[--><li><a href="/core/services/open-access-funding/funding-open-access-publication" target="">Funding open access publication</a></li><li><a href="/core/services/open-access-funding/cambridge-open-equity-initiative" target="">Cambridge Open Equity 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<!----></a></li><li class="page-breadcrumbs__item" data-v-3692cf84><span aria-hidden="true" class="breadcrumbs-wrapper__arrow" data-v-3692cf84>&gt;</span><a href="/core/journals/antiquity/issue/239B1D4D343BD0DA9E8B18BC89888DA6" class="app-link app-link__text app-link--accent" data-v-63dfaf6e data-v-3692cf84><!----><span data-v-63dfaf6e>Volume 98 Issue 400</span> <!----></a></li><li class="page-breadcrumbs__item" data-v-3692cf84><span aria-hidden="true" class="breadcrumbs-wrapper__arrow" data-v-3692cf84>&gt;</span><span data-v-3692cf84>Intestinal parasite infection and sanitation in medieval...</span></li></ul></div></div> <div class="language" data-v-3692cf84><ul class="language-switch" data-v-6b1118dd data-v-3692cf84><li aria-label="English" data-v-6b1118dd><span class="language-option current divider" data-v-6b1118dd>English</span></li><li aria-label="Français" data-v-6b1118dd><span role="button" tabindex="0" href="#" lang="fr" class="language-option" data-v-6b1118dd> Français </span></li></ul></div></div></div></div> <div class="container container__modified" data-v-01274b1d><!----> <!----> <div class="row" data-v-01274b1d><div role="complementary" aria-label="table of content" class="column__left" data-v-01274b1d><div class="col journal-container row" data-v-146270e8 data-v-01274b1d><img src="https://static.cambridge.org/covers/AQY_0_0_0/antiquity.jpg" alt="" class="journal__image" data-v-146270e8> <a href="/core/journals/antiquity" class="app-link journal__title app-link__text app-link--underlined" data-v-63dfaf6e data-v-146270e8><!----><span class="text" data-v-63dfaf6e>Antiquity <!----></span> <!----></a> <hr aria-hidden="true" class="separator default" data-v-7036083a data-v-146270e8></div> <!----> <div id="toc" class="table-of-content" data-v-01274b1d><h2>Article contents</h2> <div id="toc-list-wrapper" class="table-of-content__wrapper"><ul id="toc-list" class="list"><li class="list__item"><a href="#sec0" class="list__item__link"><span class="toc-title">Abstract</span></a></li> <li class="list__item"><a href="#sec1" class="list__item__link"><!----> <span><div class="toc-title">Introduction</div></span></a></li><li class="list__item"><a href="#sec2" class="list__item__link"><!----> <span><div class="toc-title">Materials</div></span></a></li><li class="list__item"><a href="#sec3" class="list__item__link"><!----> <span><div class="toc-title">Methods</div></span></a></li><li class="list__item"><a href="#sec4" class="list__item__link"><!----> <span><div class="toc-title">Results</div></span></a></li><li class="list__item"><a href="#sec5" class="list__item__link"><!----> <span><div class="toc-title">Discussion</div></span></a></li><li class="list__item"><a href="#sec6" class="list__item__link"><!----> <span><div class="toc-title">Conclusion</div></span></a></li><li class="list__item"><a href="#sec-fs1" class="list__item__link"><!----> <span><div class="toc-title">Funding</div></span></a></li> <!----> <li class="list__item"><a href="#references-list" class="list__item__link"><span class="toc-title">References</span></a></li></ul></div></div></div> <div class="column__main" data-v-01274b1d><div class="row" data-v-01274b1d><div class="column__main__left" data-v-01274b1d><div id="maincontent" class="col" data-v-862424e6 data-v-01274b1d><!----> <hgroup data-v-862424e6><h1 data-v-862424e6>Intestinal parasite infection and sanitation in medieval Leiden, the Low Countries</h1> <!----></hgroup> <!----> <!----> <!----> <div class="row part-of" data-v-862424e6><span class="part-of__label" data-v-862424e6> Part of: </span> <a href="/core/product/identifier/AQY_MAPS_AND_THE_MEDIEVAL_LANDSCAPE/type/BESPOKE_COLLECTION" class="part-of__collection" data-v-f0b31360 data-v-862424e6> Medieval European Archaeology </a></div> <div class="row published-date" data-v-862424e6><p data-v-862424e6> Published online by Cambridge University Press:  <strong data-v-862424e6>31 May 2024</strong></p></div> <!----> <!----> <div class="contributors-details" data-v-99f6eb26 data-v-862424e6><div class="row contributors" data-v-99f6eb26><div class="col" data-v-99f6eb26><div class="row contributor-type" data-v-792406ce data-v-99f6eb26><!----> <div class="contributor-type__contributor" data-v-792406ce><a href="/core/search?filters%5BauthorTerms%5D=Sophie%20Rabinow&amp;eventCode=SE-AU" class="app-link app-link__text app-link--accent" data-v-63dfaf6e data-v-792406ce><!----><span data-v-63dfaf6e>Sophie Rabinow</span> <!----></a> <a target="_blank" href="https://orcid.org/0000-0002-7457-8994" data-test-orcid="Sophie Rabinow" class="app-link contributor-type__contributor__orcid app-link__icon app-link--" data-v-63dfaf6e data-v-792406ce><img src="data:image/svg+xml;base64,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" alt="Open the ORCID record for Sophie Rabinow" class="app-icon icon orcid" data-v-d2c09870 data-v-63dfaf6e><!----> <span class="sr-only" data-v-63dfaf6e>[Opens in a new window]</span></a> <span data-v-792406ce>,</span></div><div class="contributor-type__contributor" data-v-792406ce><a href="/core/search?filters%5BauthorTerms%5D=Tianyi%20Wang&amp;eventCode=SE-AU" class="app-link app-link__text app-link--accent" data-v-63dfaf6e data-v-792406ce><!----><span data-v-63dfaf6e>Tianyi Wang</span> <!----></a> <a target="_blank" href="https://orcid.org/0000-0002-0776-9387" data-test-orcid="Tianyi Wang" class="app-link contributor-type__contributor__orcid app-link__icon app-link--" data-v-63dfaf6e data-v-792406ce><img src="data:image/svg+xml;base64,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" alt="Open the ORCID record for Tianyi Wang" class="app-icon icon orcid" data-v-d2c09870 data-v-63dfaf6e><!----> <span class="sr-only" data-v-63dfaf6e>[Opens in a new window]</span></a> <span data-v-792406ce>,</span></div><div class="contributor-type__contributor" data-v-792406ce><a href="/core/search?filters%5BauthorTerms%5D=Roos%20van%20Oosten&amp;eventCode=SE-AU" class="app-link app-link__text app-link--accent" data-v-63dfaf6e data-v-792406ce><!----><span data-v-63dfaf6e>Roos van Oosten</span> <!----></a> <a target="_blank" href="https://orcid.org/0000-0002-4323-5120" data-test-orcid="Roos van Oosten" class="app-link contributor-type__contributor__orcid app-link__icon app-link--" data-v-63dfaf6e data-v-792406ce><img src="data:image/svg+xml;base64,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" alt="Open the ORCID record for Roos van Oosten" class="app-icon icon orcid" data-v-d2c09870 data-v-63dfaf6e><!----> <span class="sr-only" data-v-63dfaf6e>[Opens in a new window]</span></a> <span data-v-792406ce>,</span></div><div class="contributor-type__contributor" data-v-792406ce><a href="/core/search?filters%5BauthorTerms%5D=Yolande%20Meijer&amp;eventCode=SE-AU" class="app-link app-link__text app-link--accent" data-v-63dfaf6e data-v-792406ce><!----><span data-v-63dfaf6e>Yolande Meijer</span> <!----></a> <!----> <span data-v-792406ce>&nbsp;and</span></div><div class="contributor-type__contributor" data-v-792406ce><a href="/core/search?filters%5BauthorTerms%5D=Piers%20D.%20Mitchell&amp;eventCode=SE-AU" class="app-link app-link__text app-link--accent" data-v-63dfaf6e data-v-792406ce><!----><span data-v-63dfaf6e>Piers D. Mitchell</span> <!----></a> <a target="_blank" href="https://orcid.org/0000-0002-1009-697X" data-test-orcid="Piers D. Mitchell" class="app-link contributor-type__contributor__orcid app-link__icon app-link--" data-v-63dfaf6e data-v-792406ce><img src="data:image/svg+xml;base64,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" alt="Open the ORCID record for Piers D. Mitchell" class="app-icon icon orcid" data-v-d2c09870 data-v-63dfaf6e><!----> <span class="sr-only" data-v-63dfaf6e>[Opens in a new window]</span></a> <span data-v-792406ce></span></div> <!----></div> <!----></div> <div class="col-2 collapse-link" data-v-99f6eb26><a href="#authors-details" data-toggle="collapse" aria-expanded="false" aria-controls="authors-details" class="app-link collapsed app-link__text-icon app-link--secondary reverse" data-v-63dfaf6e data-v-99f6eb26><img src="data:image/svg+xml;base64,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" alt="" class="app-icon icon arrow-down" data-v-d2c09870 data-v-63dfaf6e><span class="text" data-v-63dfaf6e>Show author details <!----></span> <!----></a></div></div> <hr aria-hidden="true" class="separator default" data-v-7036083a data-v-99f6eb26> <dl id="authors-details" class="authors-details collapse" data-v-2edb8da6 data-v-99f6eb26><div data-test-author="Sophie Rabinow" class="row author" data-v-2edb8da6><dt class="col-12 col-sm-2 title" data-v-2edb8da6>Sophie Rabinow</dt> <dd class="col content d-inline d-sm-flex" data-v-2edb8da6><span class="content__title" data-v-2edb8da6>Affiliation:</span> <div class="d-sm-flex flex-column flex-sm-1 d-inline" data-v-2edb8da6><span data-v-2edb8da6><span data-v-2edb8da6>Department of Archaeology, University of Cambridge, UK</span> </span></div></dd></div><div data-test-author="Tianyi Wang" class="row author" data-v-2edb8da6><dt class="col-12 col-sm-2 title" data-v-2edb8da6>Tianyi Wang</dt> <dd class="col content d-inline d-sm-flex" data-v-2edb8da6><span class="content__title" data-v-2edb8da6>Affiliation:</span> <div class="d-sm-flex flex-column flex-sm-1 d-inline" data-v-2edb8da6><span data-v-2edb8da6><span data-v-2edb8da6>Department of Archaeology, University of Cambridge, UK</span> </span></div></dd></div><div data-test-author="Roos van Oosten" class="row author" data-v-2edb8da6><dt class="col-12 col-sm-2 title" data-v-2edb8da6>Roos van Oosten</dt> <dd class="col content d-inline d-sm-flex" data-v-2edb8da6><span class="content__title" data-v-2edb8da6>Affiliation:</span> <div class="d-sm-flex flex-column flex-sm-1 d-inline" data-v-2edb8da6><span data-v-2edb8da6><span data-v-2edb8da6>Faculty of Archaeology, Leiden University, The Netherlands</span> </span></div></dd></div><div data-test-author="Yolande Meijer" class="row author" data-v-2edb8da6><dt class="col-12 col-sm-2 title" data-v-2edb8da6>Yolande Meijer</dt> <dd class="col content d-inline d-sm-flex" data-v-2edb8da6><span class="content__title" data-v-2edb8da6>Affiliation:</span> <div class="d-sm-flex flex-column flex-sm-1 d-inline" data-v-2edb8da6><span data-v-2edb8da6><span data-v-2edb8da6>IDDS Archeologie, Noordwijk, The Netherlands</span> </span></div></dd></div><div data-test-author="Piers D. Mitchell" class="row author" data-v-2edb8da6><dt class="col-12 col-sm-2 title" data-v-2edb8da6>Piers D. Mitchell*</dt> <dd class="col content d-inline d-sm-flex" data-v-2edb8da6><span class="content__title" data-v-2edb8da6>Affiliation:</span> <div class="d-sm-flex flex-column flex-sm-1 d-inline" data-v-2edb8da6><span data-v-2edb8da6><span data-v-2edb8da6>Department of Archaeology, University of Cambridge, UK</span> </span></div></dd></div> <div class="row" data-v-2edb8da6><dt class="col-sm-2 col-12 title" data-v-2edb8da6> * </dt> <dd class="col content" data-v-2edb8da6><div class="row" data-v-2edb8da6><div class="d-sm-flex d-inline flex-sm-1 flex-sm-wrap" data-v-2edb8da6><div class="d-inline" data-v-2edb8da6><span data-v-2edb8da6><div class="corresp"><span class="label">*</span>Author for correspondence ✉ <a href="mailto:pdm39@cam.ac.uk">pdm39@cam.ac.uk</a></div></span></div></div></div></dd></div> <hr aria-hidden="true" class="separator default" data-v-7036083a data-v-2edb8da6></dl></div></div> <div id="app-tabs" class="tabs" data-v-1d90c6ce data-v-01274b1d><div id="app-tabs-wrapper" 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class="list__item__link"><!----> <span>Methods</span></a></li><li class="list__item"><a href="#sec4" class="list__item__link"><!----> <span>Results</span></a></li><li class="list__item"><a href="#sec5" class="list__item__link"><!----> <span>Discussion</span></a></li><li class="list__item"><a href="#sec6" class="list__item__link"><!----> <span>Conclusion</span></a></li><li class="list__item"><a href="#sec-fs1" class="list__item__link"><!----> <span>Funding</span></a></li> <!----> <li class="list__item"><a href="#references-list" class="list__item__link"><span class="toc-title">References</span></a></li></ul></div> <div class="action-bar" data-v-43a4d572><div class="row items"><!----> <div class="app-dropdown d-print-none" data-v-fab090b8 data-v-113567da data-v-43a4d572><button aria-expanded="false" data-test-id="buttonSavePDFOptions" id="save-pdf-dropdown" class="app-button dropdown-menu-button app-button__text-icon app-button--secondary" data-v-2a038744 data-v-fab090b8><img 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class="abstract-graphical__text"><div class="abstract" data-abstract-type="normal"><p>In the absence of written records, disease and parasite loads are often used as indicators of sanitation in past populations. Here, the authors adopt the novel approach of integrating the bioarchaeological analysis of cesspits in an area of medieval Leiden (the Netherlands) with historical property records to explore living conditions. Using light microscopy and enzyme-linked immunosorbent assays (ELISA) they identify evidence of parasites associated with ineffective sanitation (whipworm, roundworm and the protozoan <span class='italic'>Giardia duodenalis</span>)—at residences of all social levels—and the consumption of infected livestock and freshwater fish (Diphyllobothriidae, cf. <span class='italic'>Echinostoma</span> sp., cf. <span class='italic'>Fasciola hepatica</span> and <span class='italic'>Dicrocoelium</span> sp.).</p></div></div> <hr aria-hidden="true" class="separator default" data-v-7036083a></div> <!----></div> <!----> <div class="keywords" data-v-86c27100 data-v-43a4d572><h2 data-v-86c27100>Keywords</h2> <div class="row keywords__pills" data-v-86c27100><a href="/core/search?filters[keywords]=Netherlands" data-v-f0b31360 data-v-86c27100><span data-v-f0b31360 data-v-86c27100>Netherlands</span></a><a href="/core/search?filters[keywords]=medieval" data-v-f0b31360 data-v-86c27100><span data-v-f0b31360 data-v-86c27100>medieval</span></a><a href="/core/search?filters[keywords]=palaeoparasitology" data-v-f0b31360 data-v-86c27100><span data-v-f0b31360 data-v-86c27100>palaeoparasitology</span></a><a href="/core/search?filters[keywords]=ELISA" data-v-f0b31360 data-v-86c27100><span data-v-f0b31360 data-v-86c27100>ELISA</span></a><a href="/core/search?filters[keywords]=cesspits" data-v-f0b31360 data-v-86c27100><span data-v-f0b31360 data-v-86c27100>cesspits</span></a><a href="/core/search?filters[keywords]=diarrhoea" data-v-f0b31360 data-v-86c27100><span data-v-f0b31360 data-v-86c27100>diarrhoea</span></a><a href="/core/search?filters[keywords]=Echinostoma" data-v-f0b31360 data-v-86c27100><span data-v-f0b31360 data-v-86c27100>Echinostoma</span></a><a href="/core/search?filters[keywords]=fish tapeworm" data-v-f0b31360 data-v-86c27100><span data-v-f0b31360 data-v-86c27100>fish tapeworm</span></a></div> <hr aria-hidden="true" class="separator default" data-v-7036083a data-v-86c27100></div> <!----> <dl class="article-details" data-v-6e32a161 data-v-43a4d572><div class="row" data-v-6e32a161><dt class="col-12 col-sm-3 col-md-2_5 title" data-v-6e32a161> Type </dt> <dd class="col content" data-v-6e32a161>Research Article</dd></div> <div class="row" data-v-6e32a161><dt class="col-12 col-sm-3 col-md-2_5 title" data-v-6e32a161> Information </dt> <dd class="col content" data-v-6e32a161><div class="content__journal" data-v-6e32a161><a href="/core/journals/antiquity" class="app-link app-link__text app-link--underlined" data-v-63dfaf6e data-v-6e32a161><!----><span class="text" data-v-63dfaf6e>Antiquity <!----></span> <!----></a> <span data-v-6e32a161> , <a href="/core/journals/antiquity/volume/87C69FC9A297320915DFC82CFAE65D83" class="app-link app-link__text app-link--underlined" data-v-63dfaf6e data-v-6e32a161><!----><span class="text" data-v-63dfaf6e>Volume 98 <!----></span> <!----></a></span> <span data-v-6e32a161> , <a href="/core/journals/antiquity/issue/239B1D4D343BD0DA9E8B18BC89888DA6" class="app-link app-link__text app-link--underlined" data-v-63dfaf6e data-v-6e32a161><!----><span class="text" data-v-63dfaf6e>Issue 400 <!----></span> <!----></a></span> <span data-v-6e32a161>, August 2024</span> <!----> <span data-v-6e32a161>, pp. 1006 - 1022</span> <!----></div> <div class="doi-data" data-v-6e32a161><div data-v-6e32a161>DOI: <a target="_blank" href="https://doi.org/10.15184/aqy.2024.72" class="app-link app-link__text app-link--accent" data-v-63dfaf6e data-v-6e32a161><!----><span class="text" data-v-63dfaf6e>https://doi.org/10.15184/aqy.2024.72 <!----></span> <span class="sr-only" data-v-63dfaf6e>[Opens in a new window]</span></a></div> <!----></div> <!----> <!----></dd></div> <div class="row creative-commons" data-v-6e32a161><dt class="col-12 col-sm-3 col-md-2_5 creative-commons__title"> Creative Commons </dt> <dd class="col"><div class="creative-commons__content"><div class="creative-commons__icons"><img src="/core/page-component/img/license-cc-icon.e3a74ed.svg" alt="Creative Common License - CC" class="app-icon creative-commons__icon license-cc" data-v-d2c09870><img src="/core/page-component/img/license-by-icon.33e212c.svg" alt="Creative Common License - BY" class="app-icon creative-commons__icon license-by" data-v-d2c09870></div> <div class="creative-commons__description">This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (<a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a>), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.</div></div></dd></div> <!----> <div class="row" data-v-6e32a161><dt class="col-12 col-sm-3 col-md-2_5 title" data-v-6e32a161> Copyright </dt> <dd class="col content" data-v-6e32a161><div data-v-6e32a161> Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Antiquity Publications Ltd </div></dd></div></dl> <!----> <div id="content-container" class="content-container" data-v-43a4d572><div class="content-box"><div class="article research-article NLM"> <div class="body"> <p class="p"> </p><section><div class="fig"><div class="figure-thumb"><img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_figU1.png?pub-status=live" class="aop-lazy-load-image" width="768" height="768" data-original-image="/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_figU1.png" data-zoomable="true"></div></div></section> <div class="sec intro" data-magellan-destination="sec1" id="sec1"><h2 class="A"> Introduction</h2> <p class="p"> In the Low Countries, many artefacts are recovered from cesspits (Hupperetz <a class="xref bibr" href="#ref17"><span class="show-for-sr">Reference Hupperetz, De Groote, Tys and Pieters</span>2010</a>: 279; van Oosten <a class="xref bibr" href="#ref39"><span class="show-for-sr">Reference van Oosten, Sosna and Brunclíková</span>2016a</a>: 41, 49), but the archaeological value of the material (the cess) that these pits contain is often underestimated. This article examines material from six medieval cesspits in a Low Countries town, integrating analysis of organic remains with textual records relating to town regulations and to the households within which the cesspits were located. Leiden was selected due to its promising archaeological record and the survival of documents detailing medieval street plans and inhabitants.</p> <p class="p"> Eggs from a broad range of endoparasites have been identified in soil samples from cesspits in other regions of the Low Countries (Rocha <em class="italic">et al</em>. <a class="xref bibr" href="#ref28"><span class="show-for-sr">Reference Rocha, Harter-Lailheugue, Le Bailly, Araújo, Ferreira, Serra-Freire and Bouchet</span>2006</a>; Appelt <em class="italic">et al</em>. <a class="xref bibr" href="#ref2"><span class="show-for-sr">Reference Appelt, Armougom, Le Bailly, Robert and Drancourt</span>2014</a>; Deforce <em class="italic">et al</em>. <a class="xref bibr" href="#ref12"><span class="show-for-sr">Reference Deforce, Van Hove and Willems</span>2015</a>; Rácz <em class="italic">et al</em>. <a class="xref bibr" href="#ref27"><span class="show-for-sr">Reference Rácz</span>2015</a>; Graff <em class="italic">et al</em>. <a class="xref bibr" href="#ref15"><span class="show-for-sr">Reference Graff</span>2020</a>; De Cupere <em class="italic">et al</em>. <a class="xref bibr" href="#ref11"><span class="show-for-sr">Reference De Cupere</span>2021</a>; Rabinow <em class="italic">et al</em>. <a class="xref bibr" href="#ref26"><span class="show-for-sr">Reference Rabinow, Deforce and Mitchell</span>2023</a>). The presence of these eggs—and the attendant infection by genera or species of parasites that may be identified—can help us to create a picture of parasitic infection and its interplay with social practices such as diet and sanitation in past populations (Mitchell <a class="xref bibr" href="#ref21"><span class="show-for-sr">Reference Mitchell</span>2015a</a>, <a class="xref bibr" href="#ref23"><span class="show-for-sr">Reference Mitchell</span>2023</a>). The nematodes <em class="italic">Ascaris</em> (roundworm) and <em class="italic">Trichuris</em> (whipworm), for example, can trigger such symptoms as abdominal cramps, diarrhoea, anorexia, nausea and vomiting (Stephenson <em class="italic">et al</em>. <a class="xref bibr" href="#ref31"><span class="show-for-sr">Reference Stephenson, Latham and Ottensen</span>2000</a>). Certain species of protozoa, including <em class="italic">Entamoeba histolytica</em>, <em class="italic">Giardia</em> sp. and <em class="italic">Cryptosporidium</em> sp., can also cause diarrhoea and dysentery. <em class="italic">Ascaris, Trichuris</em> and these protozoa are therefore generally considered to be indicators of sanitation conditions. Species of the genera <em class="italic">Taenia</em> (pork and beef tapeworm), <em class="italic">Echinostoma</em> (intestinal flukes) and <em class="italic">Dibothriocephalus</em> (fish tapeworm) are zoonotic parasites, which can be transferred from non-human animals to humans by eating raw or undercooked meat and fish (Ledger &amp; Mitchell <a class="xref bibr" href="#ref20"><span class="show-for-sr">Reference Ledger and Mitchell</span>2022</a>). By assessing cesspit contents and determining the types of parasites present in the medieval population of Leiden, we can improve our understanding of the health and lifestyle of the city's inhabitants. We can also address the question of whether households with indicators of more costly or poorer diet (potentially indicators of income or status) were infected by the same parasites, or if differences in infection might exist between these two groups.</p> <div class="sec" data-magellan-destination="sec1-1" id="sec1-1"><h3 class="B"> Leiden</h3> <p class="p"> The town of Leiden (<a class="xref fig" href="#fig01">Figure 1</a>), known primarily for its textile industry, was home to approximately 13 000 inhabitants at around AD 1500 (Brand <a class="xref bibr" href="#ref5"><span class="show-for-sr">Reference Brand</span>2008</a>: 96; van Steensel <a class="xref bibr" href="#ref42"><span class="show-for-sr">Reference Van Steensel and Nigro</span>2020</a>: 372), making it one of the larger urban centres of the Northern Netherlands at this time (van Oosten <a class="xref bibr" href="#ref38"><span class="show-for-sr">Reference van Oosten</span>2015</a>: 28). In the later Middle Ages (up to AD 1500), textile production was already significantly higher than in other Dutch cities (Posthumus <a class="xref bibr" href="#ref25"><span class="show-for-sr">Reference Posthumus</span>1908</a>: 368–9) and by the seventeenth century Leiden became known as the largest textile producer in Europe (de Vries <em class="italic">et al</em>. <a class="xref bibr" href="#ref13"><span class="show-for-sr">Reference De Vries, Lucassen, Lourens, Nijboer and Groenveld</span>2003</a>: 88). From the last quarter of the sixteenth century, Leiden grew at a rapid pace and the city welcomed thousands of religious refugees, mostly textile workers from what is now Belgium. A significant increase in the number and sizes of houses in the city and an expansion in its territory is therefore seen in the seventeenth century. During the early modern period (<em class="italic">c</em>. AD 1500–1800) for which significantly more detailed written records are available than for the Middle Ages, it has been estimated that two-thirds of the population was involved in the textile industry (de Vries <em class="italic">et al</em>. <a class="xref bibr" href="#ref13"><span class="show-for-sr">Reference De Vries, Lucassen, Lourens, Nijboer and Groenveld</span>2003</a>: 88). </p><section><div class="fig fig" data-magellan-destination="fig01" id="fig01"><div class="figure-thumb"><img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig1.png?pub-status=live" class="aop-lazy-load-image" width="1583" height="638" data-original-image="/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig1.png" data-zoomable="true"></div><div class="caption"><p class="p"> </p><p class="p"><span class="label">Figure 1.</span> a) location of Leiden within the Netherlands; b) a site plan of locations of pits excavated (figure by authors).</p></div></div></section> </div> </div> <div class="sec materials" data-magellan-destination="sec2" id="sec2"><h2 class="A"> Materials</h2> <p class="p"> In 2019 an area in Leiden demarked by the present-day Haarlemmerstraat to the north and the Stille Rijn to the south was excavated (administratively known as Haarlemmerstraat 101–111/Stille Rijn 8–9). The Rhine, running on the other side of the Stille Rijn, was an important transport route in the Middle Ages and the Haarlemmerstraat, then called Marendorp, was a key street connecting the Zijlpoort in the east of the city to the Rijnsburgerpoort in the west.</p> <p class="p"> Thanks to the ongoing project <em class="italic">Historisch Leiden in Kaart</em> (Mapping Historical Leiden), which provides access to historical data via a website, it is possible to look up the owners of properties that stood on the excavated site during the period <em class="italic">c</em>. 1550–1606. Map 28 from the so-called <em class="italic">Stratenboek</em> (Book of streets) (<a class="xref fig" href="#fig02">Figure 2</a>) presents a good starting point, as it shows that in 1591 the excavated area was occupied by one large square ‘plot’ and two smaller ones. The purpose of this map was not, however, to accurately depict the contours of each plot but to record façade width, presumably to determine a proportional cost for street maintenance paid by the owners (de Baar <a class="xref bibr" href="#ref10"><span class="show-for-sr">Reference de Baar</span>1985</a>). As a result, adjacent plots owned by the same individual were schematically drawn as one ‘plot’. <a class="xref fig" href="#fig02">Figure 2</a> shows the number of houses occupying the block for three sample years (1561, 1581 and 1606). While in 1561 the block consisted of only five properties (two of which were rented), this had increased to seven in 1581 and to 26 (including 12 rentals) in 1606. This increase in property numbers, and particularly in the number of rental properties, is a development that is also observed elsewhere in Leiden as population density increases significantly in the last quarter of the sixteenth century (van Oosten <a class="xref bibr" href="#ref40"><span class="show-for-sr">Reference van Oosten</span>2016b</a>: 715, fig. 8). </p><section><div class="fig fig" data-magellan-destination="fig02" id="fig02"><div class="figure-thumb"><img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig2.png?pub-status=live" class="aop-lazy-load-image" width="1583" height="1269" data-original-image="/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig2.png" data-zoomable="true"></div><div class="caption"><p class="p"> </p><p class="p"><span class="label">Figure 2.</span> Detail from <em class="italic">Stratenboek</em> (Book of streets) 28 ‘Kaart van Marendorp van de Vrouwenkerk tot de Marebrug’ dd. 1591 (Erfgoed Leiden en Omstreken, 501A, inv. nr. 5153 Stratenboek 28, available at: <a class="uri" href="https://www.erfgoedleiden.nl/collecties/archieven/archievenoverzicht/details/NL-LdnRAL-0501A/path/1.2.2.8.1.6.5.1/deep:view/scans/deep:highlight/8/deep:start/50/deep:limit/10">https://www.erfgoedleiden.nl/collecties/archieven/archievenoverzicht/details/NL-LdnRAL-0501A/path/1.2.2.8.1.6.5.1/deep:view/scans/deep:highlight/8/deep:start/50/deep:limit/10</a>). The occupations of the main occupants (not the owners) of the houses are indicated with dots in the years 1561, 1581 and 1606. The numbers correspond with Mapping Historical Leiden (<a class="uri" href="https://www.historischleideninkaart.nl">www.historischleideninkaart.nl</a>) and can be looked up via Looproutes, 1561 Tiende Penning (Tenth Penny), 1581 Volkstelling (Census) and 1606 Schoorsteengeld (Hearth tax) and then by selecting the ward Overmare Rijnzijde (RvO) (figure by authors).</p></div></div></section> <p class="p"> There is a remarkable difference in social status between the residents of this block. Most were middle-class or poor residents: they rented instead of owning (hence their occupations were not recorded), the size of each plot was small and the tax they paid was low. In contrast, the largest plot was occupied from at least 1498 until <em class="italic">c.</em> 1605 by the brewery and home of a family of wealthy brewers who paid high taxes. While the business was located on the Stille Rijn side of the block, as map 2 of the <em class="italic">Grachtenboek</em> (Book of Canals) (Erfgoed Leiden en Omstreken, 0501A, inventory number 5113) shows, the home of the brewer was located on the Haarlemmerstraat. When the 1591 map was made (<a class="xref fig" href="#fig02">Figure 2</a>), brewer Cornelis Adriaensz van Barrevelt owned the plot. He had been the owner since 1558. A few years earlier, in 1543, his father Adriaen Jans van Barrevelt (also a brewer) was the owner and it is very likely that as early as 1498 this site was already a brewery (van Steensel <a class="xref bibr" href="#ref41"><span class="show-for-sr">Reference Van Steensel</span>2016</a>).</p> <p class="p"> Leiden had at least 22 brewers in 1498 (van Steensel <a class="xref bibr" href="#ref41"><span class="show-for-sr">Reference Van Steensel</span>2016</a>) and 15 brewers in 1607 (Walle &amp; Hooymans <a class="xref bibr" href="#ref43"><span class="show-for-sr">Reference Walle and Hooymans</span>2021</a>). Brewers in the mid-sixteenth century belonged to the financial elite (Noordam <a class="xref bibr" href="#ref24"><span class="show-for-sr">Reference Noordam</span>2001</a>: 31). That their wealth was visibly greater than that of other residents can be illustrated by the size of the area occupied by breweries. The plot of Cornelis Adriaensz is five to six times wider than the average plot within the city. A further illustration of their prominent role in society is that quite a few brewers had seats on the city council. Cornelis Adriaensz served on the town council for 30 years, following in the footsteps of his father who served for 23 years.</p> <p class="p"> A total of 14 features within the excavated area were interpreted as potential cesspits (<a class="xref fig" href="#fig03">Figure 3</a>, <a class="xref table" href="#tab01">Table 1</a>). One or more sediment samples of at least 1 litre were taken from each pit, and where more than one sample was available from the same cesspit, these were taken from different sediment layers. The samples were assessed using the quickscan approach for the presence of botanical macro remains (van Haaster <a class="xref bibr" href="#ref37"><span class="show-for-sr">Reference Van Haaster and Meijer</span>2020</a>). Based on this assessment, six of the pits were regarded as cesspits used for human faecal waste and submitted for further analysis for organic macro remains (van Amerongen <a class="xref bibr" href="#ref34"><span class="show-for-sr">Reference Van Amerongen and Meijer</span>2022</a>) and intestinal parasites. Analysing samples for parasite eggs also allowed us to double check whether the quick-scan approach was a reliable method for identifying cesspits. Two of the features disregarded based on the quick-scan results were tested for parasite eggs and both were found to be negative (marked in green on <a class="xref fig" href="#fig01">Figure 1b</a>), supporting the original interpretation. Feature S724 did contain three parasite eggs (two whipworm and one trematode) but the paucity of parasite eggs compared with other samples (which contained in excess of a thousand times more eggs) suggests that these may represent contamination, perhaps having been washed in by flooding in the past. It cannot, however, be excluded that the feature was originally a cesspit that was subsequently emptied and filled with other material. </p><section><div class="fig fig" data-magellan-destination="fig03" id="fig03"><div class="figure-thumb"><img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig3.png?pub-status=live" class="aop-lazy-load-image" width="1583" height="1056" data-original-image="/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig3.png" data-zoomable="true"></div><div class="caption"><p class="p"> </p><p class="p"><span class="label">Figure 3.</span> a) cesspit S859 during excavation, showing round brick lining; b) its cross-section (cesspit use dates from 1475–1525) (figure by authors).</p></div></div></section> <div class="table-wrap" data-magellan-destination="tab01" id="tab01"><div class="caption"><p class="p"><span class="label">Table 1.</span> Details of the cesspits analysed in this study.</p></div> <span> <div class="figure-thumb"><img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab1.png?pub-status=live" class="aop-lazy-load-image" width="708" height="319" data-original-image="/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab1.png" data-zoomable="true"></div> </span> </div> </div> <div class="sec methods" data-magellan-destination="sec3" id="sec3"><h2 class="A"> Methods</h2> <div class="sec" data-magellan-destination="sec3-1" id="sec3-1"><h3 class="B"> Microscopy for intestinal parasite eggs</h3> <p class="p"> Fourteen sediment samples from the six cesspits dating from AD 1250–1600 underwent analysis for intestinal parasites. They were dated from pottery fragments recovered from the cesspit fill, and the type and size of the bricks used to construct the cesspits. Analysis was performed at the Ancient Parasites Laboratory at the University of Cambridge, following the modified RHM (rehydration, homogenization, micro-sieving) protocol described by Anastasiou and Mitchell (<a class="xref bibr" href="#ref1"><span class="show-for-sr">Reference Anastasiou and Mitchell</span>2013</a>). A 0.2g subsample was measured and disaggregated (placed into suspension) using 0.5% trisodium phosphate. The suspension was washed through three microsieves (mesh sizes 300, 160 and 20μm). The material trapped on the 20μm micro-sieve was rinsed free with distilled water, collected in a 15mL tube, centrifuged for five minutes at 4000rpm, and the supernatant removed. The concentrated material at the base of the tube was mixed with glycerol, mounted on microscope slides and analysed with digital light microscopy at 400× magnification (Olympus BX40F microscope with GXCAM-9 digital camera). The eggs of intestinal parasitic worms were identified by their shape, colour, dimensions and special characteristics using reference manuals such as Garcia (<a class="xref bibr" href="#ref14"><span class="show-for-sr">Reference Garcia</span>2016</a>). Egg dimensions were measured using the GX Capture-T software. Egg counts per gram were calculated by multiplying the number of eggs noted in each 0.2g sample by five.</p> </div> <div class="sec" data-magellan-destination="sec3-2" id="sec3-2"><h3 class="B"> ELISA for intestinal protozoa</h3> <p class="p"> Enzyme-linked immunosorbent assay (ELISA) kits, <em class="italic">Entamoeba histolytica</em> II<sup class="sup">TM</sup>, <em class="italic">Giardia</em> II<sup class="sup">TM</sup> and <em class="italic">Cryptosporidium</em> II<sup class="sup">TM</sup>, produced by TECHLAB® (Blacksburg, Virginia, USA), were used to analyse five of the samples for three species of protozoan parasites which can cause diarrhoea and dysentery. We did not test all 14 samples for reasons of cost, but the samples chosen covered the full time depth while focusing on those samples with good parasite egg survival. A 1g subsample was measured and disaggregated (placed into suspension) using 0.5% trisodium phosphate and passed through the sieves. The material from the catchment container measuring less than 20μm was collected, as the cysts and oocysts of protozoa that cause diarrhoea and dysentery in humans typically measure 5–19μm in diameter. The fluid was centrifuged to concentrate it to the volume required for the ELISA analysis. Eight wells were tested for each sample. Each ELISA analysis was repeated one month after the first run using a new sample prepared using the same method, and results were only considered positive if both tests were positive. Following manufacturer instructions, a positive and negative control were included in each plate. The absorbance values for each well were generated using an ELISA plate reader (BioTek Synergy HT). Past research has indicated these test kits have 97–100% sensitivity and specificity in modern samples (Boone <em class="italic">et al</em>. <a class="xref bibr" href="#ref4"><span class="show-for-sr">Reference Boone, Wilkins, Nash, Brandon, Macias, Jerris and Lyerly</span>1999</a>; Silva <em class="italic">et al</em>. <a class="xref bibr" href="#ref30"><span class="show-for-sr">Reference Silva</span>2016</a>).</p> </div> </div> <div class="sec results" data-magellan-destination="sec4" id="sec4"><h2 class="A"> Results</h2> <p class="p"> All 14 samples from the six cesspits analysed contained intestinal parasite eggs (<a class="xref table" href="#tab02">Table 2</a>). We identified six species of helminth parasite in total: whipworm (<em class="italic">Trichuris</em> sp.), roundworm (<em class="italic">Ascaris</em> sp.), fish tapeworm (Diphyllobothriidae), <em class="italic">Dicrocoelium</em> sp., cf. <em class="italic">Echinostoma</em> sp. fluke and cf. <em class="italic">Fasciola hepatica</em> fluke (<a class="xref fig" href="#fig04">Figure 4</a>). </p><div class="table-wrap" data-magellan-destination="tab02" id="tab02"><div class="caption"><p class="p"><span class="label">Table 2.</span> Digital-light microscopy and ELISA results. ‘Trematode’ indicates eggs whose measurements fit both with <em class="italic">Echinostoma</em> sp. and <em class="italic">Fasciola</em> sp. Egg counts represent an estimate of number of eggs per gram (raw counts for 0.2g multiplied by 5). ELISA results are not quantified, positive samples are shown with ‘+ve’, negative samples are shown with ‘-ve’.</p></div> <span> <div class="figure-thumb"><img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab2.png?pub-status=live" class="aop-lazy-load-image" width="1049" height="395" data-original-image="/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab2.png" data-zoomable="true"></div> </span> </div> <section><div class="fig fig" data-magellan-destination="fig04" id="fig04"><div class="figure-thumb"><img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig4.png?pub-status=live" class="aop-lazy-load-image" width="2362" height="1550" data-original-image="/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig4.png" data-zoomable="true"></div><div class="caption"><p class="p"> </p><p class="p"><span class="label">Figure 4.</span> Parasite eggs from the Leiden cesspits. Top left: cf. <em class="italic">Echinostoma</em> sp. (dimensions 119 × 72μm); top centre: Diphyllobothriidae (52 × 36μm); top right: cf. <em class="italic">Dicrocoelium</em> sp. (36 × 22μm); bottom left: roundworm (78 × 48μm); bottom centre: whipworm (53 × 26μm); bottom right: cf. <em class="italic">Fasciola hepatica</em> (141 × 73μm) (figure by authors).</p></div></div></section> <p class="p"> The dominant parasites were whipworm and roundworm, which were found in all samples (<a class="xref table" href="#tab02">Table 2</a>). Whipworm was identified by its lemon shape, polar plugs, smooth wall, and dimensions, while roundworm was identified by its mamillated coat, oval shape, brown colour and dimensions. The eggs of trematodes from the genera <em class="italic">Echinostoma</em> and <em class="italic">Fasciola</em> are morphologically similar and overlap in size: the size range for <em class="italic">Echinostoma</em> eggs (80–135μm long by 55–80μm wide (Centers for Disease Control and Prevention <a class="xref bibr" href="#ref8">2019a</a>) is only slightly lower than for <em class="italic">Fasciola</em> (130–150μm long by 60–90μm wide (Centers for Disease Control and Prevention <a class="xref bibr" href="#ref9">2019b</a>), although Valero and colleagues (<a class="xref bibr" href="#ref32"><span class="show-for-sr">Reference Valero, Panova, Comes, Fons and Mas-Coma</span>2002</a>) report <em class="italic">Fasciola</em> eggs as short as 125μm in modern cattle). Significantly however, the literature reports different size ranges for trematode eggs (for example, compare the ranges described in Ash and Orihel (<a class="xref bibr" href="#ref3"><span class="show-for-sr">Reference Ash and Orihel</span>2015</a>: 177) with those in Garcia (<a class="xref bibr" href="#ref14"><span class="show-for-sr">Reference Garcia</span>2016</a>)); egg sizes were also noted to vary regionally and by host (Valero <em class="italic">et al</em>. <a class="xref bibr" href="#ref33"><span class="show-for-sr">Reference Valero, Perez-Crespo, Periago, Khoubbane and Mas-Coma</span>2009</a>). Here we rely on the egg size ranges provided by the Centers for Disease Control and Prevention (CDC) because these references are easily accessible (<a class="uri" href="https://www.cdc.gov/">https://www.cdc.gov/</a>) for no charge and are commonly employed in the palaeoparasitological literature. The eggs of the fish tapeworm (Diphyllobothriidae) cestodes are oval and range between 55–75μm long and 40–50μm wide, although Leštinová and colleagues (<a class="xref bibr" href="#ref19"><span class="show-for-sr">Reference Leštinová, Soldánova, Scholz and Kuchta</span>2016</a>) report eggs of <em class="italic">Dibothriocephalus latus</em> as long as 59–81μm in modern human populations in Italy. <em class="italic">Dicrocoelium</em> was identified by its dimensions (typically 35–45μm long and 20–30μm wide), operculum, wall thickness and shape, often with one side flatter and the other more curved.</p> <p class="p"> ELISA analysis was positive in two cesspits (S728, dated 1375–1500, and S703, dated 1375–1550) for the protozoan <em class="italic">Giardia duodenalis</em>, which causes severe watery diarrhoea (<a class="xref table" href="#tab03">Table 3</a>). All ELISA tests were negative for <em class="italic">Entamoeba histolytica</em> and <em class="italic">Cryptosporidium parvum</em>. </p><div class="table-wrap" data-magellan-destination="tab03" id="tab03"><div class="caption"><p class="p"><span class="label">Table 3.</span> Raw data for the samples positive for <em class="italic">Giardia duodenalis</em> on ELISA analysis. Manufacturer guidance for the ELISA test kits state that a result with absorbance value greater than 0.150 is positive.</p></div> <span> <div class="figure-thumb"><img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab3.png?pub-status=live" class="aop-lazy-load-image" width="708" height="414" data-original-image="/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab3.png" data-zoomable="true"></div> </span> </div> </div> <div class="sec discussion" data-magellan-destination="sec5" id="sec5"><h2 class="A"> Discussion</h2> <p class="p"> The taxonomic diversity of parasites and the dominance of roundworm and whipworm are consistent with previous findings from the Low Countries (Rocha <em class="italic">et al</em>. <a class="xref bibr" href="#ref28"><span class="show-for-sr">Reference Rocha, Harter-Lailheugue, Le Bailly, Araújo, Ferreira, Serra-Freire and Bouchet</span>2006</a>; Appelt <em class="italic">et al</em>. <a class="xref bibr" href="#ref2"><span class="show-for-sr">Reference Appelt, Armougom, Le Bailly, Robert and Drancourt</span>2014</a>; Deforce <em class="italic">et al</em>. <a class="xref bibr" href="#ref12"><span class="show-for-sr">Reference Deforce, Van Hove and Willems</span>2015</a>; Rácz <em class="italic">et al</em>. <a class="xref bibr" href="#ref27"><span class="show-for-sr">Reference Rácz</span>2015</a>; Graff <em class="italic">et al</em>. <a class="xref bibr" href="#ref15"><span class="show-for-sr">Reference Graff</span>2020</a>; De Cupere <em class="italic">et al</em>. <a class="xref bibr" href="#ref11"><span class="show-for-sr">Reference De Cupere</span>2021</a>; Rabinow <em class="italic">et al</em>. <a class="xref bibr" href="#ref26"><span class="show-for-sr">Reference Rabinow, Deforce and Mitchell</span>2023</a>). Roundworm, whipworm and the protozoan <em class="italic">Giardia duodenalis</em> are all spread via the faecal-oral route of parasite transmission. Their presence within cesspits indicates that the level of sanitation in medieval Leiden was insufficient to prevent the contamination of food and drink with faeces and the reinfection of the population with these parasites.</p> <p class="p"> Parasites spread by the consumption of raw freshwater fish or other freshwater foods (cf. <em class="italic">Echinostoma</em> and Diphyllobothriidae) were also present in some cesspits. Both these helminths can infect humans through the consumption of raw, undercooked, smoked or pickled freshwater fish; <em class="italic">Echinostoma</em> can also infect freshwater shellfish and waterfowl and may be passed to humans if consumed (Huffman &amp; Fried <a class="xref bibr" href="#ref16"><span class="show-for-sr">Reference Huffman and Fried</span>1990</a>; Garcia <a class="xref bibr" href="#ref14"><span class="show-for-sr">Reference Garcia</span>2016</a>). We should bear in mind the possibility that <em class="italic">Echinostoma</em> eggs might theoretically be found in cesspit sediments in the absence of human infection, for example if infected rodents accessed the cesspits, or if the offal discarded from infected waterfowl was tossed into the cesspit. While mussel shells were found discarded in two of the cesspits, these were of marine species and not freshwater species, so could not have spread <em class="italic">Echinostoma</em>. Similarly, low numbers of <em class="italic">Dicrocoelium</em> and <em class="italic">Fasciola hepatica</em> eggs in human faeces are unlikely to indicate true human infection. These parasites generally infect the liver of ruminant animals such as sheep and cattle. If humans then eat raw or undercooked animal liver, the eggs can pass through the digestive system largely unaltered. Use of cesspits for the disposal of animal manure could also explain the presence of these parasite eggs.</p> <p class="p"> Whipworm and roundworm eggs were consistently found in all six cesspits in high counts relative to the zoonotic parasites present, as is common in palaeoparasitological studies of medieval populations (Mitchell <a class="xref bibr" href="#ref22"><span class="show-for-sr">Reference Mitchell</span>2015b</a>). Zoonotic parasites are often present in much lower counts (Graff <em class="italic">et al</em>. <a class="xref bibr" href="#ref15"><span class="show-for-sr">Reference Graff</span>2020</a>; Rabinow <em class="italic">et al</em>. <a class="xref bibr" href="#ref26"><span class="show-for-sr">Reference Rabinow, Deforce and Mitchell</span>2023</a>). In our study area, zoonotic parasites were not found in every sample, or even in every latrine. This suggests parasites contracted by eating meat or seafood caused considerably fewer infections among the population of Leiden than did parasites caused by poor sanitation. We have chosen not to statistically interrogate differences in the egg counts for whipworm and roundworm in the different cesspits, as such differences could be caused by taphonomic and depositional factors irrelevant to infection burdens, for example the number of eggs produced (which varies by individual worm), the number of people using the cesspits, and the degree to which the eggs may have been diluted with non-faecal refuse.</p> <p class="p"> Modern clinical understanding of the health consequences of parasitic infections suggests that <em class="italic">Giardia duodenalis</em> would have had the greatest impact upon the population of medieval Leiden. This protozoan can cause outbreaks of severe diarrhoea, which can lead to dehydration and death, especially in children (Ryan <em class="italic">et al</em>. <a class="xref bibr" href="#ref29"><span class="show-for-sr">Reference Ryan, Hijjawi, Feng and Xiao</span>2019</a>). The cesspits positive for <em class="italic">Giardia duodenalis</em> date from 1375–1500/1550. From just two samples it is hard to tell if this was by chance or if it might indicate that diarrhoea was more of a public health problem around the 1400s compared with earlier or later centuries. Roundworm and whipworm infection may cause malnutrition, stunted growth and reduced intelligence in children when significant numbers of worms are present (Brooker <a class="xref bibr" href="#ref7"><span class="show-for-sr">Reference Brooker</span>2010</a>). In adults with a healthy diet, roundworm and whipworm in low numbers may be tolerated without significant symptoms.</p> <p class="p"> Given the similarity in dating and location, it seems possible that cesspit S467 was used by the household of the brewer Cornelis Adriaensz van Barrevelt. The cesspit contained crab or lobster (<a class="xref table" href="#tab04">Table 4</a>), a typical high-status food (Brinkhuizen <em class="italic">et al</em>. <a class="xref bibr" href="#ref6"><span class="show-for-sr">Reference Brinkhuizen, Cooremans, Ervynck, Stoops and Van Neer</span>2018</a>), similar to the abundance illustrated in many late sixteenth- and seventeenth-century still-life paintings (Kwak <a class="xref bibr" href="#ref18"><span class="show-for-sr">Reference Kwak</span>2014</a>). Cesspit S859 is located closer to the Stille Rijn, directly next to a fire pit and therefore probably belonged to the business premises. This cesspit fell into disuse in 1525–1550, long before Cornelis Adriaensz Barrevelt was in charge of the brewery, but at this time it was probably already a brewery and was potentially run by his grandfather. The archaeological assessment of the cess identified pomegranate seeds (<a class="xref table" href="#tab04">Table 4</a>), a typical food of the upper-class (Van Haaster <a class="xref bibr" href="#ref36"><span class="show-for-sr">Reference Van Haaster</span>2008</a>: 11). </p><div class="table-wrap" data-magellan-destination="tab04" id="tab04"><div class="caption"><p class="p"><span class="label">Table 4.</span> Summary of organic macro remains, parasitological and historical data by cesspit. ‘Trematode’ indicates eggs whose measurements fit both with <em class="italic">Echinostoma</em> sp. and <em class="italic">Fasciola</em> sp. Archaeological macro remains results from Van Haaster (2020) and Van Amerongen (2022).</p></div> <span> <div class="figure-thumb"><img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab4.png?pub-status=live" class="aop-lazy-load-image" width="708" height="910" data-original-image="/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab4.png" data-zoomable="true"></div> </span> </div> <p class="p"> Map 28 from the <em class="italic">Stratenboek</em> indicates that cesspit S598 was located within a much smaller plot in the second half of the sixteenth century so was probably used by craftsmen. This is likely to also have been the case around 1450–1500—the date for the layer analysed from this pit—because quite a few marine mussel shells were found in the cesspit. Marine mussels were a typical food of the less fortunate, as illustrated in the print ‘The Lean Kitchen’ from 1563: while the table in ‘The Fat Kitchen’ is lavish with fresh meat, mussels are the only food depicted in ‘The Lean Kitchen’ (<a class="xref fig" href="#fig05">Figure 5</a>) (van der Heyden <a class="xref bibr" href="#ref35"><span class="show-for-sr">Reference Van Der Heyden</span>1563</a>). Cesspits S703 and S728 also belong to plots that were inhabited by craftsmen, at least in the second half of the sixteenth century (<a class="xref fig" href="#fig02">Figure 2</a>). The cesspits may have been used by several households as they were located near the property boundary. The finds in cesspit S703 include marine mussels, as well as grains, the seeds of fig, apple, black mulberry, cherry, plum and grape, and bone from cattle and sheep/goat. </p><section><div class="fig fig" data-magellan-destination="fig05" id="fig05"><div class="figure-thumb"><img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig5.png?pub-status=live" class="aop-lazy-load-image" width="1583" height="1705" data-original-image="/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig5.png" data-zoomable="true"></div><div class="caption"><p class="p"> </p><p class="p"><span class="label">Figure 5.</span> Engravings by P. Van der Heyden<span class="sc">,</span> after P. Bruegel. Printed in Antwerp in 1563: a) Magere Keuken (lean kitchen); b) Vette Keuken (fat kitchen) (© Rijksmuseum, Amsterdam; figure by authors).</p></div></div></section> <p class="p"> The archaeological organic data seem to be consistent with historical records: cesspits S467 (1350–1600) and S859 (1475–1525) contained rare and exotic taxa, while S598 (1450–1500), S703 (1375–1550) and S728 (1375–1500) did not and are therefore interpreted as households of low or moderate wealth. Despite this, parasite data did not identify variation between different households and professions. Roundworm and whipworm were the dominant species of parasite in all the cesspits and the eggs of zoonotic trematodes occurred in cesspits from both the poorer (S728) and possibly wealthier (S736, S859) families.</p> </div> <div class="sec conclusions" data-magellan-destination="sec6" id="sec6"><h2 class="A"> Conclusion</h2> <p class="p"> Here we present the parasite analysis of samples from six cesspits in use from 1250 to 1600 in Leiden, and integrate our findings with archaeological organic and historical evidence for the same properties. Most of the eggs identified within the cess were from roundworm and whipworm, and ELISA tests indicated the presence of the protozoan <em class="italic">Giardia duodenalis</em> within two cesspits. These species can all infect humans, causing symptoms that include diarrhoea, and are spread by poor sanitation. The zoonotic parasites Diphyllobothriidae and <em class="italic">Echinostoma</em> fluke were also likely present in the population. Identification of <em class="italic">Dicrocoelium</em> and <em class="italic">Fasciola hepatica</em> eggs within the cess likely indicates the consumption of infected ruminant livers rather than infection of the human population by these parasites. Parasite analyses also verified archaeological organic findings by contributing to the characterisation of the function of the six archaeological features as cesspits (AD 1250–1600).</p> <p class="p"> Combined macro and micro analysis of animal and plant remains and parasite eggs can provide a more comprehensive understanding of the lifestyle, diet and disease of past groups, while historical records can be valuable for contextualising archaeological data. However, the narrative they provide cannot be understood as a faithful or unbiased record for specific archaeological contexts. Earlier pre-urban contexts may also lack any historical records. For these reasons the potential for analysing the contents of cesspits as a proxy for intestinal health is more straightforward than when considering the wealth and social status of their users, which remains a complex and challenging area.</p> <p class="p"> Here, the taxonomic diversity of the parasites identified showed similarity between the different professions of the Leiden households, which may suggest broad consistency in lifestyle between different households or the shared use of the cesspits. These findings contrast with the archaeobotanical and zooarchaeological data, which showed variation between households, consistent with the professions outlined in historical records. Parasites therefore appear to be a less effective proxy for identifying social variation, but remain significant as broad dietary markers and for characterising the function of archaeological features.</p> </div> </div> <div class="back"> <div class="ack"><h2 class="A"> Acknowledgements</h2> <p class="p"> We are grateful to Techlab<sup class="sup">©</sup>, Blacksburg, USA for donating the ELISA test kits used in this study. Thanks also go to Martin Hooymans (Leiden, coordinator Mapping Historical Leiden), Nina Linde Jaspers (Amsterdam, Terra Cotta Incognita) and Otto Brinkkemper (Cultural Heritage Agency of the Netherlands). Use of material from the CDC does not constitute endorsement or recommendation by the United States Government or CDC. All material from the CDC is available on the agency website (<a class="uri" href="https://www.cdc.gov/">https://www.cdc.gov/</a>) for no charge.</p> </div><div class="sec funding-statement" data-magellan-destination="sec-fs1" id="sec-fs1"><h2 class="A"> Funding</h2> <p class="p"> SR would like to acknowledge the following funding bodies: the H.M. Chadwick Fund Studentship (University of Cambridge, UK), the Mary P. 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Available at: https://www.historischleideninkaart.nl/brouwerijen1607/ (accessed 22 April 2023).' href=https://scholar.google.com/scholar?q=Walle,+K.+&+Hooymans,+M..+2021.+Brouwerijen+1607,+een+transcriptie+van+het+rapport+van+Jan+van+Hout+over+de+bierfraude+(SAII,+inv.+nr.+1969).+Historischleideninkaart+(Mapping+Historical+Leiden).+Available+at:+https://www.historischleideninkaart.nl/brouwerijen1607/+(accessed+22+April+2023).>Google Scholar</a></div></div></div></div></div> <!----></div></div> <!----> <div id="figures-tab" class="figures tab-pane" data-v-241a4b23><div data-v-241a4b23><div class="figures__item" data-v-241a4b23><div class="figures__item__image-box" data-v-241a4b23><button class="figures__ref" data-v-241a4b23> View in content </button> <img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" alt="Figure 0" data-zoomable="true" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20241202104931-28560-mediumThumb-png-S0003598X24000723_fig1.jpg" data-enlarged-image="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20241202104931-74928-optimisedImage-png-S0003598X24000723_fig1.jpg" class="graphic" data-v-241a4b23></div> <div data-v-241a4b23><div class="caption" data-v-241a4b23><p data-v-241a4b23><span class="label" data-v-241a4b23>Figure 1.</span> <span data-v-241a4b23><span class="p">a) location of Leiden within the Netherlands; b) a site plan of locations of pits excavated (figure by authors).</span></span></p></div> </div></div> <hr aria-hidden="true" class="separator dashed" data-v-7036083a data-v-241a4b23></div><div data-v-241a4b23><div class="figures__item" data-v-241a4b23><div class="figures__item__image-box" data-v-241a4b23><button class="figures__ref" data-v-241a4b23> View in content </button> <img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" alt="Figure 1" data-zoomable="true" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20241202104931-57217-mediumThumb-png-S0003598X24000723_fig2.jpg" data-enlarged-image="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20241202104931-47264-optimisedImage-png-S0003598X24000723_fig2.jpg" class="graphic" data-v-241a4b23></div> <div data-v-241a4b23><div class="caption" data-v-241a4b23><p data-v-241a4b23><span class="label" data-v-241a4b23>Figure 2.</span> <span data-v-241a4b23><span class="p">Detail from <span class="italic">Stratenboek</span> (Book of streets) 28 ‘Kaart van Marendorp van de Vrouwenkerk tot de Marebrug’ dd. 1591 (Erfgoed Leiden en Omstreken, 501A, inv. nr. 5153 Stratenboek 28, available at: <span class="uri" href="https://www.erfgoedleiden.nl/collecties/archieven/archievenoverzicht/details/NL-LdnRAL-0501A/path/1.2.2.8.1.6.5.1/deep:view/scans/deep:highlight/8/deep:start/50/deep:limit/10"><a href="https://www.erfgoedleiden.nl/collecties/archieven/archievenoverzicht/details/NL-LdnRAL-0501A/path/1.2.2.8.1.6.5.1/deep:view/scans/deep:highlight/8/deep:start/50/deep:limit/10">https://www.erfgoedleiden.nl/collecties/archieven/archievenoverzicht/details/NL-LdnRAL-0501A/path/1.2.2.8.1.6.5.1/deep:view/scans/deep:highlight/8/deep:start/50/deep:limit/10</a></span>). The occupations of the main occupants (not the owners) of the houses are indicated with dots in the years 1561, 1581 and 1606. The numbers correspond with Mapping Historical Leiden (<span class="uri" href="https://www.historischleideninkaart.nl"><a href="http://www.historischleideninkaart.nl">www.historischleideninkaart.nl</a></span>) and can be looked up via Looproutes, 1561 Tiende Penning (Tenth Penny), 1581 Volkstelling (Census) and 1606 Schoorsteengeld (Hearth tax) and then by selecting the ward Overmare Rijnzijde (RvO) (figure by authors).</span></span></p></div> </div></div> <hr aria-hidden="true" class="separator dashed" data-v-7036083a data-v-241a4b23></div><div data-v-241a4b23><div class="figures__item" data-v-241a4b23><div class="figures__item__image-box" data-v-241a4b23><button class="figures__ref" data-v-241a4b23> View in content </button> <img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" alt="Figure 2" data-zoomable="true" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20241202104931-97868-mediumThumb-png-S0003598X24000723_fig3.jpg" data-enlarged-image="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20241202104931-01436-optimisedImage-png-S0003598X24000723_fig3.jpg" class="graphic" data-v-241a4b23></div> <div data-v-241a4b23><div class="caption" data-v-241a4b23><p data-v-241a4b23><span class="label" data-v-241a4b23>Figure 3.</span> <span data-v-241a4b23><span class="p">a) cesspit S859 during excavation, showing round brick lining; b) its cross-section (cesspit use dates from 1475–1525) (figure by authors).</span></span></p></div> </div></div> <hr aria-hidden="true" class="separator dashed" data-v-7036083a data-v-241a4b23></div><div data-v-241a4b23><div class="figures__item" data-v-241a4b23><div class="figures__item__image-box" data-v-241a4b23><button class="figures__ref" data-v-241a4b23> View in content </button> <img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" alt="Figure 3" data-zoomable="true" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab1.png" data-enlarged-image="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab1.png" class="graphic" data-v-241a4b23></div> <div data-v-241a4b23><div class="caption" data-v-241a4b23><p data-v-241a4b23><span class="label" data-v-241a4b23>Table 1.</span> <span data-v-241a4b23><span class="p">Details of the cesspits analysed in this study.</span></span></p></div> </div></div> <hr aria-hidden="true" class="separator dashed" data-v-7036083a data-v-241a4b23></div><div data-v-241a4b23><div class="figures__item" data-v-241a4b23><div class="figures__item__image-box" data-v-241a4b23><button class="figures__ref" data-v-241a4b23> View in content </button> <img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" alt="Figure 4" data-zoomable="true" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab2.png" data-enlarged-image="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab2.png" class="graphic" data-v-241a4b23></div> <div data-v-241a4b23><div class="caption" data-v-241a4b23><p data-v-241a4b23><span class="label" data-v-241a4b23>Table 2.</span> <span data-v-241a4b23><span class="p">Digital-light microscopy and ELISA results. ‘Trematode’ indicates eggs whose measurements fit both with <span class="italic">Echinostoma</span> sp. and <span class="italic">Fasciola</span> sp. Egg counts represent an estimate of number of eggs per gram (raw counts for 0.2g multiplied by 5). ELISA results are not quantified, positive samples are shown with ‘+ve’, negative samples are shown with ‘-ve’.</span></span></p></div> </div></div> <hr aria-hidden="true" class="separator dashed" data-v-7036083a data-v-241a4b23></div><div data-v-241a4b23><div class="figures__item" data-v-241a4b23><div class="figures__item__image-box" data-v-241a4b23><button class="figures__ref" data-v-241a4b23> View in content </button> <img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" alt="Figure 5" data-zoomable="true" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20241202104931-79369-mediumThumb-png-S0003598X24000723_fig4.jpg" data-enlarged-image="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20241202104931-30440-optimisedImage-png-S0003598X24000723_fig4.jpg" class="graphic" data-v-241a4b23></div> <div data-v-241a4b23><div class="caption" data-v-241a4b23><p data-v-241a4b23><span class="label" data-v-241a4b23>Figure 4.</span> <span data-v-241a4b23><span class="p">Parasite eggs from the Leiden cesspits. Top left: cf. <span class="italic">Echinostoma</span> sp. (dimensions 119 × 72μm); top centre: Diphyllobothriidae (52 × 36μm); top right: cf. <span class="italic">Dicrocoelium</span> sp. (36 × 22μm); bottom left: roundworm (78 × 48μm); bottom centre: whipworm (53 × 26μm); bottom right: cf. <span class="italic">Fasciola hepatica</span> (141 × 73μm) (figure by authors).</span></span></p></div> </div></div> <hr aria-hidden="true" class="separator dashed" data-v-7036083a data-v-241a4b23></div><div data-v-241a4b23><div class="figures__item" data-v-241a4b23><div class="figures__item__image-box" data-v-241a4b23><button class="figures__ref" data-v-241a4b23> View in content </button> <img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" alt="Figure 6" data-zoomable="true" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab3.png" data-enlarged-image="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab3.png" class="graphic" data-v-241a4b23></div> <div data-v-241a4b23><div class="caption" data-v-241a4b23><p data-v-241a4b23><span class="label" data-v-241a4b23>Table 3.</span> <span data-v-241a4b23><span class="p">Raw data for the samples positive for <span class="italic">Giardia duodenalis</span> on ELISA analysis. Manufacturer guidance for the ELISA test kits state that a result with absorbance value greater than 0.150 is positive.</span></span></p></div> </div></div> <hr aria-hidden="true" class="separator dashed" data-v-7036083a data-v-241a4b23></div><div data-v-241a4b23><div class="figures__item" data-v-241a4b23><div class="figures__item__image-box" data-v-241a4b23><button class="figures__ref" data-v-241a4b23> View in content </button> <img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" alt="Figure 7" data-zoomable="true" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab4.png" data-enlarged-image="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab4.png" class="graphic" data-v-241a4b23></div> <div data-v-241a4b23><div class="caption" data-v-241a4b23><p data-v-241a4b23><span class="label" data-v-241a4b23>Table 4.</span> <span data-v-241a4b23><span class="p">Summary of organic macro remains, parasitological and historical data by cesspit. ‘Trematode’ indicates eggs whose measurements fit both with <span class="italic">Echinostoma</span> sp. and <span class="italic">Fasciola</span> sp. Archaeological macro remains results from Van Haaster (2020) and Van Amerongen (2022).</span></span></p></div> </div></div> <hr aria-hidden="true" class="separator dashed" data-v-7036083a data-v-241a4b23></div><div data-v-241a4b23><div class="figures__item" data-v-241a4b23><div class="figures__item__image-box" data-v-241a4b23><button class="figures__ref" data-v-241a4b23> View in content </button> <img src="data:image/gif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==" alt="Figure 8" data-zoomable="true" data-src="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20241202104931-11930-mediumThumb-png-S0003598X24000723_fig5.jpg" data-enlarged-image="https://static.cambridge.org/binary/version/id/urn:cambridge.org:id:binary-alt:20241202104931-88337-optimisedImage-png-S0003598X24000723_fig5.jpg" class="graphic" data-v-241a4b23></div> <div data-v-241a4b23><div class="caption" data-v-241a4b23><p data-v-241a4b23><span class="label" data-v-241a4b23>Figure 5.</span> <span data-v-241a4b23><span class="p">Engravings by P. Van der Heyden<span class="sc">,</span> after P. Bruegel. Printed in Antwerp in 1563: a) Magere Keuken (lean kitchen); b) Vette Keuken (fat kitchen) (© Rijksmuseum, Amsterdam; figure by authors).</span></span></p></div> </div></div> <!----></div></div> <!----> <!----> <!----> <!----> <!----> <!----> <!----> <!----> <div id="metrics-tab" publication-date="31 May 2024" class="metrics tab-pane" data-v-c41a0c86><div class="app-loader" data-v-c41a0c86></div></div></div></div> <!----></div> <div role="complementary" aria-label="related contents" class="column__main__right" data-v-01274b1d><div class="access-block row access-status" data-v-5fad35b8 data-v-01274b1d><span class="has-access" data-v-5fad35b8><img 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Wang",searchUrl:"\u002Fcore\u002Fsearch?filters%5BauthorTerms%5D=Tianyi%20Wang&eventCode=SE-AU",orcidUrl:"https:\u002F\u002Forcid.org\u002F0000-0002-0776-9387"},{givenNames:"Roos",surname:"van Oosten",nameStyle:l,affiliations:[{text:"Faculty of Archaeology, Leiden University, The Netherlands"}],isCorresponding:b,notes:a,isAnonymous:b,fullName:"Roos van Oosten",searchUrl:"\u002Fcore\u002Fsearch?filters%5BauthorTerms%5D=Roos%20van%20Oosten&eventCode=SE-AU",orcidUrl:"https:\u002F\u002Forcid.org\u002F0000-0002-4323-5120"},{givenNames:"Yolande",surname:"Meijer",nameStyle:l,affiliations:[{text:"IDDS Archeologie, Noordwijk, The Netherlands"}],isCorresponding:b,notes:a,isAnonymous:b,fullName:"Yolande Meijer",searchUrl:"\u002Fcore\u002Fsearch?filters%5BauthorTerms%5D=Yolande%20Meijer&eventCode=SE-AU",orcidUrl:f},{givenNames:"Piers D.",surname:"Mitchell",nameStyle:l,affiliations:[{text:x}],isCorresponding:c,notes:"\u003Cdiv class=\"corresp\"\u003E\u003Cspan class=\"label\"\u003E*\u003C\u002Fspan\u003EAuthor for correspondence ✉ \u003Ca href=\"mailto:pdm39@cam.ac.uk\"\u003Epdm39@cam.ac.uk\u003C\u002Fa\u003E\u003C\u002Fdiv\u003E",isAnonymous:b,fullName:"Piers D. Mitchell",searchUrl:"\u002Fcore\u002Fsearch?filters%5BauthorTerms%5D=Piers%20D.%20Mitchell&eventCode=SE-AU",orcidUrl:"https:\u002F\u002Forcid.org\u002F0000-0002-1009-697X"}]},translators:{contributors:[],label:"Translated by"}},collections:[{link:"\u002Fcore\u002Fproduct\u002Fidentifier\u002FAQY_MAPS_AND_THE_MEDIEVAL_LANDSCAPE\u002Ftype\u002FBESPOKE_COLLECTION",id:"AQY_MAPS_AND_THE_MEDIEVAL_LANDSCAPE",title:"Medieval European Archaeology"}],publishedDate:"31 May 2024",keywords:[{url:"\u002Fcore\u002Fsearch?filters[keywords]=Netherlands",name:"Netherlands"},{url:"\u002Fcore\u002Fsearch?filters[keywords]=medieval",name:"medieval"},{url:"\u002Fcore\u002Fsearch?filters[keywords]=palaeoparasitology",name:"palaeoparasitology"},{url:"\u002Fcore\u002Fsearch?filters[keywords]=ELISA",name:"ELISA"},{url:"\u002Fcore\u002Fsearch?filters[keywords]=cesspits",name:"cesspits"},{url:"\u002Fcore\u002Fsearch?filters[keywords]=diarrhoea",name:"diarrhoea"},{url:"\u002Fcore\u002Fsearch?filters[keywords]=Echinostoma",name:"Echinostoma"},{url:"\u002Fcore\u002Fsearch?filters[keywords]=fish tapeworm",name:"fish tapeworm"}],openPracticeBadges:[],doi:{url:"https:\u002F\u002Fdoi.org\u002F10.15184\u002Faqy.2024.72",value:"10.15184\u002Faqy.2024.72"},copyright:{statement:["Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Antiquity Publications Ltd"],holder:["The Author(s)"],year:[2024]},creativeCommons:{descriptions:["This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (\u003Ca href=\"https:\u002F\u002Fcreativecommons.org\u002Flicenses\u002Fby\u002F4.0\u002F\" target=\"_blank\"\u003Ehttps:\u002F\u002Fcreativecommons.org\u002Flicenses\u002Fby\u002F4.0\u002F\u003C\u002Fa\u003E), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited."],oaLicenseType:"CC-BY",licenses:["CC","BY"]},acceptedManuscript:b,type:"research-article",pageRange:{range:"1006 - 1022",firstPage:"1006",lastPage:"1022"},typeDescription:"Research Article",commentsCount:M,topicsAndSubtopics:f},journal:{id:N,title:o,titleSlug:O,mnemonic:"AQY",titleHistory:[],isFirstView:b,journalSlug:O,isCompanion:b,parentCompanionJournalName:o,associatedParentCollection:f,paymentInfo:{prices:{"£":{price:16,sku:p,skuNew:m,currency:"£"},"€":{price:19,sku:p,skuNew:m,currency:"€"},US$:{price:26,sku:p,skuNew:m,currency:"US$"},AU$:{price:31,sku:p,skuNew:m,currency:"AU$"}}},url:P,firstViewUrl:"\u002Fcore\u002Fjournals\u002Fantiquity\u002Ffirstview",coverUrl:"https:\u002F\u002Fstatic.cambridge.org\u002Fcovers\u002FAQY_0_0_0\u002Fantiquity.jpg",submitMaterialsUrl:"\u002Fcore\u002Fjournals\u002Fantiquity\u002Finformation\u002Fauthor-instructions\u002Fsubmitting-your-materials",hasHistory:b,latestTitle:o,latestId:N,hasPastTitle:b,issue:{id:"239B1D4D343BD0DA9E8B18BC89888DA6",number:"400",title:"Issue 400",publishedDate:"August 2024",printPublishTimestamp:1722470400000,url:Q},volume:{id:"87C69FC9A297320915DFC82CFAE65D83",number:"98",title:"Volume 98",publishedDate:"October 2024",printPublishTimestamp:1727740800000,url:"\u002Fcore\u002Fjournals\u002Fantiquity\u002Fvolume\u002F87C69FC9A297320915DFC82CFAE65D83"}},abstract:{graphicalAbstract:{title:"Abstract",graphicalContent:"\u003Cdiv class=\"abstract\" data-abstract-type=\"graphical\"\u003E\u003Cp\u003E\u003Cimg class=\"graphic\" orientation mimesubtype=\"png\" mimetype=\"image\" position type href=\"S0003598X24000723_figAb.png\" src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fcontent\u002Fid\u002Furn%3Acambridge.org%3Aid%3Aarticle%3AS0003598X24000723\u002Fresource\u002Fname\u002FS0003598X24000723_figAb.png?pub-status=live\" \u002F\u003E\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E",textContent:"\u003Cdiv class=\"abstract\" data-abstract-type=\"normal\"\u003E\u003Cp\u003EIn the absence of written records, disease and parasite loads are often used as indicators of sanitation in past populations. Here, the authors adopt the novel approach of integrating the bioarchaeological analysis of cesspits in an area of medieval Leiden (the Netherlands) with historical property records to explore living conditions. Using light microscopy and enzyme-linked immunosorbent assays (ELISA) they identify evidence of parasites associated with ineffective sanitation (whipworm, roundworm and the protozoan \u003Cspan class='italic'\u003EGiardia duodenalis\u003C\u002Fspan\u003E)—at residences of all social levels—and the consumption of infected livestock and freshwater fish (Diphyllobothriidae, cf. \u003Cspan class='italic'\u003EEchinostoma\u003C\u002Fspan\u003E sp., cf. \u003Cspan class='italic'\u003EFasciola hepatica\u003C\u002Fspan\u003E and \u003Cspan class='italic'\u003EDicrocoelium\u003C\u002Fspan\u003E sp.).\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E"}},content:{html:"\u003Cdiv class=\"article research-article NLM\"\u003E\n\n\u003Cdiv class=\"body\"\u003E\n\u003Cp class=\"p\"\u003E \n\u003C\u002Fp\u003E\u003Csection\u003E\u003Cdiv class=\"fig\"\u003E\u003Cdiv class=\"figure-thumb\"\u003E\u003Cimg src=\"data:image\u002Fgif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==\" data-src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_figU1.png?pub-status=live\" class=\"aop-lazy-load-image\" width=\"768\" height=\"768\" data-original-image=\"\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_figU1.png\" data-zoomable=\"true\"\u003E\u003C\u002Fdiv\u003E\u003C\u002Fdiv\u003E\u003C\u002Fsection\u003E\n\u003Cdiv class=\"sec intro\" data-magellan-destination=\"sec1\" id=\"sec1\"\u003E\u003Ch2 class=\"A\"\u003E Introduction\u003C\u002Fh2\u003E\n\u003Cp class=\"p\"\u003E In the Low Countries, many artefacts are recovered from cesspits (Hupperetz \u003Ca class=\"xref bibr\" href=\"#ref17\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Hupperetz, De Groote, Tys and Pieters\u003C\u002Fspan\u003E2010\u003C\u002Fa\u003E: 279; van Oosten \u003Ca class=\"xref bibr\" href=\"#ref39\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference van Oosten, Sosna and Brunclíková\u003C\u002Fspan\u003E2016a\u003C\u002Fa\u003E: 41, 49), but the archaeological value of the material (the cess) that these pits contain is often underestimated. This article examines material from six medieval cesspits in a Low Countries town, integrating analysis of organic remains with textual records relating to town regulations and to the households within which the cesspits were located. Leiden was selected due to its promising archaeological record and the survival of documents detailing medieval street plans and inhabitants.\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E Eggs from a broad range of endoparasites have been identified in soil samples from cesspits in other regions of the Low Countries (Rocha \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref28\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Rocha, Harter-Lailheugue, Le Bailly, Araújo, Ferreira, Serra-Freire and Bouchet\u003C\u002Fspan\u003E2006\u003C\u002Fa\u003E; Appelt \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref2\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Appelt, Armougom, Le Bailly, Robert and Drancourt\u003C\u002Fspan\u003E2014\u003C\u002Fa\u003E; Deforce \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref12\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Deforce, Van Hove and Willems\u003C\u002Fspan\u003E2015\u003C\u002Fa\u003E; Rácz \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref27\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Rácz\u003C\u002Fspan\u003E2015\u003C\u002Fa\u003E; Graff \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref15\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Graff\u003C\u002Fspan\u003E2020\u003C\u002Fa\u003E; De Cupere \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref11\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference De Cupere\u003C\u002Fspan\u003E2021\u003C\u002Fa\u003E; Rabinow \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref26\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Rabinow, Deforce and Mitchell\u003C\u002Fspan\u003E2023\u003C\u002Fa\u003E). The presence of these eggs—and the attendant infection by genera or species of parasites that may be identified—can help us to create a picture of parasitic infection and its interplay with social practices such as diet and sanitation in past populations (Mitchell \u003Ca class=\"xref bibr\" href=\"#ref21\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Mitchell\u003C\u002Fspan\u003E2015a\u003C\u002Fa\u003E, \u003Ca class=\"xref bibr\" href=\"#ref23\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Mitchell\u003C\u002Fspan\u003E2023\u003C\u002Fa\u003E). The nematodes \u003Cem class=\"italic\"\u003EAscaris\u003C\u002Fem\u003E (roundworm) and \u003Cem class=\"italic\"\u003ETrichuris\u003C\u002Fem\u003E (whipworm), for example, can trigger such symptoms as abdominal cramps, diarrhoea, anorexia, nausea and vomiting (Stephenson \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref31\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Stephenson, Latham and Ottensen\u003C\u002Fspan\u003E2000\u003C\u002Fa\u003E). Certain species of protozoa, including \u003Cem class=\"italic\"\u003EEntamoeba histolytica\u003C\u002Fem\u003E, \u003Cem class=\"italic\"\u003EGiardia\u003C\u002Fem\u003E sp. and \u003Cem class=\"italic\"\u003ECryptosporidium\u003C\u002Fem\u003E sp., can also cause diarrhoea and dysentery. \u003Cem class=\"italic\"\u003EAscaris, Trichuris\u003C\u002Fem\u003E and these protozoa are therefore generally considered to be indicators of sanitation conditions. Species of the genera \u003Cem class=\"italic\"\u003ETaenia\u003C\u002Fem\u003E (pork and beef tapeworm), \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E (intestinal flukes) and \u003Cem class=\"italic\"\u003EDibothriocephalus\u003C\u002Fem\u003E (fish tapeworm) are zoonotic parasites, which can be transferred from non-human animals to humans by eating raw or undercooked meat and fish (Ledger &amp; Mitchell \u003Ca class=\"xref bibr\" href=\"#ref20\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Ledger and Mitchell\u003C\u002Fspan\u003E2022\u003C\u002Fa\u003E). By assessing cesspit contents and determining the types of parasites present in the medieval population of Leiden, we can improve our understanding of the health and lifestyle of the city's inhabitants. We can also address the question of whether households with indicators of more costly or poorer diet (potentially indicators of income or status) were infected by the same parasites, or if differences in infection might exist between these two groups.\u003C\u002Fp\u003E\n\u003Cdiv class=\"sec\" data-magellan-destination=\"sec1-1\" id=\"sec1-1\"\u003E\u003Ch3 class=\"B\"\u003E Leiden\u003C\u002Fh3\u003E\n\u003Cp class=\"p\"\u003E The town of Leiden (\u003Ca class=\"xref fig\" href=\"#fig01\"\u003EFigure 1\u003C\u002Fa\u003E), known primarily for its textile industry, was home to approximately 13 000 inhabitants at around AD 1500 (Brand \u003Ca class=\"xref bibr\" href=\"#ref5\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Brand\u003C\u002Fspan\u003E2008\u003C\u002Fa\u003E: 96; van Steensel \u003Ca class=\"xref bibr\" href=\"#ref42\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Van Steensel and Nigro\u003C\u002Fspan\u003E2020\u003C\u002Fa\u003E: 372), making it one of the larger urban centres of the Northern Netherlands at this time (van Oosten \u003Ca class=\"xref bibr\" href=\"#ref38\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference van Oosten\u003C\u002Fspan\u003E2015\u003C\u002Fa\u003E: 28). In the later Middle Ages (up to AD 1500), textile production was already significantly higher than in other Dutch cities (Posthumus \u003Ca class=\"xref bibr\" href=\"#ref25\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Posthumus\u003C\u002Fspan\u003E1908\u003C\u002Fa\u003E: 368–9) and by the seventeenth century Leiden became known as the largest textile producer in Europe (de Vries \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref13\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference De Vries, Lucassen, Lourens, Nijboer and Groenveld\u003C\u002Fspan\u003E2003\u003C\u002Fa\u003E: 88). From the last quarter of the sixteenth century, Leiden grew at a rapid pace and the city welcomed thousands of religious refugees, mostly textile workers from what is now Belgium. A significant increase in the number and sizes of houses in the city and an expansion in its territory is therefore seen in the seventeenth century. During the early modern period (\u003Cem class=\"italic\"\u003Ec\u003C\u002Fem\u003E. AD 1500–1800) for which significantly more detailed written records are available than for the Middle Ages, it has been estimated that two-thirds of the population was involved in the textile industry (de Vries \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref13\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference De Vries, Lucassen, Lourens, Nijboer and Groenveld\u003C\u002Fspan\u003E2003\u003C\u002Fa\u003E: 88).\n\u003C\u002Fp\u003E\u003Csection\u003E\u003Cdiv class=\"fig fig\" data-magellan-destination=\"fig01\" id=\"fig01\"\u003E\u003Cdiv class=\"figure-thumb\"\u003E\u003Cimg src=\"data:image\u002Fgif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==\" data-src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig1.png?pub-status=live\" class=\"aop-lazy-load-image\" width=\"1583\" height=\"638\" data-original-image=\"\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig1.png\" data-zoomable=\"true\"\u003E\u003C\u002Fdiv\u003E\u003Cdiv class=\"caption\"\u003E\u003Cp class=\"p\"\u003E \u003C\u002Fp\u003E\u003Cp class=\"p\"\u003E\u003Cspan class=\"label\"\u003EFigure 1.\u003C\u002Fspan\u003E a) location of Leiden within the Netherlands; b) a site plan of locations of pits excavated (figure by authors).\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\u003C\u002Fdiv\u003E\u003C\u002Fsection\u003E\n\u003C\u002Fdiv\u003E\n\u003C\u002Fdiv\u003E\n\u003Cdiv class=\"sec materials\" data-magellan-destination=\"sec2\" id=\"sec2\"\u003E\u003Ch2 class=\"A\"\u003E Materials\u003C\u002Fh2\u003E\n\u003Cp class=\"p\"\u003E In 2019 an area in Leiden demarked by the present-day Haarlemmerstraat to the north and the Stille Rijn to the south was excavated (administratively known as Haarlemmerstraat 101–111\u002FStille Rijn 8–9). The Rhine, running on the other side of the Stille Rijn, was an important transport route in the Middle Ages and the Haarlemmerstraat, then called Marendorp, was a key street connecting the Zijlpoort in the east of the city to the Rijnsburgerpoort in the west.\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E Thanks to the ongoing project \u003Cem class=\"italic\"\u003EHistorisch Leiden in Kaart\u003C\u002Fem\u003E (Mapping Historical Leiden), which provides access to historical data via a website, it is possible to look up the owners of properties that stood on the excavated site during the period \u003Cem class=\"italic\"\u003Ec\u003C\u002Fem\u003E. 1550–1606. Map 28 from the so-called \u003Cem class=\"italic\"\u003EStratenboek\u003C\u002Fem\u003E (Book of streets) (\u003Ca class=\"xref fig\" href=\"#fig02\"\u003EFigure 2\u003C\u002Fa\u003E) presents a good starting point, as it shows that in 1591 the excavated area was occupied by one large square ‘plot’ and two smaller ones. The purpose of this map was not, however, to accurately depict the contours of each plot but to record façade width, presumably to determine a proportional cost for street maintenance paid by the owners (de Baar \u003Ca class=\"xref bibr\" href=\"#ref10\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference de Baar\u003C\u002Fspan\u003E1985\u003C\u002Fa\u003E). As a result, adjacent plots owned by the same individual were schematically drawn as one ‘plot’. \u003Ca class=\"xref fig\" href=\"#fig02\"\u003EFigure 2\u003C\u002Fa\u003E shows the number of houses occupying the block for three sample years (1561, 1581 and 1606). While in 1561 the block consisted of only five properties (two of which were rented), this had increased to seven in 1581 and to 26 (including 12 rentals) in 1606. This increase in property numbers, and particularly in the number of rental properties, is a development that is also observed elsewhere in Leiden as population density increases significantly in the last quarter of the sixteenth century (van Oosten \u003Ca class=\"xref bibr\" href=\"#ref40\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference van Oosten\u003C\u002Fspan\u003E2016b\u003C\u002Fa\u003E: 715, fig. 8).\n\u003C\u002Fp\u003E\u003Csection\u003E\u003Cdiv class=\"fig fig\" data-magellan-destination=\"fig02\" id=\"fig02\"\u003E\u003Cdiv class=\"figure-thumb\"\u003E\u003Cimg src=\"data:image\u002Fgif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==\" data-src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig2.png?pub-status=live\" class=\"aop-lazy-load-image\" width=\"1583\" height=\"1269\" data-original-image=\"\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig2.png\" data-zoomable=\"true\"\u003E\u003C\u002Fdiv\u003E\u003Cdiv class=\"caption\"\u003E\u003Cp class=\"p\"\u003E \u003C\u002Fp\u003E\u003Cp class=\"p\"\u003E\u003Cspan class=\"label\"\u003EFigure 2.\u003C\u002Fspan\u003E Detail from \u003Cem class=\"italic\"\u003EStratenboek\u003C\u002Fem\u003E (Book of streets) 28 ‘Kaart van Marendorp van de Vrouwenkerk tot de Marebrug’ dd. 1591 (Erfgoed Leiden en Omstreken, 501A, inv. nr. 5153 Stratenboek 28, available at: \u003Ca class=\"uri\" href=\"https:\u002F\u002Fwww.erfgoedleiden.nl\u002Fcollecties\u002Farchieven\u002Farchievenoverzicht\u002Fdetails\u002FNL-LdnRAL-0501A\u002Fpath\u002F1.2.2.8.1.6.5.1\u002Fdeep:view\u002Fscans\u002Fdeep:highlight\u002F8\u002Fdeep:start\u002F50\u002Fdeep:limit\u002F10\"\u003Ehttps:\u002F\u002Fwww.erfgoedleiden.nl\u002Fcollecties\u002Farchieven\u002Farchievenoverzicht\u002Fdetails\u002FNL-LdnRAL-0501A\u002Fpath\u002F1.2.2.8.1.6.5.1\u002Fdeep:view\u002Fscans\u002Fdeep:highlight\u002F8\u002Fdeep:start\u002F50\u002Fdeep:limit\u002F10\u003C\u002Fa\u003E). The occupations of the main occupants (not the owners) of the houses are indicated with dots in the years 1561, 1581 and 1606. The numbers correspond with Mapping Historical Leiden (\u003Ca class=\"uri\" href=\"https:\u002F\u002Fwww.historischleideninkaart.nl\"\u003Ewww.historischleideninkaart.nl\u003C\u002Fa\u003E) and can be looked up via Looproutes, 1561 Tiende Penning (Tenth Penny), 1581 Volkstelling (Census) and 1606 Schoorsteengeld (Hearth tax) and then by selecting the ward Overmare Rijnzijde (RvO) (figure by authors).\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\u003C\u002Fdiv\u003E\u003C\u002Fsection\u003E\n\u003Cp class=\"p\"\u003E There is a remarkable difference in social status between the residents of this block. Most were middle-class or poor residents: they rented instead of owning (hence their occupations were not recorded), the size of each plot was small and the tax they paid was low. In contrast, the largest plot was occupied from at least 1498 until \u003Cem class=\"italic\"\u003Ec.\u003C\u002Fem\u003E 1605 by the brewery and home of a family of wealthy brewers who paid high taxes. While the business was located on the Stille Rijn side of the block, as map 2 of the \u003Cem class=\"italic\"\u003EGrachtenboek\u003C\u002Fem\u003E (Book of Canals) (Erfgoed Leiden en Omstreken, 0501A, inventory number 5113) shows, the home of the brewer was located on the Haarlemmerstraat. When the 1591 map was made (\u003Ca class=\"xref fig\" href=\"#fig02\"\u003EFigure 2\u003C\u002Fa\u003E), brewer Cornelis Adriaensz van Barrevelt owned the plot. He had been the owner since 1558. A few years earlier, in 1543, his father Adriaen Jans van Barrevelt (also a brewer) was the owner and it is very likely that as early as 1498 this site was already a brewery (van Steensel \u003Ca class=\"xref bibr\" href=\"#ref41\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Van Steensel\u003C\u002Fspan\u003E2016\u003C\u002Fa\u003E).\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E Leiden had at least 22 brewers in 1498 (van Steensel \u003Ca class=\"xref bibr\" href=\"#ref41\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Van Steensel\u003C\u002Fspan\u003E2016\u003C\u002Fa\u003E) and 15 brewers in 1607 (Walle &amp; Hooymans \u003Ca class=\"xref bibr\" href=\"#ref43\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Walle and Hooymans\u003C\u002Fspan\u003E2021\u003C\u002Fa\u003E). Brewers in the mid-sixteenth century belonged to the financial elite (Noordam \u003Ca class=\"xref bibr\" href=\"#ref24\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Noordam\u003C\u002Fspan\u003E2001\u003C\u002Fa\u003E: 31). That their wealth was visibly greater than that of other residents can be illustrated by the size of the area occupied by breweries. The plot of Cornelis Adriaensz is five to six times wider than the average plot within the city. A further illustration of their prominent role in society is that quite a few brewers had seats on the city council. Cornelis Adriaensz served on the town council for 30 years, following in the footsteps of his father who served for 23 years.\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E A total of 14 features within the excavated area were interpreted as potential cesspits (\u003Ca class=\"xref fig\" href=\"#fig03\"\u003EFigure 3\u003C\u002Fa\u003E, \u003Ca class=\"xref table\" href=\"#tab01\"\u003ETable 1\u003C\u002Fa\u003E). One or more sediment samples of at least 1 litre were taken from each pit, and where more than one sample was available from the same cesspit, these were taken from different sediment layers. The samples were assessed using the quickscan approach for the presence of botanical macro remains (van Haaster \u003Ca class=\"xref bibr\" href=\"#ref37\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Van Haaster and Meijer\u003C\u002Fspan\u003E2020\u003C\u002Fa\u003E). Based on this assessment, six of the pits were regarded as cesspits used for human faecal waste and submitted for further analysis for organic macro remains (van Amerongen \u003Ca class=\"xref bibr\" href=\"#ref34\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Van Amerongen and Meijer\u003C\u002Fspan\u003E2022\u003C\u002Fa\u003E) and intestinal parasites. Analysing samples for parasite eggs also allowed us to double check whether the quick-scan approach was a reliable method for identifying cesspits. Two of the features disregarded based on the quick-scan results were tested for parasite eggs and both were found to be negative (marked in green on \u003Ca class=\"xref fig\" href=\"#fig01\"\u003EFigure 1b\u003C\u002Fa\u003E), supporting the original interpretation. Feature S724 did contain three parasite eggs (two whipworm and one trematode) but the paucity of parasite eggs compared with other samples (which contained in excess of a thousand times more eggs) suggests that these may represent contamination, perhaps having been washed in by flooding in the past. It cannot, however, be excluded that the feature was originally a cesspit that was subsequently emptied and filled with other material.\n\u003C\u002Fp\u003E\u003Csection\u003E\u003Cdiv class=\"fig fig\" data-magellan-destination=\"fig03\" id=\"fig03\"\u003E\u003Cdiv class=\"figure-thumb\"\u003E\u003Cimg src=\"data:image\u002Fgif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==\" data-src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig3.png?pub-status=live\" class=\"aop-lazy-load-image\" width=\"1583\" height=\"1056\" data-original-image=\"\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig3.png\" data-zoomable=\"true\"\u003E\u003C\u002Fdiv\u003E\u003Cdiv class=\"caption\"\u003E\u003Cp class=\"p\"\u003E \u003C\u002Fp\u003E\u003Cp class=\"p\"\u003E\u003Cspan class=\"label\"\u003EFigure 3.\u003C\u002Fspan\u003E a) cesspit S859 during excavation, showing round brick lining; b) its cross-section (cesspit use dates from 1475–1525) (figure by authors).\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\u003C\u002Fdiv\u003E\u003C\u002Fsection\u003E\n\u003Cdiv class=\"table-wrap\" data-magellan-destination=\"tab01\" id=\"tab01\"\u003E\u003Cdiv class=\"caption\"\u003E\u003Cp class=\"p\"\u003E\u003Cspan class=\"label\"\u003ETable 1.\u003C\u002Fspan\u003E Details of the cesspits analysed in this study.\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\n\u003Cspan\u003E\n\u003Cdiv class=\"figure-thumb\"\u003E\u003Cimg src=\"data:image\u002Fgif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==\" data-src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab1.png?pub-status=live\" class=\"aop-lazy-load-image\" width=\"708\" height=\"319\" data-original-image=\"\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab1.png\" data-zoomable=\"true\"\u003E\u003C\u002Fdiv\u003E\n\n\u003C\u002Fspan\u003E\n\u003C\u002Fdiv\u003E\n\u003C\u002Fdiv\u003E\n\u003Cdiv class=\"sec methods\" data-magellan-destination=\"sec3\" id=\"sec3\"\u003E\u003Ch2 class=\"A\"\u003E Methods\u003C\u002Fh2\u003E\n\u003Cdiv class=\"sec\" data-magellan-destination=\"sec3-1\" id=\"sec3-1\"\u003E\u003Ch3 class=\"B\"\u003E Microscopy for intestinal parasite eggs\u003C\u002Fh3\u003E\n\u003Cp class=\"p\"\u003E Fourteen sediment samples from the six cesspits dating from AD 1250–1600 underwent analysis for intestinal parasites. They were dated from pottery fragments recovered from the cesspit fill, and the type and size of the bricks used to construct the cesspits. Analysis was performed at the Ancient Parasites Laboratory at the University of Cambridge, following the modified RHM (rehydration, homogenization, micro-sieving) protocol described by Anastasiou and Mitchell (\u003Ca class=\"xref bibr\" href=\"#ref1\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Anastasiou and Mitchell\u003C\u002Fspan\u003E2013\u003C\u002Fa\u003E). A 0.2g subsample was measured and disaggregated (placed into suspension) using 0.5% trisodium phosphate. The suspension was washed through three microsieves (mesh sizes 300, 160 and 20μm). The material trapped on the 20μm micro-sieve was rinsed free with distilled water, collected in a 15mL tube, centrifuged for five minutes at 4000rpm, and the supernatant removed. The concentrated material at the base of the tube was mixed with glycerol, mounted on microscope slides and analysed with digital light microscopy at 400× magnification (Olympus BX40F microscope with GXCAM-9 digital camera). The eggs of intestinal parasitic worms were identified by their shape, colour, dimensions and special characteristics using reference manuals such as Garcia (\u003Ca class=\"xref bibr\" href=\"#ref14\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Garcia\u003C\u002Fspan\u003E2016\u003C\u002Fa\u003E). Egg dimensions were measured using the GX Capture-T software. Egg counts per gram were calculated by multiplying the number of eggs noted in each 0.2g sample by five.\u003C\u002Fp\u003E\n\u003C\u002Fdiv\u003E\n\u003Cdiv class=\"sec\" data-magellan-destination=\"sec3-2\" id=\"sec3-2\"\u003E\u003Ch3 class=\"B\"\u003E ELISA for intestinal protozoa\u003C\u002Fh3\u003E\n\u003Cp class=\"p\"\u003E Enzyme-linked immunosorbent assay (ELISA) kits, \u003Cem class=\"italic\"\u003EEntamoeba histolytica\u003C\u002Fem\u003E II\u003Csup class=\"sup\"\u003ETM\u003C\u002Fsup\u003E, \u003Cem class=\"italic\"\u003EGiardia\u003C\u002Fem\u003E II\u003Csup class=\"sup\"\u003ETM\u003C\u002Fsup\u003E and \u003Cem class=\"italic\"\u003ECryptosporidium\u003C\u002Fem\u003E II\u003Csup class=\"sup\"\u003ETM\u003C\u002Fsup\u003E, produced by TECHLAB® (Blacksburg, Virginia, USA), were used to analyse five of the samples for three species of protozoan parasites which can cause diarrhoea and dysentery. We did not test all 14 samples for reasons of cost, but the samples chosen covered the full time depth while focusing on those samples with good parasite egg survival. A 1g subsample was measured and disaggregated (placed into suspension) using 0.5% trisodium phosphate and passed through the sieves. The material from the catchment container measuring less than 20μm was collected, as the cysts and oocysts of protozoa that cause diarrhoea and dysentery in humans typically measure 5–19μm in diameter. The fluid was centrifuged to concentrate it to the volume required for the ELISA analysis. Eight wells were tested for each sample. Each ELISA analysis was repeated one month after the first run using a new sample prepared using the same method, and results were only considered positive if both tests were positive. Following manufacturer instructions, a positive and negative control were included in each plate. The absorbance values for each well were generated using an ELISA plate reader (BioTek Synergy HT). Past research has indicated these test kits have 97–100% sensitivity and specificity in modern samples (Boone \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref4\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Boone, Wilkins, Nash, Brandon, Macias, Jerris and Lyerly\u003C\u002Fspan\u003E1999\u003C\u002Fa\u003E; Silva \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref30\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Silva\u003C\u002Fspan\u003E2016\u003C\u002Fa\u003E).\u003C\u002Fp\u003E\n\u003C\u002Fdiv\u003E\n\u003C\u002Fdiv\u003E\n\u003Cdiv class=\"sec results\" data-magellan-destination=\"sec4\" id=\"sec4\"\u003E\u003Ch2 class=\"A\"\u003E Results\u003C\u002Fh2\u003E\n\u003Cp class=\"p\"\u003E All 14 samples from the six cesspits analysed contained intestinal parasite eggs (\u003Ca class=\"xref table\" href=\"#tab02\"\u003ETable 2\u003C\u002Fa\u003E). We identified six species of helminth parasite in total: whipworm (\u003Cem class=\"italic\"\u003ETrichuris\u003C\u002Fem\u003E sp.), roundworm (\u003Cem class=\"italic\"\u003EAscaris\u003C\u002Fem\u003E sp.), fish tapeworm (Diphyllobothriidae), \u003Cem class=\"italic\"\u003EDicrocoelium\u003C\u002Fem\u003E sp., cf. \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E sp. fluke and cf. \u003Cem class=\"italic\"\u003EFasciola hepatica\u003C\u002Fem\u003E fluke (\u003Ca class=\"xref fig\" href=\"#fig04\"\u003EFigure 4\u003C\u002Fa\u003E).\n\u003C\u002Fp\u003E\u003Cdiv class=\"table-wrap\" data-magellan-destination=\"tab02\" id=\"tab02\"\u003E\u003Cdiv class=\"caption\"\u003E\u003Cp class=\"p\"\u003E\u003Cspan class=\"label\"\u003ETable 2.\u003C\u002Fspan\u003E Digital-light microscopy and ELISA results. ‘Trematode’ indicates eggs whose measurements fit both with \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E sp. and \u003Cem class=\"italic\"\u003EFasciola\u003C\u002Fem\u003E sp. Egg counts represent an estimate of number of eggs per gram (raw counts for 0.2g multiplied by 5). ELISA results are not quantified, positive samples are shown with ‘+ve’, negative samples are shown with ‘-ve’.\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\n\u003Cspan\u003E\n\u003Cdiv class=\"figure-thumb\"\u003E\u003Cimg src=\"data:image\u002Fgif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==\" data-src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab2.png?pub-status=live\" class=\"aop-lazy-load-image\" width=\"1049\" height=\"395\" data-original-image=\"\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab2.png\" data-zoomable=\"true\"\u003E\u003C\u002Fdiv\u003E\n\n\u003C\u002Fspan\u003E\n\u003C\u002Fdiv\u003E\n\u003Csection\u003E\u003Cdiv class=\"fig fig\" data-magellan-destination=\"fig04\" id=\"fig04\"\u003E\u003Cdiv class=\"figure-thumb\"\u003E\u003Cimg src=\"data:image\u002Fgif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==\" data-src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig4.png?pub-status=live\" class=\"aop-lazy-load-image\" width=\"2362\" height=\"1550\" data-original-image=\"\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig4.png\" data-zoomable=\"true\"\u003E\u003C\u002Fdiv\u003E\u003Cdiv class=\"caption\"\u003E\u003Cp class=\"p\"\u003E \u003C\u002Fp\u003E\u003Cp class=\"p\"\u003E\u003Cspan class=\"label\"\u003EFigure 4.\u003C\u002Fspan\u003E Parasite eggs from the Leiden cesspits. Top left: cf. \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E sp. (dimensions 119 × 72μm); top centre: Diphyllobothriidae (52 × 36μm); top right: cf. \u003Cem class=\"italic\"\u003EDicrocoelium\u003C\u002Fem\u003E sp. (36 × 22μm); bottom left: roundworm (78 × 48μm); bottom centre: whipworm (53 × 26μm); bottom right: cf. \u003Cem class=\"italic\"\u003EFasciola hepatica\u003C\u002Fem\u003E (141 × 73μm) (figure by authors).\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\u003C\u002Fdiv\u003E\u003C\u002Fsection\u003E\n\u003Cp class=\"p\"\u003E The dominant parasites were whipworm and roundworm, which were found in all samples (\u003Ca class=\"xref table\" href=\"#tab02\"\u003ETable 2\u003C\u002Fa\u003E). Whipworm was identified by its lemon shape, polar plugs, smooth wall, and dimensions, while roundworm was identified by its mamillated coat, oval shape, brown colour and dimensions. The eggs of trematodes from the genera \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E and \u003Cem class=\"italic\"\u003EFasciola\u003C\u002Fem\u003E are morphologically similar and overlap in size: the size range for \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E eggs (80–135μm long by 55–80μm wide (Centers for Disease Control and Prevention \u003Ca class=\"xref bibr\" href=\"#ref8\"\u003E2019a\u003C\u002Fa\u003E) is only slightly lower than for \u003Cem class=\"italic\"\u003EFasciola\u003C\u002Fem\u003E (130–150μm long by 60–90μm wide (Centers for Disease Control and Prevention \u003Ca class=\"xref bibr\" href=\"#ref9\"\u003E2019b\u003C\u002Fa\u003E), although Valero and colleagues (\u003Ca class=\"xref bibr\" href=\"#ref32\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Valero, Panova, Comes, Fons and Mas-Coma\u003C\u002Fspan\u003E2002\u003C\u002Fa\u003E) report \u003Cem class=\"italic\"\u003EFasciola\u003C\u002Fem\u003E eggs as short as 125μm in modern cattle). Significantly however, the literature reports different size ranges for trematode eggs (for example, compare the ranges described in Ash and Orihel (\u003Ca class=\"xref bibr\" href=\"#ref3\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Ash and Orihel\u003C\u002Fspan\u003E2015\u003C\u002Fa\u003E: 177) with those in Garcia (\u003Ca class=\"xref bibr\" href=\"#ref14\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Garcia\u003C\u002Fspan\u003E2016\u003C\u002Fa\u003E)); egg sizes were also noted to vary regionally and by host (Valero \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref33\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Valero, Perez-Crespo, Periago, Khoubbane and Mas-Coma\u003C\u002Fspan\u003E2009\u003C\u002Fa\u003E). Here we rely on the egg size ranges provided by the Centers for Disease Control and Prevention (CDC) because these references are easily accessible (\u003Ca class=\"uri\" href=\"https:\u002F\u002Fwww.cdc.gov\u002F\"\u003Ehttps:\u002F\u002Fwww.cdc.gov\u002F\u003C\u002Fa\u003E) for no charge and are commonly employed in the palaeoparasitological literature. The eggs of the fish tapeworm (Diphyllobothriidae) cestodes are oval and range between 55–75μm long and 40–50μm wide, although Leštinová and colleagues (\u003Ca class=\"xref bibr\" href=\"#ref19\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Leštinová, Soldánova, Scholz and Kuchta\u003C\u002Fspan\u003E2016\u003C\u002Fa\u003E) report eggs of \u003Cem class=\"italic\"\u003EDibothriocephalus latus\u003C\u002Fem\u003E as long as 59–81μm in modern human populations in Italy. \u003Cem class=\"italic\"\u003EDicrocoelium\u003C\u002Fem\u003E was identified by its dimensions (typically 35–45μm long and 20–30μm wide), operculum, wall thickness and shape, often with one side flatter and the other more curved.\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E ELISA analysis was positive in two cesspits (S728, dated 1375–1500, and S703, dated 1375–1550) for the protozoan \u003Cem class=\"italic\"\u003EGiardia duodenalis\u003C\u002Fem\u003E, which causes severe watery diarrhoea (\u003Ca class=\"xref table\" href=\"#tab03\"\u003ETable 3\u003C\u002Fa\u003E). All ELISA tests were negative for \u003Cem class=\"italic\"\u003EEntamoeba histolytica\u003C\u002Fem\u003E and \u003Cem class=\"italic\"\u003ECryptosporidium parvum\u003C\u002Fem\u003E.\n\u003C\u002Fp\u003E\u003Cdiv class=\"table-wrap\" data-magellan-destination=\"tab03\" id=\"tab03\"\u003E\u003Cdiv class=\"caption\"\u003E\u003Cp class=\"p\"\u003E\u003Cspan class=\"label\"\u003ETable 3.\u003C\u002Fspan\u003E Raw data for the samples positive for \u003Cem class=\"italic\"\u003EGiardia duodenalis\u003C\u002Fem\u003E on ELISA analysis. Manufacturer guidance for the ELISA test kits state that a result with absorbance value greater than 0.150 is positive.\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\n\u003Cspan\u003E\n\u003Cdiv class=\"figure-thumb\"\u003E\u003Cimg src=\"data:image\u002Fgif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==\" data-src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab3.png?pub-status=live\" class=\"aop-lazy-load-image\" width=\"708\" height=\"414\" data-original-image=\"\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab3.png\" data-zoomable=\"true\"\u003E\u003C\u002Fdiv\u003E\n\n\u003C\u002Fspan\u003E\n\u003C\u002Fdiv\u003E\n\u003C\u002Fdiv\u003E\n\u003Cdiv class=\"sec discussion\" data-magellan-destination=\"sec5\" id=\"sec5\"\u003E\u003Ch2 class=\"A\"\u003E Discussion\u003C\u002Fh2\u003E\n\u003Cp class=\"p\"\u003E The taxonomic diversity of parasites and the dominance of roundworm and whipworm are consistent with previous findings from the Low Countries (Rocha \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref28\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Rocha, Harter-Lailheugue, Le Bailly, Araújo, Ferreira, Serra-Freire and Bouchet\u003C\u002Fspan\u003E2006\u003C\u002Fa\u003E; Appelt \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref2\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Appelt, Armougom, Le Bailly, Robert and Drancourt\u003C\u002Fspan\u003E2014\u003C\u002Fa\u003E; Deforce \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref12\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Deforce, Van Hove and Willems\u003C\u002Fspan\u003E2015\u003C\u002Fa\u003E; Rácz \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref27\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Rácz\u003C\u002Fspan\u003E2015\u003C\u002Fa\u003E; Graff \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref15\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Graff\u003C\u002Fspan\u003E2020\u003C\u002Fa\u003E; De Cupere \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref11\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference De Cupere\u003C\u002Fspan\u003E2021\u003C\u002Fa\u003E; Rabinow \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref26\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Rabinow, Deforce and Mitchell\u003C\u002Fspan\u003E2023\u003C\u002Fa\u003E). Roundworm, whipworm and the protozoan \u003Cem class=\"italic\"\u003EGiardia duodenalis\u003C\u002Fem\u003E are all spread via the faecal-oral route of parasite transmission. Their presence within cesspits indicates that the level of sanitation in medieval Leiden was insufficient to prevent the contamination of food and drink with faeces and the reinfection of the population with these parasites.\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E Parasites spread by the consumption of raw freshwater fish or other freshwater foods (cf. \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E and Diphyllobothriidae) were also present in some cesspits. Both these helminths can infect humans through the consumption of raw, undercooked, smoked or pickled freshwater fish; \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E can also infect freshwater shellfish and waterfowl and may be passed to humans if consumed (Huffman &amp; Fried \u003Ca class=\"xref bibr\" href=\"#ref16\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Huffman and Fried\u003C\u002Fspan\u003E1990\u003C\u002Fa\u003E; Garcia \u003Ca class=\"xref bibr\" href=\"#ref14\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Garcia\u003C\u002Fspan\u003E2016\u003C\u002Fa\u003E). We should bear in mind the possibility that \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E eggs might theoretically be found in cesspit sediments in the absence of human infection, for example if infected rodents accessed the cesspits, or if the offal discarded from infected waterfowl was tossed into the cesspit. While mussel shells were found discarded in two of the cesspits, these were of marine species and not freshwater species, so could not have spread \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E. Similarly, low numbers of \u003Cem class=\"italic\"\u003EDicrocoelium\u003C\u002Fem\u003E and \u003Cem class=\"italic\"\u003EFasciola hepatica\u003C\u002Fem\u003E eggs in human faeces are unlikely to indicate true human infection. These parasites generally infect the liver of ruminant animals such as sheep and cattle. If humans then eat raw or undercooked animal liver, the eggs can pass through the digestive system largely unaltered. Use of cesspits for the disposal of animal manure could also explain the presence of these parasite eggs.\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E Whipworm and roundworm eggs were consistently found in all six cesspits in high counts relative to the zoonotic parasites present, as is common in palaeoparasitological studies of medieval populations (Mitchell \u003Ca class=\"xref bibr\" href=\"#ref22\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Mitchell\u003C\u002Fspan\u003E2015b\u003C\u002Fa\u003E). Zoonotic parasites are often present in much lower counts (Graff \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref15\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Graff\u003C\u002Fspan\u003E2020\u003C\u002Fa\u003E; Rabinow \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref26\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Rabinow, Deforce and Mitchell\u003C\u002Fspan\u003E2023\u003C\u002Fa\u003E). In our study area, zoonotic parasites were not found in every sample, or even in every latrine. This suggests parasites contracted by eating meat or seafood caused considerably fewer infections among the population of Leiden than did parasites caused by poor sanitation. We have chosen not to statistically interrogate differences in the egg counts for whipworm and roundworm in the different cesspits, as such differences could be caused by taphonomic and depositional factors irrelevant to infection burdens, for example the number of eggs produced (which varies by individual worm), the number of people using the cesspits, and the degree to which the eggs may have been diluted with non-faecal refuse.\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E Modern clinical understanding of the health consequences of parasitic infections suggests that \u003Cem class=\"italic\"\u003EGiardia duodenalis\u003C\u002Fem\u003E would have had the greatest impact upon the population of medieval Leiden. This protozoan can cause outbreaks of severe diarrhoea, which can lead to dehydration and death, especially in children (Ryan \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref29\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Ryan, Hijjawi, Feng and Xiao\u003C\u002Fspan\u003E2019\u003C\u002Fa\u003E). The cesspits positive for \u003Cem class=\"italic\"\u003EGiardia duodenalis\u003C\u002Fem\u003E date from 1375–1500\u002F1550. From just two samples it is hard to tell if this was by chance or if it might indicate that diarrhoea was more of a public health problem around the 1400s compared with earlier or later centuries. Roundworm and whipworm infection may cause malnutrition, stunted growth and reduced intelligence in children when significant numbers of worms are present (Brooker \u003Ca class=\"xref bibr\" href=\"#ref7\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Brooker\u003C\u002Fspan\u003E2010\u003C\u002Fa\u003E). In adults with a healthy diet, roundworm and whipworm in low numbers may be tolerated without significant symptoms.\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E Given the similarity in dating and location, it seems possible that cesspit S467 was used by the household of the brewer Cornelis Adriaensz van Barrevelt. The cesspit contained crab or lobster (\u003Ca class=\"xref table\" href=\"#tab04\"\u003ETable 4\u003C\u002Fa\u003E), a typical high-status food (Brinkhuizen \u003Cem class=\"italic\"\u003Eet al\u003C\u002Fem\u003E. \u003Ca class=\"xref bibr\" href=\"#ref6\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Brinkhuizen, Cooremans, Ervynck, Stoops and Van Neer\u003C\u002Fspan\u003E2018\u003C\u002Fa\u003E), similar to the abundance illustrated in many late sixteenth- and seventeenth-century still-life paintings (Kwak \u003Ca class=\"xref bibr\" href=\"#ref18\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Kwak\u003C\u002Fspan\u003E2014\u003C\u002Fa\u003E). Cesspit S859 is located closer to the Stille Rijn, directly next to a fire pit and therefore probably belonged to the business premises. This cesspit fell into disuse in 1525–1550, long before Cornelis Adriaensz Barrevelt was in charge of the brewery, but at this time it was probably already a brewery and was potentially run by his grandfather. The archaeological assessment of the cess identified pomegranate seeds (\u003Ca class=\"xref table\" href=\"#tab04\"\u003ETable 4\u003C\u002Fa\u003E), a typical food of the upper-class (Van Haaster \u003Ca class=\"xref bibr\" href=\"#ref36\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Van Haaster\u003C\u002Fspan\u003E2008\u003C\u002Fa\u003E: 11).\n\u003C\u002Fp\u003E\u003Cdiv class=\"table-wrap\" data-magellan-destination=\"tab04\" id=\"tab04\"\u003E\u003Cdiv class=\"caption\"\u003E\u003Cp class=\"p\"\u003E\u003Cspan class=\"label\"\u003ETable 4.\u003C\u002Fspan\u003E Summary of organic macro remains, parasitological and historical data by cesspit. ‘Trematode’ indicates eggs whose measurements fit both with \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E sp. and \u003Cem class=\"italic\"\u003EFasciola\u003C\u002Fem\u003E sp. Archaeological macro remains results from Van Haaster (2020) and Van Amerongen (2022).\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\n\u003Cspan\u003E\n\u003Cdiv class=\"figure-thumb\"\u003E\u003Cimg src=\"data:image\u002Fgif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==\" data-src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab4.png?pub-status=live\" class=\"aop-lazy-load-image\" width=\"708\" height=\"910\" data-original-image=\"\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab4.png\" data-zoomable=\"true\"\u003E\u003C\u002Fdiv\u003E\n\n\u003C\u002Fspan\u003E\n\u003C\u002Fdiv\u003E\n\u003Cp class=\"p\"\u003E Map 28 from the \u003Cem class=\"italic\"\u003EStratenboek\u003C\u002Fem\u003E indicates that cesspit S598 was located within a much smaller plot in the second half of the sixteenth century so was probably used by craftsmen. This is likely to also have been the case around 1450–1500—the date for the layer analysed from this pit—because quite a few marine mussel shells were found in the cesspit. Marine mussels were a typical food of the less fortunate, as illustrated in the print ‘The Lean Kitchen’ from 1563: while the table in ‘The Fat Kitchen’ is lavish with fresh meat, mussels are the only food depicted in ‘The Lean Kitchen’ (\u003Ca class=\"xref fig\" href=\"#fig05\"\u003EFigure 5\u003C\u002Fa\u003E) (van der Heyden \u003Ca class=\"xref bibr\" href=\"#ref35\"\u003E\u003Cspan class=\"show-for-sr\"\u003EReference Van Der Heyden\u003C\u002Fspan\u003E1563\u003C\u002Fa\u003E). Cesspits S703 and S728 also belong to plots that were inhabited by craftsmen, at least in the second half of the sixteenth century (\u003Ca class=\"xref fig\" href=\"#fig02\"\u003EFigure 2\u003C\u002Fa\u003E). The cesspits may have been used by several households as they were located near the property boundary. The finds in cesspit S703 include marine mussels, as well as grains, the seeds of fig, apple, black mulberry, cherry, plum and grape, and bone from cattle and sheep\u002Fgoat.\n\u003C\u002Fp\u003E\u003Csection\u003E\u003Cdiv class=\"fig fig\" data-magellan-destination=\"fig05\" id=\"fig05\"\u003E\u003Cdiv class=\"figure-thumb\"\u003E\u003Cimg src=\"data:image\u002Fgif;base64,R0lGODlhAQABAIAAAMLCwgAAACH5BAAAAAAALAAAAAABAAEAAAICRAEAOw==\" data-src=\"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig5.png?pub-status=live\" class=\"aop-lazy-load-image\" width=\"1583\" height=\"1705\" data-original-image=\"\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_fig5.png\" data-zoomable=\"true\"\u003E\u003C\u002Fdiv\u003E\u003Cdiv class=\"caption\"\u003E\u003Cp class=\"p\"\u003E \u003C\u002Fp\u003E\u003Cp class=\"p\"\u003E\u003Cspan class=\"label\"\u003EFigure 5.\u003C\u002Fspan\u003E Engravings by P. Van der Heyden\u003Cspan class=\"sc\"\u003E,\u003C\u002Fspan\u003E after P. Bruegel. Printed in Antwerp in 1563: a) Magere Keuken (lean kitchen); b) Vette Keuken (fat kitchen) (© Rijksmuseum, Amsterdam; figure by authors).\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\u003C\u002Fdiv\u003E\u003C\u002Fsection\u003E\n\u003Cp class=\"p\"\u003E The archaeological organic data seem to be consistent with historical records: cesspits S467 (1350–1600) and S859 (1475–1525) contained rare and exotic taxa, while S598 (1450–1500), S703 (1375–1550) and S728 (1375–1500) did not and are therefore interpreted as households of low or moderate wealth. Despite this, parasite data did not identify variation between different households and professions. Roundworm and whipworm were the dominant species of parasite in all the cesspits and the eggs of zoonotic trematodes occurred in cesspits from both the poorer (S728) and possibly wealthier (S736, S859) families.\u003C\u002Fp\u003E\n\u003C\u002Fdiv\u003E\n\u003Cdiv class=\"sec conclusions\" data-magellan-destination=\"sec6\" id=\"sec6\"\u003E\u003Ch2 class=\"A\"\u003E Conclusion\u003C\u002Fh2\u003E\n\u003Cp class=\"p\"\u003E Here we present the parasite analysis of samples from six cesspits in use from 1250 to 1600 in Leiden, and integrate our findings with archaeological organic and historical evidence for the same properties. Most of the eggs identified within the cess were from roundworm and whipworm, and ELISA tests indicated the presence of the protozoan \u003Cem class=\"italic\"\u003EGiardia duodenalis\u003C\u002Fem\u003E within two cesspits. These species can all infect humans, causing symptoms that include diarrhoea, and are spread by poor sanitation. The zoonotic parasites Diphyllobothriidae and \u003Cem class=\"italic\"\u003EEchinostoma\u003C\u002Fem\u003E fluke were also likely present in the population. Identification of \u003Cem class=\"italic\"\u003EDicrocoelium\u003C\u002Fem\u003E and \u003Cem class=\"italic\"\u003EFasciola hepatica\u003C\u002Fem\u003E eggs within the cess likely indicates the consumption of infected ruminant livers rather than infection of the human population by these parasites. Parasite analyses also verified archaeological organic findings by contributing to the characterisation of the function of the six archaeological features as cesspits (AD 1250–1600).\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E Combined macro and micro analysis of animal and plant remains and parasite eggs can provide a more comprehensive understanding of the lifestyle, diet and disease of past groups, while historical records can be valuable for contextualising archaeological data. However, the narrative they provide cannot be understood as a faithful or unbiased record for specific archaeological contexts. Earlier pre-urban contexts may also lack any historical records. For these reasons the potential for analysing the contents of cesspits as a proxy for intestinal health is more straightforward than when considering the wealth and social status of their users, which remains a complex and challenging area.\u003C\u002Fp\u003E\n\u003Cp class=\"p\"\u003E Here, the taxonomic diversity of the parasites identified showed similarity between the different professions of the Leiden households, which may suggest broad consistency in lifestyle between different households or the shared use of the cesspits. These findings contrast with the archaeobotanical and zooarchaeological data, which showed variation between households, consistent with the professions outlined in historical records. Parasites therefore appear to be a less effective proxy for identifying social variation, but remain significant as broad dietary markers and for characterising the function of archaeological features.\u003C\u002Fp\u003E\n\u003C\u002Fdiv\u003E\n\u003C\u002Fdiv\u003E\n\u003Cdiv class=\"back\"\u003E\n\u003Cdiv class=\"ack\"\u003E\u003Ch2 class=\"A\"\u003E Acknowledgements\u003C\u002Fh2\u003E\n\u003Cp class=\"p\"\u003E We are grateful to Techlab\u003Csup class=\"sup\"\u003E©\u003C\u002Fsup\u003E, Blacksburg, USA for donating the ELISA test kits used in this study. Thanks also go to Martin Hooymans (Leiden, coordinator Mapping Historical Leiden), Nina Linde Jaspers (Amsterdam, Terra Cotta Incognita) and Otto Brinkkemper (Cultural Heritage Agency of the Netherlands). Use of material from the CDC does not constitute endorsement or recommendation by the United States Government or CDC. All material from the CDC is available on the agency website (\u003Ca class=\"uri\" href=\"https:\u002F\u002Fwww.cdc.gov\u002F\"\u003Ehttps:\u002F\u002Fwww.cdc.gov\u002F\u003C\u002Fa\u003E) for no charge.\u003C\u002Fp\u003E\n\u003C\u002Fdiv\u003E\u003Cdiv class=\"sec funding-statement\" data-magellan-destination=\"sec-fs1\" id=\"sec-fs1\"\u003E\u003Ch2 class=\"A\"\u003E Funding\u003C\u002Fh2\u003E\n\u003Cp class=\"p\"\u003E SR would like to acknowledge the following funding bodies: the H.M. Chadwick Fund Studentship (University of Cambridge, UK), the Mary P. Dole Medical Fellowship (Mount Holyoke College, USA) and The Louise Fitz-Randolph Fellowship (Mount Holyoke College, USA).\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\n\n\u003C\u002Fdiv\u003E\n\u003C\u002Fdiv\u003E",tableOfContent:[{level:i,current:b,title:"\u003Cdiv class=\"toc-title\"\u003EIntroduction\u003C\u002Fdiv\u003E",url:"sec1"},{level:i,current:b,title:"\u003Cdiv class=\"toc-title\"\u003EMaterials\u003C\u002Fdiv\u003E",url:"sec2"},{level:i,current:b,title:"\u003Cdiv class=\"toc-title\"\u003EMethods\u003C\u002Fdiv\u003E",url:"sec3"},{level:i,current:b,title:"\u003Cdiv class=\"toc-title\"\u003EResults\u003C\u002Fdiv\u003E",url:"sec4"},{level:i,current:b,title:"\u003Cdiv class=\"toc-title\"\u003EDiscussion\u003C\u002Fdiv\u003E",url:"sec5"},{level:i,current:b,title:"\u003Cdiv class=\"toc-title\"\u003EConclusion\u003C\u002Fdiv\u003E",url:"sec6"},{level:i,current:b,title:"\u003Cdiv class=\"toc-title\"\u003EFunding\u003C\u002Fdiv\u003E",url:"sec-fs1"}],footnotes:[],fulltextNotes:[],references:[{id:"ref1",displayNumber:a,existInContent:c,content:"\u003Cspan class=\"string-name\"\u003E\u003Cspan class=\"surname\"\u003EAnastasiou\u003C\u002Fspan\u003E, \u003Cspan class=\"given-names\"\u003EE.\u003C\u002Fspan\u003E\u003C\u002Fspan\u003E &amp; 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Dataset",date:t,tpages:f,doi:a,sid:e},innerRefId:"cite41",title:K,doi:a,crossRefLink:a,pubMedLink:a}]},{id:"ref42",displayNumber:a,existInContent:c,content:"\u003Cspan class=\"string-name\"\u003E\u003Cspan class=\"surname\"\u003EVan Steensel\u003C\u002Fspan\u003E, \u003Cspan class=\"given-names\"\u003EA.\u003C\u002Fspan\u003E\u003C\u002Fspan\u003E \u003Cspan class=\"year\"\u003E2020\u003C\u002Fspan\u003E. \u003Cspan class=\"chapter-title\"\u003EMeasuring urban inequalities. 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Spatial patterns of service access in sixteenth-century Leiden",aulast:a,aufirst:a,au:a,pub:"Firenze University Press",date:C,spage:"369",epage:f,doi:a,sid:e},innerRefId:"cite42",title:L,doi:a,crossRefLink:a,pubMedLink:a}]},{id:"ref43",displayNumber:a,existInContent:c,content:"\u003Cspan class=\"string-name\"\u003E\u003Cspan class=\"surname\"\u003EWalle\u003C\u002Fspan\u003E, \u003Cspan class=\"given-names\"\u003EK.\u003C\u002Fspan\u003E\u003C\u002Fspan\u003E &amp; \u003Cspan class=\"string-name\"\u003E\u003Cspan class=\"surname\"\u003EHooymans\u003C\u002Fspan\u003E, \u003Cspan class=\"given-names\"\u003EM.\u003C\u002Fspan\u003E\u003C\u002Fspan\u003E. \u003Cspan class=\"year\"\u003E2021\u003C\u002Fspan\u003E. Brouwerijen 1607, een transcriptie van het rapport van Jan van Hout over de bierfraude (SAII, inv. nr. 1969). Historischleideninkaart (Mapping Historical Leiden). Available at: \u003Ca class=\"uri\" href=\"https:\u002F\u002Fwww.historischleideninkaart.nl\u002Fbrouwerijen1607\u002F\"\u003Ehttps:\u002F\u002Fwww.historischleideninkaart.nl\u002Fbrouwerijen1607\u002F\u003C\u002Fa\u003E (accessed \u003Cspan class=\"date-in-citation access-date\"\u003E22 April 2023\u003C\u002Fspan\u003E).\u003Ca class='ref-link' target='_blank' aria-label='Google Scholar link for Walle, K. & Hooymans, M.. 2021. Brouwerijen 1607, een transcriptie van het rapport van Jan van Hout over de bierfraude (SAII, inv. nr. 1969). Historischleideninkaart (Mapping Historical Leiden). Available at: https:\u002F\u002Fwww.historischleideninkaart.nl\u002Fbrouwerijen1607\u002F (accessed 22 April 2023).' href=https:\u002F\u002Fscholar.google.com\u002Fscholar?q=Walle,+K.+&+Hooymans,+M..+2021.+Brouwerijen+1607,+een+transcriptie+van+het+rapport+van+Jan+van+Hout+over+de+bierfraude+(SAII,+inv.+nr.+1969).+Historischleideninkaart+(Mapping+Historical+Leiden).+Available+at:+https:\u002F\u002Fwww.historischleideninkaart.nl\u002Fbrouwerijen1607\u002F+(accessed+22+April+2023).\u003EGoogle Scholar\u003C\u002Fa\u003E",item:[{googleScholarLink:"https:\u002F\u002Fscholar.google.com\u002Fscholar?q=Walle,+K.+&+Hooymans,+M..+2021.+Brouwerijen+1607,+een+transcriptie+van+het+rapport+van+Jan+van+Hout+over+de+bierfraude+(SAII,+inv.+nr.+1969).+Historischleideninkaart+(Mapping+Historical+Leiden).+Available+at:+https:\u002F\u002Fwww.historischleideninkaart.nl\u002Fbrouwerijen1607\u002F+(accessed+22+April+2023).",openUrlParams:{genre:n,date:aj,sid:e,title:f},innerRefId:"cite43",title:"Walle, K. & Hooymans, M.. 2021. Brouwerijen 1607, een transcriptie van het rapport van Jan van Hout over de bierfraude (SAII, inv. nr. 1969). Historischleideninkaart (Mapping Historical Leiden). Available at: https:\u002F\u002Fwww.historischleideninkaart.nl\u002Fbrouwerijen1607\u002F (accessed 22 April 2023).",doi:a,crossRefLink:a,pubMedLink:a}]}],figures:[{contentId:"fig01",label:"Figure 1.",description:"\u003Cspan class=\"p\"\u003Ea) location of Leiden within the Netherlands; b) a site plan of locations of pits excavated (figure by authors).\u003C\u002Fspan\u003E",thumbnailSrc:"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary-alt:20241202104931-28560-mediumThumb-png-S0003598X24000723_fig1.jpg",enlargedSrc:"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary-alt:20241202104931-74928-optimisedImage-png-S0003598X24000723_fig1.jpg",attrib:[]},{contentId:"fig02",label:"Figure 2.",description:"\u003Cspan class=\"p\"\u003EDetail from \u003Cspan class=\"italic\"\u003EStratenboek\u003C\u002Fspan\u003E (Book of streets) 28 ‘Kaart van Marendorp van de Vrouwenkerk tot de Marebrug’ dd. 1591 (Erfgoed Leiden en Omstreken, 501A, inv. nr. 5153 Stratenboek 28, available at: \u003Cspan class=\"uri\" href=\"https:\u002F\u002Fwww.erfgoedleiden.nl\u002Fcollecties\u002Farchieven\u002Farchievenoverzicht\u002Fdetails\u002FNL-LdnRAL-0501A\u002Fpath\u002F1.2.2.8.1.6.5.1\u002Fdeep:view\u002Fscans\u002Fdeep:highlight\u002F8\u002Fdeep:start\u002F50\u002Fdeep:limit\u002F10\"\u003Ehttps:\u002F\u002Fwww.erfgoedleiden.nl\u002Fcollecties\u002Farchieven\u002Farchievenoverzicht\u002Fdetails\u002FNL-LdnRAL-0501A\u002Fpath\u002F1.2.2.8.1.6.5.1\u002Fdeep:view\u002Fscans\u002Fdeep:highlight\u002F8\u002Fdeep:start\u002F50\u002Fdeep:limit\u002F10\u003C\u002Fspan\u003E). The occupations of the main occupants (not the owners) of the houses are indicated with dots in the years 1561, 1581 and 1606. The numbers correspond with Mapping Historical Leiden (\u003Cspan class=\"uri\" href=\"https:\u002F\u002Fwww.historischleideninkaart.nl\"\u003Ewww.historischleideninkaart.nl\u003C\u002Fspan\u003E) and can be looked up via Looproutes, 1561 Tiende Penning (Tenth Penny), 1581 Volkstelling (Census) and 1606 Schoorsteengeld (Hearth tax) and then by selecting the ward Overmare Rijnzijde (RvO) (figure by authors).\u003C\u002Fspan\u003E",thumbnailSrc:"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary-alt:20241202104931-57217-mediumThumb-png-S0003598X24000723_fig2.jpg",enlargedSrc:"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary-alt:20241202104931-47264-optimisedImage-png-S0003598X24000723_fig2.jpg",attrib:[]},{contentId:"fig03",label:"Figure 3.",description:"\u003Cspan class=\"p\"\u003Ea) cesspit S859 during excavation, showing round brick lining; b) its cross-section (cesspit use dates from 1475–1525) (figure by authors).\u003C\u002Fspan\u003E",thumbnailSrc:"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary-alt:20241202104931-97868-mediumThumb-png-S0003598X24000723_fig3.jpg",enlargedSrc:"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary-alt:20241202104931-01436-optimisedImage-png-S0003598X24000723_fig3.jpg",attrib:[]},{contentId:"tab01",label:"Table 1.",description:"\u003Cspan class=\"p\"\u003EDetails of the cesspits analysed in this study.\u003C\u002Fspan\u003E",thumbnailSrc:bg,enlargedSrc:bg,attrib:[]},{contentId:"tab02",label:"Table 2.",description:"\u003Cspan class=\"p\"\u003EDigital-light microscopy and ELISA results. ‘Trematode’ indicates eggs whose measurements fit both with \u003Cspan class=\"italic\"\u003EEchinostoma\u003C\u002Fspan\u003E sp. and \u003Cspan class=\"italic\"\u003EFasciola\u003C\u002Fspan\u003E sp. Egg counts represent an estimate of number of eggs per gram (raw counts for 0.2g multiplied by 5). ELISA results are not quantified, positive samples are shown with ‘+ve’, negative samples are shown with ‘-ve’.\u003C\u002Fspan\u003E",thumbnailSrc:bh,enlargedSrc:bh,attrib:[]},{contentId:"fig04",label:"Figure 4.",description:"\u003Cspan class=\"p\"\u003EParasite eggs from the Leiden cesspits. Top left: cf. \u003Cspan class=\"italic\"\u003EEchinostoma\u003C\u002Fspan\u003E sp. (dimensions 119 × 72μm); top centre: Diphyllobothriidae (52 × 36μm); top right: cf. \u003Cspan class=\"italic\"\u003EDicrocoelium\u003C\u002Fspan\u003E sp. (36 × 22μm); bottom left: roundworm (78 × 48μm); bottom centre: whipworm (53 × 26μm); bottom right: cf. \u003Cspan class=\"italic\"\u003EFasciola hepatica\u003C\u002Fspan\u003E (141 × 73μm) (figure by authors).\u003C\u002Fspan\u003E",thumbnailSrc:"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary-alt:20241202104931-79369-mediumThumb-png-S0003598X24000723_fig4.jpg",enlargedSrc:"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary-alt:20241202104931-30440-optimisedImage-png-S0003598X24000723_fig4.jpg",attrib:[]},{contentId:"tab03",label:"Table 3.",description:"\u003Cspan class=\"p\"\u003ERaw data for the samples positive for \u003Cspan class=\"italic\"\u003EGiardia duodenalis\u003C\u002Fspan\u003E on ELISA analysis. Manufacturer guidance for the ELISA test kits state that a result with absorbance value greater than 0.150 is positive.\u003C\u002Fspan\u003E",thumbnailSrc:bi,enlargedSrc:bi,attrib:[]},{contentId:"tab04",label:"Table 4.",description:"\u003Cspan class=\"p\"\u003ESummary of organic macro remains, parasitological and historical data by cesspit. ‘Trematode’ indicates eggs whose measurements fit both with \u003Cspan class=\"italic\"\u003EEchinostoma\u003C\u002Fspan\u003E sp. and \u003Cspan class=\"italic\"\u003EFasciola\u003C\u002Fspan\u003E sp. Archaeological macro remains results from Van Haaster (2020) and Van Amerongen (2022).\u003C\u002Fspan\u003E",thumbnailSrc:bj,enlargedSrc:bj,attrib:[]},{contentId:"fig05",label:"Figure 5.",description:"\u003Cspan class=\"p\"\u003EEngravings by P. Van der Heyden\u003Cspan class=\"sc\"\u003E,\u003C\u002Fspan\u003E after P. Bruegel. Printed in Antwerp in 1563: a) Magere Keuken (lean kitchen); b) Vette Keuken (fat kitchen) (© Rijksmuseum, Amsterdam; figure by authors).\u003C\u002Fspan\u003E",thumbnailSrc:"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary-alt:20241202104931-11930-mediumThumb-png-S0003598X24000723_fig5.jpg",enlargedSrc:"https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary-alt:20241202104931-88337-optimisedImage-png-S0003598X24000723_fig5.jpg",attrib:[]}]},pdf:{standardResolution:{fileUrl:"\u002Fcore\u002Fservices\u002Faop-cambridge-core\u002Fcontent\u002Fview\u002F0BAEF8C8616457E42BF6C2C9AB8D05FF\u002FS0003598X24000723a.pdf\u002Fintestinal-parasite-infection-and-sanitation-in-medieval-leiden-the-low-countries.pdf",fileSizeInMb:4,articleTitle:w,slugTitle:"intestinal-parasite-infection-and-sanitation-in-medieval-leiden-the-low-countries"},highResolution:f,media:f},classification:[],supplementaryMaterials:[],relations:{corrections:[],correctionsOriginals:[],retractions:[],retractionsOriginals:[],addendums:[],addendumsOriginals:[],hasAnyRelations:b,hasAnyOriginalArticle:b},settings:{hasAccess:c,isOpenAccess:c,displayRightsLink:c,shouldDisplayCrossMark:b,shouldDisplayNasaAds:b,suppressPdf:b,isShareable:c,isAnnotationsEnabled:b,disableArticleCommentary:b,displayArticleCommentaryAsDiscussionLinks:b,isCommentsEnabled:b,hasContent:c,shouldDisplaySubmitContent:b,isResearchDirections:b,isQuestionCollection:b,isMathjaxEnabled:b},citationCount:3,openUrlParams:"?genre=article&atitle=Intestinal%20parasite%20infection%20and%20sanitation%20in%20medieval%20Leiden%2C%20the%20Low%20Countries&jtitle=Antiquity&title=Antiquity&date=2024&volume=98&issue=400&spage=1006&epage=1022&sid=https%3A%2F%2Fwww.cambridge.org%2Fcore&aulast=Rabinow&aufirst=Sophie&doi=10.15184\u002Faqy.2024.72",ecommerceProducts:{digitalSku:m,paperBackSku:f,hardBackSku:f},subject:[],permissionUrl:"https:\u002F\u002Fs100.copyright.com\u002FAppDispatchServlet?publisherName=CUP&publication=AQY&title=Intestinal%20parasite%20infection%20and%20sanitation%20in%20medieval%20Leiden%2C%20the%20Low%20Countries&publicationDate=31%20May%202024&author=Sophie%20Rabinow%2C%20Tianyi%20Wang%2C%20Roos%20van%20Oosten%2C%20Yolande%20Meijer%2C%20Piers%20D.%20Mitchell&copyright=Copyright%20%C2%A9%20The%20Author(s)%2C%202024.%20Published%20by%20Cambridge%20University%20Press%20on%20behalf%20of%20Antiquity%20Publications%20Ltd&contentID=10.15184%2Faqy.2024.72&startPage=1006&endPage=1022&orderBeanReset=True&volumeNum=98&issueNum=400&oa=CC-BY"},breadcrumbs:[{name:"Home",url:"\u002Fcore"},{name:"Journals",url:"\u002Fcore\u002Fpublications\u002Fjournals"},{name:o,url:P},{name:"Volume 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opgraving Haarlemmerstraat 101–111 tot Stille Rijn 8–9 in Leiden, gemeente Leiden","western","S0003598X24000723","unknown","Antiquity","article_aqy_ind_pur","International Journal of Paleopathology","2015","International Journal for Parasitology","2016","Parasitology","Advances in Parasitology","Intestinal parasite infection and sanitation in medieval Leiden, the Low Countries","Department of Archaeology, University of Cambridge, UK","Atlas of human parasitology","Ups en Downer. Bundel artikelen bij het afscheid van mr. W. Downer als gemeentearchivaris van Leiden","Leiden de geschiedenis van een Hollandse stad, 1574–1795","Diagnostic medical parasitology","2020","Exchanging medieval material culture","Sanitation, latrines and intestinal parasites in past populations","Parasites in past civilizations and their impact upon health","De geschiedenis van de Leidsche lakenindustrie","Archeobotanica uit ‘s-Hertogenbosch. Milieuomstandigheden, bewoningsgeschiedenis en economische ontwikkelingen in en rond een (post)Middeleeuwse groeistad (Groningen Archaeological Studies 6)","De stad, het vuil en de beerput: de opkomst, verbreiding en neergang van de beerput in stedelijke context","Archaeologies of waste: encounters with the unwanted","Historisch Leiden in Kaart: Vermogensbelasting, 1498","Economic inequality in pre-industrial societies: causes and effect",0,"C06207AB2CE3EE948718B5F6E30870D7","antiquity","\u002Fcore\u002Fjournals\u002Fantiquity","\u002Fcore\u002Fjournals\u002Fantiquity\u002Fissue\u002F239B1D4D343BD0DA9E8B18BC89888DA6","Simplifying the process of extracting intestinal parasite eggs from archaeological sediment samples: a comparative study of the efficacy of widely-used disaggregation techniques","10.1016\u002Fj.ijpp.2013.04.004","Polyphasic analysis of a Middle Ages coprolite microbiota, Belgium","PLoS ONE","2014","10.1371\u002Fjournal.pone.0088376","TechLab and alexon Giardia enzyme-linked immunosorbent assay kits detect cyst wall protein 1","Journal of Clinical Microbiology","10.1128\u002FJCM.37.3.611-614.1999","Een pre-industriële samenleving onder spanning. Leiden rond 1500","Leids Jaarboekje. Eeuwig Leiden","2008","Schepenhuisstraat - Hoogpoort: aan tafel bij de Gentse bourgeoisie uit de eerste helft van de 18de eeuw","Stadsarcheologie. Bodem en monument in Gent","Estimating the global distribution and disease burden of intestinal nematode infections: adding up the numbers – a review","40","2010","10.1016\u002Fj.ijpara.2010.04.004","A multidisciplinary analysis of cesspits from late medieval and post-medieval Brussels, Belgium: diet and health in the fourteenth to seventeenth centuries","International Journal of Historical Archaeology","2021","10.1007\u002Fs10761-021-00613-8","Analysis of pollen and intestinal parasite eggs from medieval graves from Nivelles, Belgium: taphonomy of the burial ritual","Journal of Archaeological Sciences: Reports","10.1128\u002F9781555819002","A comparative study of parasites in three latrines from medieval and Renaissance Brussels, Belgium (14th–17th centuries)","10.1017\u002FS0031182020001298","Echinostoma and Echinostomiasis","10.1016\u002FS0065-308X(08)60107-4","Tracing zoonotic parasite infections throughout human evolution","International Journal of Osteoarchaeology","2022","10.1002\u002Foa.2786","Eggs as a suitable tool for species diagnosis of causative agents of human Diphyllobothriosis (Cestoda)","PLoS Neglected Tropical Diseases","10.1371\u002Fjournal.pntd.0004721","Human parasites in medieval Europe: lifestyle, sanitation and medical treatment","10.1016\u002Fbs.apar.2015.05.001","2023","10.1017\u002F9780511732386","Leiden in Last. De financiële positie van de Leidenaren aan het einde van de Middeleeuwen","Jaarboek der sociale en economische geschiedenis van Leiden en omstreken","2001","Continuity in intestinal parasite infection in Aalst (Belgium) from the medieval to early modern period (12th-17th centuries)","41","43","49","10.1016\u002Fj.ijpp.2023.03.001","Parasitology in an archaeological context: analysis of medieval burials in Nivelles, Belgium","Journal of Archaeological Sciences","10.1016\u002Fj.jas.2014.10.023","Paleoparasitological remains revealed by seven historic contexts from ‘Place d'Armes’, Namur, Belgium","Memorias do Instituto Oswaldo Cruz","10.1590\u002FS0074-02762006001000008","Giardia: an under-reported foodborne parasite","10.1016\u002Fj.ijpara.2018.07.003","Performance of microscopy and ELISA for diagnosing Giardia duodenalis infection in different pediatric groups","Parasitology International","10.1016\u002Fj.parint.2016.08.012","Malnutrition and parasitic helminth infections","10.1017\u002FS0031182000006491","Patterns in size and shedding of Fasciola hepatica eggs by naturally and experimentally infected murid rodents","Journal of Parasitology","10.1645\u002F0022-3395(2002)088[0308:PISASO]2.0.CO;2","Fluke egg characteristics for the diagnosis of human and animal fascioliasis by Fasciola hepatica and F. gigantica","Acta Tropica","10.1016\u002Fj.actatropica.2009.04.005","IDDS Rapport 2335","The Dutch Great Stink: the end of the cesspit era in the pre-industrial towns of Leiden and Haarlem","European Journal of Archaeology","10.1080\u002F14619571.2016.1147677","https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab1.png","https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab2.png","https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab3.png","https:\u002F\u002Fstatic.cambridge.org\u002Fbinary\u002Fversion\u002Fid\u002Furn:cambridge.org:id:binary:20241129190724458-0811:S0003598X24000723:S0003598X24000723_tab4.png"));</script><script src="/core/page-component/06cd607.js" defer></script><script src="/core/page-component/20147ec.js" defer></script><script src="/core/page-component/66884fb.js" defer></script><script src="/core/page-component/6f4302c.js" defer></script> </div> </div> <div id="article-new-home-productCitations" class="product-citations-modal reveal-modal medium" data-reveal role="dialog" aria-labelledby="article-new-home-citedByModalHeader"> <div class="header"> <div class="heading_07 margin-bottom" id="article-new-home-citedByModalHeader">Cited by</div> </div> <div class="citation-content"> <div class="row collapse header margin-top productCitations-content"> <ul class="small-12 small-centered columns citations"> <li class="fade-in section-container active"> <a href="#" class="section-button" data-id="article-new-home-crossref-citations"> <div class="circular medium citation"> <img src="https://assets.crossref.org/logo/crossref-logo-100.png" alt="Crossref logo"> <span class="citation-count">3</span> </div> </a> </li> <li class="fade-in section-container"> <a href="#" class="section-button" data-id="article-new-home-scholar-citations"> <div class="circular medium citation"> <img src="https://upload.wikimedia.org/wikipedia/commons/a/a9/Google_Scholar_logo_2015.PNG" alt="Google Scholar logo"> </div> </a> </li> </ul> </div> <div class="row wrapper no-padding-top section-content"> <div class="small-10 small-centered columns"> <section class="content" id="article-new-home-crossref-citations"> <div class="large-12 columns"> <div class="panel margin-top-small citation-container"> <div class="row"> <div class="medium-12 columns"> <div class="print-only print-heading margin-bottom-large">Crossref Citations</div> <div class="row margin-bottom"> <div class="small-1 columns"> <a href="http://www.crossref.org/citedby/index.html" target="_blank"> <img src="https://assets.crossref.org/logo/crossref-logo-100.png" alt="Crossref logo"> </a> </div> <div class="small-11 columns"> <h5 class="heading_10"> This article has been cited by the following publications. 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