Iron Deficiency Anemias in early Mongolian Nomads.



This paper describes pathological lesions attributed to Iron Deficiency Anemias in human skeletal remains from archaeological sites dating from Early Iron and Bronze Age (7th century BC) to 1st-2nd century AD contexts in Western and Central Mongolia. The various pathological changes provide useful information about nomadic living conditions in this time period and suggest general health status of these people. This study presents the lesions and implied health conditions of Chandman (Bronze and Iron age) and Hunnu (BC 209 - AD 93) nomadic populations from Mongolia. Here I will talk about implied health conditions through the distributions of Cribra Orbitalia among Bronze and Iron Age nomadic populations from Mongolia. The collections sampled for this presentation are from the Late Bronze site of Chandman, and the Hunnu period site of Borkhan Tolgoi, curated in the Department of Anthropology, Institute of Archaeology of the Mongolian Academy of Sciences. Both sexes and all age categories are represented in these materials. In these samples from both historical periods, cribra orbitalia is noted at relatively high frequencies. This is suggestive of iron deficiency anemias during childhood and in women.

Geographic, historic, and archaeological background

The Chandman site dates from the 7-3rd century B.C. It is located in Western Mongolia. The necropolis is located in the Chandman Mountains near the Uvs aimag city of Ulaangom. Chandmans’ position is –49’ N, 92’ E, and it has a continental climate, with an average annual temperature of –1C. The winter (October to April) is cold (with temperatures often dropping to –35 C in January and February), whereas summer (July to September) is pleasant (with temperatures sometimes as high as 22 C).  Precipitation is light (300-400 mm per year), because of its relatively high altitude (921 m) (The Mongolian physical geography, 1969). From the 1972 to 1974, the burial site was wholly excavated by Mongolian-Russian expedition, by archaeologist Navaan, Tseveendorj (1978) and Bolkov, Mamanova.

Sites in the Egiin Gol valley of northern Mongolia were occupied from approximately the 3rd century B.C to the 2nd century A.D. The necropolis of Borkhan Tolgoi is located in the Egiin Gol valley near the Egiin Gol river, 10 km from its confluence with the Selenge, a main tributary of lake Baikal. The valley’s position is –49.27’ N, 103.30’E, and it has a continental climate, with an average annual temperature of –1C. The winter (October to April) is cold (with temperatures often dropping to –30 C in January and February), whereas summer (July to September) is pleasant (with temperatures sometimes as high as 22 C).  As in western Mongolia, precipitation here is light (300-400 mm per year). Because of its relatively high altitude (885 m), the valley floor is covered with snow from mid November to April, and ice thickness on the Selenge reaches 1.8 m during this period (The Mongolian physical geography, 1969). From the 1997 to 2001, the burial site was wholly excavated by French-Mongolian expedition, under the sponsorship of UNESCO, by archaeologist Terbat (2003) and Sheskar.

Historical characteristics of The Bronze and Early Iron Age:

From the end of the Neolithic period the forefathers of the Mongols gradually progressed to the production of bronze implements. The earliest finds of metal implements date from the thirteenth to seventh centuries BC. A great number of bronze implements, various decorations and household utensils discovered in many parts of Mongolia. Rock pictures painted in red found on the territory of Mongolia date back to the Bronze age and are typical only of this region. They rock pictures also show stylized animals and human figures standing hand-in hand, with an eagle with its wings have been found in the territory of Mongolia.

In the Bronze Age great changes took place in the economy and culture of the ancient inhabitants of Central Asia.   

Along with stone –cist graves, deer stones are also widely found in Mongolia. These are upright stone slabs decorated with stylized pictures of running deer and finely engraved drawings of knives, daggers, bows and arrows.

Historical background of the Hunnu Empire:

By the fifth to fourth centuries BC two tribal unions, Hunnu and Dümhü, had formed in Central Asia, and the latest historical and biological research, including the work ‘’The Hereditary Polymorphism and Genegeography of Mongolia’s Population’’  (1986) carried out by the Mongolian Dr. J.Batsuuri, suggests that at least some elements of the Hunnu tribal union were ancient Mongols.

By the third century BC the Hunnus had become the most powerful cattle-breeding tribe. They met their needs in food and clothing livestock produce and traded with their settled neighbours, mainly Chinese, for agricultural products, handicrafts and jewelry. But from the first century BC the Hunnus also began to cultivate land.

In excavations of the sites of ancient Hunnu towns, complex defensive structures, semi-subterranean dwelling pits with heating appliances, remains of workshop, crop-storage houses, iron works and various kinds of cast-iron ware have been discovered.      

The Hunnus are known to have made different kinds of pottery, manually or on a potter‘s wheel, and to have created jewelry out of gold, silver and precious stones, s well as practising spinning and weaving.

The peak of the power of the Hunnu tribal union was in the third century BC, when the powerful empire which subsequently played a major role in the social and political history of Euro-Asian nomadic tribes took shape. The center of this empire, headed by the ruler Shan’yui, was in the basin of the Tuul river. The power was inherited in 209 BC by Modun.

Lands under Hunnu rule were divided into three parts: the central part comprised the nomadic horde of the Shan’yui, and the eastern and western parts were headed by the princes chosen by the Shan’yui from among his sons or relatives.

The Hunnus had their own written language, the symbols of which were similar to the letters of Orhon script.   

However, the mighty empire of the nomads did not last long. After a fierce internal struggle, in AD53-55 it broke up into Southern and Northern Hunnu. In AD 93 the Northern Hunnus ceased to exist as an independent state: some 500,000 of them joined the Xian’pi tribe and assumed that tribal name. Some of the Northern Hunnus drifted away from their native territory to the Caspians steppes and moved on further west to the Danube-Carpathian valleys, where they formed a sizeable nomadic state under the leadership of Attila.

 Material and Method.

The cranial samples used in this study were from collections of various periods. Two predominant series can be considered as the core of this study:

1.      The Chandman material is of Bronze and Iron age (VII-III BC) date from Western Mongolia. This was excavated in 1972-1974 by the joint Mongolian-Russian expedition. The Bronze and Iron Age collection consists of the remains of approximately 108 individuals represented by generally complete individuals or by crania only.

2.      The Egiin Gol material was excavated between 1998-1999 during a Mongolian–French collaborative expedition, the focus here is on the Hunnu period (BC 209- AD 93) from Central north Mongolia. The Hunnu collection represents approximately 72 skeletal individuals and 71 individuals represented by skulls only.

These materials, also in the collections of the Department of Anthropology, Institute of Archaeology, of the Mongolian Academy of Sciences, were examined macroscopically. In addition to the macroscopic examination, were made for the evaluation of pathological data. Traditional methods (Brothwell.1981, Goodman, 1987; Ortner and Putshar, 1983) were used to determine sex, age and pathological cases from the assembled crania.

Result and discussion.

1). Considering first the Bronze and Iron Age material from the Chandman Site in Western Mongolia. Of the 108 individual crania from the Chandman Nomadic population from Bronze and Iron age period, Cribra-Orbitalia was observed on 34 individuals (28.7 %). Of these, 15 are male (23.4 %), 10 are female (27.8 %) and 6 (75%) are subadult. Recording the distribution of the pathology, nodes are bilaterally distributed, with slightly more occurrences in the females and subadults. Listed by age differences, children have a 75.0 % occurrence, adults - 34.7%, old adults - 17.45%. As you can see from this, cribra-orbitalia was found to be much more common in children. Possibly many cases of childhood cribra-orbitalia must heal with advancing age or else lead to an early death in order to explain the lower incidence among adults.     

2). The distribution of Cribra Orbitalia in human remains from the Hunnu period (BC 209- AD 93) Borkhan Tolgoi Site in the Egiin Gol valley of central north Mongolia is as follows:

Of the 71 individual crania from the site, 11 individuals (12.7 %) displayed this pathology. Of these, 2 are male (5.3 %), 5 are female (29.4 %) and 4 (25.0 %) are subadult. Recording the distribution of Cribra-Orbitalia, nodes are bilaterally distributed, with slightly more occurrences in the females and subadults.

The distribution of Cribra orbitalia in the Chandman and Borkhan Tolgoi samples suggests that in both the Bronze Age and Hunnu Period sites there is a sex based difference in general health status. However, Cribra orbitalia is noted with the highest frequencies in subadults (75%). This may suggest a recovery process, or alternatively, that females have a higher differential survival rate with the condition.

Many authors interpret Cribra orbitalia as a consequence of insufficient or shoddy feeding. This is possible however it may also stem from some infectious diseases such as malarias. In addition the bony response may be representative of more than one type of anemias (Hengen, 1971; Marcsik, 1985).

By way of regional population sample comparison, among reported West-European series Cribra orbitalia is noted at approximately 10%-33% in adults, and 24%-59% among subadults (Bujilova, 1995; Marcsik, 1975, 1985; Yankauskas, 1993).

Rathbun (1984), studying the middle to late Archaic period in the American state of South Carolina found the frequency of Cribra orbitalia to be approximately 23% in the samples he examined. This time period corresponds to approximately the early Iron Age in the Old World.

Suzuki (1993) examined frequencies of Cribra orbitalia in early Japan (500 AD), noting approximately13% among adults and 24% among children.

Marscik (1985) found Cribra orbitalia at nearly 59% in an Avar period Hungarian sample.

Now, to recapitulate the Mongolian data, among the West-Mongolian early Iron Age sample Cribra orbitalia is found in approximately 28% of adults, and approximately 85% of subadults. Among the Central Northern Mongolian Hunnu period sample, Cribra-orbitalia is found in approximately 14% of adults, and 25% of subadults. These figures compare well with the New World and European data. Note in general the highest percentages per capita carrying the condition are subadults.

The high frequencies of Cribra orbitalia among the Mongolian Chandman and Hungarian Avar children falls into place through the perspective of living stress induced by the process of learning and mastering new territory. The people represented by the Chandman burials were of a more heterogeneous makeup, as they were connected with the melange of Europoid and Mongoloid components of that time in that place.  Handsuren, (1969), T.Tot, Firshtein, (1971), Dorjsuren, (1961), Sukhbaatar (1971) suggest population of Avar period (IY-YI AD) Hungary, was migration from Central Asia, in particular from Mongolia of Jujan  (IY-Y AD) period.

Some researchers suggest Cribra-orbitalia represents a sequelae stemming from some infectious diseases, for instance, some intestinal diseases, malaria and anemia, etc (Hengen.1971; Marcsik.1975).

If we can safely extrapolate the frequency of Cribra orbitalia among the Chandman subadults to a larger sample, it is likely that a number of soft tissue conditions as noted above may contribute to the skeletal expression of this pathology.

Mamanova (1978) reporting demographic aspects of the Chandman series concludes that infant death-rate frequencies correspond to particularities of physiological development. She notes that failing immunity appears to come in the first months of life, where intestinal problems begin when weaning from breastfeeding to solid foods.


Cranial materials from Bronze and Iron Age to Hunnu period samples were examined for paleopathological information suggestive of iron deficiency anemias in early Mongolian Nomad populations.

The demographics as well as pathology distributions among adults in these samples correspond relatively well with comparative samples representing European and New World populations, however a wider range of relative frequencies is found to occur among subadults, for the various regions examined.

          Cribra-orbitalia is found at relatively high levels among subadults and in woman from late Bronze early Iron age to Hunnu period in these samples from the Chandman and Borkhan Tolgoi sites, representing nomadic populations. This appears to have been a result of iron deficiency anemias, and some infection or parasitic infestation likely due to generally unhealthy living conditions among Nomads



The author is deeply indebted to Dr. Mark Nathan Cohen, of the Department of anthropology, SUNY Plattsburgh, for supporting to participate in a symposium on Paleopathology and Economic Intensification, April 18-21 in Clearwater Florida USA.













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