An Archaeological Case of Cleft Lip and Palate in Late Imperial China (1796–1820  ce ) and Its Social Implications

As a congenital defect, orofacial clefts, if untreated, would lead to biological and social challenges. In addition to the requirements of intense care immediately after birth, orofacial clefting can cause lifelong difficulties with eating and speaking, with the possibility of social marginalization and exclusion. In this study, a young male (16–18 years) with signs of congenital craniofacial anomalies from the Wenchi cemetery in northern China from the Qing Dynasty (1796–1820 ce ) was investigated. Macroscopic and CT analyses showed a defective right primary palate including the alveolar arch and defective bilateral secondary palates, in addition to a severe deviation of the nasal septum. These features suggested a birth defect of unilateral cleft lip and bilateral cleft palate. Despite these conditions, the individual was interred in a formal family tomb with standard grave goods and in association with an adult female, suggesting full integration into his community. The person survived the critical period of growth and development after birth and his remains were not tainted by shame. However, the death of the individual at such a young age suggests the innate frailty or vulnerability of children with birth defects. This is the first case of cleft lip and palate from an archaeological context in China. The study not only enriches our knowledge of the history of congenital craniofacial anomalies but also provides rare insight into historical caregiving and inclusive social attitudes toward individuals with visible birth defects in late imperial China.