









































Bioarchaeology International
Volume 7, Number 1: 1–31
DOI: 10.5744/bi.2022.0011

Copyright © 2023 University of Florida Press

Structural Violence and Physical Death at 
Tlatelolco: Selecting the Chronically Malnourished 
for Sacrifice at a Late Postclassic Mesoamerican 
City (1300– 1521 CE)
Kelly E. Blevins,a,b* Madeline McGrane,b Josefina Mansilla Lory,c Salvador 
Guilliem Arroyo,d and Jane E. Buikstrab

aDepartment of Archaeology, Durham University, Durham, UK
bCenter for Bio archae ol o gi cal Research, School of Human Evolution and Social Change, Arizona State 
University, Tempe, AZ, USA

cDirección de Antropología Física, Instituto Nacional de Antropología e Historia, Mexico City, Mexico
dZona Arqueológica Tlatelolco, Instituto Nacional de Antropología e Historia, Mexico City, Mexico
*Correspondence to: Kelly E. Blevins, Department of Archaeology, Durham University, Lower Mount Joy 
South Rd, Durham DH1 3LE, United Kingdom. 

E- mail: blevinske1@gmail . com

ABSTRACT Human sacrifice in Mesoamerican cities was diverse and highly ritualized, and it remains incompletely under-
stood. Knowing who was selected for ritual violence is essential for interpreting specialized mortuary deposits 
and furthering research on Mexica society. To understand the structure and variability of sacrificial and mor-
tuary practices, we examine here three burial contexts from Tlatelolco, a densely populated city in the heart of 
the Triple Alliance. The interment contexts of Grupo Norte (n = 52) and Paso a Desnivel (n = 45) had been exca-
vated from within the ceremonial center near the Tlatelolco Templo Mayor, and Atenantitech (n = 40) from a 
bordering calpulli or neighborhood. To establish which contexts are likely sacrificial deposits, we compare the 
age- at- death distributions, biological sex, and perimortem ritual trauma across these sites. We seek to under-
stand if social status determined sacrificial inclusion by using metabolic and infectious disease as proxies for 
resource inequality. We find that the residential deposit approximates an attritional mortality distribution and 
that ceremonial center deposits primarily comprised non- adults, who also presented with significantly higher 
rates of metabolic and infectious disease than the non- adults from the residential site. Informed by previous 
studies and the ethnohistorical literature, we propose that impoverished individuals living on the margins of 
Mexica society were chosen as sacrificial victims. High prevalence of metabolic and infectious disease comor-
bidity indicates that these individuals endured long- term nutritional deficiency, apparently vitamin C. Further, 
variation in age, pathology, and perimortem treatment among ceremonial center deposits reveals the striking 
diversity of ritualized killings in a prominent Mexica city.

Keywords: human sacrifice; structural violence; Tlatelolco; Mesoamerica; Mexica; scurvy

 El sacrificio en mesoamérica fue en extremo diverso, con muy diferentes y complejos rituales, saber quién y 
porqué fue seleccionado, para ser consagrados en un lugar específico es fundamental para interpretar los de-
pósitos mortuorios y avanzar en la investigación sobre la sociedad mexica. Para comprender la estructura y vari-
abilidad de las prácticas mortuorias, examinamos tres contextos de entierros de Tlatelolco, una ciudad 
densamente poblada localizada en el corazón de la Triple Alianza. Los contextos de entierro de Grupo Norte 

Received 22 February 2022
Revised 27 June 2022

Accepted 27 June 2022



Structural Violence and Physical Death at Tlatelolco2

Mexica sacrificial rites were complex, distinctive, and 
predictable; human sacrifice was methodically prac-
ticed throughout an annual cycle of ceremonies and 
festivals. Human remains were offered to the gods as 
intricate ofrendas from contexts as grand as templos 
mayores to commonplace residential courtyards, bod-
ies were butchered for ceremonial consumption, and 
skulls were organized into racks and columns called 
tzompantli as dramatic displays of authority (Chávez 
Balderas 2017; Horcasitas and Heyden 1971; López Lu-
ján and Olivier 2010; Núñez Enríquez 2006). There are 
rich bio archae ol o gi cal records of human sacrifice from 
the Mexica cities Tenochtitlan- Tlatelolco that corrobo-
rate these detailed ethnohistorical depictions, such as 
displays of severed heads on tzompantli skull racks 
(Chávez Balderas 2017; González Rul 1963; Pijoan 
Aguadé et al. 1989), caches of dismembered and sorted 
human bones (Pijoan Aguadé 1997; Pijoan Aguadé 
et al. 1995), and ribcages and sternums with evidence of 
heart extraction (Chávez Balderas 2017). Pennock 
(2012) estimates that 87 human sacrificial rites occurred 
during an annual ceremonial cycle from Sahagún’s 
 Florentine Codex— The Ceremonies, each a purposeful 
transaction between the worldly and otherworldly.

How people were chosen for sacrificial rites, how-
ever, remains unclear, despite their identities being 
central for understanding Mexica social hierarchy and 
societal organization. Ethnohistoric sources suggest 
that elements of social identity or perhaps intersecting 
identities, such as age, gender, health, or ethnic affili-
ation; status as a slave or war captive; or emulation of 
the deity being worshipped determined who was se-
lected for ritual sacrifice (summarized in Graulich 
2016:221– 267; Iguaz 1993; Ingham 1984; Paulinyi 2013; 
Román Berrelleza and Chávez Balderas 2006; Román 
Berrelleza and Rodríguez 1997). Some Mexica scholars 

identify the Flowery Wars (state- sanctioned warfare) 
as the primary method for capturing sacrificial vic-
tims (Davies 1977; Ingham 1984; Read 1998). The so-
cial identities of sacrificial victims were likely as 
diverse as the ceremonies themselves.

Bio archae ol o gi cal analysis of sacrificial deposits is 
key to clarifying how social identities predisposed in-
dividuals to specialized forms of ritual killings and 
sacrificial inclusion overall. The skeleton serves as a re-
cord of lived experience, simultaneously document-
ing an individual’s age and sex and showing how 
these persona intersected with risk of chronic malnu-
trition, disease, and traumatic injury (De La Cova 
2011, 2012, 2014; Null et al. 2004; Watkins 2012). Skel-
etal analyses of human sacrifices from Mexica cities 
Tenochtitlan- Tlatelolco have revealed that primary 
interments largely comprised non- adults (De La Cruz 
et al. 2008; Guilliem Arroyo 1999; López Luján 1993; 
Román Berrelleza 1990, 2010; Román Berrelleza and 
Chávez Balderas 2006), underscoring the importance 
of age for sacrificial inclusion. Templo de Ehécatl- 
Quetzalcóatl, subsequently referred to as Templo R, 
and Ofrenda 48 are examples of such sacrificial depos-
its comprising mostly non- adults.

In the ceremonial center of Tlatelolco, Guilliem Ar-
royo (1999) and his team excavated 43 human burials 
from the base of Templo R (Guilliem Arroyo 1999); 
 approximately 70  percent of the individuals were 
younger than 10 years (De La Cruz et al. 2008; Guilliem 
Arroyo 1999). De la Cruz and colleagues (2008) used 
ancient DNA (aDNA) methods to assess sex of the 
Templo R non- adult remains and found that nearly all 
the individuals were male. Excavated from the base of 
Tenochtitlan’s Templo Mayor, Ofrenda 48 contained 
42 flexed interments of non- adults between two and 
seven years old inside a rectangular tomb with white 

(n = 52) y Paso a Desnivel (n = 45) habían sido excavados dentro del centro ceremonial cerca del Templo Mayor 
de Tlatelolco, y Atenantitech (n = 40) de un barrio o calpulli limítrofe. Para confirmar y explicar qué contextos 
son depósitos de sacrificio, comparamos las distribuciones de edad biológica al morir, el sexo y el trauma ritual 
perimortem en estos restos humanos. Buscamos esclarecer si el estatus social determina la inclusión sacrificato-
ria mediante el análisis de enfermedades metabólicas e infecciosas como parámetros de una desigualdad de 
recursos. Encontramos que los individuos del sitio de enterramientos residencial se aproxima a una distribu-
ción de mortalidad por deterioro físico y que los depósitos de restos humanos del centro ceremonial estaban 
compuestos principalmente por sujetos no adultos que a su vez presentan tasas significativamente más altas de 
enfermedades metabólicas e infecciosas que los no adultos del sitio residencial. Con base en estudios previos y 
la literatura etnohistórica, proponemos que algunos individuos con una calidad de vida menoscabada que vivían 
en los márgenes de la sociedad mexica, fueron elegidos como víctimas de sacrificio. La alta prevalencia de co-
morbilidad de enfermedades metabólicas e infecciosas indica que estas personas soportaron durante un largo 
plazo deficiencias nutricionales, aparentemente de vitamina C. Además, la variación entre la edad, la patología 
y el tratamiento perimortem entre los individuos de los depósitos mortuorios del centro ceremonial revela una 
sorprendente diversidad de rituales sacrificiales en una ciudad mexica prominente.

Palabras claves: sacrificio humano; violencia estructural; Tlatelolco; Mesoamerica; Mexica; escorbuto



Blevins et al. 3

stucco walls (López Luján 1993; Román Berrelleza 
1990). The young ages of the individuals and the abun-
dance of blue pigments, jugs sculpted with the face of 
Tlaloc, and offerings of aquatic nature, such as marine 
shells, suggest that this was a sacrificial offering to 
Tlaloc, the deity of the aquatic realm and bringer of 
rains (López Luján 1993).

Templo R and Ofrenda 48 sacrificial deposits have 
been linked to periods of drought and famine reported 
in Mexica codices throughout the fourteenth and fif-
teenth centuries (De La Cruz et al. 2008; Guilliem Ar-
royo 1999; Read 1998:183; Román Berrelleza 1999; 
Román Berrelleza and Chávez Balderas 2006; Therrell 
et al. 2004). In the Mexica worldview, childhood was 
a liminal phase between the otherworldly and the 
worldly (López Austin 2004:324; Román Berrelleza 
2010). Children possessed a purity that, combined with 
their lingering connection to the otherworldly, made 
them particularly valuable to the gods. As such, in-
fants and children were ritually killed and offered as 
blood sacrifice to appease deities responsible for pre-
venting droughts, ensuring bountiful crop yields, and 
infusing energy into each new year (Anderson and 
Dibble 1981; Read 1998). Ethnohistoric accounts de-
scribe “little noble children” being sacrificed as a 
small- scale but annual occurrence (Arnold 1999). An-
nually, as payment for rains, and therefore fertile land 
and plentiful harvests, children were ritually killed not 
inside city centers but within Lake Texcoco or near 
bodies of water in the mountains surrounding the 
 Basin of Mexico, as recounted by Durán and others 
(Broda de Casas 1971; Horcasitas and Heyden 1971:157; 
Paulinyi 2013). Chroniclers of Nueva España, Durán, 
Motolinía, Pomar, and Sahagún report variable num-
bers of children sacrificed during these annual or 
 special occasions, from one to four (Benavente 2014:50; 
Horcasitas and Heyden 1971:157), 10 to 15 (Pomar 
1989:168– 169), or “many” (Anderson and Dibble 1981:1).

Further, an important aspect of Mexica child sac-
rifice was ixiptla, or living representations of the gods 
and their assistants (López Luján and Olivier 2010; 
Román Berrelleza 2010; Román Berrelleza and Chávez 
Balderas 2006). This concept has been invoked to ex-
plain the male sex bias of the Templo R non- adults, as 
Ehécatl- Quetzalcóatl is a male deity (Román Ber-
relleza and Chávez Balderas 2006). The exclusively 
young ages of the Ofrenda 48 non- adults have been 
interpreted as the embodiment of the tlaloques, 
Tlaloc’s child- sized assistants (Román Berrelleza 
1990). Additionally, Román Berrelleza (1990, 1999, 
2010) has reported that more than 50 percent of the 
non- adults from Templo R and Ofrenda 48 have 
 skeletal pathologies, namely cribra orbitalia, porotic 
 hyperostosis, and severe carious lesions. De la Cruz 

et  al. (2008) and Paulinyi (2013) interpret the high 
 pathology prevalence as further support for the cen-
trality of ixiptla in child sacrifice, as some deities 
were patrons of specific disorders and diseases (De 
La Cruz et al. 2008; Paulinyi 2013). Pathology preva-
lence figures, however, have not been published, nor 
do we know whether these pathologies occurred at 
similar frequencies in individuals who were not sac-
rificed (i.e., those who died natural deaths).

If non- adults were indeed selected for sacrifice 
based on the diseases that marked them as embodied 
deities, then we must specify those disease etiologies 
to understand if and how living circumstances predis-
posed non- adults to sickness and therefore sacrifice. 
Chronic malnutrition and infection offer clear insight 
concerning these children’s living environment and 
socioeconomic status and, intrinsically related, their 
ability to access adequate nutrition (Farmer 1996a, 
1996b; Fotso 2006; Harpham 2009).

Here we investigate how the mechanisms for 
 selecting non- adults for human sacrifice reflect social 
hierarchy and inequity in a densely populated late 
Postclassic Mesoamerican city, Tlatelolco, by using in-
fection and vitamin C deficiency as proxies for re-
source inequity. By the arrival of the Spanish in 1519 
CE, Tlatelolco housed the largest marketplace in the 
Mesoamerica; tens of thousands of visitors purportedly 
attended the city center daily (Pagden 1986:103). 
Tlatelolco was located approximately three kilometers 
north of the Triple Alliance imperial capital, Tenochtit-
lan, and was connected to it by a causeway. Tenochtitlan- 
Tlatelolco were contiguous human- modified islands in 
the Basin of Mexico that were rapidly settled and devel-
oped by the Mexica people within the 200 to 300 years 
prior to European contact (Davies 1980; Sanders et al. 
1979; Solis and Morales 1990). When the Spanish ar-
rived, Tlatelolco had been annexed by Tenochtitlan and 
continued to serve as the ceremonial and commercial 
heart of the city (Anderson and Schroeder 1997:49– 51); 
tens of thousands individuals were thought to have 
lived in the contiguous islands (Jiménez Martínez 
2021). As a ceremonial center and densely populated 
metropolis, Tlatelolco is an ideal place to investigate 
the intersection of Mexica religious ideology and urban 
inequality.

While it is clear that the Tlatelolco skeletal collec-
tions include definitive evidence of ritualized sacrifice 
and dismemberment (Guilliem Arroyo 2008; Pijoan 
Aguadé et al. 1989, 1995; Pijoan Aguadé and Mansilla 
Lory 2010), the lack of archaeological contextual infor-
mation, including maps and grave goods, has thus far 
impeded formal investigation, with the exception of 
Templo R. There are hundreds of individual burials 
from multiple contexts that remain unanalyzed. 



Structural Violence and Physical Death at Tlatelolco4

Individual burials from different areas of the site 
 remain difficult to interpret, given the paucity of 
comparative data from late Postclassic ceremonial 
centers (see Appendix S1 Archaeological Context). To 
expand our understanding of ritual sacrifice and spe-
cialized mortuary practices and how individuals were 
chosen for  inclusion in such contexts at Tlatelolco, we 
compared osteobiographical profiles of two uncharac-
terized mortuary deposits (Grupo Norte and Paso a 
Desnivel) excavated from the ceremonial center to a 
mortuary deposit excavated from Atenantitech, a neigh-
borhood adjacent to the ceremonial center. We aim to 
(1) determine if individuals interred in the ceremonial 
center were sacrificed, (2) reveal the variability of spe-
cialized mortuary and sacrificial treatment between the 
Tlatelolco ceremonial center and a residential site, and 
(3) identify whether aspects of social status as reflected 
by malnutrition and infection determined sacrificial 
inclusion.

Materials

Skeletal assemblages analyzed in this study: 
Grupo Norte, Paso a Desnivel, and 
Atenantitech

For this study, we analyzed skeletons that were exca-
vated from the Tlatelolco ceremonial center during a 
period of intense urban development and salvage ar-
chaeology in 1961 and 1962. The northwestern area of 
the site was excavated then, and of particular interest 
are the areas that presently house the Eje Central Lázaro 
Cárdenas avenue. A group of structures, Templo I 
Norte, Templo II Norte, and Templo Redondo, subse-
quently referred to as Grupo Norte (Fig. 1), had associ-
ated burials, previously reported as including primary 
inhumations, cremations, and mixed burials (González 
Rul and García Mejía 1962). Hundreds of burials were 
excavated from Grupo Norte. The iconic Ossuary 14 of 

Figure 1. Map of the Basin of Mexico during the Late Postclassic period showing the location of Tenochtitlan- Tlatelolco. Expanded area shows the 
approximate boundaries of the Tlatelolco ceremonial precinct (teal) and Atenantitech barrio (yellow) overlaid on modern- day Mexico City. 
Approximate excavation locations of the skeletons considered in this study are marked in red. Basin of Mexico map by Yavidaxiu, public domain, 
via Wikimedia Commons. Map of Tlatelolco modified from Google, Imagery 2021 CNES/Airbus, Maxar Technologies, following work by HJPD CC 
BY- SA 3.0.



Blevins et al. 5

more than 150 dismembered, defleshed, and commin-
gled individuals was excavated from this area (Pijoan 
Aguadé 1997; Pijoan Aguadé et al. 1995), but many sin-
gle burials were recovered as well. Skeletons were also 
recovered from the context Paso a Desnivel, which 
translates to “overpass.” This collection of burials is 
thought to have been excavated from an area just north-
west of Grupo Norte where there now exists a highway 
overpass on Eje Central Lázaro Cárdenas (Fig. 1).

The primary burials from Grupo Norte (n = 52) and 
Paso a Desnivel (n = 45) remain unpublished, likely in 
part due to the aforementioned difficulties delineating 
mortuary contexts, lack of documented grave goods, 
and absence of maps, drawings, and levels. As archae-
ologist Francisco González Rul explained in an inter-
view, the salvage nature of the Grupo Norte and Paso 
a Desnivel excavations meant that the areas were ex-
cavated simultaneously and burials were given num-
bers as they were excavated, regardless of context 
(Guilliem Arroyo, personal communication, 2016). For 
example, Entierros 7– 20 and 89– 124 were excavated 
from the Grupo Norte complex, and Entierros 21– 71 
were excavated from Paso a Desnivel. Thanks to the 
decades of archival work by Salvador Guilliem Arroyo 
and the Proyecto Tlatelolco team, it was possible to 
match the burial numbers and contexts recorded in 
Francisco González Rul’s field notebook with the 
burial numbers of the skeletons stored in the Instituto 
Nacional de Antropología e Historia (INAH) Direc-
ción de Antropología Física (DAF) Tlatelolco collec-
tion, stored in the Museo Nacional de Antropología 
(MNA) in Mexico City, Mexico.

Beginning in 1988, archaeologist Maria de Jesus 
Sanchez Vazquez led the salvage excavation of a resi-
dential area in the neighborhood of Atenantitech, a 
barrio of Tlatelolco (Caso 1956) (Fig. 1). An area of ap-
proximately 5,500 m2 was sampled, and 56 burials 
were excavated by 1990; 45 of those burials were moved 
to INAH- DAF for curation, and 40 were available for 
analysis here (Calderon 2009). Burials were excavated 
from multiple stratigraphic levels spanning the late 
Postclassic occupation of Tlatelolco. Although the 
foundations of residential buildings were found in sev-
eral levels, all skeletons were excavated from an open 
area delimited by buildings, further supporting its 
long- term use as a centro funerario (Jesús Sánchez 
Vázquez, personal communication). Both adults 
and non- adults were recovered from the site. Most of 
the non- adults were buried in a cluster separate from 
the adults, providing some evidence of age- based 
mortuary behavior (Calderon 2009). Cremations were 
apparently excavated from the site as well, but there is 
no indication of how many. The skeletal assemblage 
excavated from Atenantitech serves as a normal mor-
tality comparison for the ceremonial center contexts.

Methods

Data collection

The first author collected all the raw age, sex, and pa-
thology data macroscopically from the INAH- DAF 
Tlatelolco skeletal collections at the MNA in Mexico 
City, Mexico.

Sex recording details
Sex was primarily assessed using pelvic morphology. 
When necessary due to incomplete preservation, how-
ever, cranial morphology and scapula glenoid, hu-
meral head, and/or femoral head width measurements 
were used to assign sex. No attempt was made to as-
sess the sex of non- adult skeletal morphology (Appen-
dix S1 Methodology: Sex assessment).

While reconciling context and burial numbers as 
recorded in the original field notebook with burial 
numbers on the storage boxes, however, it was possi-
ble to match skeleton IDs to those published as part 
of aDNA studies. Therefore, genetic sex assignments 
were included for the Grupo Norte and Paso a Desnivel 
individuals analyzed by Morales- Arce et al. (2019) and 
for individuals in the comparative Templo R sample 
analyzed by De La Cruz et al. (2008) (Table A1).

Age recording details
Non- adults. When teeth were available, age range es-
timates were generated using The London Atlas of 
Tooth Development and Eruption (AlQahtani et al. 
2010). Otherwise, age was estimated using skeletal el-
ement measurements (Maresh 1970) and/or epiphyseal 
union stages as collated by Schaefer et al. (2009) (see 
Appendix S1 Methodology: Non- adult age assess-
ment). For statistical treatment, the average value of 
each non- adult’s age range was selected as a point es-
timate for all summary statistics and analyses.

Adults. Age ranges were generated using Transition 
Analysis ADBOU Age Estimation v2.1.046 (available 
at http:// statsmachine . net / software / ADBOU2/) for 
 individuals whose epiphyses were obliterated and 
dental development was complete (Boldsen et  al. 
2002). The corrected point estimate was rounded to 
the nearest whole number and used as the age esti-
mate for all summary statistics and analyses. Age 
ranges and point estimates for all individuals can be 
found in Table A1.

Paleopathological recording details

Differential diagnosis
A differential diagnosis was designed using published 
criteria for scurvy, rickets, porotic lesions caused by 

http://statsmachine.net/software/ADBOU2/


Structural Violence and Physical Death at Tlatelolco6

acquired anemia, and infectious disease (Klaus and 
Lynnerup 2019; Ortner and Mays 1998; Ragsdale et al. 
1981; Schattmann et al. 2016; Snoddy et al. 2018; Stu-
art‐Macadam 1991; Weston 2012). Each individual was 
assigned present, absent, or unobservable for each 
pathological indicator. See Appendix S2 (A, B, 
and C): “Pathology Distribution Figures” for intra- 
skeleton preservation and pathological distributions. 
Diagnostic pathological changes caused by rickets 
were not observed in any individuals, so the final 
pathological categories for the analysis were scurvy, 
anemia, and infectious disease (Table A2). See 
 Appendix S1 Table S1 missing data assessment for 
a  summary of how unobservable/missing values 
 affected sample sizes for each analysis.

Scurvy. Individuals were diagnosed with scurvy if 
they had at least one diagnostic indicator or at least 
two suggestive indicators as defined in Table A2. The 
differential diagnosis was designed using criteria pub-
lished by Snoddy et al. (2018) and Schattmann et al. 
(2016), and photographic examples of indicators can 
be seen in Figure 2. Individuals were determined to be 
scurvy free if they had cranial and postcranial ele-
ments preserved and no diagnostic lesions or only 
one suggestive lesion. In this study, most scorbutic 
changes were isolated to cranial and mandibular ele-
ments. Therefore, if an individual did not have a 
 preserved skull or cranial fragments and had no 
postcranial pathological changes diagnostic or sugges-
tive of scurvy, they were identified as unobservable 
(NA) for scurvy.

Anemia. Penetrating porotic lesions accompanied 
by expansive diploë and thinning of the outer table on 
the orbits and cranial vault were considered indicative 
of anemia (Types 3, 4, and 5 from Stuart- Macadam 
1991). If an individual did not have a preserved skull 
or cranial fragments, they were identified as unob-
servable (NA) for anemia.

Infectious disease. An individual was identified as 
having infectious disease if they had subperiosteal new 
bone formation (SPNBF), osteolytic changes, or osteo-
blastic changes suggestive of infection. In this study, 
diffuse SPNBF was recorded as infection due to its 
documented and hypothesized associations with sys-
temic bacterial and viral infections (Burrows 1971; 
Csonka and Pace 1985; Haygood and Williamson 1994; 
Lakey et  al. 2008; Rasool 2001; Teo and Peh 2004). 
SPNBF was identified as an indicator of infection 
when the lesion patterning suggested a systemic stim-
ulus (Ragsdale et al. 1981; Weston 2012). Specifically, 
the SPNBF must have been (1) present on at least a 
third of the diaphysis of long bones and (2) bilaterally 
distributed or present across multiple skeletal ele-
ments. Additionally, individuals with SPNBF along 
the visceral surface of the vertebral portion of the ribs 

were identified as having an infection (Cheng Pau 
et al. 2009; Collier et al. 1967; Davies- Barrett et al. 2019; 
Roberts et al. 1994). SPNBF lesions formed in response 
to the pooling of blood and subsequent inflammation 
on the distal aspects of long bones, thought to be 
caused by scorbutic hemorrhaging (Choi et al. 2007; 
Gulko et al. 2015), were not considered as indicators of 
infection.

In several cases, osteolytic and osteoblastic changes 
could be reliably attributed to a more specific disease 
process, such as treponemal disease and tuberculosis 
(Baker et al. 2020; Klaus and Lynnerup 2019; Pálfi et al. 
2012). Those data will be analyzed in subsequent pub-
lications, but in this analysis, those individuals were 
recorded as having infectious disease. Therefore, “in-
fectious disease,” as recorded here, refers to unspeci-
fied and specific infections. Only individuals with 
more than half of their appendicular and axial skele-
tons preserved were recorded as observable for infec-
tious disease.

Comparative age and sex data. The well- documented 
sacrificial assemblage from Templo R was used as a 
comparative sample for paleodemographic analyses. 
These skeletons are curated in the Tenochtitlan Tem-
plo Mayor Museum and were not analyzed as part of 
this study, so they are not included in the pathology 
analyses. We used age estimates previously published by 
Moreiras Reynaga et al. (2021), De la Cruz et al. (2008), 
and Guilliem Arroyo (1999), as indicated in  Table A1.

Cut marks. The first author documented perimor-
tem cut marks typical of those previously identified 
at Tlatelolco by Pijoan Aguadé (1995, 1997). All skele-
tal elements were macroscopically examined for 
 perimortem trauma. Perimortem trauma related to 
ritual treatment was classified as dismemberment, 
scalping, cut marks from defleshing and/or disartic-
ulation, heart extraction, or decapitation (following 
Hamilton 2016; Jelíneck 1993; Pijoan Aguadé 1997; 
Pijoan Aguadé and Mansilla Lory 2010; Pijoan 
Aguadé et  al. 1995; Tiesler and Olivier 2020). Dis-
memberment was identified as percussive impacts 
near ligament attachments or joints (Fig. 3a). Scalp-
ing was identified as cut marks on the calvarium 
(Fig. 3b). Defleshing/disarticulation was identified as 
clusters of cut marks around tendon or muscle at-
tachment sites, including the vertebral rib  ends 
(Fig. 3c). Heart extraction was identified as cut marks 
on the sternal ends of the ribs, multiple perimortem 
fractures on sternal rib ends (Fig.  4a, b), and/or bi-
sected sterna and/or manubriam (Fig. 4c). Decapita-
tion was identified as cut marks on the basicranium, 
cervical vertebrae, and/or first rib. Using written 
 descriptions and photos, composite distributions of 
perimortem trauma were created in Pixelmator Pro 
v2.0.5 Junipero.



Figure 2. Examples of pathological indicators used in the differential diagnosis (skeleton ID). (a) Ectocranial temporal and greater sphenoid wing 
porosity and new bone formation (NBF) (196_116). (b) Endocranial occipital NBF (128_40). (c) Endocranial sphenoid foramen rotundum NBF 
(128_40). (d) Endocranial sphenoid lesser wing NBF (121_24). (e) Orbit NBF and porosity (118_19). (f) Posterior zygomatic and posterior maxilla 
NBF (195_114). (g) Anterior maxilla and infraorbital foramen porosity (195_114). (h) Medial mandible coronoid process porosity (118_19). (i) Inferior 
pars basilaris porosity (56_14D). (j) Scapula supraspinous fossa NBF and porosity (121_24). (k) Visceral surface ilium NBF, vascular impressions, 
and porosity (195_114). (l) Distal anterolateral humerus metaphysis NBF and porosity (121_24). (m) Anterolateral rib shaft NBF and porosity 
(182_94). (n) Rib sternal end porosity (183_95b). (o) Anterior distal femur metaphysis porosity (56_14D). (p) Orbit penetrating and expansive 
porosity (ATN_22_28). (q) Anterior ulnae diffuse NBF (121_24). (r) Anterolateral tibia diaphysis NBF (129_43). Photos taken by first author or Juan 
Salvador Rivera Sánchez INAH- DAF (h).



Structural Violence and Physical Death at Tlatelolco8

Radiocarbon dating

To understand better the chronology of the mortuary 
deposits, seven individuals were chosen for radiocar-
bon dating: three from Grupo Norte, three from Paso 
a Desnivel, and one from Atenantitech. Samples of six 
vertebral elements and one ilium weighing between 
344 and 693 mg were processed by the University of 
Arizona AMS Laboratory.

Comparative analyses

Paleodemographic comparisons
To differentiate between special mortuary and nor-
mal mortality deposits, we compared the age- at- death 

distributions of the three ceremonial center contexts, 
Grupo Norte, Paso a Desnivel, and Templo R, and one 
residential context, Atenantitech. The distributions 
were visualized by binned age categories as well as 
by  Kaplan– Meier survival curves. To determine if 
there are significant differences among the mortuary 
contexts, two multiway (1: all contexts; 2: ceremonial 
center contexts) and one pairwise (residential context 
and ceremonial center context) log- rank tests were 
performed on the survival times (i.e., age- at- death dis-
tributions). Log- rank test was chosen because we are 
only interested in differences in overall survival curve 
distribution and not controlling for any confounding 
factors. To correct for the family- wise error rate that 
results from performing multiple statistical tests, the 

Figure 3. (a) Right femur distal epiphyseal surface, three angles; impact from dismemberment; Grupo Norte 
182_94. (b) Posterior parietals and occipital; scalping with inset; Paso a Desnivel 135_55. (c) Right proximal 
humerus; cut marks (defleshing and/or disarticulation) on crest of greater tubercle with inset; Paso a Desnivel 
137_59.



Blevins et al. 9

Bonferroni adjustment was made by dividing the orig-
inal alpha value by the number of log- rank tests, for a 
corrected alpha value of α = 0.05/3 = 0.016.

In addition to age- at- death distributions, we com-
pared sex ratios across all contexts. Sex of individuals 
younger than 16 years was previously assessed using 
amplicon (De la Cruz et al. 2008) and whole- genome 
sequencing (Morales- Arce et al. 2019).

Metabolic and infectious disease distributions
Chi- square analysis. First, we performed a chi- square 
test on a 3 × 4 contingency table to identify differ-
ences  in metabolic disease, infectious disease, and 
 comorbidity of infectious and metabolic disease dis-
tributions between the ceremonial center contexts 
(Grupo Norte and Paso a Desnivel) and residential 
context (Atenantitech). Scurvy and anemia were 
 collapsed into a metabolic disease category to avoid 

uncertainty in the etiology of orbital lesions. To en-
sure comparable results across contexts, analyses were 
limited to individuals with age estimates younger 
than 20  years because (1) the ratio of non- adults to 
adults is higher in the ceremonial center contexts, 
and (2) skeletal manifestations of pathologies differ 
between non- adults and adults. The cutoff of 20 years 
was chosen to include adolescent individuals with 
non- obliterated epiphyses who had age ranges span-
ning 16 to 22 years. Although it is recommended to 
use a Fisher’s exact test for contingency tables when 
>20 percent of the cells have values fewer than five, a 
chi- square test was chosen because it is better suited 
for the interpretation and visualization of multiway 
contingency tables (SI Methodology: Chi- square vi-
sualizations). To be conservative, we performed Fish-
er’s exact tests and found similar p- values for both 
tests.

Figure 4. Paso a Desnivel 140_65. (a) Left rib #4 visceral surface showing perimortem break on sternal 
end (left) and same rib with view of external surface showing perimortem break (right) with black circle 
showing plastic deformation. (b) Right rib #2 showing perimortem break at the sternal end from the 
visceral (left) and external (right) surfaces. (c) Perimortem bisection of sternum. White arrows showing 
lack of color differential and/or plastic deformation.



Structural Violence and Physical Death at Tlatelolco10

All statistical tests and plotting were done in 
 RStudio (R version 4.1.2) using base R and the ggplot2, 
ggridges, Bchron, tidyr, dplyr, tibble, survminer, 
 survival, and corrplot packages (Haslett and Parnell 
2008; Kassambara et  al. 2019; Müller and Wickham 
2020; Therneau 2015; Wei and Simko 2017; Wickham 
2016, 2020; Wickham et al. 2020; Wilke 2017). All of 
the R code can be found at https:// github . com / Kelzor 
/ Human - sacrifice - and - malnutrition - at - Tlatelolco.

Cut marks. The perimortem trauma distribu-
tions  were visually compared using the composite 
distributions and a bar chart of counts.

Results

Paleodemographic comparisons

There are clear differences in age- at- death distri-
butions between ceremonial and residential con-
texts (Fig.  5). The residential context, Atenantitech, 

approximates a normal- mortality distribution as a U- 
shaped curve with peaks in the first five years of life 
and during adulthood. There were no perinates or in-
fants recovered from the Atenantitech cemetery, sug-
gesting perinates and infants had distinct mortuary 
treatment. In contrast to the U- shaped distribution 
of Atenantitech, the Grupo Norte and Paso a 
Desnivel distributions are dominated by peaks in 
the 1-  to  5- year and 10-  to 20- year age categories and 
have few adult individuals. The Templo R distribu-
tion differs from all other contexts with the largest 
peaks in the youngest age categories, 0– 1 and 1– 5.

Kaplan– Meier survival curves illustrate the proba-
bility of individuals remaining in the sample as age 
increases (Fig. 6). The log- rank test result for all con-
texts indicates that there is a significant difference 
among survival curves (p < 0.001) (Fig.  6a, Table  1). 
There are significant differences among survival 
curves of the ceremonial center contexts (p = 0.007) 
(Fig. 6b) and between the residential context, Atenan-
titech, and the ceremonial center context with the most 

Figure 5. Age- at- death distribution by context. For the age ranges, the lower value is exclusive, and the 
higher value is inclusive. For example, Age Group 1– 5 contains individuals more than one year of age at 
death up to and including five years of age at death, whereas individuals one year or less of age at death 
are in Age Group 0– 1.

https://github.com/Kelzor/Human-sacrifice-and-malnutrition-at-Tlatelolco
https://github.com/Kelzor/Human-sacrifice-and-malnutrition-at-Tlatelolco


Blevins et al. 11

similar survival curve, Paso a Desnivel (p  =  0.004) 
(Fig. 6c, Table 1). The age- at- death distributions of At-
enantitech and Templo R are significantly different 
from one another and the other two ceremonial center 
contexts, Grupo Norte and Paso a Desnivel.

There is a marked sex skew in non- adults from the 
ceremonial center (Fig. 7). The Templo R non- adults 
are almost entirely male, and the Paso a Desnivel and 
Grupo Norte non- adults are almost entirely female. 
The individuals aged 16+ years- at- death from Templo 

R are all male. The 16+ individuals from Paso a 
Desnivel and Grupo Norte show less sex bias than in 
the younger individuals, but the older individuals are 
predominantly female. No individuals younger than 
16 years from Atenantitech have sex assessments be-
cause biomolecular work has not been performed on 
these remains. The 16+ individuals from Atenantitech 
approximate an even female to male ratio at 56:44.

Metabolic and infectious disease 
distributions

The comparison of infection, metabolic disease, and 
comorbidity distributions across the three contexts 
was limited to individuals younger than 20, because 
pathology frequencies are similar within contexts and 
age groups before 20+ years (Fig. 8). There are clear 
visual differences in pathology prevalence among 

Table 1. Log- Rank Test Results by Context Comparison.

Comparison χ2 df p

All contexts 32.4 3 <0.001*
Ceremonial contexts 9.8 2 0.007*
Residential and most similar ceremonial 8.1 1 0.004*

*Significant at α = .05/3 = .016.

Figure 6. Survival curves of (a) all contexts, (b) ceremonial center contexts, and (c) residential and most closely related ceremonial center context.



Structural Violence and Physical Death at Tlatelolco12

contexts (Fig.  9). The distributions of pathology 
across all contexts are significantly different, χ2(6, 
n  = 85) = 25.812, p < 0.001. The distributions of 
 pathology between the two ceremonial center contexts 
are  significantly different as well, χ2(3, n = 71) = 11.441, 
p = 0.009. The pathology distributions between Aten-
antitech and Grupo Norte do not significantly differ, 
χ2(3, n = 51) = 7.427, p = 0.059 (Table 2) (see Appendix 
S1 Figure S1 Chi- square visualizations).

The pathology distribution by age category and 
 context reveals that the percentage of unaffected in-
dividuals from Atenantitech remains similar across 
all age categories, despite small sample sizes per age 
category (Fig.  8). Individuals from the ceremonial 
center deposits show evidence of infection co- 
occurring consistently with metabolic disease in 
non- adults 0– 10 years of age- at- death. Infectious and 
metabolic comorbidity, however, does not occur in 
the youngest individuals from Atenantitech. All the 
individuals aged 20+ from the ceremonial center 
 deposits are affected. Among the Atenantitech age 
groups, the individuals aged 20+ have the highest 
prevalence of infection without co- occurrence of 
metabolic disease.

Cut marks

Paso a Desnivel has five to six times as many occur-
rences of perimortem trauma as the other two con-
texts (n = 21), and it is the only context with evidence 
of heart extraction (Fig.  10, Table  3). Grupo Norte 
(n = 4) and Atenantitech (n = 3) have similar amounts 
of perimortem trauma, but the types of ritualized 
traumas differ between the two sites (Figs. 10 and 11, 
 Table 3). The only forms of ceremonial perimortem 
trauma identified at Atenantitech are defleshing/dis-
articulation and scalping, whereas dismemberment is 
also present at Grupo Norte. All types of perimortem 
trauma were observed across all age groups, except for 
heart extraction, which was only observed in two 
adults, a female and male. There are no apparent sex- 
based differences among perimortem traumas, but 
only 60 percent of individuals have sex assignments 
(Table 3).

Radiocarbon dating

All seven bone samples yielded sufficient collagen for 
analysis, and the atomic C/N ratios range from 3.2 to 
3.4, which is considered to be of sufficient quality 

Figure 7. Sex prevalence by context and age category. Sample sizes indicate the number of individuals for 
which sex assessments were possible. Genetic sex determination of individuals in the 0– 16 age category was 
performed by De La Cruz et al. (2008) (Templo R) and Morales- Arce et al. (2019) (Grupo Norte and Paso a 
Desnivel).



Blevins et al. 13

(Deniro 1985). The IntCal20 (Reimer et al. 2020) cali-
brated dates from the Grupo Norte samples, two Paso 
a Desnivel samples and the sample from Atenantitech, 
were dated between 1332 and 1445 CE (95  percent 
probability interval) (Fig. 12, raw data in Appendix S1 
Table S2). One sample from Paso a Desnivel was dated 
to 897– 1025 CE (95 percent probability interval).

Were the Individuals from the Ceremonial 
Center Sacrificed?

Despite the limitations of analyzing skeletons with in-
complete provenience information, we were able to 
identify meaningful trends within and among con-
texts that strongly suggest at least some, if not all, of 
the ceremonial center individuals were ritually killed; 
individuals buried in the ceremonial center deposits 
are significantly younger with skewed sex ratios, 

have  significantly more evidence of metabolic and 
infectious disease, and were ritually processed with 
greater variability than those buried in the residential 
context of Atenantitech.

Given that the ethnohistorical and (bio)archaeolog-
ical records indicate that the ritual killing of children 
was an integral part of Mexica religion and enabled 
dialogue between the earthly and supernatural realms, 
it is unsurprising that there would be many non- adult 
sacrificial deposits at Tlatelolco. While the residen-
tial  context of Atenantitech approximates a normal 
mortality distribution, the age distributions of 
Grupo Norte, Paso a Desnivel, and Templo R are sig-
nificantly younger (Fig. 3), with high frequencies oc-
curring in the 15– 20 age group, when individuals 
should be at their most resilient (Weiss 1973). The 
Grupo Norte and Paso a Desnivel age distributions 
deviate from that of Templo R (Fig. 5), with higher 
frequencies of older children (5– 10 and 10– 15) and 

Figure 8. Prevalence of pathology by context across age groups. Sample size is indicated for each context for each age category. Note that there is 
only one observable individual from Atenantitech for the 10– 15 year age category.



Figure 9.  Prevalence of pathology in individuals younger than 20 years by context.

Table 2. Contingency Tables and Chi- Square Test Results for Each Combination of Contexts.

Comorbidity Infection Metabolic Unaffected

Paso a Desnivel 22 4 8 0
Grupo Norte 16 1 12 8
Atenantitech 2 1 3 8

χ2 df N p
25.81 6 85 <0.001*

Comorbidity Infection Metabolic Unaffected

Paso a Desnivel 22 4 8 0
Grupo Norte 16 1 12 8

χ2 df N p
11.44 3 71 0.009*

Comorbidity Infection Metabolic Unaffected

Grupo Norte 16 1 12 8
Atenantitech 2 1 3 8

χ2 df N p
7.42 3 51 0.059

*Significant at α = .05/3 = .016.



Blevins et al. 15

adolescents (15– 20) (Fig.  3). Moreover, the Grupo 
Norte and Paso a Desnivel non- adults who have 
 genetic sex assessments are predominantly female, 
the opposite of what is observed at Templo R (Fig. 7). 
The skew toward female inclusion is also present 
in the adult individuals, but it is less pronounced. It 
is  possible that these deposits are combinations of 

sacrificial victims, war captives, slaves, and children, 
which has been described by colonial- period chron-
iclers (Horcasitas and Heyden 1971:256), chosen for 
their embodiment of a female deity. Compared to 
Templo R, Grupo Norte and Paso a Desnivel have a 
marked absence of infants (defined here as 0– 1 year), 
which could reflect the different roles played by these 

Table 3. Perimortem trauma occurrence by context, age, and sex. Sex assignments of non- adults were made from genetic X and Y 
chromosome data by Morales Arce et al. (2019).

Context Perimortem Trauma Number of Individuals
Age- at- Death Point Estimate in 
Years (Sex Where Applicable)

Paso a Desnivel Defleshing/disarticulation 8 4, 5, 5, 6 (F), 9, 15 (F), 15, 20 (F)
Defleshing/disarticulation and scalping 1 18 (M)
Defleshing/disarticulation and dismemberment 3 18.5 (M), 19.5 (F), 20.25 (M)
Defleshing/disarticulation and heart extraction 1 24.5 (F)
Scalping 1 11.5 (M)
Scalping and heart extraction 1 30 (M)

Grupo Norte Defleshing/disarticulation 1 0.75
Scalping 1 2.5
Dismemberment 2 4.75 (F), 11.5

Atenantitech Defleshing/disarticulation 2 17 (F), 25 (M)
Scalping 1 3.5

Figure 10. Count of each type of perimortem trauma by context. Some individuals are represented more than 
once because they had more than one type of peri- postmortem trauma.



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Blevins et al. 17

Figure 12. Ridgeline plot of radiocarbon dating probability distributions colored by context.

victims of ritual killings. Similar to observations 
by  Román Berrelleza (1990, 1999, and 2010), the 
 individuals from the ceremonial center contexts are 
characterized by a high frequency of porotic cranial 
and orbital lesions. In the case of Paso a Desnivel, all 
individuals have evidence of metabolic disease, infec-
tion, or both. Although the difference in pathology 
distribution between Grupo Norte and Atenantitech 
is not statistically significant, Atenantitech has the 
highest frequency of unaffected non- adults and the 
lowest frequency of comorbidities overall (Fig. 9).

Given that evidence for some perimortem trauma 
was identified in all contexts analyzed here, it is 
 surprising that no such evidence has been reported 
from Templo R or Ofrenda 48, aside from a single bi-
sected femur (Román Berrelleza 1990). The reported 
method of child sacrifice involved throat cutting, 
which would not necessarily leave skeletal evidence. 
Indeed, Medrano Enríquez (2021) also remarks on 
the lack of perimortem trauma from throat cutting, 
cut marks on the cervical vertebrae or basicranium, 
in sacrificed non- adults from Tula (1000– 1200 CE). 
Except for the two cases of heart extraction from Paso 
a Desnivel, the perimortem trauma likely reflects 
distinctive ritualized treatment for the bones and 
flesh after death. Ethnohistoric accounts describe an 
intimate relationship between sacrifice and ceremo-
nial consumption by nobles, priests, and warriors 
(Anderson and Dibble 1981:24, 29; Carrasco 1999:84, 
174– 176; Heyden 1994:192– 193; Horcasitas and Hey-
den 1971:191). This ceremonial consumption of sacri-
ficed flesh, along with the ritualized flaying and 
re- purposing of skins (Carrasco 1999:145; Heyden 

1994:485), could explain the evidence for soft tissue 
removal. Further, dismembered body parts were de-
posited in funerary spaces as a way to consecrate the 
ground (Núñez Enríquez 2006:149), but it is possible 
that other sacrificial and ceremonial acts could have 
been performed to sanctify burials. This could explain 
the evidence for soft tissue removal at Atenantitech. 
Interestingly, the context with the highest frequency 
of pathology is also the context with the most counts 
of perimortem trauma (Paso a Desnivel).

Together, the demographic homogeneity, high pa-
thology prevalence, and perimortem trauma strongly 
suggest that Grupo Norte and Paso a Desivel, like Tem-
plo R and Ofrenda 48, were sacrificial deposits. Further, 
interpreted within the osteological paradox, the trend of 
high comorbidity and low unaffected prevalence within 
these contexts suggests that these individuals were not 
dying natural deaths (Wood et al. 1992). That so many 
of these individuals have skeletal indicators of infectious 
and metabolic disease suggests that they were robust to 
have survived until the point of sacrifice. Some of these 
individuals likely could have survived into adulthood.

There are few comparative data for sacrificial depos-
its of single burials from Mexica sites, as much of the 
mortuary research has focused on ossuary deposits 
with clear evidence of sacrifice, elite burials, or caches 
of decapitated crania (Chávez Balderas 2017; González 
Rul 1997; Pijoan Aguadé 1997;Pijoan Aguadé et  al. 
1989; Pijoan Aguadé and Mansilla Lory 1997, 2010). 
There are, however, some comparable examples from 
Central Mexico. Within Central Mexico, there is 
only one example of a middle- late Postclassic non- 
adult mass burial, to the authors’ knowledge. At 



Structural Violence and Physical Death at Tlatelolco18

Teopanzolco, Morelos, approximately 100 km south 
of Tenochtitlan- Tlatelolco, a cache of at least 92 indi-
viduals was dated to the middle- late Postclassic pe-
riod using ceramic burial goods (Lagunas Rodríguez 
and Serrano Sanchez 1972; Smith 2010). Over half of 
the individuals were non- adults, and most individu-
als had skeletal evidence of disarticulation or limb, 
hand, or foot removal. Of the adults, males and fe-
males were represented equally (Lagunas Rodríguez 
and Serrano Sanchez 1972). Two Postclassic burials 
from Cholula, Puebla, demonstrate small- scale child 
sacrifice, more like accounts by Spanish chroni-
clers  than the larger deposits at Teopanzolco and 
Tenochtitlan- Tlatelolco. Two children were exca-
vated from a central altar within the ceremonial 
plaza; their skulls were found disarticulated and ar-
ranged away from the postcranial elements (Lagunas 
Rodríguez et al. 1976:74). Gabriel de Rojas (a colonial 
mayor of Cholula) reported in 1581 that human sacri-
fices were performed in Cholula during times of 
drought. He described the sacrifice of children cap-
tured or bought of ages 6– 10 (Rojas 1927).

Due to the absence of maps, levels, drawings, and 
original burial photos, we assessed burial chronology 
through radiocarbon dating. Six out of seven date es-
timates fall between 1332 and 1445 CE (95  percent 
probability interval), in agreement with the generally 
accepted timeframe for the founding of Tenochtitlan 
and Tlatelolco and the subsequent growth in size and 
influence of the connected cities. Interestingly, one 
 individual from Paso a Desnivel, 134- 53, was dated 
to 897– 1025 CE (95 percent probability interval), ap-
proximately 300– 400  years before the supposed 
founding of the cities. The earlier date from Paso a 
Desnivel suggests that at least this area of the site and 
probably others were recurrently used for sacrificial 
deposits for centuries. It is notable that the individual 
dated 300– 400 years earlier than the others, Paso a 
Desnivel 134- 53, is not an outlier in pathology or per-
imortem trauma; Paso a Desnivel 134- 53 has meta-
bolic and infectious disease and perimortem cut 
marks consistent with defleshing and/or disarticula-
tion, strikingly similar distributions as observed 
among the other non- adults from Paso a Desnivel. 
Although this is an unexpected finding, it under-
scores the continuity of Mesoamerican religious and 
ceremonial practices. The islands of Lake Texcoco 
may have been occupied or used for specialized cere-
monial activities during the Postclassic (900– 1200 CE) 
period; many communities existed along the shores of 
Lake Texcoco during this time (Gorenflo 2015).

The continuity of religious ideology and sacrificial 
practices in the Basin of Mexico in the early to late 
Postclassic periods is supported further by Medrano 
Enríquez’s (2021) analysis of sacrificed non- adults 

from Tula (1000– 1200 CE). Of the 49 individuals re-
covered from a sacrificial deposit, 45 are non- adults. 
Of the 27 non- adults with sufficient preservation for 
analysis, 23 (85.2 percent) exhibit signs of scurvy. The 
prevalence figures for periosteal new bone forma-
tion  (91.3 percent), cribra orbitalia (78.6 percent), and 
porotic hyperostosis (95.7  percent) are similarly high. 
Additionally, the individuals have similar distributions 
of perimortem trauma consistent with scalping and de-
fleshing: scrapes across cranial bones and cut marks on 
proximal and distal long bones. The age, pathology, 
and ritualized perimortem trauma similarities between 
sacrificial victims from Tula and Tlatelolco observed 
here are in line with the many other forms of evidence 
linking Tula and the Toltecs to Tenochtitlan- Tlatelolco 
and the Mexica (Anawalt 1990; Iverson 2018; Leonardo 
López Luján and López Austin 2009).

Physical, Cultural, and Structural Violence 
at Tlatelolco

Human sacrifice was performed in Mesoamerica 
across millennia, balancing relationships with the 
gods to ensure the continuation of the universe (Boone 
1984; González Torres 1994, 2010; Pijoan Aguadé and 
Mansilla Lory 1997). During the late Postclassic pe-
riod in Tenochtitlan- Tlatelolco, sacrifice functioned 
as state- sanctioned cosmological currency for life 
and fertility (Ingham 1984; Read 1998). Within the 
Mexica cosmology, human sacrifice was an obliga-
tory act to ensure the continual renewal of the world 
and the nourishment of all those who live in it (López 
Austin 2004:392– 393). It was a calculated, highly con-
textualized, and often consensual act between reli-
gious priests and human bodies: the ultimate 
currency to the gods. Human sacrifice required fas-
tidious preparation and mental and emotional focus 
and was not the bloodthirsty, vengeful act frequently 
portrayed by colonial elites and in more recent popu-
lar culture.

The Mexica calendar consisted of 18 months, 
and during each month, multiple sacrifices were or-
chestrated with specific goals, requirements, and 
treatments of the sacrificial victim(s) (see Anderson 
and Dibble 1981). Alfredo López Austin identifies 
four types of human sacrifice and their goals: physi-
cal manifestations of the gods (ixiptla) to complete 
and renew their worldly life cycle, tributes/payments 
to the gods to sustain and placate them, companions 
for  the gods (and lords) to accompany them, and 
those sacrificed for the purposes of their skin to imbue 
the wearer with the power of Xipe Tótec (López Aus-
tin 200:433– 435). Accordingly, some sacrificed indi-
viduals were chosen for their physical prowess and 



Blevins et al. 19

honorable representation of a deity; some were lauded 
and idolized for the days, months, or years preceding 
their death; and many were of the honorable noble, 
merchant, and warrior classes (Anderson and Dibble 
1981:9– 10; López Austin 200:409). Bio archae ol o gi-
cal  evidence from Tenochtitlan’s Templo Mayor 
shows that the decorative processing of skulls from 
sacrificed adults was determined by the high or low 
social status of the individual, further highlighting 
the socioeconomic diversity of ritually killed individ-
uals in Tenochtitlan- Tlatelolco (Ragsdale et al. 2016).

Most scholars have interpreted Mexica child sacri-
fice as a combination of tribute and ixiptla. The high 
pathology prevalence observed in non- adult remains 
from Templo R and Ofrenda 48 has been interpreted 
to mean that children of “precarious health” were se-
lected for sacrifice, as regular payment to the gods was 
required and the child would likely die anyway or be-
cause the child exhibited the disease of a patron deity 
(Román Berrelleza 1990, 1999, 2010). Indeed, Durán 
reports that sick children were dressed as the god Tez-
catlipoca and sacrificed as his ixiptla (Horcasitas 
and  Heyden 1971:110). The individuals analyzed in 
this study, however, were not only sick with infec-
tious   disease but also were suffering from chronic 
malnutrition. This distinction between disease eti-
ologies indicates that tribute played a role in the sac-
rifice of these individuals in addition to ixiptla, as 
specified diseases of patron deities are infectious or 
congenital.

We propose that children of “precarious health” 
were sacrificed not only because of their living repre-
sentations of patron deities but also because of low so-
cioeconomic status. Sahagún and Dúran describe 
how during times of famine and financial hardship in 
Tenochtitlan- Tlatelolco, destitute parents sold their 
children as sacrificial tribute to survive (Anderson and 
Dibble 1950:39; Anderson and Dibble 1981:8; Horcasi-
tas and Heyden 1971:281– 282). Situated within what is 
known of Mexica lifeways, the sacrifice of the non- 
adults from Grupo Norte and Paso a Desnivel resulted 
from difficult decisions by parents in a plea to the 
gods to end a period of hardship, possibly famine, for 
all of those in the city. That these non- adults were likely 
selected from lower- class families who were already dis-
proportionately affected by economic hardship, how-
ever, reveals how cosmological obligations were not 
evenly distributed across Mexica social hierarchies.

Although human sacrifice was a cosmological neces-
sity and act of divine reverence, it also functioned as a 
state- sanctioned tool of political power in the Mexica 
empire. Human sacrifice enabled targeted control of 
tributary provinces and the lower classes of what was 
known to be a highly stratified and hierarchical society 
(Broda de Casas 1972; Dibble and Anderson 2012). The 

state dictated who would die so that the rest could pros-
per. Foucault (1978) provides a framework for recogniz-
ing the unequal effects of power structures on bodies 
and lives, biopolitics. Mbembé (2003, 2008) extends this 
framework explicitly to include the control of death: ne-
cropolitics. Necropolitics can be distilled as the state’s 
“power and capacity to dictate who may live and who 
must die” (Mbembé 2008:152). The high prevalence of 
metabolic and infectious disease among those who had 
to die in the Tlatelolco ceremonial center exposes con-
current forms of violence operating within the city.

Galtung (1969, 1990) proposes three self- reinforcing 
forms of violence: cultural, physical, and structural. 
Here, the credence that human sacrifice begets life and 
prosperity could be interpreted as cultural violence: 
the religious rite of human sacrifice legitimized phys-
ical violence as a necessity and thus required there be 
a reliable source of human capital to expend. Ethno-
historic records describe slave markets at which adults 
and children were sold explicitly for sacrificial 
 purposes (Anderson and Dibble 1950:19; Graulich 
2016:241– 246; Horcasitas and Heyden 1971:133, 279– 
280). So that the Mexica could continually repay cos-
mological debts with human sacrifice, mechanisms of 
structural violence could have maintained socioeco-
nomic stratification, detected here as unequal access 
to resources between those who were ritually killed 
and those who died natural deaths.

Like Klaus (2012), we acknowledge that a structural 
violence framework was developed in response to 
Western capitalist power structures, colonization and 
imperialism, the transatlantic slave trade, and twen-
tieth-  to twenty- first- century warfare and therefore is 
not directly applicable to a society that was largely 
eliminated through conquest and colonialism. Addi-
tionally, we acknowledge that the meaning and expe-
rience of death for the Mexica are unknowable and 
that the available accounts of Mexica lifeways were re-
corded through the lens of colonial ideology and as-
similative motives. A bio/necropolitics framework, 
however, allows us to explore the disproportionate 
metabolic and infectious disease prevalence among 
these sacrificed non- adults as interlocked processes of 
social stratification and dictated death; city- wide hard-
ships disproportionately affected lower social status 
households, as we see in modern cities.

Although Mexica society was highly stratified 
(Smith and Hicks 2017), there are few direct accounts 
of poverty and the impoverished within Tenochtitlan- 
Tlatelolco. Aztec scholar Inga Clendinnen offers an 
explanation as to why: “The poor are given scant atten-
tion in the sources as we have them: as so often, they 
press silently beyond the rim of the described” (Clend-
innen 2014:147). Some glimpses into the experiences 
of  the poorest inhabitants of Tenochtitlan- Tlatelolco 



Structural Violence and Physical Death at Tlatelolco20

come from ethnohistorical accounts. Sahagún de-
scribes how those too poor to participate would hover 
at the margins of ceremonial feasts, begging for just a 
mouthful of leftovers (Dibble and Anderson 1979:124, 
129). Resource inequity in the city was acknowledged 
by the state through Huey Tecuilhuitl, during which 
the ruler provided food in the style of a soup kitchen. 
Maize gruel was piled into canoes and distributed 
through the city; the poor arrived at dawn to collect as 
much as they could carry (Anderson and Dibble 
1981:13; Tezozómoc 1943:35– 36). Sahagún states that 
individuals without bowls would heap maize gruel 
into their clothing. People would then wait for a single 
handful of tamales at midday (Anderson and Dibble 
1981:96). Not all who queued would receive food, as “at 
this time, ordinarily, there is a want of the necessities 
of life” (Anderson and Dibble 1981:14). Sahagún de-
scribes violent scenes of those scrambling for food and 
those who were fortunate enough to be ahead in line. 
“What can we do, we who are poor? In misfortune hath 
the feast day come! To what avail is our misery? Misera-
ble are our small children!” (Anderson and Dibble 
1981:98). Durán describes further evidence of institu-
tionalized poverty that occurred during the Feast of 
Tlacaxipehualiztli; during the forty days of this rite, no-
blemen allowed poor men to don the skins of their sac-
rificed slaves, enabling the poor men to go door to door 
and beg simultaneously for themselves and for the no-
blemen whose skins they had borrowed (Anderson and 
Dibble 1981:54; Horcasitas and Heyden 1971:182– 183).

These descriptions suggest that people surviving on 
the margins of society in Tenochtitlan- Tlatelolco faced 
food insecurity, undoubtedly resulting in malnutri-
tion. Scurvy results from insufficient vitamin C in-
take. In adults, signs and symptoms can appear as 
early as 29 days after complete vitamin C depletion, 
with signs possibly observable on skeletal remains (ec-
chymosis and swollen, bleeding gums) occurring as 
early as 36 to 42 days after depletion (Hodges et al. 
1971). When the diet was limited to an insufficient 
amount of vitamin C (1 mg daily), however, scurvy 
signs occurred after 82 days, with swollen, bleeding 
gums and hemorrhaging occurring as early as 163 to 
182 days (Krebs 1953). When sufficient vitamin C is re-
introduced into the diet, scurvy- related SPNBF is re-
sorbed in as few as four weeks (Polat et al. 2015). In 
adults, around 10 mg of vitamin C daily is enough to 
prevent clinical scurvy (Hodges et al. 1971; Krebs 1953). 
It is recommended that non- adults (1– 19 years) con-
sume at least 20 mg of vitamin C daily (FAO/WHO 
Group 1970), but it is likely that 5– 10 mg of daily 
 vitamin C would be sufficient to prevent clinical 
scurvy, especially in infants and children (1– 12 years) 
(FAO/WHO Group, 1970). Outside of controlled ex-
perimental conditions, it is rare that an individual’s 

diet is completely depleted of vitamin C; therefore, 
skeletal evidence of scurvy could suggest at least five 
months of deficient dietary intake, possibly more.

Porotic, hypertrophic lesions of the cranial vault 
and orbits are associated with acquired anemia and 
may form in response to iron, folate, or B12 deficiency 
(Walker et  al. 2009). Acquired anemia and scurvy 
commonly co- occur (Khalife et  al. 2019; Pan et al. 
2021), not only because vitamin C deficiency leads to 
decreased ability to metabolize iron and folate, but 
also because malnourished individuals are typically 
deficient in multiple nutrients (Cox 1969; Fain 2005). 
Overall, the prevalence of metabolic disease in the cer-
emonial center contexts is exceptionally high. For 
comparison, the prevalence of scurvy in the non- 
adults from the ceremonial center contexts is much 
higher in the case of Paso a Desnivel (85.3 percent) and 
slightly higher in the case of Grupo Norte (68.41 per-
cent) than a mass burial from the Great Irish Famine 
(62.8 percent) (Geber and Murphy 2012).

For the ceremonial center contexts, comorbidity 
was more prevalent than either metabolic or infec-
tious disease alone. Vitamin C plays an important 
role in the innate and adaptive immune responses. 
Ascorbic acid is essential for ensuring the integrity of 
epithelial cells and wound healing, mitigating the ox-
idative stress caused by active phagocytes, and main-
taining adequate antibody levels (see Carr and 
Maggini 2017). Vitamin C deficiency, porotic hyper-
ostosis, and cribra orbitalia have all been linked to 
respiratory infection (Bakaev and Duntau 2004; He-
milä 2017; O’Donnell et al. 2020). The recurrent cycles 
of nutrient deficiency likely led to increased vulnera-
bility to infection in these individuals.

The pathologies observed in the ceremonial center 
contexts are indicative of long- term dietary deficiency, 
as evidenced by skeletal manifestations of scurvy and 
acquired anemia and their frequent comorbidity with 
infection. The variety of grains, legumes, vegetables, 
insects, and small game available in the Basin of Mex-
ico is thought to have led to nutritionally complete 
diets (Ortiz de Montellano 1978), although maize was 
heavily cultivated and formed much of the diet (Morei-
ras Reynaga et  al. 2020). Maize, beans, amaranth, 
chia, squash, chilies, and various fruits and vegetables 
were grown within the city through the chinampa 
(raised field) agricultural system (Ortiz de Montellano 
1990:94– 97; Read 1998:7). These crops were grown si-
multaneously for efficient and abundant agricultural 
production. By the Late Postclassic, however, it is es-
timated that there were over one million inhabitants 
in the Basin of Mexico, and possibly 200,000 within 
Tenochtitlan- Tlatelolco (Ortiz de Montellano 1978; 
Ortiz de Montellano 1990:106; Santley and Rose 1979; 
Smith 2008). The population density likely surged 



Blevins et al. 21

alongside societal stratification and food security dis-
parities among social classes during periods of food 
scarcity and famine (Hassig 1981). Today, vitamin C 
deficiency is observed in refugee camps where relief 
food is predominantly cereals without supplements 
(Desenclos et al. 1989), low- income populations within 
high- income countries with limited access to non- 
processed foods (Mosdøl et al. 2008), and low- income 
countries (Rowe and Carr 2020). Similarly, tortillas, 
gruel, and tamales, which contain no vitamin C, were 
dietary staples for commoners, slaves, and the poor 
and were purportedly the main sources of calories 
during periods of food scarcity and famine (Anderson 
and Dibble 1981:14; Hassig 1981).

What Does Atenantitech as a Normal 
Mortality Sample Tell us about 
Tlatelolco City Life?

Atenantitech is characterized by a lower pathology 
prevalence and proportionally less comorbidity than 
the ceremonial center contexts. Although lower 
than  the ceremonial center contexts, the prevalence 
of scurvy in the Atenantitech non- adults was also rel-
atively high (35.68 percent), suggesting that resource 
inequity may have transected multiple social classes 
in Tlatelolco and malnutrition may have been com-
mon. The prevalence of scurvy at Atenantitech is 
comparable to that identified in non- adults from ru-
ral and urban mixed- status northern England ceme-
teries (20.93– 35.13 percent), dating to the eighteenth 
to nineteenth centuries (Gowland et al. 2018). Despite 
being from drastically different contexts, these data 
show that ~30 percent prevalence of scurvy is not ab-
normal for a community cemetery, especially from 
disadvantaged populations.

Conclusions

By delineating the etiologies of skeletal pathologies on 
sacrificial victims, we exposed how social hierarchies 
impacted those living and dying in a Mexica city. We 
compared three ceremonial contexts and one residen-
tial mortuary context from the Tlatelolco ceremonial 
center and determined that these ceremonial center 
deposits are sacrificial in nature and comprise mostly 
non- adults. Variability in age, sex, pathology, and per-
imortem trauma distributions among the ceremonial 
center contexts shows that ritual immolations in the 
Tlatelolco ceremonial center were diverse, represent-
ing different ceremonies dedicated to varied deities. 
The high prevalence of metabolic and infectious 
 disease and comorbidity in the ceremonial center 

contexts studied suggests that individuals who were 
chosen for sacrifice suffered from long- term malnutri-
tion. We interpret this to mean that resource inequal-
ity and food insecurity were commonplace, within the 
city center and possibly across Basin of Mexico com-
munities. Although we cannot be certain that the non- 
adult sacrificial victims lived in Tenochtitlan- Tlatelolco 
or the larger Lake Texcoco area, isotopic profiles from 
Templo R non- adults indicate that they grew up in the 
Basin of Mexico (Moreiras Reynaga et al. 2021). There-
fore, it seems that migrant status may not have deter-
mined risk of sacrificial inclusion. The recovery and 
analysis of Postclassic Basin of Mexico mortuary as-
semblages, especially those from normal mortality 
contexts, will certainly improve our understanding 
of how Mexica cosmology and socioeconomic hierar-
chy maintained and exploited social difference.  Future 
work comparing the ancestry of these sacrificed indi-
viduals to natural mortality assemblages from com-
munities subjugated by the Mexica will reveal further 
how social identities dictated death at Tlatelolco.

Acknowledgments

We sincerely thank the three anonymous reviewers 
and BI editors, whose feedback greatly improved this 
manuscript. Data collection and radiocarbon dating 
was performed with permission from INAH- DAF 
and the INAH Consejo de Arqueología. Samples for 
radiocarbon dating were removed from the MNA as 
allowed by Orden de Salida 12645 and exported to 
Arizona with permission as outlined by INAH Oficio 
401- 3- 4718. All photos are shared with permission 
from INAH- DAF. KEB worked with undergraduate 
student Samantha Vargas to produce the first digital 
inventories for all analyzed skeletons for the INAH- 
DAF permanent collections record, Registro Único. 
In addition, KEB generated the only known inven-
tory, preservation, and pathology summary by box 
and burial ID of the Tlatelolco D.F. skeletal collection 
and shared it with INAH- DAF. This research was 
funded by a Fulbright- García Robles Fellowship 
awarded to KEB and a National Science Foundation 
Doctoral  Dissertation Research Improvement Grant 
(BCS- 1945812) awarded to KEB and Anne C. Stone. 
This article is open access thanks to funding awarded 
to KEB from the School of Human Evolution and So-
cial Change, Arizona State University. We are grate-
ful for all the help and support provided by David 
Volcanes Vidal, Juan Manuel Argüelles, Irma Mar-
tínez Chavez, Juan Salvador Rivera Sánchez, Saman-
tha Vargas, Alejandro Alvarado González, and all 
other INAH- DAF staff during data collection at 
MNA. We are indebted to Maria de Jesus Sanchez 



Structural Violence and Physical Death at Tlatelolco22

Vazquez’s counsel and expertise on the Atenantitech 
excavation. We are thankful for Greg Hodgins and 
the University of Arizona AMS laboratory staff for 
answering many questions about interpreting radio-
carbon dating results. We thank María Ávila- Arcos, 
Michael  E. Smith, Christopher Morehart, and Mi-
chelle Hegmon for their feedback on early drafts of 
the manuscript.

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Supplemental Information

Appendix S1. Archaeological context, 
replicable methodology, study limitations, 
Table S1 missing data assessment, Table S2 
raw radiocarbon dating data, and Figure S1 
chi- square visualizations

Archaeological Context: Burial Excavations 
at Tlatelolco

The ceremonial center and Templo Mayor of Tlatelolco 
remain in a protected archaeological site in the Cu-
auhtémoc neighborhood of Mexico City. The Tlatelolco 
skeletal collection, excavated from the archaeological 
site and salvage projects in the surrounding area, is the 
largest stored at the Instituto Nacional de Antro-
pología e Historia (INAH) Dirección de Antropología 
Física (DAF). Over 1,000 individuals have been recov-
ered from multiple contexts within the ceremonial 
center and surrounding neighborhoods:  Iztatlan, 
Nonoalco, and Atenantitech (Caso 1956; González 
Rul 1961, 1994; González Rul and García Mejía 1962; 
Martínez del Río 1945). Although recovery of human 
remains and artifacts from the site dates to the nine-
teenth century (Hamy 1884; Herrera and Cicero 1895), 
the first rigorous excavations at Tlatelolco were exe-
cuted between 1944 and 1948 by Robert Barlow, Pablo 
Martínez del Río, and Antonieta Espejo (Angulo V 
1991; Espejo 2018; Martínez del Río 1945). This project 
is notable for uncovering Tlatelolco’s Templo Mayor 
and delineating its construction phases and the un-
precedented magnitude of techniques used to preserve 
organic remains (Angulo V 1991; Matos Moctezuma 
2008). Some human remains were excavated during 
this time, including isolated skulls with the first cervi-
cal vertebra (Espejo 1945). The excavation summaries 
allude to five offerings and thousands of human skele-
tal remains that were excavated from the walls and re-
cesses of the Templo Mayor, but unfortunately their 
location is currently unknown (Noguera 1966).

Archaeological excavations at Tlatelolco expanded 
during the 1960s, mostly as salvage projects stimulated 
by urban development. Urban architect and city plan-
ner, Mario Pani, began improving the infrastructure 
of Mexico City; this involved building a major road 
and the Nonoalco- Tlatelolco housing complex north-
west of the Zona Arqueológica de Tlatelolco (Angulo 
V 1991). Nonoalco- Tlatelolco refers to the area bor-
dered to the west by the Avenida de los Insurgentes 
and the Puente de Nonoalco, to the north by the street 
of Manuel Gonzalez, to the south by Ricardo Flores 
Magón, and to the east by Paseo de la Reforma. 
Francisco González Rul led the salvage archaeology 

project with INAH between 1960 and 1964, and Edu-
ardo Contreras Sánchez continued between 1965 and 
1968 (González Rul 1961, 1963; González Rul and 
García Mejía 1962; Guilliem Arroyo 1999). Between 
1960 and 1966, the area south of the Templo Mayor 
was excavated (Angulo V 1991).

Approximately 1,050 burials were identified south 
of the Templo Mayor during the 1960s excavations 
(Guilliem Arroyo 1999:66). Only approximately 350 
individuals, including primary and comingled buri-
als as well as caches of skeletal elements, from the 
1965– 1966 excavations, however, have been curated 
and stored in the Museo Nacional de Antropología 
(MNA). Angulo V (1991:114– 115) suggests that at least 
one context in the southern area resulted from “una 
muerte masiva y colectiva,” because many burials were 
superimposed and a homogeneous layer of zacatapal-
loli, agave spines used for autosacrifice rolled in balls 
of grass, covering “many” of the burials. He suggests 
these burials could have been either the result of the 
massacre that occurred during the annexation of 
Tlatelolco by Tenochtitlan, a fifteenth- century epi-
demic, or a sacrifice of war prisoners. In addition to 
inhumations, special deposits of human remains were 
recovered, such as a cache of mandibles (Serrano Sán-
chez and López Alfonso 1972), a cache of isolated hu-
man teeth (Romano 1963), and a tzompantli (González 
Rul 1963).

The Tlatelolco skeletal collection is curated by 
INAH Dirección de Antropología Física (DAF), and it 
is stored in the MNA. The collection includes human 
burials excavated since the 1960s from the ceremonial 
center as well as Tlatelolco barrios, such as Iztatlan and 
Nonoalco. Most skeletons have separate box and burial 
numbers with no further contextual information. 
The  boxes are numbered “Tlatelolco  D.F. 1” through 
“Tlatelolco D.F. 633,” but the burial numbering restarts 
at 1 several times, such that there are multiple skeletons 
labeled Entierro 1, Entierro 2, Entierro 3, and so on. In 
some cases, the re- initiation of a burial numbering cy-
cle signals the start of a new excavation project, as is the 
case with the 1965– 1966 Southern Patio excavations. 
There are not, however, enough “Entierro 1” entries for 
every mortuary context to have its own numbering sys-
tem. Therefore, for example, Entierros 1 through 50 
could span many specialized mortuary deposits from 
different areas of the ceremonial center.

Serrano Sánchez and López Alonso acknowledge 
the lack of published information on pre- Hispanic 
Tlatelolco burials, despite being the largest skeletal 
collection stored in MNA- DAF (Serrano Sánchez and 
López Alfonso 1972). The authors analyzed a subset 
(n = 57) of these individuals from the Southern Patio, 
ostensibly from the same burial context. The authors 
argue that although these burials were deposited 



Blevins et al. 27

within a short period of time because they were all 
 excavated from a similar level, between 2 and 2.5 
 meters, the burials do not appear to be simultaneous. 
All but three of the burials in Feature 9 were direct, 
flexed inhumations, 70  percent oriented with cra-
nium to the east and feet to the west. One infant was 
buried in a large pot, and two young adults show evi-
dence of dismemberment before burial, such that all 
skeletal elements were present, but the torso, limbs, 
and cranium were not in anatomical position. Ser-
rano and López examined the skeletons in situ, so it 
was not possible to observe cut marks on the burials 
with evidence of dismemberment. Dismemberment 
cut marks, however, have been documented from 
other areas of the site (Pijoan Aguadé et al. 1995), and 
Sahagún chronicled that dismemberment and canni-
balism were practiced during ceremonial sacrifices 
(Anderson and Dibble 1981).

No seated burials or bound mortuary bundles were 
identified in the Southern Patio mortuary assemblage, 
despite being typical of other contemporaneous cere-
monial complexes and frequently depicted in codices 
as normal mortuary treatment in the Basin of Mexico 
during the Postclassic (Anderson and Dibble 1978:44– 
45; Berdan and Anawalt 1997:205; Iguaz 1993). Seated 
and bound burials, however, were purportedly found 
elsewhere at Tlatelolco (González Rul and García Me-
jía 1962). The burial goods are diverse without any 
apparent trends, except distinctions between adult and 
juvenile burial assemblages. Plates, pots, bowls, and 
figurines were found in adult burials, and juvenile 
burials were associated with small vessels, small figu-
rines, and clay marbles. Additionally, the placement of 
a round dish over the skull typified juvenile burials. 
In three cases, a human radius thought to be an offer-
ing was found in a juvenile and two adult burials. The 
majority (63.16 percent) of the individuals in Feature 
9 were classified as infantiles, but the chronological age 
is not specified (Serrano Sánchez and López Alfonso 
1972). Given the high percentage of juveniles, the au-
thors suggest that this burial complex was a selective 
burial site, resulted from a high infant mortality event, 
or reflects a ceremonial sacrifice. Of the individuals for 
which skeletal sex estimation was possible (n = 13), five 
are female and six are male. Given the young ages of 
these individuals, the number of males may be over-
estimated, as sexual dimorphism may not yet be ex-
pressed in youthful skeletal structures.

Unfortunately, it is not possible to identify which 
skeletons were examined by Serrano Sánchez and 
López Alonso (1972) from Feature 9. The current cat-
alog of skeletons only provides excavation date, box 
number, and burial number, with no reference to 
feature or trench location. Many of the burials 
were excavated from an open area circumscribed by 

various temples and structures, but there must have 
been some that were associated with these structures. 
It will be impossible to delimit the undoubtedly tem-
porally and contextually different mortuary assem-
blages without better models for mortuary behavior 
and burial structure. Although the morphologic vari-
ation of Tlatelolco skeletons and isolated skeletal ele-
ments has been studied extensively (see López Alonso 
and Jiménez López 2016), the lack of contextual data 
has prevented hypothesis- driven research on these 
collections for over a century. Upon accessing the cat-
alog at the MNA (Herrera and Cicero, 1895), Eusebio 
Dávalos Hurtado reports, “nos encontramos con un 
verdadero caos que sólo nos permitió aclarar una 
parte ínfima del problema” (Davalos Hurtado 1951:24).

In 1987, archaeologist Salvador Guilliem Arroyo led 
the best documented mortuary excavation from the 
Tlatelolco ceremonial center (Guilliem Arroyo 1999). 
Within the first year, the team began excavating an 
elaborate ceremonial complex at the base of Templo de 
Ehécatl- Quetzalcóatl, subsequently referred to as 
Templo R. The ceremonial complex took three seasons 
to excavate and comprised 43 human burials: 37 non- 
adults and six adults (De La Cruz et al. 2008; Guilliem 
Arroyo 1999). The non- adults were buried in pots or 
inhumed. At least 19 individuals showed evidence 
of sacrifice, such as dismemberment, mutilation, and 
decapitation in situ (Guilliem Arroyo 1999). Of 43 
 individuals excavated from the base of Templo R, 
~70 percent were younger than 10 years (De La Cruz 
et al. 2008; Guilliem Arroyo 1999). Over 2,000 objects 
were recovered from the complex. The mass of offer-
ings and the young ages of the individuals led to the 
interpretation that the ceremonial complex was a sac-
rificial appeasement to the deity Ehécatl- Quetzalcóatl 
(De La Cruz et al. 2008; Guilliem Arroyo 1999).

Methodology

Sex assessment
The greater sciatic notch and preauricular sulcus were 
recorded and interpreted as in Buikstra and Ubelaker 
(1994). Character states of the ischium and pubic bone 
were recorded following Gómez- Valdés et  al. (2017) 
and Klales et al. (2012). The composite arc and subpu-
bic angle were recorded following Bruzek (2002), and 
assessment of sexually dimorphic cranial features fol-
lowed standards published by Buikstra and Ubelaker 
(1994). Individuals were assigned a sex of F, F?, M?, M, 
or NA after considering the gestalt of the aforemen-
tioned assessments. For the purposes of the following 
analyses, the non- ambiguous and ambiguous catego-
ries for each sex were collapsed, such that all individ-
uals included in the analyses are either F, M, or NA.



Structural Violence and Physical Death at Tlatelolco28

Non- adult age assessment
An age or age range based on developmental stage was 
assigned to each preserved and visible tooth; in some 
individuals, teeth had been glued into the sockets, and 
root development was not observable. Of all an indi-
vidual’s observable teeth, the minimum and maxi-
mum ages were used to create an age range.

When teeth were unobservable or not present, long 
bone length was used to estimate age. Humeral, radial, 
ulnar, femoral, tibial, fibular, iliac, ischial, and pubic 
lengths were recorded to the nearest millimeter using 
a standard osteometric board. Depending on which 
elements were preserved, a minimum and maximum 
age was determined using both male and female 10th– 
90th percentile ranges as published by Maresh (1970).

For non- adults with fully formed permanent den-
tition or unobservable third molars, epiphyseal union 
stage was recorded as open, fusing, fused, or obliter-
ated. The ages corresponding to epiphyseal union 
stages of all available skeletal elements were used to 
generate a range of minimum to maximum age. Since 
there is not a comprehensive Mexican reference sam-
ple for epiphyseal union stages, the first author gener-
ated conservative age ranges by using the summary 
tables for epiphyseal union stages presented by 
Schaefer et al. (2009), which represent an amalgam of 
 several skeletal aging studies (Albert and Maples 
1995; Cardoso 2008; Coqueugniot and Weaver 2007; 
McKern and Stewart 1957; Sahni et  al. 1995; M. C. 
Schaefer 2008; Webb and Suchey 1985).

Pathology recording
Each skeleton was arranged in anatomical position, 
and each element was macroscopically inspected for 
pathological porosity, osteoblastic changes, osteoclas-
tic changes, and perimortem trauma. A light source 
such as a headlamp or desk lamp and a 30× jeweler’s 
loupe were used to identify these pathological changes. 
All pathological changes were described in free- form 
format, documenting lesion location and distribu-
tion, dimensions, and status (active, healing, healed, 
mixed). Each pathology was photographed with an iP-
hone 8 camera during the descriptive process so that 
timestamps could be referenced within the descrip-
tion. This resulted in a descriptive and photographic 
pathology narrative for each individual that could be 
used for digital inter- country consultation and refer-
enced throughout the differential diagnosis process.

Chi- square visualizations
To visualize the Pearson residuals from the multiway 
the chi- square test, we used the corrplot R package 
(Wei and Simko 2017). Based on the proportional con-
tribution of each cell, we reduced the overall contin-
gency table into two 2 × 3 contingency tables and 

performed two more chi- square tests to assess further 
which associations contribute to statistical signifi-
cance. We used the Bonferroni correction to adjust 
the p- values of the post hoc chi- square tests, for a cor-
rected alpha value of α = .05/3 = 0.016.

In the overall comparison, comorbidity and unaf-
fected status contribute the most to the observed chi- 
square score (Fig. S1d). Atenantitech is characterized 
by a low comorbidity prevalence and high unaffected 
prevalence, whereas the opposite is true for Paso a 
Desnivel (Fig. S1a). The comparison between the cer-
emonial center sites shows that the difference in dis-
tribution is driven by the low prevalence of unaffected 
individuals in Paso a Desnivel (Figs. S1b and S1e). The 
difference, although not statistically significant, be-
tween Atenantitech and Grupo Norte contexts is 
caused by lower comorbidity and higher unaffected in 
Atenantitech (Figs. S1c and S1f).

Missing Data Assessment

For paleodemographic analyses, all individuals with 
age estimates were included. For pathology compari-
sons across contexts and age ranges, only individuals 
who were observable for metabolic and infectious dis-
ease were included (Table S1). This resulted in a 11.11– 
21.15 percent loss of individuals and a mean age change 
of 2.66– 7.28 percent across contexts.

Similarly, for the dataset of individuals younger 
than 20, the subset of individuals who were observable 
for metabolic and infectious disease comprised 5.56– 
22.22 percent fewer individuals with mean age changes 
0.4– 3.4 percent across contexts.

Limitations

Clearly, the results of this study are tempered by the 
lack of contextual and spatial data, along with archae-
ological site reports. We believe, however, that by 
 attempting to delineate mortuary contexts and in-
terpreting the data within the rich archaeological 
and ethnohistoric record of Tenochtitlan- Tlatelolco, 
we have drawn meaningful conclusions from skele-
tons previously without provenience.

The dental and skeletal age ranges for non- adults 
were generated from non- Mexican reference samples, 
which may mean individuals are systematically over-  
or underaged. Since we do not make any claims about 
specific chronological ages, these biases should not af-
fect the main conclusions of this study.

There are several caveats to consider regarding the 
metabolic and infectious disease differential diagno-
ses. Without radiographs, it is impossible to be certain 
if individuals with penetrating porotic cranial lesions 
resulted from marrow hypertrophy or were caused by 



Blevins et al. 29

Figure S1. (a– c) The circles are plotted proportionally in size to the chi- square residual values; blue and red indicate a positive or negative 
association between the row and column variables, respectively. (d– f) The circles are plotted proportionally to the relative contribution of 
each cell to the chi- square statistic, calculated as the r2/chi2.

Table S1. Age- at- Death Summary Statistics by Context for Each Analysis Dataset.

Context n Median Mean SD Min Max

All individuals Atenantitech 40 20.15 22.95 19.77 1.2 83
Grupo Norte 52 7.25 11.25 12.07 0.5 67
Paso a desnivel 45 12 13.85 12.41 2 76

Individuals with observable pathology Atenantitech 32 20.15 24.05 21.24 1.2 83
Grupo Norte 41 7 10.43 11.41 0.5 67
Paso a desnivel 40 11.75 13.48 12.62 2 76

% change in sample size, median, and mean Atenantitech − 20.00 0.00 4.78
Grupo Norte − 21.15 − 3.45 − 7.28
Paso a desnivel − 11.11 − 2.08 − 2.66

Individuals younger than 20 Atenantitech 18 5.5 7.48 5.81 1.2 19.5
Grupo Norte 45 5.5 7.93 6.11 0.5 19.5
Paso a desnivel 36 8 9.65 5.83 2 19.5

Individuals younger than 20 with observable pathology Atenantitech 14 5.5 7.23 5.55 1.2 17
Grupo_Norte 37 6 7.96 6.14 0.5 19.5
Paso a desnivel 34 9 9.96 5.85 2 19.5

% change in sample size, median, and mean Atenantitech − 22.22 0.00 − 3.40
Grupo Norte − 17.78 8.33 − 0.40
Paso a desnivel − 5.56 11.11 − 3.14



Structural Violence and Physical Death at Tlatelolco30

the hemorrhaging → inflammation → capillary forma-
tion cascade caused by vitamin C deficiency. To miti-
gate this limitation, we chose to limit a diagnosis of 
anemia to cranial lesions appearing to penetrate the 
cortical bone and expose the trabeculae. Additionally, 
we chose to integrate scurvy and anemia assignments 
into a single “metabolic” category. Further, we are 
aware that vitamin C deficiency may cause subperios-
teal new bone formation (SPNBF) on the diaphyses of 
long bones, not just around the metaphyses. In this 
study, diaphyseal scurvy- related SPNBF may have 
been misclassified as evidence of infection. Even if our 
estimates of comorbidity are inflated, it does not af-
fect the fact that the ceremonial center deposits have 
an exceptionally high prevalence of metabolic disease. 
Lastly, the authors are aware that systemic SPNBF 
has  many known etiologies in non- adults, namely, 
congenital and metabolic disorders and neoplasms 
(Bisseret et al. 2015; Chen et al. 2012). Given the rarity 
of these conditions, however, we believe that even if we 
have misdiagnosed some non- infectious cases of 
SPNBF as infectious, it would not affect the overall 
results.

While the activity status of all pathological changes 
was recorded (active, healing, healed), the introduc-
tion of this variable into analyses would have limited 
statistical power by further decreasing sample sizes. 
We believe this is not an essential distinction to make 
for the purposes of this paper and that the absence of 
this distinction does not detract from the overall 
conclusions.

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Table S2. Radiocarbon Dating Raw Data.

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TLT_3_56_14D Templo Norte 555 21 intcal20 3
TLT_11_134_53 Paso a Desnivel 1066 21 intcal20 6
TLT_13_137_58 Paso a Desnivel 528 21 intcal20 9
TLT_15_143_70 Paso a Desnivel 514 21 intcal20 4
TLT_17_189_107 Templo Norte 493 21 intcal20 26
TLT_19_193_112 Templo Norte 560 21 intcal20 13.5
ATN_2_22_28 Atenantitech 527 22 intcal20 20.5

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