PAPERS ON PALEOPATHOLOGY

. resented a t the

6 Apri l 1983

Indianapolis, Indiana

SECTION 1: PALEOPATHOLOGY IN NORTH AMERICA: A REGIONAL SURVEY

Convener: Charles F. Merbs

INTRODUCTORY STATEMENT

Charles F. Merbs, Ar izona State Un ive rs i t y

Paleopathologists approach the i r subject f rom a va r ie t y o f d i f f e ren t back- grounds and perspect ives. Some concentrate on pa r t i cu la r areas o f pathology, some on unusual k inds o f evidence, and some on special techniques. Most t e n d t o l imit t h e i r studies t o one geographical region, trying to unders tand the signif icance o f i t s par t icu lar environmental variables, cu l tu ra l as well as physical, t o t h e pa t te rns o f pathology they observe. T h e record o f pathology in a par t icu lar g r o u p depends upon factors as d iverse as the presence o f disease agents in the environment, the absence o f n u t r i e n t s in t h e diet, a n d cul tura l ly-determined responses t o disease, and they a re l i ke l y t o v a r y great ly f rom one area t o another . Each region has experienced a somewhat d i f f e ren t h i s to ry o f research w i th d is t inc t approaches to paleopathology sometimes developing, shared t o some ex tent b y others work ing in t h e same geographic area, but re lat ive ly unknown o r poor ly understood outside tha t region. Repor ts on groups from dif ferent geographical areas a re presented a t nat ional meetings, but seldom i s there any real attempt to compare resu l ts f rom two d is t inc t regions t o t r y to establ ish the rea l i ty o f t he di f ferences repor ted a n d t h e i r possible signif icance. Signif icance i s relat ive, and it is of ten d i f f i cu l t t o evaluate t h e signif icance o f one's own f indings, except in re lat ion t o the f ind ings o f others. A r e Eskimos pa r t i cu la r l y p rone t o osteoarthr i t is , Midwestern lndians t o treponemal disease, and Southwestern Indians t o porot ic hyperostosis, or are these merely erroneous impressions tha t have developed as a resu l t o f research provinc ia l ism?

T h i s symposium was organized as a f i r s t step toward b reak ing down the ba r r i e rs of research provincial ism, to g e t people to look a t environmental ( inc lud ing cu l tu ra l ) factors o f pathology in broader perspect ive, t o share philosophical and methodological approaches t o the subject, and to suggest problems f o r potent ia l ly p roduc t i ve f u t u r e research. With th i s goal in mind, the cont inent was d i v ided in to e igh t major regions [ t h e Northeast being unfor tunate ly omitted), one ind iv idua l represent ing each region. Each par t ic ipant was requested t o review the h i s to ry of paleopathology in h is o r he r region, to discuss some o f the important f ind ings and c u r r e n t issues in tha t region, and t o suggest areas of potent ia l ly s igni f - icant f u t u r e research. Given the 20 minute time l im i t f o r ind iv idua l presentations, t h i s was a v e r y d i f f i cu l t if not impossible task. However, t he par t ic ipants have put a real e f f o r t i n t o it, and, in so doing, have con t r i bu ted s igni f icant ly toward a broader geographical appreciat ion o f paleopathology in N o r t h America.

PREHISTORIC ALASKA

Michael R. Zimmerman, Jeanes Hospital, Philadelphia

Several mummified bodies f rom Alaska have been examined ove r t h e past decade, the oldest be ing a mammoth a n d some smaller mammals from t h e collection o f t he American Museum o f Natura l H is to ry . These frozen remains have been radiocarbon dated a t over 21,000 years B .P. and show remarkable preservat ion o f microscopic anatomy. Human mummies have been studied f rom t h e Aleut ian and St. Lawrence Islands, a n d have demonstrated the an t iqu i t y o f pneumonia, trauma, and atherosclerosis.

T h e frozen family o f Bar row i s a unique find in terms o f t h e in tac t archaeologic provenance. F ive indiv iduals were ident i f ied, c rushed and frozen in the i r house. T h i s t a l k focuses on t h e anatomic f ind ings of the bodies, two o f which were almost pe r fec t l y preserved. S tandard autopsy procedures were used on the N o r t h e r n B o d y and t h e Southern Body, bo th females who d ied o f c r u s h i n g in jur ies. Nor the rn Body was a young, re lat ive ly heal thy adul t . Southern Body was middle-aged a n d showed atherosclerosis. She had probab ly su f fe red a complicated pneumonia ear l ier in he r l i fe, a n d may have been lac ta t ing a t t h e time o f her death. She may also have had t r ich inosis. T h e th ree o ther indiv iduals were poor ly-preserved skeletonized sub-adults.

THE NORTHWEST

Jerome S. Cybulsk i , National Museum o f Man, Ottawa

The ear ly h i s to ry o f paleopathology in the Northwest can be said t o have star ted w i th Boas' late n ineteenth c e n t u r y descr ipt ions o f a r t i f i c ia l c ran ia l deformation and h i s reference to a syph i l i t i c skul l , fol lowed b y p u t a t i v e examples o f sku l l t rephinat ion, a r th r i t i s , osteomyelit is a n d repor t s on dental health, but it was n o t until t he 1970s tha t any serious attempt was made to deal w i th skeletal pathology.

D u r i n g the past s ix years, su rveys have inc luded sites from b o t h the p re - h is tor ic and ear ly h is tor ic per iods (preh is tor ic remains c lustered between 1,000 B.C. a n d A.D. 500, h is tor ic contact occu r r i ng during the la t te r h a l f o f t he e ighteenth c e n t u r y ) . Evidence has been found o f c r i b r a orb i ta l ia and anky los ing spondyl i t is in b o t h periods. We have found possible rheumatoid a r th r i t i s , Scheuermann's disease, a n d spondylolysis ( t h e l a t te r more common in the preh is tor ic than in ear ly h i s to r i c ) . Osteoar thr i t i s is common, and there i s a possible case o f Paget's disease, but t h e predom- inant pathology among preh is tor ic males i s major trauma. In ear ly h is tor ic skeletons, there i s evidence o f malignant tumors, tuberculosis, syphi l is, chronic s inus infect ion a n d dental abscesses. There i s also a recent d iscovery o f a bu r ia l w i th signs o f t h e periosteal bone inflammation normally associated w i th syphi l is .

THE PLAINS

B r u c e Bradtmi l ler , Un ive rs i t y o f Tennessee

T h e h i s to ry of Plains paleopathology i s d i v ided i n t o th ree broad periods. T h e f i rs t , t h r o u g h about 1950, i s character ized by descript ions o f path- ological condi t ions in museum specimens. T. Dale Stewart a n d ~ l e s Hrdl iEka were t h e most ac t ive during t h i s per iod. They general ly inc luded pathological remarks as a p a r t of a complete skeletal analysis. T h e second period, f rom about 1950 t o about 1970 exh ib i ted a sh i f t in focus t o t h e la rger skeletal collections then becoming available. Pathological descr ipt - ions were usual ly repor ted as appendices t o archeological s i te repor ts . T h e third period, beg inn ing about 1970, i s cont inuing. In t h i s era, large studies w i th paleopathology as t h e main focus have begun t o appear. John B. Cregg was a pioneerin th i s f ield, a n d h i s work cont inues in South Dakota; my work in Tennessee complements h i s in many ways. These later studies, a n d those appear ing now, share the populat ion as t h e unit o f research.

T h e work under way a t Tennessee explores t h e biological ef fects associated w i th European contact o f t he Ar ikara, between 1650 and 1830 A.D. A l though a comprehensive data set i s being collected, t o date I have focused on small p a r t s o f t he tota l health question. Nevertheless, combining path- ology data w i th demography, H a r r i s lines, long bone metr ics a n d ethnohist - or ical data wi l l ul t imately allow a considerable unders tand ing o f t he total health o f t he A r i ka ra during t h i s period.

Several problems should be addressed in t h e paleopathology o f t h e Plains. Among the most pressing i s the re lat ionship between heal th and disease among the pro toh is tor ic Ar ikara, a n d the heal th a n d disease o f na t i ve Americans c u r r e n t l y living in South Dakota. T h e move t o ef fect rebur ia ls o f p reh is tor ic skeletal remains in the Plains could seriously hamper o u r ab i l i t y t o explore the natura l h i s to ry o f heal th and disease in t h i s reg ion.

THE MIDWEST

Della Col l ins Cook, Un ive rs i t y o f Indiana

Paleopathologists in the Midwest enjoy general ly good skeletal p reservat ion and preh is tor ic mor tuary pract ices t h a t resu l t in large, easily recovered series. Archaeologists and other specialists p rov ide us w i th a wealth o f data on subsistence and other re levant condit ions of prehistor ic l i fe . Among the in teres t ing issues in o u r region a r e the re lat ionship o f social status t o health, high frequencies o f a n endemic syph i l i s o r yaws-l ike disease in post-Archaic times, the appearance o f a tuberculos is- l ike disease wi th t h e advent o f la rge populat ion aggregates in Mississippian times, and changes in health and t race element content consequent o n the adoption o f maize as an important p a r t o f t he d iet .

THE SOUTHEAST

Kenneth R. T u r n e r , Un ive rs i t y o f Alabama

T h r o u g h the 1870s. Southeastern paleopathology was merely a n occasional domain f o r local amateur ant iquarians. Subsequently, until 1933, full- time workers appeared, whose research a n d col lect ing were general ly systematic, usual ly focused on theoret ical issues, a n d a f f i l ia ted w i th major nat ional museums. Later (1933 - 1942), t h e p ro l i f i c CWA-WPA Southeast archaeological excavations fostered much descr ip t ive research. D u r i n g th i s decade, major collections grew, some professionals received extensive t ra in ing, a n d local inst i tu t ional faci l i t ies emerged. A pe r iod of quiescence followed (1942 - ca 19601, during which a constant t r i c k l e of repo r t s des- c r i bed materials recovered by CWA-WPA projects. Beg inn ing a round 1960, most Southeastern graduate anthropology departments developed, w i th per ipheral g r o w t h in paleopathological research. Late 19th c e n t u r y researchers in the Southeast were in teres ted in disease as a factor in cu l tu re change, in i t ia ted debate on the geographical origin o f syphi l is, and speculated on pre-Columbian cannibalism. Most work during t h e 1900s has been descript ive, w i th some during the 1930s mentioning pu ta - t i v e ef fects o f c iv i l izat ion on health. Research since 1960 has tended t o approach a similar theme w i th greater sophistication, be ing of ten concerned w i th pathology as indicat ive o f cu l tu ra l a n d biological stress, but not ions concerning preh is tor ic cu l tu res have tended toward oversimpl i f icat ion. Presently, however, t he most u r g e n t issues invo lve protect ion and management o f research collections.

PREHISTORIC CALIFORNIA INDIANS

Ph i l l ip L. Walker, Un ive rs i t y o f Cal i fornia, Santa Barbara

Paleopathological studies o f Cal i fornia Indians a re l imited by t h e prac t ice o f cremation among many o f t h e preh is tor ic inhabi tants o f t h e state. T h e Centra l Val ley and t h e Santa Barbara Channel areas a r e two regions where cremation was pract iced on ly t o a l imited extent, and comparat ively l a rge collections o f human skeletal remains have been examined f o r t he presence of a va r ie t y o f d i f f e ren t pathological condit ions.

In t h e Cent ra l Valley, t he f requency o f H a r r i s l ines appears t o decrease th rough time. . Th i s may re f lec t changes in subsistence strategies t h a t decreased t h e probab i l i t y o f s tarvat ion during the late winter, when Cal i fornia Indians sometimes experienced food shortages. In t h e Santa Barbara Channel area, a d i f f e ren t pa t te rn i s apparent , w i th some Late Period collections exh ib i t i ng high frequencies o f H a r r i s l ines in comparison w i th collections from ear l ier sites.

The two areas d i f f e r in a number o f o ther respects. In t h e Cent ra l Valley, dental caries rates exh ib i t re la t ive ly l i t t l e temporal var iat ion. In the Santa Barbara area, caries ra tes decrease s ign i f i cant ly t h r o u g h

time, perhaps because o f a change in d ie t f rom one o f p lan t foods w i t h a high carbohydra te content t o one conta in ing substant ia l quant i t ies of f i s h w i t h a high f l uo r ide content. T h e r e i s also a d i f fe rence in t h e incidence o f l inear denta l hypoplasia in t h e two regions. These lesions a r e q u i t e common in remains f rom t h e Sacramento area, but uncommon in material f rom t h e Santa Barbara area.

THE SOUTHWEST

Char les F. Merbs, Ar izona State U n i v e r s i t y

T h e s t u d y o f paleopathology in t h e American Southwest beg ins w i t h Ernes t Hooten's work on skeletons recovered f rom Pecos Pueblo, New Mexico, t h e f i r s t t ime tha t t h e subject was app l ied t o an e n t i r e popu- lat ion. More recent work has been concerned w i t h t h e h i s t o r y o f var ious diseases in t h e Southwest such as tuberculosis, syphi l is , a n d coccidioidomycosis. Evidence f o r t h e presence o f tubercu los is now appears well establ ished a t si tes such as Nuvakwewtaqa a n d Point of Pines, Arizona, a n d Tocito, New Mexico, w i t h t h e oldest evidence (A.D. 875 - 975) coming from a small Kayenta Anasazi s i te in nor theas tern Ar izona. Evidence f o r t h e presence o f o the r in fect ious diseases in t h e Southwest i s much more equivocal.

F rac tures o f var ious k i n d s a r e common, a long w i t h evidence o f occasional violence, scalping, a n d possible cannibalism. Porot ic hyperostos is a n d c r i b r a orbi tal ia, common in many Southwestern skeletal series, have been associated w i th i r o n def ic iency anemia re lated t o heavy dependence upon maize. However, some in fan ts a n d ch i l d ren f rom Nuvakwewtaqa, Sundown, a n d Elden Pueblo, a l l in Arizona, show involvement o f t h e sku l l i n te r i o r a n d t h e postcranial skeleton suggest ive o f more severe nu t r i t i ona l def ic iency. I n te res t i ng examples o f congenital o r developmental condi t - ions inc lude a possible case o f acromegaly from Po t te ry Mound Pueblo, New Mexico, a n d one o f at lanto-occipi tal C2-3 fusion w i t h possible traumatic consequences from t h e B r i g h t Angel Ru in , Grand Canyon, Arizona.

MEXICO AND CENTRAL AMERICA

F r a n k P. Saul a n d Jul ie Mather Saul, Medical College o f Ohio

T h e development o f paleopathologic research in t h i s region was b r i e f l y rev iewed in terms o f several important Mexican teachers a n d inves t iga tors o f t h e recent pas t ( t h e anthropologis t Juan Comas a n d t h e phys ic ian a n d anthropologis t Eusebio DSvalos) a n d t h e t r a i n i n g a n d ac t iv i t ies o f c u r r e n t Mexican (and a v e r y few o the r ) scholars.

T h e v e r y complex geographic-ecologic se t t ing o f t h i s v e r y la rge a n d

varied region was discussed in relation t o i t s dif ferential effect upon cultures and their mortal remains. Also emphasized was the unusual biologic and cul tural continuity over time in the Maya and similar areas.

The major portion o f the presentation was devoted to a review o f basic questions for th is area [and many others) that relate to health over time. Selected indicators (age a t death, stature, dental at t r i t ion and caries, linear enamel hypoplasia, radiographic lines and bands o f increased density, spongy o r porotic hyperostosis, ossified periosteal hemorrhages, and new laboratory techniques [ t race element analysis, e.g. Schwninger l were reviewed in relation t o a chronologic orientation (hunt ing and gathering vs incipient and later agr icul ture with population expansion vs time o f contact [ 'The Columbian Exchange'] vs colonial vs modern) together with comment regarding questions unique to th is area (e.g. the pre- Columbian Maya collapse).

Although a great deal o f information was presented concerning health over time and the pre-Columbian presence o r apparent absence o f certain diseases, it i s obvious that th is major region requires a more complete synthesis and more f ield and laboratory research.

Acknowledqements

We thank Professors Lourdes ~ Q r q u e z and Carlos Serrano for their help with th is part icular presentation, not forgett ing the many Mexican physical anthropologists and physicians who have helped us in the past.

SECTION 2: INBORN, CONGENITAL, AND DEVELOPMENTAL ABNORMALITIES I N PALEOPATHOLOGY

Convener: John B. Gregg

INTRODUCTORY STATEMENT

John B. Gregg, Un ive rs i t y o f South Dakota

Paleopathologists have repor ted few invest igat ions o f inborn a n d develop- mental anomalies in ancient human remnants. A symposium on congenital defects scheduled by the Paleopathotogy Association in 1979 was cancelled f o r lack o f support . T h e best explanat ion f o r t h i s absence o f enthusiasm is the dear th o f specimens hav ing exemplary congenital anomalies f o r discussion. Cancellation o f t h i s session was most unfor tunate, because t h e v e r y fact t ha t obvious, over t , i n b o r n anomalies a r e r a r e in ancient human remnants but v e r y prevalent today should have stimulated e n q u i r y t o expla in t h i s dichotomy. D i d i nbo rn anomalies ex is t in t h e pas t? Does t h e pauc i ty o f over t o r d isabl ing congenital anomalies in ancient people re f lec t ' su rv i va l o f the f i t tes t? ' A r e t h e anomalies preva lent in t h e cu l tu ra l l y sophist icated twent ieth c e n t u r y wor ld something new? If o v e r t anomalies ex is ted in t h e past, why a re there few remains o f af fected indiv iduals among ancient human skeletons a n d mummies?

Factors implicated as mutagens, capable o f causing congenital anomalies, a r e endogenous (aberrat ions in genetic transmission), and exogenous (affectat ion o f t h e fe tus a t some po in t in embryogenesis, when it i s susceptible). Many chemicals, d rugs, and o ther agents a r e suspect as cause fo r i nbo rn anomalies a n d in f luent ia l in mutations. Compared to the present , in the d is tan t past t he re were few establ ished mutagenic factors available to t h e pregnant female. Maternal n u t r i t i o n has been evaluated thorough ly f o r i t s ef fect on pregnancy and on t h e fetus. Minckler e t a1 (1971: 123) repor ted tha t spontaneous abort ions occur in 20% o f pregnancies, and c i ted l n h o r n (1967). who showed tha t chromo- somal abnormalit ies accompanied 25% o f these. I f the f requency o f p rematur i ty a n d spontaneous abort ion were known f o r the prev ious in- habi tants o f a cer ta in region, it cou ld be used as an index of possible abnormal pregnancies.

Certa in condit ions catalyze the appearance o f congenital anomalies. Isolation (geographic, cu l tura l , l inguist ic , economic, o r rel igious) i s a potent factor perpetuat ing genetic anomalies in a populat ion. Consang- u i n i t y a n d incest promote perpetuat ion o f gene-mediated abnormalit ies. Unfor tunate ly , l i t t l e paleopathological evidence ex is ts re la t ing t o preg- nancies and inbo rn defects in t h e societies t h a t condoned consanguin i ty and incest.

D i f f e ren t congenital and developmental anomalies t h a t occur red in

ant iqu i ty , some new information re la t ing t o t h e f requency of p rematu r i t y a n d spontaneous abort ion in ancient N o r t h America, a n d information re la t ing t o a means o f evaluat ing t h e bones o f premature a n d newborn in fan ts f o r evidence o f nu t r i t i ona l a n d metabolic s t ress during pregnancy wi l l be presented in t h i s discussion. A select panel w i l l ponder t h e data presented, compare t h e evidence submitted w i t h the i r own experiences a n d w i th t h e information available f rom other sources, t hen advise regard- ing f u t u r e invest igat ions in t h e realm o f congenital and developmental abnormalit ies in an t iqu i t y .

Reference

Minckler,J., Anstal1,H.B. and T.M.Minckler. 1971. Pathobiology, A n In t roduct ion . C.V.Mosby Co. St. Louis

HEREDITARY MULTIPLE EXOSTOSES I N AN INDIVIDUAL FROM A SOUTHERN ONTARIO IROQUOIS POPULATION

M. A n n e Katzenberg, Un ive rs i t y o f Toronto, Marc A. Kelley, Un ive rs i t y o f Rhode Is land a n d Susan Pfe i f fer , Un ive rs i t y o f Guelph

Skeletal lesions character is t ic o f he red i ta ry mul t ip le exostoses were discovered in a bundle bu r ia l f rom a protohistor ic I roquo is ossuary. T h e disease, inher i ted as an autosomal dominant, i s n o t uncommon today, ye t there a re few repor ted cases f rom ear l ier human populations. T h e bund le bu r ia l was d is t inc t f rom t h e h i g h l y mixed remains o f approximately 457 indiv iduals. No o ther bones exh ib i t i ng exostoses were found in t h e ossuary.

CONGENITAL DISTURBANCES IN ENDOCHONDRAL BONE DEVELOPMENT IN TWO ARCHEOLOGICAL HUMAN SKELETONS FROM NORTH AMERICA

Donald J. O r t n e r a n d Stephen Hunter , Smithsonian Ins t i t u t i on

Achondroplasia (chondrodyst rophy) i s an inher i ted and congenital d is turbance o f g r o w t h in which endochondral bone formation i s diminished but intramembraneous bone formation i s normal o r near ly so. In achond- roplasia, centers o f endochondral ossif ication, in addi t ion t o hav ing abnormally slow growth , t end t o fuse ear l ier than normal. accentuat ing the e f fec t o f slow growth . Inher i tance i s t h r o u g h a simple dominant mode, but the degree o f expression (penetrance) o f t he condit ion var ies and tends t o be weak. In domestic animals selective breed ing has led to several syndromes in which d i f f e ren t p a r t s o f t h e skeleton a re d i f f e r - ent ia l ly af fected (e .g . t he bulldog, dachshund, boxer, Pekinese, a n d Boston t e r r i e r ) . In humans t h e disease tends to b e generalrzed w i th al l centers o f endochondral ossif ication af fected.

In archeological human skeletal samples t h e disease i s well documented

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in b o t h t h e O l d a n d t h e New World, a l though t h e number o f cases i s small (a round ten) . T w o p rev ious l y un repo r ted cases a r e presented. One, t ha t o f a young c h i l d (NMNH 382291). i s f rom t h e Bel le Glade Mound in Flor ida a n d exh ib i t s t h e classic features o f achondroplasia -- short, t h i c k long bones w i t h d ispropor t ionate ly en la rged epiphyseal ends. T h e o the r case (NMNH 271813) i s unusual in tha t t h e major g r o w t h d is turbance a f fec ts p r imar i l y t h e humer i a n d t h e pelv is . Leng th g r o w t h in t h e o the r bones i s normal o r near normal, a l though t h e r e i s evidence o f bowing and o the r features ind ica t ive o f defect ive endochondral bone formation. T h e l a t t e r case i s f rom a Pueblo s i t e in t h e American southwest. T h e t w o cases i l l us t ra te t h e va r ie t y in t h e expression o f car t i lage g r o w t h d is turbances.

DEVELOPMENTAL DEFECTS OF VERTEBRAL BODIES I N A CANADIAN ESKIMO ISOLATE

Char les F. Merbs, Ar izona Sta te Un ive rs i t y

T h e Sadlermiut, an isolated Eskimo ( I n u i t ) g r o u p tha t l i ved on Southampton Is land n o r t h o f Hudson B a y in t h e Canadian A rc t i c , succumbed t o an epidemic during t h e w in ter o f 1902 - 03. Seven o f t h e Sadlermiut skele- tons, from a series number ing s l i gh t l y less than 100 indiv iduals, exh ib i t a developmental defect i nvo l v ing thoracic a n d lumbar ver tebrae. T h e defect ranges f rom a small c l e f t o r hole in t h e ve r teb ra l body t o a fa i lu re o f a signif icant po r t i on o f t h e body t o develop. In i t s most severe form, the defect, best known c l in ica l ly as 'sagit tal c l e f t vertebra, ' d iv ides t h e body i n t o two par ts , resu l t i ng in an te r i o r exposure o f t h e neu ra l canal, a n d present ing a ' b u t t e r f l y ' appearence in anteroposter ior radiographs. T h e af fected indiv iduals, rang ing in estimated age from 6 t o Y O years, have a tota l o f 13 ver tebrae af fected. T w o mi ld examples o f t h e condi- t ion were also d iscovered among 400 skeletons o f ne ighbor ing T h u l e c u l t u r e Eskimo g roups .

T h i s paper also discusses o the r congenital a n d developmental condi t ions found in t h e Sadlermiut series, i nc lud ing spina b i f ida, Scheuermann's disease, and third metacarpals w i t h missing s t y lo id processes. T h e predisposi t ion o f ind iv idua ls w i t h these condi t ions t o ea r l y degenerat ive o r traumatic changes in t h e skeletal system i s also considered.

TRANSVERSE LINE FORMATION IN PROTEIN-DEPRIVED NEWBORN RHESUS MONKEYS

Mark A . Murchison, Douglas W. Owsley a n d A r t h u r J . Riopelle, Louisiana State U n i v e r s i t y

Radiographs o f 85 newborn rhesus monkeys. Macaca mulatta, were examined f o r evidence of t ransverse l ines in t h e prox imal a n d d is ta l ends o f t h e l e f t r ad ius . Transverse l ines ( H a r r i s l ines) in l o n g bones

a r e densi ty anomalies though t to b e associated w i th in terva ls o f s t ress during growth. T h i s research documents the f requency of postnata l transverse-l ine formation (i.e. formation o f birth l ines) a n d seeks t o determine whether the amount o f d ie tary p ro te in available t o the animal af fects t h e f requency o f l ine formation.

Newborn rhesus monkeys (n=30) were placed on a pro te in - res t r ic ted d iet . Data f o r t h e experimental animals were compared w i th a cont ro l g r o u p (n=55) tha t was maintained on a d ie t adequate in prote in. A h igher mean number a n d a h ighe r percentage of t ransverse l ines occur in the contro l animals than in pro te in - res t r ic ted infants.

Given the use o f t ransverse l ines as na tu ra l markers in g r o w t h studies a n d as indicators o f morb id i ty and malnut r i t ion in bioarchaeology compari- sons, it i s usefu l t o c l a r i f y the t ypes o f factors t h a t lead t o l i ne formation. Archeological implications are discussed.

CONGENITAL ANOMALIES OF THE LOWER SPINE IN TWO ARIKARA SKELETAL SERIES

B r u c e Bradtmil ler, Un ive rs i t y o f Tennessee

Skeletal collections f rom the Su l ly (39SL4) a n d Larson (39WW2) sites in South Dakota a re compared w i th respect t o congenital anomalies o f t h e lumbosacral region o f t he ver tebra l column. Spina b i f i da occulta a n d separate neura l arches a re specif ical ly considered. Spina b i f ida occulta. the par t ia l o r complete lack o f fusion o f t h e s x r a l neura l laminae i n t o spinous tuberc les i s a completely genetic t r a i t . Separate neura l arches, o r spondylolysis, occur as a separation a t one o r b o t h p a r s i n te ra r t i cu la r i s . It apparent ly has some genetic a n d some behavioral component. T h e Su l ly si te dates f rom 1650 - 1700 A.D., a n d t h e Larson s i te f rom 1679 - 1733 A.D. T h e y a re located near each o the r in the Missour i R ive r Basin.

T h e overal l incidence o f these anomalies in the two groups is qu i te d i f ferent . T h e Larson series contains o v e r twice the f requency o f separate neural arches as the Su l ly series; spina b i f ida occulta occurs over fou r times as f requent ly in t h e Larson site. Pat te rns o f age a n d sex d is t r ibu t ion o f these t r a i t s a re documented, and contrasted between the two sites. In the case o f spina b i f ida occulta. these data suggest tha t t he groups a re genetical ly d is t inct . T h e la rge d i f ference o f separate neura l arches between the sites cou ld be due to a genetic diff- erence o r t o a behavioral di f ference. T h e suggest ion i s made, based on these as well as o ther data, t ha t b o t h genetic and behavioral factors are responsible f o r t he high incidence o f t h i s t r a i t .

ANCIENT INBORN FACIAL CLEFTS AND NON-ODONTOGENIC FISSURAL CLEFTS

John B. Gregg, Un ive rs i t y o f South Dakota, Marv in J. Allison, Medical College of Virg in ia, Sylvester Cl i f ford, Un ive rs i t y o f South Dakota, Enr ique Gerszten, Medical College o f V i rg in ia a n d Walter E. Klippel, Un ive rs i t y o f Tennessee

Unusual, apparent congenital facial fusion defects in s ix ancient sku l ls from t h e Upper Missour i R i v e r Basin a n d southeastern U.S.A. a re pres- ented a n d discussed. T h e s imi lar i ty between non-odontogenic f i ssura l defects and o v e r t a n d occult lip and palate c le f t i ng i s explored. Some specimens in other collections now labeled 'dental abscess' o r 'dental tumor' may represent these anomalies. Because o f t h e s imi lar i ty in emb- ryo logy a n d anatomy, non-odontogenic f i ssura l cys ts must b e considered as an abor t ive form o f facial c lef t ing. B y determining the f requency w i t h which these occul t anomalies occur, it may b e possible t o estimate t h e f requency w i t h which these occul t anomalies occur it may b e possible t o estimate the f requency o f o v e r t facial c l i f t i n g in t h e past, despite t h e fact t ha t skeletons w i th ove r t facial c le f t i ng a re found on ly in f requent ly .

MATERNAL MORTALITY I N ARIKARA INDIAN VILLAGES OF THE POST-CONTACT PERIOD

Douglas W . Owsley, Louisiana State Un ive rs i t y and Bruce Bradtmi l ler , Un ive rs i t y o f Tennessee

H i g h in fan t morta l i ty and high morta l i ty f o r late adolescent and young adu l t females suggest tha t obstetr ica l hazards may be one explanation fo r di f ferences in male and female morta l i ty curves . T h i s poss ib i l i t y i s invest igated in Ar i ka ra skeletal series b y determining t h e frequency o f females who died w i th fetal remains in u tero . Two females (0.9%) were so ident i f ied. Examination o f t h e females and the fetal remains do n o t p rov ide evidence tha t s t ress o f ch i ldbear ing was t h e cause of death in these cases.

PANEL DISCUSSION

Moderator : John B . Gregg Panelists: Dav id A . B i r k e t t (Middlesbrough, England), F rank P. Saul Medical College o f Ohio, Theodore A . Reyman, Mount Carmel Mercy Hospital (Det ro i t ) a n d Michael R . Zimmerman, Jeanes Hospital (Philadelphia)

T h e discussion was opened by D r . Gregg, who read two conf l i c t ing opin i ons from the n ineteenth cen tu ry . One wr i te r , in 1839, said tha t it was a common Ind ian custom to des t roy deformed babies (an explanation f requen t l y put fo rward t o expla in t h e pauc i ty of remains showing

congenital anomalies). O n the o the r hand, in 1861 George Cat l in wro te tha t in fan ts w i th deformit ies were looked a f t e r most tender ly , 'protected arTd guarded w i th superst i t ious care.' D r . Zimmerman took issue w i th Catl in 's re l iab i l i t y as a n observer, po in t i ng out t h a t h e was an a r t i s t who cher ished h is relat ionships w i t h t h e Ind ians a n d would always defend them against what might b e considered calumny.

D r . Reyman, a f t e r congra tu la t ing the authors on a f ine a r r a y o f papers, went on t o say tha t it would b e a misapprehension t o cont inue bel iev ing tha t congenital anomalies in ancient remains a r e ra re . Many anomalies go unnot iced o r unreported, simply because they a re re la t ive ly minor and would have caused n o s igni f icant cl inical d i f f i c u l t y during l i fe. Some might have on ly sof t t issue expression and would there fore be missed in skeletal remains. O the rs might masquerade as acqu i red defects, a n d some wi l l be missed because o ther d isorders so d i s to r t t he remains t h a t classical features a r e n o t recognized. Some anomalies can be seen on ly in t h e tota l skeleton, t h u s n o t be ing spot ted in par t ia l remains. A t t h e same time, cer ta in congenital anomalies were probab ly n o t p resent in t h e past, e.g. fetal alcohol syndrome, drug associated anomalies a n d those re lated t o tox ic chemicals o r i r radiat ion, which would n o t have been present before the Indus t r i a l Revolut ion and t h e marked increase in populat ion density.

He fe l t t ha t we should begin t o describe and catalog any a n d a l l changes observed, so tha t as o u r knowledge advances in o the r areas (e.g. demo- graphic studies i nvo lv ing HLA t yp ing ) , we may beg in t o appreciate the association between cer ta in populat ions a n d cer ta in anomalies. We should t r y t o answer quest ions about consanguin i ty and t h e development o f pa t te rns o f anomalies in a populat ion, o r questions concerning cu l tu ra l pa t te rns o r environmental factors and the i r association w i t h anomalies.

He also stressed t h e fact t ha t we do have evidence from t h e past f o r t h e existence o f congenital anomalies. T h e ancient Egypt ians knew about genetic dwar fs (A f r i can pygmies), achondroplastic dwarfs, and possib ly also p i t u i t a r y dwarfs. Evidence f rom paint ings, sculptures and wr i t t en sources should be compared w i th t h e evidence from human remains, bo th mummified and skeletal, t h u s p rov id ing a clearer p i c t u r e o f t h e t ype and amount o f such congenital disorders, par t icu lar ly i f the human remains a re equivocal; in such cases, the addi t ion o f h is tor ica l accounts could lead to a f i rm diagnosis. He fe l t t ha t we now have the interest , t he ab i l i t y , a n d the techniques to accomplish th is , and could produce a major addi t ion to human h is tory .

D r . Saul also fe l t t ha t it was incor rec t t o state tha t congenital abnorm- al i t ies a r e n o t seen in ancient human remains. T h e y a re seen, b u t - only in a r t forms, such as the Olmec 'child-man' sculptures, which may indicate Downs Syndrome, o r the At lantean f igures tha t indicate dwarfism. Dwar fs were also descr ibed b y Spanish explorers. T h e lack o f skeletal remains might be due to ceremonial disposal of bodies, which (according t o Dura'n and Mendieta) invo lved burning.

We also see dental abnormalit ies: e.g. odontomes (ben ign dental tumors), enamelomas (dental pear ls) , gemmated ( twinned) teeth.

A l l o f these a re present in t h e Maya area, a n d p robab ly elsewhere, but the i r presence i s no t emphasized because they a r e o f l i t t l e funct ional signif icance.

Sometimes t h e abnormalit ies may have been misdiagnosed. He was able t o rediagnose congenital dysraphism a t bregma in an a d u l t male from Chichen l tz6 (900 - 1200 A.D.), which had been p rev ious l y l isted, in 1940, as an 'old, healed, depressed f racture. '

Regarding the condit ion o f remains, D r . Saul warned tha t caut ion i s necessary because postmortem root and o the r damage can mimic cys ts , etc., especially in f ragmentary material. Ver tebra l material i s of ten lack ing o r bad ly damaged, but Genoves found sacralized L5s in 6 o u t o f 11 sacra a t Oaxaca (t ime o f contact), a n d t h e Sauls found 2 fused C2 - 3s, possib ly Klippel-Feil Syndrome, a t Tancah (also time o f contact) .

Def in i t ion i s also a problem. I s spondylolysis congenital, as once believed, o r i s it traumatic, as i s t h e c u r r e n t belief, o r i s it perhaps a combina- t ion of b o t h ? T h e f ragmentary na tu re o f t he materials has l imited them to one case in t h e i r own work, a 400 B.C. specimen from Cuello, indicated by a fragment o f t h e upper right a r t i cu la r process.

It i s v e r y important t o g o on looking f o r congenital anomalies. N o t on l y a re some of them important from a funct ional po in t o f view, but those t h a t a r e hered i ta ry in na tu re p rov ide def in i te clues t o populat ion gene flow, especially endogamy ( in-breeding) . D r . Saul i l lus t ra ted h is comments w i t h slides, bo th from a r t and from h is own invest igat ions o f human remains.

D r . B i r k e t t was asked to compare what h e had heard today w i th f ind ings from European paleopathology. He said t h a t h i s immediate response was t o note the simi lar i ty, a l though it was h i s impression tha t there might be a h ighe r incidence o f cer ta in anomalies.

(Ed. note: A t t h i s point, because o f technical d i f f icu l t ies w i th the taping, D r . B i r ke t t ' s remarks became uninte l l ig ib le. We reg re t the inconvenience t o o u r subscr ibers)

SECTION 3: CONTRIBUTED PAPERS

CUTANEOUS PATHOLOGY IN A SOUTH AMERICAN MUMMY

Harvey Sasken, B rown Un ivers i ty , Marv in Al l ison a n d Enr ique Gerszten, Medical College o f V i rg in ia

D u r i n g t h e examination o f a South American mummy, a female aged about for ty , f rom n o r t h e r n Chile, cutaneous a l te ra t ions were discerned. O n pathologic examination, t h e sk in i s medium t o d a r k b rown in color w i t h a sweet, s l i gh t l y pungen t aroma. Ha i r s a r e present, as a r e dermal r i dges . Numerous 0.1 cm smooth sur faced popu lar elevat ions punctuate t h e ex terna l surface.

Specimens f o r light microscopy a r e p repa red by rehyd ra t i on in modified Ruf fe r ' s solution, fol lowed b y rou t i ne dehydra t ion a n d p a r a f f i n a n d g lycol methacry late embedding. Elect ron microscopic samples a r e p re - pa red by simultaneous rehydra t ion a n d f i xa t ion in 5% g lu tara ldehyde a n d 0.075 M PIPES b u f f e r a t Q°C. T h e t issues a r e pos t f i x e d in 0504 a n d embedded in S p u r r ' s low v iscosi ty res in .

T h e epidermis i s absent, n o nucle i a r e ev ident . Ha i r s w i t h abundant b rown pigment s i tuated w i th in wel l -preserved fo l l icu lar s t r u c t u r e s a r e recognized. Smooth muscle a n d collagen bundles a r e easi ly d iscerned. Numerous d iscrete a n d qu i te subt le d issolut ion a n d des t ruc t i ve processes a r e recognized th roughou t t h e dermis. Some o f these areas a r e re la ted t o sur face elevations. T h e r e i s f u r t h e r ind icat ion tha t some o f these lesions can b e re lated t o vessels. We concluded tha t t he re i s ev idence o f a vascular re la ted necro t iz ing process. O f t h e several categories of disease possible, we feel t ha t t h e r e i s compell ing evidence f o r a systemic in fect ion. O the r t issues a r e c u r r e n t l y be ing examined.

TREPANNING PRACTICE IN PREHISTORIC DENMARK

Pia Bennike, U n i v e r s i t y o f Copenhagen

A s p a r t o f a paleopathology s tudy , i nc lud ing computer reg is t ra t ion o f al l human remains from preh is to r ic Denmark, a tota l o f 19 t repanned sku l ls was found, which represented 3% o f a l l well p rese rved p reh i s to r i c skul ls .

New c 1 4 dat ings showed tha t sku l l s u r g e r y cou ld be dated back t o 3,500 years B.C. A v e r y un i fo rm location o f the t repanat ions may also indicate tha t t h e sku l l s u r g e r y was per fo rmed f o r t h e same cause, p r imar i l y a f te r man-induced i n j u r y .

T h i s research was suppor ted by the Danish Medical Council, t h e Danish Counci l o f t h e Humanities, a n d Queen Margre the 11's Archaeological Foundation.

OSTEOARTHROSIS: A CHANGING PATTERN

D .A. B i r ke t t . Middlesbrough, Eng land

T h e pauc i ty o f evidence f o r rheumatoid a r t h r i t i s in ancient skeletal remains i s in sharp contrast t o t h e obvious s igns o f osteoarthrosis o r degenerat ive joint disease, which was common throughout preh is tor ic a n d h is tor ic periods, as it i s today in medical pract ice. However, it has been suggested t h a t t h e p a t t e r n o f joint involvement o f t h i s disease has changed, possibly because o f a d i f f e ren t l i fes ty le and changed occupations. A n attempt has been made t o draw together f igures o f t he incidence o f osteoarthrosis in t h e l a rge r joints o f t h e skeleton in a number o f d i f fe rent populat ions f rom d i f f e ren t living sites a n d per iods in Great Br i ta in , in o rde r t o show changes over t h e centuries.

NAPOLEON BONAPARTE: WHAT IS THE REAL EVIDENCE OF ARSENIC POISONING?

Peter K . Lewin, Hospital f o r Sick Chi ldren, Toronto

Evidence i s presented tha t a h a i r specimen obtained from Napoleon a t t he time o f h is death contained normal levels o f arsenic ( 1 . 4 p a r t s pe r mil l ion] a n d elevated levels o f antimony (5.6 ppm). It i s there- fore concluded tha t Napoleon did not die o f chronic arsenic poisoning. T h e provenance of t h e ha i r i s clear.

SECTION 4: A.A.P.A. SESSIONS ON PALEOPATHOLOGY

A . SKELETAL ANALYSIS AND THE EFFECTS OF SOCIOECONOMIC STATUS ON HEALTH

A biological perspect ive on preh is tor ic social s tatus (A.M.Palkovich)

Chi ldhood stress, age a t death and social s tatus a t Dickson Mound, A.D. 590 - 1300 (A.H,Goodman, N .A.Rothschi ld and G.J .Armelagos)

Social s tatus a n d health: a comparison o f Middle Woodland and Mississ- ippian populat ions f rom westcentral I l l ino is (D.C.Cook)

T h e cu l tu ra l determinants o f Mississippian community health: a n exam- inat ion o f populat ions f rom two areas o f western I l l ino is (G.R.Milnet-)

Subsistence role behavior and t h e infect ious disease experience on the preh is tor ic Georgia coast (C .S .Larsen)

Status a n d heal th in Colonial South Carol ina: Belleview Plantat ion 1738 - 1756 (T.A.Rathbun a n d J.D.Scurry)

The biological ef fects o f European contact among t h e A r i k a r a (B . Bradtmi l ler)

A n examination o f d i f fe rent ia l s tatus a n d health fo r t he p reh is to r i c Anasazi from Black Mesa, Ar izona (C.Piacentini a n d D.L.Martin1

Comments by J .E.Buikstra, Northwestern Un ive rs i t y

Some o f t he most important p roduc ts o f t h i s session were t h e caut ions: to be c r i t i ca l concerning the possible biases in t h e sample, however large (Cook), which can indeed a f fec t heal th status estimates. Another cogent comment was t h e observat ion tha t we cannot equate community health d i rec t ly w i th o u r osteological indicators wi thout qual i f icat ion - e.g. how d o hypoplasias o r per ios t i t i s t ranslate i n t o populat ion hea l th? Some o f the more provocat ive resu l ts emerged f rom studies o f southwestern remains (Piacentini and Mar t in , Palkovich) . Bo th po in ted t o t h e importance o f exp l ic i t def in i t ion o f s tatus markers as seen in t h e archaeo- logical record and as corroborated by ethnographic evidence, as models against which community heal th may b e evaluated. T h e fact t ha t Piacentini a n d Mar t in found g r a v e const ruc t ion r a t h e r than g rave goods more consistent w i t h expectat ions i s s igni f icant , and should su rp r i se no-one who has care fu l l y considered the re lat ionship between the social dimensions o f mor tuary behavior, status, a n d health. Mi lner i l lus t ra ted the need f o r care fu l considerat ions o f regional var iat ion in heal th before we generalize about heal th status in Mississippian populat ions. He also presented a provocat ive hypothesis impl icat ing bean prepara t ion tech- n iques in t h e heal th s ta tus o f Dickson Mounds Mississippian populat ions, when compared t o t h e inhabi tants o f t he Cahokia area. Goodman a n d Cook both i l lus t ra ted t h e importance o f developing models t h a t care fu l l y evaluate temporal change a n d status di f ferences. Goodman suggested

t ha t s tatus di f ferences, as seen in g r a v e goods, may ref lect advantaged health status in Mississippian Dickson Mounds. However, Cook f i nds n o s u ~ h association in t h e lower I l l ino is Val ley Mississippian series tha t she has studied. T h e biological costs a n d benef i ts o f an ag r i cu l tu ra l existence a r e also considered by Larsen, who argues tha t females were more disad- vantaged in t h e Georgia Coast region during t h e sh i f t t o agr icu l tu re . Bradtmi l ler documented t h e costs of European contact t o na t ive Americans, and Rathbun noted the fact t h a t el i tes f rom the colonial per iod were n o t necessari ly more heal thy than lower status counterpar ts . In general, t he conclusions would seem t o suppor t t he not ion t h a t high status a n d advantaged heal th status d o not necessari ly correlate, a n d tha t human beings have not always made 'healthful1 choices in t h e i r attempts to d is t ingu ish themselves from peers.

Skeletal and dental pathologies in a Cercocebus albigena sample (D.Clauser)

Pat terns o f human-induced in ju r ies o f t he preh is tor ic skeletons f rom Denmark (P.L.Bennike)

Paleoepidemiology o f a nat ive Cal i forn ian skeletal populat ion (R.D.Jurmain)

Degenerative joint disease in t h e skeletal remains f rom Ku lubnar t i , Republ ic o f Sudan (L . Ki lgore)

R i b lesions in chron ic pulmonary tuberculos is (M.A.Kelley and M.S.Micozzi)

Evidence f o r t he an t iqu i t y o f tuberculos is in t h e New World: skeletal pathology in t h e sacroiliac region (M .S.Micozzi and M.A. Kelley)

Health status o f colonial i ron-worker slaves (J.L.Angel a n d J.O.Kelley)

Caries in permanent dent i t ions o f p ro toh is tor ic Easter Is landers (A.M.Mires, D.W.Owsley and G.W.Gill)

Comments by J.L.Angel. Smithsonian Ins t i t u t i on

T h i s was a chance synthesis o f papers, no t a symposium. There was n o common th read tying them together, but it was a n in teres t ing session w i t h good discussion. Clauser 's major f ind ings regard ing f rac tures disagrees w i th Schultz ' p rev ious l i n k i n g o f f rac tures w i th arborea l i ty . Bennike stresses ar row wounds and t rephinat ions in preh is tor ic times, w i t h decap- i ta t ion occu r r i ng in the V i k i n g period. Jurmain noted ear ly extreme dental wear and f requen t ver tebra l osteophytosis. K i lgore f i nds females more stressed than males in h e r s tudy o f medieval Nubia. Kel ley a n d Micozzi note t h e uncer ta in ty o f opinions about the o r ig in o f p reh is tor ic tuberculos is and subt le ty requ i red f o r diagnosis. Kel ley a n d Angel, in t h e i r s tudy o f 31 b lack i ron-work ing slaves, found them t o be fa i r l y healthy, except f o r evidence o f inadequate chi ldhood d ie t and s igns of occupational stress. Mires, Owsley a n d Gi l l no ted a h ighe r adu l t f requency o f caries than in o ther Pacif ic groups, p robab ly related t o a sweet, s ta rchy d iet .

Committee for the Tenth Annual Meeting

Charles F. Merbs: Scientific Chairman

John B. Cregg: Chairman, Congenital Anomalies Symposium

Della Collins Cook: Local Arrangements Chairman

Eve Cockburn: Meeting Report Editor

RESOURCES I N PALEOPATHOLOGY

T h e Paleopathology Association i s compil ing a l i s t ing o f ind iv idua ls who a r e w i l l ing a n d able t o per fo rm t h e specialized studies essential t o o u r in terd isc ip l inary f ield. Members who would be in te res ted in col laborat ing on studies o f skeletal o r mummified remains a r e u r g e d t o complete t h e form below and send it to:

Michael R. Zimmerman, M.D., Ph.D. Ch ie f o f Anatomic Pathology Jeanes Hospital 7600 Centra l Avenue Philadelphia, PA 1911 1

Name:

( t i t le ) (surname) ( f i r s t name)

Address:

(c i ty . state, zip) ( coun t r y )

Telephone number: Of f ice ( ) - Home ( 1 -

Check off any category in which you have special in terest o r exper t ise:

- Skeletal biology - Gross pathology (bone - ; soft t issue - )

Histopathology [bone ; soft t issue ) - - - - Radiology - Age determination (adu l t - ; subadult - 1

Dat ing (radiocarbon ; other ) - - - - Chemical analysis - Microbiology

Congenital disease - - A r t h r i t i s - Trauma - Infect ious disease - Neoplasia

Parasitology - - Other