Diagnosis of occupationally related 

 paleopathology: Can it be done? 



Ann Stirland 



1 he occupations followed by people in the past and the 

 activities in which they most widely indulged have probably 

 not changed greatly until recently. The development of mod- 

 em technology has brought changes in occupations, tool 

 types and usages that may in time produce characteristic 

 skeletal variations. There are already reports in the clinical 

 literature relating such changes to occupation (Mintz and 

 Fraga 1973). In the past, activity-related pathology may have 

 been expressed as stress fractures of the tibia in hunter- 

 gatherer groups which "ran down" their large prey. No matter 

 how good the preservation and recovery of artifacts from an 

 archeological site, however, the interpretation of their use 

 and the activities involved relies heavily on assumptions 

 based on ethnographic and historical parallels. Such interpre- 

 tation is speculative. 



It is a truism that an archeological site usually has no 

 documentary records. The occupations and activities of its 

 population are, therefore, unknown except from their ar- 

 tifacts. Paleopathological diagnosis brings its own problems. 

 Human bone has only two responses to any insult: either 

 normal bone is lost or new bone is added. Such limited re- 

 sponses lead to difficulties in equating specific pathological 

 lesions with particular occupations. Hven in a modern clini- 

 cal context diagnosis is an inexact science, and many of the 

 relationships between occupation and pathology are still not 

 clearly understood. Much occupational pathology will be 

 confined to soft tissue and will leave no record on the skel- 

 eton. There is also the problem of distinguishing lesions 

 which are attributable to a direct traumatic event, age de- 

 generation, or developmental defects from those specifically 

 related to occupation. 



Paleopathologists have only recently attempted to relate 

 some pathology to occupation, and they arc constantly made 

 aware of the problems and limitations of such interpretation 

 of the material. There are, however, some positive aspects. 

 Unlike the clinician, the paleopathologist is working with the 

 whole dry skeleton. Changes in bone are seen in their very 

 early stages and conditions which may be clinically symp- 

 tomless can be detected. 

 40 



Occupationally related paleopathology is, by definition, 

 nonrandom and habitual. If, despite the problems, some oc- 

 cupations can be diagnosed then this will provide an impor- 

 tant tool in archeological reconstruction. The ability to iden- 

 tify some skills, trades or professions can lead to the 

 extrapolation of this evidence into other sites and periods, 

 making a further valuable contribution to archeology. 



Skeletal studies 



The only comprehensive skeletal study of activity-induced 

 pathology so far produced is that by Merbs ( 1983). Although 

 the Sadlermiut series analyzed was not particularly large, 

 consisting of 41 male and 50 female adult skeletons, the 

 group was thought to meet many of the necessary criteria for 

 such a study (Merbs 1983:4,5). These include a limited num- 

 ber of specialized, but known, activities, good skeletal pres- 

 ervation and recovery, a relatively narrow time span, and 

 both cultural and genetic isolation. The paleopathological 

 lesions in the group were evaluated in six categories: os- 

 teoarthritis, osteophytosis, vertebral compression, other de- 

 generative features of the vertebral column (porosity of the 

 articular body surfaces, Schmorl's nodes and laminal spurs), 

 spondylolysis, and anterior tooth loss. The largest category 

 was that of osteoarthritis. Merbs analyzed Sadlermiut ac- 

 tivity patterns and discussed their possible stresses on areas 

 of the skeleton (1983: 147-156). He correlated the patterns of 

 activity and pathology. In his conclusions. Merbs argued that 

 the osteophytosis of the vertebral columns is a normal de- 

 generative condition and a consequence of bipedalism. A 

 number of the other pathological lesions, however, were cor- 

 related with particular activities, known or reconstructed. 

 Both sex and side differences were shown to be important. 

 Of particular interest were some elements of specific ac- 

 tivities which had not been anticipated during Merbs's recon- 

 struction of Sadlermiut behavior patterns. These elements 

 were suggested, however, by particular patterns of pathology 

 (Merbs 1983:184). This unexpected result provides an op- 

 timistic conclusion to the study and suggests further potential 

 for such reconstruction. 



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