Theoretical and methodological issues in paleopathology * 9 



NMNH 385788 



■^ 



■^ 



C^^ 



CBlastic 



CLytic 



CMixed 



Figure 4. Computer-aided design drawing of the pattern of various types of lesions in a probable case of 

 treponematosis from a pre-Columbian archeological site in Virginia, U.S.A. Note the pattern of proliferative 

 bone lesions (Elastic) versus those that are largely destructive (Lytic) in nature. (Drawing based on an adult 

 male skeleton from the Fisher Site, Virginia. U.S. National Museum of Natural History Catalog No. 385788.) 



At the moment, however, the process of generating a 

 graphic image showing the distribution of lesion types in a 

 skeletal specimen is tedious and time consuming. In cases 

 where there are several different types of lesions and a com- 

 plex distribution pattern, CAD may offer important insight 

 regarding the pathological process and is well worth the time 

 investment. Eventually, when the system is developed fur- 

 ther, it will be much easier to use. We also anticipate develop- 

 ing a data base management system to store the data which 

 will allow statistical analysis of types of lesions. 



Theoretical issues in paleopathology 



Theory in paleopathology is poorly developed at present. 

 This, in part, reflects the problems in the data base discussed 

 above. There are, however, some tentative scholarly probes 

 in paleopathological research that are starting to raise impor- 

 tant theoretical issues. Research on skeletal disease in hunter- 

 gatherer, as compared with agricultural skeletal populations, 

 is one example (Cohen and Armclagos 1984). Clearly an 

 improved theoretical context will become increasingly im- 

 portant as we continue to ask questions about the broader 

 meaning of our data and observations. 



One of the fundamental questions within the context of 

 paleopathological evidence of infectious diseases now being 

 asked is "what does the presence of infectious lesions of the 

 skeleton mean, for both the health of the individual and the 

 population from which such an individual comes?" There is, 

 of course, a fundamental question about accuracy in diag- 

 nosis of infectious lesions. Assuming, for the moment, that 

 such a diagnosis is possible and is accurate, we can begin to 

 interpret the significance of such findings. Is. for example, 

 an increased prevalence of skeletons with infectious lesions 

 in a population an indicator of poor health for that popula- 

 tion'.' 



The easy assumption is that a relatively high prevalence of 

 cases of infectious skeletal disease in a skeletal sample is, 

 indeed, indicative of decreased population health. This may, 

 in fact, be true, but additional evidence is likely to be needed 

 to support this conclusion. The reason this assumption might 

 not be true lies in the nature of the bone tissue response to 

 infectious disease. In some cases of skeletal infection, the 

 primary site is bone (e.g., septic arthritis). More commonly, 

 however, involvement of the skeleton in infectious disease 

 occurs late in the disease process (e.g. , treponematosis). This 

 means that the individual with the disease must survive the 



Zagreb Paleopathology Symp. 1988 



