Theoretical and methodological issues 

 in paleopathology 



Donald J. Ortner 



1 he progress of paleopathology, as a specific subject of 

 research, parallels the development of many scientific and 

 scholarly disciplines. This process includes an overlapping 

 sequence of phases, each of which contributes to the objec- 

 tive of improved understanding regarding the scientific sig- 

 nificance of the discipline. Stages in development include: 

 ( 1 ) definition of a well-defined subject area of scientific inter- 

 est and significance, (2) creation of a methodology for con- 

 ducting research on the subject, (3) accumulation of a body 

 of descriptive data related to the subject, (4) development of 

 a classification system for what is observed, (5) generation of 

 hypotheses regarding the scientific/scholarly significance of 

 observed phenomena, and (6) relating data and hypotheses to 

 similar research and theory in cognate fields. 



The progress made through each of these stages in pal- 

 eopathology varies, but there is an emerging awareness of 

 critical problems that need to be resolved before major fur- 

 ther development can take place. The objectives of this paper 

 are to explore the current status of research in paleopathol- 

 ogy, highlight areas where problems and opportunities exist, 

 and oft'er some suggestions on strategies for future research. I 

 hope that most readers will understand that my emphasis on 

 research in skeletal paleopathology reflects my own research 

 bias and is not due to a failure to recognize the importance of 

 other avenues of research. The principles expressed in this 

 essay should, in fact, apply broadly to most research in pal- 

 eopathology. 



Interest in pathological specimens from paleontological 

 and archeological sites has existed for more than 150 years 

 (Ortner and Putschar 1981:5). The establishment of pal- 

 eopathology as a distinct focus of scientific research goes 

 back at least to the early part of this century with the remark- 

 able research and publications of RufTer, Elliot-Smith, 

 Wood-Jones, Moodie, and others. This early research was 

 largely descriptive and classificatory in nature, asking the 

 question "what is it?" when confronted with a paleopatho- 

 logical specimen. This emphasis on description continues to 

 predominate in publications on paleopathology today. How- 

 ever, another question, "what does it mean?" is being asked 

 with increasing frequency and is forcing us to look more 



Zofinb Paleopathology Symp. J 988 



carefully at our descriptive methodology, classificatory sys- 

 tem, and theoretical assumptions. This process reflects the 

 recognition that paleopathology must, increasingly, address 

 broader issues in the biomedical and anthropological sci- 

 ences in addition to its well-established contributions to the 

 history of human disease. 



Answers to the fundamental questions of "what is it?" and 

 "what does it mean?" remain problematic in many ca.ses, 

 although we are much further along with answers to the 

 former question than the latter. Problems in responding to the 

 question "what is it?" involve issues of description and clas- 

 sification. The current reference point for such responses is 

 in medicine and primarily with its subdisciplines of pathol- 

 ogy and radiology. In this context, two issues are relevant to 

 this essay. First, even in a modem clinical setting, it may be 

 difl'icult or impossible to arrive at an accurate diagnosis (clas- 

 sification) of a pathological condition affecting a living pa- 

 tient. Second, even when diagnosis is possible in a modem 

 medical patient, the necessary criteria may not apply or be 

 available for classification of similar diseases in paleopatho- 

 logical specimens. A response to the question "what does it 

 mean?" requires an adequate base of data in which the ques- 

 tion "what is it?" has been answered with reasonable scien- 

 tific precision on a sufficient number of specimens. A re- 

 sponse also requires a theoretical context in which issues of 

 biological mechanisms, cultural influences, and strategies of 

 human adaptation can be considered and evaluated. 



Significant progress in achieving creative responses to 

 both these questions will depend on much greater attention to 

 the methodological problems which now limit the utility of 

 past and current research in paleopathology. For example, we 

 need a method for describing pathological cases that provides 

 information which can be evaluated independently by other 

 observers. We also need to develop a classificatory system 

 for paleopathology which will take into consideration the 

 type and detail of infomiation that is available and can be 

 evaluated in a paleopathological specimen. This will almost 

 certainly mean that we will be including some features that 

 arc not presently part of the classificatory system associated 

 with orthopedic radiology and pathology. This cannot, of 



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