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Summary of audience discussion: Tuberculous involvement in 

 one-third of an archeological population is an unprecedented rate. 

 The author of this study defended his diagnosis on the basis of 

 including only lesions characteristic of tuberculosis seen in the 

 spine, hip and ribs. Costal periostitis in an appropriate pattern re- 

 flects the presence of empyema of tuberculous origin since it could 

 not be identified on x-ray in 400 modern patients with pyogenic 

 pneumonia. Such a study, however, needs to be carried out on 

 modem patients with pyogenic empyema. Recognition of charac- 

 teristic, empyema-induced tuberculous costal periostitis in an ar- 

 cheological population will usually double the tuberculous frequen- 

 cy predicted by the more traditional measures. Known close 

 interaction between these natives and the colonists makes highcr- 

 than-usual frequencies of tuberculosis plausible. Since historical 

 records in earlier periods may be influenced by imprecision of 

 diagnostic tenninology and even by political influences (deriving 

 from administrative, self-serving reports as may have occurred dur- 

 ing the South African colonial era), such evidence should not be 

 used in isolation but may, as in this case, be considered supportive. 



Zagreb Ptileopatholiiay Symp. t988 



