132 • Takao Suzuki 



/ 



\ 



Nonspecific Inflammation 



\ 



Periosiiils 



exsudative 



Periostitis 



purulenta 

 Periostitis 



fibrosa 



/ 



Osteomyelitis suppurative 



sequestrum 



involucrum 



cloaca lormation 



Specific Inflammation 



/ 



Periostitis 

 tuberculosa 



\ 



Periostitis ossificans 

 "plaquelike" deposition 

 tfiickening of exterior 

 smaller/larger pores 

 uneven hypervascularity 



\ 



Spondylitis tuberc 

 (kyphosis, etc ) 



Dactylitis tuberc 

 (spina ventosa) 



Osteomyelitis 



k- 



Independent entity 



in 

 paleopathology 



Periostitis 

 syphilitica 



y 



/ \ 



Caries sicca in the skull 

 (stellate scars, etc.) 



Gummatous 

 periost - osteomyelitis 

 (snail ■ track pattern, etc ) 



y 



Figure 5. Lesions in specific and nonspecific inflammatory conditions of bone. 



The main reason for this difference between clinical and 



paleopathology is that many of the periosteal reactions may 

 be part of the expression of a specific disease process, 

 which can be identified in a living patient, whereas in ar- 

 cheological specimens the pathological characteristics nec- 

 essary to make a specific diagnosis are not available. This 

 would have the effect of increasing the frequency of non- 

 specific periostitis in archeological skeletal series. 



Such a special situation of peiiostitis in paleopathology is 

 shown in Figure 5. Thus in the present study, due to the 

 possible admixture of these two kinds of infections among 

 the archeological specimens, the author cannot help but deal 

 with all inflammatory changes in the bone as nonspecific 

 inflammation, excluding only the typical/demonstrable case 

 showing specific changes of bone tuberculosis and syphilis. 



Results 



Gross examination of the infectious changes was conducted 

 on four skeletal series: the Jomon (prehistoric) series includ- 

 ing 272 individuals, the Ainu series of 178 individuals, the 

 Meiji (early modem; antibiotic era) Japanese series of 1 13 

 individuals, and the Hdo (latest medieval/earliest modem) 

 Japanese series consisting of 923 skulls, 308 femora, and 253 

 tibiae. The data on cranial syphilis of the Edo series was 

 quoted from the previous study carried out by the author 

 (Suzuki 1984a). 



FREQUENCY OF THE INFECTIOUS LESION. The TCSUltS are 



shown in Table 2. The highest frequency can be seen in the 

 Meiji Japanese series and the lowest was in the Jomon series. 



SEX DIFFERENCES OF THE FREQUENCY. ExCCpt for the Edo 



Japanese series, the number and total frequency of infectious 

 lesions in both sexes are shown in Table 3. There is no statis- 

 tical significance between the male and female frequencies 

 (X^ = 0.267 < p(O.Ol)]. The frequency of cranial syphilis in 

 the Edo series also fails to reveal statistical significance be- 

 tween both sexes [x^ = 2.04 < p (0.01)]. 



SEVERITY OF INFECTIOUS CHANGE. Most infcCtioUS ICSionS 



of bone can be generally classified as either periostitis or 

 osteomyelitis. As is well known, periostitis shows various 

 degrees of involvement, from slight and weak change to 

 severe and drastic (Stothers and Metress 1975; Lallo et al. 

 1978). In this study the severity of such infectious change 

 was basically classified into periostitis and osteomyelitis, 

 and f)eriostitis was subdivided into two categories, slight and 

 severe. Slight periostitis was defined as the extent of involve- 

 ment of the periosteal surface (Lallo etal. 1978) correspond- 

 ing to the stage 1-11 proposed by Stothers and Metress 

 (1975). Severe periostitis was defined by the nature of tissue 

 destruction — whether pitted, ridged, scarred, or showing 

 sinus tracts (Lallo etal. 1978). The result is shown in Table 4. 

 It should be noted that there is no clear evidence of os- 

 teomyelitis in the Jomon series. 



Zagreb Paleopathology Symp. 1988 



II 



