134 • Takao Suzuki 



Figure 6. Three cases of advanced chronic osteomyelitis from Medieval period: left, right tibia of mature female from 

 Ichino-Torii site (courtesy of Dr. A. Naito); center, distal end of right femur of adult from Zaimokuza site; right, left 

 tibia of young individual from Katsuyama-Tate site. 



EVIDENCE OF SPECIFIC INFLAMMATION OF BONE. There waS 



no possible case of tuberculosis or syphilis in the Jomon 

 skeletal series. Except for the Jomon series, typical cases of 

 both tuberculosis and syphilis could be detected in the Edo, 

 Ainu, and Meiji skeletal materials, as shown in Table 2. The 

 frequency of these specific inflammatory diseases varies 

 from 1 . 1 to 5.4% among the later three skeletal series. 



Discussion 



Based on a paleopathological study of the inflammatory le- 

 sions in the skeletal materials of the Japanese from the Jomon 

 (prehistoric) to Meiji (early modem) periods and the Ainu 

 population, the qualitative transition of the infectious disease 

 will be discussed here from the standpoint of their bio- 

 ecological background. 



Taxonomically two major categories can be recognized: 

 nonspecific inflammatory change including ordinary perios- 

 titis and osteomyelitis, and specific inflammatory change 

 caused by tuberculosis and syphilis, which can be defined by 

 the typical/demonstrative morphology and distribution of the 

 lesion. In a field of paleopathology dealing with dry-bone 

 specimens, it is sometimes inevitable to encounter the bor- 

 derline case showing equivocal inflammatory lesion between 

 nonspecific and specific. This means that periostitis appear- 

 ing in the dry bones may be treated as an independent entity. 

 In this study, cases showing such equivocal periosteal reac- 

 tion ("periostitis ossificans") were included as nonspecific 



inflammation. In this sense, specific bone diseases diag- 

 nosed as tuberculosis or syphilis were detected with certainty 

 only by the characteristic changes and distribution of bone 

 lesions. 



QUALITATIVE TRANSITION OF THE INFECTIOUS DISEASES 



It should be emphasized that a relatively higher frequency of 

 nonspecific inflammatory lesions represented by plaquelike 

 periostitis appeared in the Jomon skeletal series. Further- 

 more, almost all of them showed slight/moderate periostitis 

 limited to the exterior surface of the bone, and there was no 

 case showing severe/advanced chronic osteomyelitis with 

 such characteristic features as involucrum. sequestrum, and 

 cloaca formation. It should be noted that no such advanced 

 case of osteomyelitis has been found to date anywhere among 

 the Jomon skeletal remains, whose number is the largest in 

 this country. One of the oldest cases of .severe advanced 

 nonspecific osteomyelitis is from the medieval period (Fig- 

 ure 6). It seems that such advanced infectious cases may be 

 found more frequently among the population after the Jomon 

 period provided that the number of skeletal remains from 

 Yayoi and Kofun period are complete and sufficient to exam- 

 ine paleopathologically. 



Why is the frequency of advanced infectious cases con- 

 siderably lower in the Jomon series? The Jomon society de- 

 pended on hunting, gathering, and fishing activities. The 

 Jomon population density was estimated to be quite low. 



Zafireh Paleopathology Symp. 1988 



I 



