176 • Mary Lucas Powell 



Figure 2. Irene Mound, NMNH 385528, 

 treponematosis, sabre shins (shown with non- 

 pathological tibia, center, for comparison). 



Figure 3. Moundville, tibia. 



Results 



A diagnosis of endemic treponematosis was initially sug- 

 gested in both series by the frequent appearance of localized 

 or extensive periostitis on the shafts of the tibia, fibula, ra- 

 dius and ulna. The thickness and degree of remodeling of this 

 new bone suggested the recurrent episodes of periosteal in- 

 flammation described by Hackett (195 i) during the late sec- 

 ondary and tertiary stages of yaws. Many tibiae display areas 

 of localized apposition along the anterior crest, a region sub- 

 ject to the frequent minor trauma noted by Hackett as an 

 exacerbating factor in soft tissue lesion formation. Others 

 show more severe extensive pathological involvement, illus- 

 trated by cases from Irene Mound (Figure 2) and Moundville 

 (Figure 3) that resemble the deformity known in modem 

 treponematosis as "sabre shins." 



Md 1394 

 Figure 4. Moundville, cranial lesions. 



Figure 5. Moundville, cranial lesion in frontal. 



Other lesions suggestive of late-stage treponemal disease 

 appear as small, circular depressions on the outer cranial 

 vault, seen here in an adult case from Moundville (Figure 4). 

 The gummatous ulcers that often develop in yaws and en- 

 demic syphilis frequently infect bone lying close beneath the 

 skin. Their particular pattern of tissue destruction and heal- 

 ing results in the pathognomonic osteolytic lesions known as 

 "caries sicca" (Hackett 1976). The cranial lesions seen in 

 these series are neither large nor extensive, and show con- 

 siderable remodeling before death. The single exception is a 

 large, penetrating, frontal lesion (Figure 5) from a young 

 Moundville woman who probably died from superinfection. 

 Posterior vault lesions (Figure 6) often show more clearly 

 than frontal lesions the characteristic stellate configuration of 

 the healed scar. 



The mucocutaneous and osseous tissues of the nasal and 

 oral cavities are also common sites of treponemal pathology. 

 Osteolytic lesions penetrated the palate and maxilla of a 



Zagreb Paleopathology Symp. 1988 



