Treponematosis and tuberculosis in the prehistoric southeastern United States • 177 



Figure 6. Moundvilie. posterior cranial vault, stellate le- 

 sions. 



Figure 7. Irene Mound, NMNH 385540, treponematosis, 

 right nasal margin remodeling. 



young adult female from Irene Mound (Figure 7), who also 

 displays remodeled frontal lesions. The right border of her 

 nasal aperture shows extensive remodeling. Destruction of 

 facial structures of this sort is known as "gangosa," a Spanish 

 word referring to the harsh nasal quality of the victim's voice 

 (Hudson 1958). Because of their pre-Columbian prove- 

 nience, no historical descriptions of the Moundvilie or Irene 

 Mound populations exist. However, in 1709 the Englishman 

 John Lawson described ailments that resemble endemic trep- 

 onematosis among the Santee Indians some 200 miles to the 

 north of Irene Mound. He wrote, ". . . they have a sort of 

 Rheumatism or Burning of the Limbs, which tortures them 

 grievously, at which times their legs are so hot, that they 

 employ the young People continually to pour water down 

 them" (1709:223). Lawson also noted "another Distemper, 

 which is, in some respects, like the Pox, but is attended with 

 no Gonorrhea. This not seldom bereaves them of their 

 Nose." (1709:223). The Santee made a clear distinction be- 

 tween pre-Contact and post-Contact diseases, leading Law- 

 son to comment "... the Natives of America have for many 

 Ages (by their own Confession) been afflicted with a Dis- 

 temper much like the Lues Venerea which hath all the Symp- 

 tions of the Pox, being different in this only: for 1 never could 

 learn, that this Country-Distemper, or Yawes, is begun or 

 continued with a Gonorrhea. ... I have known mercurial 

 Unguents and remedies work a Cure, following the same 

 methods as in the Pox" (1709:18). 



The "Rheumatism" and "nocturnal pains in the limbs" 

 described to Lawson by the Santee correspond well to the 

 episodes of ostalgia (deep bone pain) that afflict late second- 

 ary and tertiary cases of yaws and endemic syphilis. The 

 ulceration and loss of nasal structures, the ab.sence of urethral 

 discharge ("gonorrhea"), the responsiveness of the skin le- 

 sions to "mercurial Unguents and Remedies," and the essen- 

 tially self-limiting nature of the disease are also prominent 

 characteristics of endemic treponematoses. 



Zagreb Paleopalhology Symp. 1988 



In both series, the demographic profiles of individuals 

 displaying skeletal pathology diagnostic or suggestive of en- 

 demic treponemal disease closely matched the demographic 

 profiles of the series as a whole. Skeletal evidence of the 

 disease was age-accumulative: older adults were more likely 

 to bear lesions than were younger adults, adolescents, or 

 children. The great majority of the observed lesions were 

 well remodeled, indicating that the disease was not active 

 around the time of death. 



Lawson commented that the Santee "are wholly Strangers 

 to . . . the Phthisick," a term referring to pulmonary tuber- 

 culosis (Jaffe 1972:955). Although it may have been absent 

 in that population, tuberculosis is evidenced by a variety of 

 skeletal lesions at Moundvilie and at Irene Mound. Of the ten 

 individuals from Moundvilie with bone lesions diagnostic of 

 tuberculosis, only one displays "classic" vertebral destruc- 

 tion. This young man died in his late twenties, a decade short 

 of the average adult male age at death. Virtually his entire 

 spine from T3 downward to his sacrum shows pathological 

 involvement (Figure 8). The bodies of six thoracic vertebrae 

 have been destroyed, producing the anterior kyphosis char- 

 acteristic of spinal tuberculosis or Pott's disease. Numerous 

 large round osteolytic lesions with smooth margins appear in 

 the bodies of several lower thoracic and lumbar vertebrae. As 

 compensation for the loss of bone mass, the remaining por- 

 tions of several vertebrae have fused to provide support for 

 the thorax. Ribs 6 through 10 on both sides display small 

 shallow osteolytic lesions and poorly remodeled periostitis 

 on their pleural aspects. Their necks and heads are considera- 

 bly distorted, with the same combination of destructive and 

 proliferative reaction. No other postcranial tuberculous le- 

 sions were noted, and the skull is unfortunately absent. The 

 extensive remodeling evident in all areas of pathological in- 

 volvement indicates survival for some considerable length of 

 time despite severe deformity, as has been abundantly dcKU- 

 mented in modem clinical cases (Myers 1 95 1). 



