178 • Mary Lucas Powell 





Figure 8. Moundville, spinal tuberculosis. 



Figure 9. Irene Mound, NMNH 385562, lumbar vertebrae, 

 TB lesions. 



Two mature women from Moundville each bore osteolytic 

 lesions on a single lumbar vertebrae, but such isolated de- 

 struction suggests a diagnosis of blastomycosis rather than 

 tuberculosis (Chick 1 97 1 ). No cases with tuberculous lesions 

 of the hip, knee, or cranium were observed. However, seven 

 adults and two subadults displayed rib lesions closely match- 

 ing those described from clinical cases in the Hamann-Todd 

 collection by Kelley and Micozzi (1984) as characteristic of 

 chronic pulmonary tuberculosis. The two subadults (ages 

 birth to 6 months and 7 to 8 years) display extensive, diffuse, 

 unremodeled periostitis on the pleural aspects of multiple 

 right and left ribs. The seven adults were evenly distributed 

 through the third, fourth, and fifth decades of life, and all 

 displayed lesions at least partially remodeled at death. Wom- 

 en and men were equally represented. This age and sex dis- 

 tribution of adult cases matches that reported in the Hamann- 

 Todd study. 



In the Irene Mound .series, three cases bear osteolytic le- 

 sions in thoracic or lumbar vertebrae suggestive of spinal 

 tuberculosis. L2 through L5 of a young woman (Figure 9) 

 display extensive shallow lesions on the paradiscal surfaces. 

 T3 and T4 of a second young woman bear deep centrally 

 located osteolytic lesions , and L2 through L5 of a young man 

 exhibit widespread circumferential lesions. One older wom- 

 an displayed extensive destruction of her left sacroiliac au- 

 ricular surface with minimal remodeling (Figure 10). Two 

 adults displayed periostitis on the pleural aspect of the 

 .scapula, and the pleural aspect of the sternum was also sim- 

 ilarly affected in one case. 



As in the Moundville series, the most abundant extraver- 

 tebral tuberculous lesions were those alTccting the pleural 

 aspects of the ribs. These lesions appeared in 8 of the 10 



cases. In one case focal osteolytic lesions were surrounded 

 by osteoblastic response. Seven of the 8 displayed localized 

 or diffuse periostitis, illustrated here by the most extreme 

 case (Figure 1 1), the young female adult with multiple lum- 

 bar paradiscal lesions. 



The mean age at death of the 10 Irene Mound cases with 

 tuberculous vertebral, pelvic, and rib lesions was 29.5 years, 

 five years below the modal sample age of 34.9 years. One 

 young adolescent, one older adolescent, and four adults aged 

 20 to 24.9 years constituted the younger set of cases. Ap- 

 proximately 15 years separated the oldest of these cases from 

 the youngest of the four remaining cases, all in their early to 

 late 40s. Female prevalence is double that for males, in con- 

 trast to the equal representation of the sexes at Moundville. 



Conclusions 



Analyses of archeological data on subsistence and skeletal 

 indicators of nutritional quality at Moundville and Irene 

 Mound suggest that both populations enjoyed diets adequate 

 to promote vigorous immune response to infectious disease. 

 The rank-stratified social organization of the Moundville 

 chiefdom may have created certain dietary differences be- 

 tween elite and non-elite segments of the population, but a 

 broad range examination of the social dimensions of health 

 and disease at the paramount site revealed no significant 

 differences in dental disease or skeletal pathology (Powell 

 1988). The nature and degree of social dilTerentiation at Irene 

 Mound have not yet been delineated, but significant rank- 

 determined, dietary inequalities seem improbable (D.G. An- 

 derson, pers. comm. 1987). Good nutrition is a less critical 

 factor in resistance to endemic treponematosis than in re- 



Za^reh Paleopalholo^y Symp. t9SH 



