226 • Charlotte Roberts 



data in the ideal world has to be done with reference to 

 clinical texts and experience. The diagnosis and interpreta- 

 tion of trauma is. of necessity, heavily reliant on radiographic 

 analysis, and this particular research is based very much 

 around this theme. Correlation with other classes of evidence 

 is without doubt essential to the potential success of interpre- 

 tation of the data. 



History of trauma studies 



Trauma can be defined as any bodily injury or wound and 

 may affect the bone and/or soft tissues of the body. Fractures 

 can be defined as the result of any traumatic event which 

 leads to a complete or partial break in the continuity of bone. 

 Trauma is a common affliction of modem lifestyles, as it was 

 in the past, and people do, and did, react to it in a variety of 

 ways. Trauma is painful, visual and debilitating, and Withers 

 (I960: 1 ) perhaps summarizes these thoughts on the implica- 

 tions of trauma: "In times of stress, pain or of sorrow, the 

 human being will go to any length to try and find help." In 

 human skeletal studies it is difficult to be precise in aspects 

 such as complications of particular fractures but it is essential 

 to be aware of these potential complexities. Applied anatom- 

 ical studies in paleopathology should be one of the first con- 

 siderations. 



Data on fractures for paleopathologists in past years has 

 appeared in four forms: (1) as part of a bone report (i.e., 

 incidence of fractures), (2) as a specific study on fracture 

 patterns in particular populations, (3) as a study of fractures 

 of a specific bone, and (4) as part of a treatise on paleo- 

 pathology. 



The quality and quantity of analysis and interpretation of 

 trauma is determined by the worker's preferences or the arch- 

 eologist's requirements for a bone report. In many cases 

 basic descriptions of skeletons present is all that is provided 

 or required. In other cases a more detailed report is appropri- 

 ate. All human skeletal reports describe any traumatic lesions 

 observed in the populations (e.g.. Wells 1982:161). Some 

 literature has also appeared which exclusively describes trau- 

 ma in a specific population (e.g.. Zivanovic 1984; Lovejoy 

 and Heiple 1981; Jurmain this volume). In Britain, occasion- 

 al publications specifically on ancient skeletal trauma have 

 also appeared (see Manchester and Elmhirst 1 980; Manches- 

 ter 1978; Courville 1965) but these have tended to concen- 

 trate on the wound appearance and the potential weaponry 

 causing the injury. 



Case studies of unusual pathological lesions (e.g. , Roberts 

 1987) have been and always will be prolific in paleopathol- 

 ogy, as the method is an efficient way of transmitting infor- 

 mation. Studies concerning trauma have also appeared in this 

 type of literature. Although useful, there is little possibility 

 for synthetic study from isolated reports. 



Several books deal with paleopathology generally (Ben- 

 nike 1985; Ortnerand Putschar 1981). Obviously, these vol- 

 umes discuss trauma, but the very widespread nature of pal- 

 eopathology precludes expansion of data on trauma into a 

 more valid interpretation for human skeletal studies. 



In modem clinical literature the contributions to trau- 

 matology are prolific and make comparison between modem 

 and ancient trauma possible. Incidence rates of fractures, sex 

 ratios and age ranges, causes, types of treatment, healing, 

 and complications are all well documented. This provides 

 an, as yet, unrealized potential for comparing ancient frac- 

 tures with modem data. 



Present study 



The potential for the study of trauma in populations has not 

 yet been fully appreciated. While trauma in osteoarcheologi- 

 cal analysis is universally reported, there is often little expan- 

 sion of the basic data. Fortunately, in Britain extensive 

 documentary research and archeological excavation and in- 

 terpretation has led to a considerable archive of information 

 which can be utilized to supplement human skeletal observa- 

 tions not only in trauma but in many other paleopathological 

 studies. Obviously, limitations have to be realized, and col- 

 laboration between the skeletal specialist and specialists con- 

 versant with all types of evidence being used is essential. As 

 Daniels ( 1978:28) stated, " Archaeology has become a sub- 

 ject too complex for the simple polymath to handle." 



Considerable thought about trauma studies, developed by 

 the author in 1983. led to a proposal for research. The hy- 

 pothesis to be tested was as follows: Populations were capa- 

 ble of and had the technology and intelligence to treat trauma 

 in antiquity. To test this hypothesis the research design en- 

 compasses: ( 1 ) study of dry bone evidence for trauma in the 

 form of fractures of long bones (humerus, radius, ulna, 

 femur, tibia and fibula) and the skull, using macroscopic 

 observation and radiography; (2) correlation of this data with 

 other classes of evidence to illuminate the knowledge of 

 treatments and technology used in each time period from the 

 Roman to late and post-Medieval eras. 



The rationale for the selective study of long bone and skull 

 fractures is that injury to these areas of the body would be 

 more detrimental to the individual's well being than, for 

 example, a fracture of the rib, clavicle, or a peripheral bone. 

 Trauma is extremely devastating not only skeletally but gen- 

 erally to the body system. 



The main sources of evidence used were human skeletal 

 remains, modern clinical comparative data, secondary docu- 

 mentary sources, ethnographical studies, art forms, and ar- 

 cheological data such as surgical artifacts, environmental 

 data indicating hygiene, living conditions and diet relevant to 

 healing of fractures. 



Zagreb Paleopathology Symp. 1988 



