Carcinoma in paleopathological material • 265 



On a social level, an understanding of diseases and their 

 prevalence at a given time might help in a general under- 

 standing of one's past. Paleopathology oftcrs a good oppor- 

 tunity for population studies as populations were relatively 

 stable geographically over fairly long periods of time. Dis- 

 ease determination can also provide good markers for popu- 

 lation studies, as has been the case with sickle cell hemo- 

 globin. All of these benefits depend on accurate diagnosis, 

 and it is in that direction that we should turn our attention. 

 Apart from the technical innovations and improvements, 

 there is the matter of improving data. Most discoveries in 

 science are based on empirical findings, at least initially. The 

 potential for future studies, such as a change in immunity 

 over the millennia, changing environmental factors and their 

 effects, or changing customs with respect to perception of 

 disease, depends on an accurate data base. An accurate data 

 base depends in turn on large numbers of examples. We need 

 larger numbers of examples, documented as accurately as 

 possible as to disease and provenience, to make real prog- 

 ress. 



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Summary of audience discussion: Estimates of the modem fre- 

 quency of bone involvement in cancer and other diseases are based 

 on autopsy, clinical, and radiological data. Examination of skeletal 

 tissues in routine autopsies is limited, while clinical attention with 

 consequent radiological study is usually dependent on patient com- 

 plaint of pain and dysfunction. Thus, the available bone involve- 

 ment patterns are highly selective and no doubt overlook many 

 lesions which would be evident in osteological examinations if such 

 bodies were skeletonized. Total body x-rays of, say, 100 patients 

 dying of each of several common cancers and subsequently autop- 

 sied could provide a database against which patterns of bone in- 

 volvement found in ancient skeletons could be measured. 



A recent study demonstrated that the lytic lesions of bone found 

 in erosive arthropathies actually accommodate fat-producing cells 

 capable of providing lubricating fat in joints that have lost their 

 cartilage. Histological studiesof the content of lytic lesions found in 

 an autopsy study might reveal similar "surprises." 



Zagreb Paleopathology Symp. 1988 



