372 BUREAU OF AMERICAN ETHNOLOGY [Bull. 182 



females, and perhaps also the sick, injured and elderly, may have been 

 buried elsewhere. (3) The change from a hunting and gathering 

 economy to a more settled way of life may have changed the likeli- 

 hood of exposure to disease or injury and allowed the less fit to 

 recover, or at least to live somewhat longer. The archeological evi- 

 dence for difference in date and culture suggests other factors: New 

 diseases may have appeared. Increases in population, made possible 

 by the introduction of agriculture, may have led to more frequent 

 contacts with other groups, both for the exchange of goods and of 

 diseases. Finally there may have been changes in customs involving 

 the treatment of the sick and injured. 



Diagnosis is the first problem in dealing with skeletal abnormali- 

 ties. If it is difficult for physicians to identify and deal with all of 

 the pertinent factors influencing the condition of their living patients, 

 it is infinitely more difficult for the anthropologist, dealing with much 

 less complete information, and often with damaged or incomplete 

 skeletons, to interpret the evidence accurately. Diagnosis must be 

 based almost entirely upon the appearance of the bone — surface tex- 

 ture, shape, and structure as seen in cross section and X-ray. One 

 must remember that the "pathology" seen may be in its initial stages, 

 advanced, healing, or healed, and interpret it in the light of what 

 is known about disease in general, the cultural evidence, and the state 

 of preservation of the bones. In the case of Occaneechi skeletal re- 

 mains, the state of the bones on examination made the evidence on 

 pathology more than usually difficult to interpret: Fine sand in the 

 medullary cavities introduced extraneous shadows and masked de- 

 tail in the X-rays ; while damage to the surface removed some of the 

 evidence, and caused areas of lessened density that could have been 

 misleading had not the bones been examined together with both 

 lateral and anteroposterior radiographs. 



The types of skeletal abnormality seen presented very little that 

 was unusual; they include the more common anomalies, several 

 fractures that had healed after infection and/or deformity, arthritides 

 of various sorts, and a group of bones which showed what for the 

 time will be called "inflammatory changes." Even this simple classi- 

 fication must be tentative. Some of the conditions now considered 

 developmental variations of unknown causation may be found later 

 to be of traumatic or pathogenic origin ; some of the arthritides may 

 be due to pathogenic causes rather than degenerative changes associ- 

 ated with aging; and some of the "inflammatory changes" may be 

 sequelae of traumata, while others may have arisen from pathogens or 

 metabolic aberrations. Apparent deformities may be due either to 

 muscular stresses or to well-healed fractures. 



Differences in the way of life at the two sites would lead us to 

 expect differences in the incidence of degenerative changes ; yet other 



