376 BUREAU OF AMERICAN ETHNOLOGY [Bull. 182 



the next most frequently affected sites are the bones of the forearm." 

 Both of these sites are relatively unprotected by muscle and fat, and 

 both are exposed. The tibia especially is likely to be injured — by 

 bruises from falls or kicks, chronic abrasion from kneeling on rough 

 ground, scratches from bushes and undergrowth, and similar every- 

 day accidents. Multiple lesions, either in single bones or several bones 

 within the skeleton, are not incompatible with the possibility of their 

 traumatic origin. 



The fourth type of "inflammatory change" presents a fairly uniform 

 pattern as to alterations in bone thickness, weight, density, and texture, 

 the bones affected, and the apparent lack of any focus of infection. 

 The total picture is one of a systemic affection, probably more or less 

 chronic, rather than acute infection. The pathologists who examined 

 the bones and radiographs were of the opinion that this type of bony 

 change may be due to nutritional deficiencies, possibly in calcium 

 or protein, which alter microscopic bone structure, the structurally 

 weakened tibiae becoming bowed, rather than breaking under the 

 weight of the body. The high frequency of this "new" ( ? deficiency) 

 disease at the Clarksville site, and its single appearance at the Tollif ero 

 site could be associated with the changes in diet which produced the 

 striking differences in tooth wear. Nevertheless, unless these bony 

 changes can be identified wdth a particular nutritional deficiency, and 

 the latter can be shown to be probable m these sites, the diagnosis 

 must remain tentative. 



In general, the Tollifero population seems to have enjoyed some- 

 what better health than the Clarksville population. As suggested 

 earlier, part of this impression may be due to elimination of some of 

 the less fit by selective burial; but one would not expect their total 

 elimination. Thus it is safe to conclude that disease affecting the bones 

 was somewhat more common at the Clarksville site than at the earlier 

 Tollifero site. Nevertheless, the range of disabilities seems to have 

 been limited to an occasional developmental variation, an infected 

 wound, traumata of varying severity, and possibly, malnutrition. 

 The "swollen, bowed tibia syndrome" does not seem to show any clear 

 correlation with the age or sex of the affected persons, although it 

 appears primarily in adults. Other diseases which did not affect the 

 bones presumably existed, but of these there is no evidence. Similarly, 

 there is no evidence of the presence of other diseases wliich do affect 

 the bones: For example, the radiographs gave no indication of the 

 increased density typical of syphilis, or of the mosaic structure seen 



"Goldstein (1957) noted that "Inflammatory lesions" of Texas Indians were nearly 6 

 times as frequent In the tibiae as In other bones. His "Inflammatory lesions" Include both 

 localized and generalized swellings, of all degrees of severity. 



