The Archaeology of Disease (review)

This survey of paleopathology, fitting midway along the continuum between educated laymen and paleopathologists, will appeal to the general public, students, archeologists, anthropologists, and medical and other scientists. At the start, background is provided on terminology, the history, methods, and limitations of the field, the classification of diseases, and paleodemography. In considering the interaction of biological and cultural factors and disease, the authors do fall into the trap of thinking undeveloped areas to be paradisiacal. Congenital diseases and a strong chapter on dental disease follow.

“The Chapter of accidents is the longest chapter in the book” (p. 65), on the skeletal evidence of fractures, trepanation, and other ancient treatment modes. Joint disease, another frequently encountered process, is simply classified into bone formation and destruction, characteristic of the various nosologic entities of osteoarthritis, rheumatoid arthritis, and so on. The effect of occupation is considered in some detail, such as the use of the longbow by the crewmen of the sunken sixteenth-century British warship Mary Rose.

Infectious disease brings up the paradox of paleopathology: the “normal” skeleton probably represents an individual who died of fulminating disease, while abnormal skeletons represent people resistant enough to survive until involvement of the skeleton. Discussion of the interaction of individual, social, environmental, and biological factors in the treponematoses is particularly thorough.

Loosely associated disorders are grouped together under metabolic and endocrine disease. The distinction between iron-deficiency and hereditary anemia could have been made clearer, but this chapter is otherwise adequate, limited to diseases for which there is paleopathologic evidence, such as osteoporosis and vitamin deficiencies.

Last comes a discussion of the neoplastic diseases, reviewing the limited number of cases in the literature, the limitations of gross examination, and limited funding that prevents extensive radiology. As more intensive paleopathologic examinations reveal more cases of cancer, this reviewer has become less convinced of the importance of the role played by the modern environment in the genesis of cancer, with the exception of the well-documented association of cigarette smoking and lung cancer.

Areas considered in the first edition (1983) for the advancement of paleopathology are reviewed, with a discussion of new technologies. Areas of investigation for the future are suggested: health and the transition to agriculture, health in urban versus rural communities, and health and gender.

The book is well illustrated, with an extensive bibliography. Covering the field in 202 pages, a daunting task, leads to some inevitable superficiality, and the authors make no bones about their concentration on skeletal and dental disease. A complete review of the field should include mummies, but would be twice the size (and cost). The simplest and best recommendation for The Archaeology of Diseaseis that I am ordering it for my paleopathology course.