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Thule Paleopathology: The Health shows they still had a moderate degree of Concerns of an Lifestyle logistical mobility that was seasonally-based (Buikstra 1976; Stenton 1991). Many semi- Katherine Bishop subterranean dwellings have been recorded at suspected large winter settlements along Introduction the coast, while smaller, more temporary, Though “many people may think of tent-dwellings have been found at proposed the skeleton as merely a framework to which summer settlements in the interior the more important soft tissues, those (McCartney and Savelle 1985). The Thule allowing for maintenance of life and expanded from coastal and interior Alaska personally identifiable characteristics, are (including the Aleutian Islands) along the attached and protected” (Jerkic 1993:214), coast of the central Arctic, extending as far the human skeleton can provide a vast array east as the Eastern Canadian coast and of knowledge once these soft tissues break Greenland prior to European contact. down. Examining the skeletal remains for Cultural variations have been documented at pathological markers, ante mortem stresses settlements across this vast range; however, and other anomalies is the study of disease there are many characteristics of the Thule in ancient populations called Human lifestyle that were consistent, and this Paleopathology (Aufderheide et al. 1998). general lifestyle will be applied to the These “osteobiographies” can be related to skeletal and mummified human remains the specific environment, diet and lifestyle discussed in this paper. The general environ- of individuals (Lovell and Dublenko 1999). ment, diet and habitual lifestyle of Thule While the osteological record for Thule is will be used to explore issues concerning scarce, I hope to demonstrate that the Thule health. remains that have been recovered provide While full-body remains (i.e. sufficient information to suggest the overall mummies) are rarely found within the health of Thule based on their Arctic archaeological record, they are incredibly lifestyle. useful when they do occur. Fortunately, the environmental factors present in the Arctic Who were Thule? are favorable for the creation of such Thule or Neoeskimo describes a mummified remains. The cold climate, non- culture that prospered in Alaska and the acidic soils and sparse carnivorous Canadian Arctic from roughly 800-700 BP scavengers have preserved a number of until they gave rise to the present known Arctic mummies which will be used culture around the time of European contact in this analysis (Cockburn et al. 2000; (Cassidy 1977; Hawkey and Merbs 1995). Zimmerman and Aufderheide 1984; Originating in and migrating east Zimmerman et al. 2000). The remaining into North America during a period of evidence discussed will be skeletal-based, glacial cooling, the Thule were hunter- with comparison to modern skeletal remains gatherers who specialized in marine and the applied ethnographic data from mammal hunting in the winter (with a strong recent Inuit populations. There are many emphasis on ) and caribou and theories in Arctic paleopathology based on smaller game hunting in the summer. The specific remains; however, I am choosing to Thule exhibited a more sedentary lifestyle focus on the main, and mostly recurring, than the cultures that pre-dated them in the health conditions that the Thule would have Arctic though; the archaeological evidence experienced.

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The osteological paradox individuals. There are also limitations of Before jumping into the bio- studying specific Native North American archaeological record, it is important to first remains. If remains are found, permission examine the limitations of using sparse needs to be granted by the local Inuit leaders skeletal remains to study the health of an before any studies can be conducted. In entire population. Keenleyside (1998) some instances entire studies have been outlined the four main limitations of: forbidden (Tom Porawski, personal …our ability to reconstruct the communication, March 2010). Other studies health of past populations…1) have been conditionally granted as, for many diseases, particularly acute example, certain parts of a skeleton may not infectious diseases, leave no be examined due to societal taboos evidence in bone; 2) different (Zimmerman and Aufderheide 1984). diseases produce similar skeletal To summarize, paleopathology can changes, making accurate be invaluable, but only if it is done with diagnosis difficult; 3) skeletal caution; while it does provide a sample of samples may be biased due to individuals, the sample is not necessarily differential burial practices or representative of an entire population. In preservation; and 4) skeletal order to effectively conduct osteological samples consist of individuals research, it is important to note the type of who failed to survive and are remains, the relative preservation of these therefore not representative of remains, and to what extent they have been the populations from which they studied when reported in the literature. This are derived (53). paper includes specimens from young and The fourth limitation described refers to the old individuals and only includes those Osteological Paradox, which has been specimens that were relatively well- identified by many anthropologists as the preserved; the sources for all specimens main limitation when studying skeletal have also been included from which to draw remains within the archaeological record your own conclusions (Table 1). (Wood et al. 1992). The majority of osteological specimens that are analyzed Environmental impact represent individuals that died of non- There are many physical, chemical natural causes, which creates an anomaly- and infectious environmental factors related rich study sample. Although Wood et al. to health concerns which have been (1992) and Byers (1994) discuss the documented as affecting present, as well as correlation of sedentism to the paradox, the past, populations (Kumar et al. 2007; basis of their argument is important for this Roberts and Manchester 2005). Many of analysis: simply put, skeletal remains do not these agents are evident in the present Arctic accurately represent an entire demography. environment and can be directly related to The types of remains that are the environment the Thule lived in. Physical analyzed need to be considered as well. The agents that contribute to negative health relative age of the remains (of the individual include temperature and trauma. As Hawkey at death) can also provide results that are not and Merbs (1993) outlined, the temperatures representative of an entire population. As experienced by the Thule could have been discussed by White and Folkens (2005), below -50˚C in the winter, which is well most health concerns increase with age, below the point at which flesh freezes. producing a worse-case scenario for elderly Frostbite would not have been the only

TOTEM vol 19 2010-2011 TOTEM 52 health concern associated with temperature, The absence of sun in the Arctic and as cold temperatures have been found to the related chemical agent (or lack thereof) accelerate musculoskeletal trauma. As a may have affected Thule health. Vitamin D, result, individuals would be more sus- which is obtained through the sun’s rays, ceptible to the effects of trauma in the cold, allows the body to process calcium which is which then increased the severity of said necessary to repair all bone (Kumar et al. trauma. 2007). Both osteoporosis and problems with Also, cold temperatures would have basic skeletal repair has been described in created the need for a completely enclosed Thule skeletons (Cassidy 1997; Hawkey and space such as that seen in the Thule semi- Merbs 1993; Keenleyside 1998; Zimmerman subterranean dwellings. These dwellings and Aufderheide 1984; Zimmerman et al. contained entire families, all of their waste, 2000), which suggests that a lack of vitamin as well as the smoke and soot from seal oil D (possibly caused by a lack of sunlight) lamps (Keenleyside 1998; Zimmerman et al. may have increased these problems. 2000). Evidence from the mummies Demineralization of bone and other analyzed by Cockburn et al. (1998), such osteoporotic problems can be the result Zimmerman and Aufderheide (1984) and of postmortem bone damage and decay; Zimmerman et al. (2000) demonstrated an however, specific specimens demonstrate incidence of emphysema and other anthra- excellent preservation in addition to osteo- cotic problems in the lungs. These lung porotic markers suggesting that these bone conditions may be a direct result of the conditions did, in fact, exist among Thule smoke within the dwelling. Emphysema can (Keenleyside 1998). Therefore, based on be directly analyzed through lung tissue, colder temperatures, the conditions present while other lung problems have been in their dwellings and the lack of sunlight suggested by Keenleyside (1998) as being experienced by Thule, environmental factors evident in osteological lesions within the had a direct affect on overall health and ribs of specimens. Air pollution, another predisposed individuals to specific diseases. cause of emphysema, has never been suspected, suggesting that these black lungs You are what you eat are a direct result of lamp smoke. Directly related to the environment, Thule would have also been the Thule had a relatively limited diet that predisposed to a number of “zoonotic and was obtained through hunting and some parasitic infections because of the close and gathering. Their hunting was directly constant contact with their waste”, which affected by the seasonal variations in the was stored within the dwelling (Keenleyside polar ice pack, coupled with variable 1998:53). Specific osteological markers vegetation that ranged from scarce to demonstrate that “staphylococcal, strepto- nonexistent (Stenton 1991). For example, coccal, and fungal infections” were present “during abnormally cold winters when within some populations; these organisms bowhead [whale] migrations were restricted, have been shown to spread from animal Thule Eskimos depended upon alternate waste directly to individuals (Keenleyside [re]sources, or perhaps suffered drastic short 1998:62; White and Folkens 2005). These term population loss, similar to that which is infections could have resulted from animal well documented in Arctic Literature” waste at the site of a kill as well as from the (McCartney and Savelle 1985:51). Periods increased refuse within the dwelling itself. of starvation are a direct result of limited diet, which is visible within the skeletal

TOTEM vol 19 2010-2011 TOTEM 53 record; one mummy analyzed by (conditions where the bone tissue becomes Zimmerman et al. (2000) demonstrated that spongy) were present in skeletal remains a child specifically died of starvation. analyzed by Keenleyside (1998). Both of Similarly, the skeletal remains studied by these conditions have been strongly linked Buikstra (1976), Keenleyside (1998), to iron deficiencies and resulting anemia. Kennedy (1989), and Zimmerman et al. Iron deficiencies arise in diets that lack iron- (2000) contain osteological markers called rich vegetables, beans, or specific red meat. Harris lines, physical growth arrest lines that While the Thule had a diet rich in red-meat, occur on bones which indicate a severe periods of malnutrition would have been stress such as a strong fever, malnutrition, or sufficient enough to cause anemia in some extreme and prolonged shock (White and individuals and would have increased the Folkens 2005). A repetitive patterning of risk for cribra orbitalia and porotic Harris lines occurs because of a regular hyperostosis. The evidence of spongy bone stress cycle due to a specific disease or from tissue has also been associated with diseases a constant state of malnutrition (Buikstra such as syphilis; however, prior to European 1976:356). The prevalence of many contact, this pathogen had not been repetitive patterns on numerous samples documented in the Arctic. suggests that the source of growth arrest was Within the mummies analyzed by also widespread. While a specific disease Zimmerman and Aufderheide (1984) and may have been the cause of Harris lines in discussed in Cockburn et al. (1998), there some individuals, malnutrition due to an was strong evidence of atherosclerosis, unstable and limited food supply is the which is a condition of the heart related to a logical source for a wider demographic. diet heavy in animal fats and cholesterol. A A well-balanced diet includes fruits, fatty diet would have helped create stores of vegetables, meat, grains, and dairy, which nutrition for individuals during periods of all have unique vitamins and nutrients a food shortage, however too much fat and human body needs to remain healthy. The cholesterol is dangerous for the heart and type of food consumed by the Thule is not can lead to heart failure (Kumar et al. 2007). considered well-balanced and would have Atherosclerosis is not a condition visible in caused specific deficiencies. Many defic- the skeletal record; however, the mummies iencies can lead to further problems, and in demonstrated that it was present in Thule some instances, disease. Spina bifida was communities, and that the fatty Thule diet noted in some samples analyzed by Merbs would have increased the risk for certain (2004), which is a spinal condition present at heart diseases. Not only did the Thule eat a birth. This condition has been linked to lot of red meat, they also consumed raw deficiencies in folic acid in the mother meat, which has been known to carry (Kumar et al. 2007; Roberts and Manchester parasites. Similar to the infections that may 2005 2009). Folic acid is a supplement have resulted from close contact with their found in grains, cereals, beans and the dry refuse, parasites associated with consuming leaves of some vegetables and fruits, which raw meat would have created many would have been absent in the Thule diet. gastrointestinal problems as evident in one Other genetic factors may be related to the of the mummies from Utqiagvik presence of spina bifida in Thule skeletons, (Zimmerman and Aufderheide 1984). but these factors have yet to be analyzed in Trichinosis, which is an infection caused by present-day cases. Similarly, both cribra a parasite, was evident in the mummy’s orbitalia and porotic hyperostosis gastrointestinal tract and has been linked to

TOTEM vol 19 2010-2011 TOTEM 54 the consumption of undercooked lifestyle had a sexual division of labor that meat. would have also changed with the seasons. One positive health aspect of Thule Every activity Thule participated in would subsistence patterns relates to the lack of have had risks associated with it, especially refined sugars and starches. Studies done by in relation to trauma. As already mentioned, Cassidy (1977), Hillson (2001), Jerkic the cold climate increases the risk of severe (1993), Keenleyside (1998), and trauma. In addition to this risk, travelling on Zimmerman et al. (2000) concluded that sleds, riding in umiaks (a type of skin boat) Thule had a much lower rate of dental and kayaks, as well as travelling on ice caries; some samples had no incidence increases the chance for impact-related falls whatsoever. This finding can be attributed to and drowning. In addition to the hazards the lack of sugars in the diet; a correlation associated with where Thule activities took has been shown between increased tooth place, the tasks themselves increased the decay and a diet rich in sugar (Goodman risk of trauma. Within the skeletal record, 1993). It should be noted, however, that specific musculoskeletal markers (MSMs) there is evidence of destructive wear on illustrate the stresses associated with these teeth; layers of dentine were exposed specific day-to-day activities. relatively early in the life of specimens. This Specifically associated with the enamel erosion has been attributed to the habitual stress involved in everyday life, reliance on teeth as a tool in everyday life “…certain anatomical regions such as the (Jerkic 1993). It has also been suggested that bones of the upper extremities, lower in times of food shortage, the Thule would extremities, thorax, manual and pedal have chewed on animal hide, which would appendages…” would have particular have caused dental wear over time MSMs (Kennedy 1989:308). The work of (Zimmerman et al. 2000:59). While there are Jerkic (1993) and Lovell and Dublenko many causes for dental deterioration, the (1990) demonstrate where MSMs are lack of sugars in Thule diet is the strongest indicative of excessive use and subsequent evidence for the lack of dental caries strain on the joints associated with lifting, throughout the population. carrying, paddling and rowing, among other The overall subsistence patterns activities. Arthritis is one condition that can would have created problems with result from constant and excessive strain on malnutrition, vitamin deficiencies, and in the joints and was evident in some skeletal some instances, starvation in Thule samples analyzed by Hawkey and Merbs communities. These instances are specific (1995), Jerkic (1993) and Keenleyside examples of health problems and may not (1998). Jerkic (1993:227) also discussed one have been experienced by the entire particular infection called osteomyelitis, population. Studies of health related to the which resulted from a severe fracture in the diet of modern Inuit strongly suggest that left humerus of the sample. This example these specific types of dietary problems illustrates that there is not only an increased would have been prevalent as a result of the risk of trauma associated with the habitual Thule lifestyle. lifestyle, but there is also an increased risk due to infection and other healing problems Life is habitual that can occur in addition to the initial The environment and the available trauma. subsistence in the Arctic conditioned a There have also been indications of specific labor-intensive Thule lifestyle. This contact between Thule groups that increases

TOTEM vol 19 2010-2011 TOTEM 55 risks of both trauma and disease. Steen and in most skeletal remains, there is still a Lane (1998) outlined instances of warfare in suggested risk of dental deterioration and the Aleutian Islands, which has a direct ante mortem tooth loss. The Thule lifestyle correlation to increase risk in trauma and required a lot of physical activity which death. Keenleyside (1998) discussed the taxed the body, as seen through specific potential for spread of disease associated MSMs. This stress increases the risk for with trade routes. This same mechanism has joint problems such as arthritis, increases the been the suggested cause for the spread of susceptibility of severe trauma, and in some European disease post contact. instances, increases the risk for death. There are particular concerns While the cases analyzed here associated with trauma caused by a labour- illustrate a rather pessimistic outlook on intensive lifestyle. Not only are Thule at an overall health, it is important to remember increased risk of experiencing trauma, but these are specific cases of what could have because of their environment, they are at happened and is not what definitely occurred risk of more serious trauma that requires an for everyone in the entire population. The extensive amount of time to heal properly. limitations presented by the analysis of Thule relied upon this lifestyle in order to skeletal remains in the archaeological record survive; if a member of their basic family will always create a biased outlook on unit became injured and was unable to overall health. Furthermore, while it was not perform their everyday practices, the entire discussed here, the lack of European contact group suffered. actually protected Thule from such diseases as “…smallpox, influenza, measles, scarlet Overall health and conclusion fever, mumps, diphtheria, whooping cough, As Keenleyside (1998:66) rightly syphilis, gonorrhea, typhoid, chicken pox, noted, “many aspects of the physical and poliomyelitis, and tuberculosis” (McGhee cultural environment provided conditions 1994:571). These diseases decimated many favorable for the outbreak and spread of populations post-European contact including diseases” among the Thule. These many Arctic populations (Stenton 1991). In conditions create health problems that leave relation to what occurred for Inuit health specific traces on the skeletal record, as well post-contact, pre-contact Thule health was as within mummified remains. Paleo- very good. pathology uses these specific markers to Overall, the use of skeletal remains demonstrate the risks associated with provides a limited yet in-depth analysis (on environment, diet and lifestyle. Arctic an individual level) of Thule health. Using environmental factors have been shown to skeletal remains in conjunction with other cause a stressed immune system, emphy- lines of evidence proves that a skeleton is sema and other lung diseases, bacterial more than a mere framework to which the infection from both staphylococcus and more important soft tissues are attached and streptococcus, and osteoporosis in many protected; the framework of a single human samples. The subsistence of the Thule has can become the illustrative framework for an also been correlated to starvation, mal- entire culture. nutrition, spina bifida, atherosclerosis, gastrointestinal infections such as trich- Acknowledgements inosis, as well as cribra orbitalia and porotic Special thanks to Dr. Lisa Hodgetts for hyperstosis. While there is reduced risk of allowing me to audit her Arctic Archaeology dental caries associated with this diet as seen course, thereby initiating and fueling my

TOTEM vol 19 2010-2011 TOTEM 56 interest on this topic. Her advice on the changes among ancient subject was immeasurably helpful; I hope I Eskimos. International Journal of fulfilled my promise by keeping it Osteoarchaeology 5(4): 324-338. interesting. Hillson, Simon. 2001. Recording dental Works Cited caries in archaeological human remains. International Journal of Aufderheide, Arthur C., Conrado Osteoarchaeology 11:249-289. Rodgríquez-Martín, and Odin Langjoen. 1998 The Cambridge Jerkic, Sonja. 1993. Burials and bones: a Encyclopaedia of human summary of burial patterns and paleopathology. Cambridge human skeletal research in University Press, Cambridge. Newfoundland and Labrador. Newfoundland Studies 9(2):1-22. Buikstra, Jane E. 1976. The Caribou Eskimo: general and specific disease. Keenleyside, Anne. 1998. Skeletal evidence American Journal of Physical of health and disease in pre-contact Anthropology 45(3):351-368. Alaskan Eskimos and . American Journal of Physical Byers, Steven N. 1994. On stress and stature Anthropology 107:51-70. in the ‘osteological paradox’. Current Anthropology 35(3):282- Kennedy, Kenneth A.R. 1989. Markers of 284. occupational stress: conspectus and prognosis of research. International Cassidy, Claire M. 1977. Probable Journal of Osteoarchaeology malignancy in a Sadlermiut Eskimo 8(5):305-310. mandible. American Journal of Physical Anthropology 46(2):291- Kumar, Vinay, Abul K. Abbas, Nelson 296. Fausto, and Richard N. Mitchell, eds. 2007. Robbins Basic Pathology, 8th Cockburn, Aidan, Eve Cockburn and edition. Philadelphia: Saunders- Theodore Allen Reyman. 1998. Elsevier. Mummies, disease and ancient cultures. Cambridge University Lovell, Nancy C. and Aaron A. Dublenko. Press, Cambridge. 1999. Further aspects of fur trade life depicted in the skeleton. International Journal of Goodman, Alan H. 1993. On the Osteoarchaeology 9:248-256. interpretation of health from skeletal remains. Current Anthropology McCartney, Allen P., and James M. Savelle. 34(3):281-288. 1985. Thule Eskimo whaling in the central Canadian Arctic. Arctic Hawkey, Diane E., and Charles F. Merbs. Anthropology 22(2):37-58. 1995. Activity-induced musculoskeletal stress markers (MSM) and subsistence strategy

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McGhee, Robert. 1994. Disease and the findings. Arctic Anthropology development of . 21(1):53-64. Current Anthropology 35(5):115-144. Zimmerman, Michael R., Anne M. Jensen, and Glenn W. Sheehan. 2000. Agnaiyaaq: Merbs, Charles F. 2004. Sagittal clefting of the autopsy of a frozen Thule mummy. the body and other vertebral Arctic Anthropology 37(2):52-59. developmental errors in Canadian Inuit skeletons. American Journal of Physical Anthropology 123:236-249.

Roberts, Charlotte, and Keith Manchester. 2005. The archaeology of disease, 3rd edition. New York: Cornell University Press.

Steen, Susan L., and Robert W. Lane. 1998. Evaluation of habitual activities among two Alaskan Eskimo populations based on musculoskeletal stress markers. International Journal of Osteoarchaeology 8(5):341-353.

Stenton, Douglas R. 1991. Caribou population dynamics and Thule culture adaptations on Southern Baffin Island, N.W.T... Arctic Anthropology 28(2):15-43.

White, Tim D., and Pieter A. Folkens. 2005. The Human Bone Manual. Elsevier Academic Press, Burlington, MA.

Wood, James W., George R. Milner, Henry C. Harpending, and Kenneth M. Weiss. 1992. The osteological paradox: problems of inferring prehistoric health from skeletal samples. Current Anthropology 33(4):343-370.

Zimmerman, Michael R. and Arthur C. Aufderheide. 1984. The frozen family of Utqiagvik: the autopsy

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