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TH E GLOBA L H ISTORY OF PALEOPATHOLOGY
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TH E GLOBA L H ISTORY OF PALEOPATHOLOGY
Pioneers and Prospects
EDITED BY JANE E. BUIKSTRA AND CHARLOTTE A. ROBERTS
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1
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To J. Lawrence Angel and Calvin Wells, who inspired this volume.
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PREFACE
" is volume took inspiration from an informal editors generated an international list of deceased discussion that we had while participating in a paleopathologists deserving biographic credit for symposium on repatriation sponsored by the their pioneering, seminal contributions to paleo- Museum of London in March 2007. Over lunch pathology. Some scholars had had a career-long in a local public house, Charlotte lamented that dedication to the - eld; others had made one or two a proper biography—richly deserved—of the key contributions while generally pursuing other late Calvin Wells and his seminal contributions professional interests and vocations. We therefore to paleopathology had not yet appeared. At that divided the list into full biographies and briefer stage she was thinking only of a single paper that “moments.” We initially discussed limiting the would be submitted to a prominent journal or volume to researchers who were no longer living edited volume. She would never have imagined in 2007, but then decided to include individuals something so extensive as this 76-chapter tome! who were retired or nearing retirement age. Our Meanwhile, Jane responded that she had col- logic was that nobody would be foolish enough lected considerable primary documentation of J. to attempt another such volume for some time, Lawrence (Larry) Angel’s distinguished life and and we wished key contributors to paleopathol- works in the National Anthropological Archives ogy such as Arthur Aufderheide, Don Brothwell, while preparing for a plenary lecture at the 2006 Domingo Campillo, Keith Manchester, Charles European Paleopathology meeting in Santorini, Merbs, Donald Ortner, and Eugen Strouhal to be Greece. We both agreed that these two biogra- recognized. Interviews frequently enriched these phies should be published. chapters, and we encouraged authors of biogra- As we began to expand our vision, we dis- phies for deceased paleopathologists to consult cussed our de- nition of paleopathology as well as with former students and descendants, while also who should be considered a paleopathologist. In a mining previously published obituaries and biog- strict sense paleopathology is, of course, the study raphies, along with archival materials. of ancient disease, and both of us situated paleopa- We deeply regret that three paleopatholo- thology within bioarchaeology, due to that - eld’s gists died during the production of this vol- contextual emphasis (Buikstra 1977; Buikstra and ume (2007–2010): Mahmoud El-Najjar, Shelley Beck 2006). In many other circumstances, how- Saunders, and Philip Walker. Each has received ever, paleopathology is considered a sub- eld of biographic treatment here. Walker was to author physical anthropology, itself a subdiscipline of the chapter on Charles Merbs (Chapter 8), a task anthropology, along with archaeology, sociocul- he was unable to - nish. Buikstra and McBride tural anthropology, and linguistic anthropology. completed the manuscript for this chapter, work- While many paleopathologists are anthropolo- ing with text and notes provided by Cynthia gists, others are found in clinical practice and in Brock, Phil’s partner. departments of anatomy, pathology, radiology, Readers will notice that we have not standard- and related biomedical - elds. Recognizing this ized the use of last vs. - rst names within our bio- breadth and long-term history, we began to muse graphical chapters; we have allowed our authors to about a larger project. make individual choices. Many biographies were Our concept quickly developed a life of its written by former students or close colleagues, own, leading to this edited volume. Initially the who chose to address their subjects in familiar
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terms. Others were further removed from their that would ultimately comprise this volume. Ten subjects and therefore chose to refer to individu- excellent papers were presented in Copenhagen— als by their last names, occasionally embellished four biographies: Aufderheide, Moodie, Putschar, by professional titles. Some also felt that reporting Stewart; 4 regions: Australia, Israel, Japan, Sweden; personal details, such as the names of spouses and one organization: the Paleopathology Association; other family members, was intrusive. Others even and one method: imaging. let their subjects read their e4 orts! Upon perusing Meanwhile, the editors explored publishing his biography, Charles F. Merbs requested that he options. Following prospectus preparation and be referred to as “Chuck.” submission to four presses during the spring of As with all endeavors of this nature and mag- 2008, we were pleased to hear (April 12) from Peter nitude, choices had to be made. For individual Prescott, senior editor for Life Sciences of Oxford biographies, we included paleopathologists who University Press (OUP). " us began the conver- we felt had made lasting contributions, as mea- sations that ultimately led to a contract being sured by their impact on the - eld of paleopathol- o4 ered by OUP on September 31, 2008. During ogy through direct study of ancient disease in October 2008, having signed our contract, we human remains. We therefore decided, for exam- issued letters of instruction to authors, including ple, that historians of medicine were outside the standard advice concerning fonts, style, and espe- scope of this volume. As the - rst person to coin cially chapter lengths. Most contributors followed the term “paleopathology,” we have included much of our advice, though a few chapters arrived Robert Wilson Shufeldt (Chapter 29), though his well beyond word counts, one being three times career and especially his personal life was no role the recommended size; negotiations ensued. model for future generations. We realize that not all would agree with our ST RUC T U R E O F choices, although we have made every e4 ort to THE VOLUME be as inclusive and fair as possible. We hope that For the biographies, we have adopted a model those who identify what they believe to be omis- drawn from Women in the Biological Sciences: A sions will publish other histories and thus lend Biobibliographic Sourcebook (Grinstein, Bierman, further visibility to this vital - eld. and Rose 1997). We circulated an entry for Barbara A5 er selecting individuals for stand-alone McClintock (Buckner 1997), which illustrated the biographies and moments, we turned to other pro- separation of the biographical information from spective sections, which ultimately included: the her professional contributions. " is model had history of paleopathology in speci- c geographic served well in a previous set of biographies in regions with traditions in paleopathology; relevant which the senior editor had participated (Powell overarching topics such as nonhuman paleopa- et al. 2006), and it was therefore adopted here. thology, dental anthropology, and mummy stud- " e structure for the topical, organizations, ies; chapters on organizations, key congresses, and key congresses, education, and future trends education in paleopathology; and past and future (methods) is also relatively straightforward. " e trends (methods). Again, we tried to be inclusive authors chosen to develop these chapters are emi- and fair during all selection processes, including nent paleopathologists, intimately associated with those for authors of these various contributions. their subject matter, organizers and other key play- ers in symposia, short courses, congresses, and T H E VOLU M E , organizations. " e regional histories proved more T H E C O N T R AC T, challenging, however, for a number of reasons. A N D T H E E U RO P E A N We attempted to achieve global coverage PA L E O PAT H OL O GY (Figures P.1 and P.2), with a primary goal of engag- MEETINGS SYMPOSIUM ing authors from within the targeted world areas. We recruited authors beginning in March 2007 and We felt that such contextualized perspectives extending throughout the year. By early 2008 the were more desirable than prioritizing scholars— current list of contributors was nearly in place, and however quali- ed—from Western or Anglo aca- the editors were recruiting papers for the European demic traditions. Copyediting frequently proved Paleopathology Meetings to be held in Copenhagen challenging in circumstances where English was during late August 2008. " is e4 ort, we believed, not a - rst language (and occasionally when it was), would lend important visibility to the project. As we but we - rmly believe this was the right approach. were allotted only two-and-a-half hours, we were " e editors frequently bantered about quaint state- able to sample only a small portion of the chapters ments in British “English” and “Americanisms,”
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Preface ix
MICRONESIA
POLYNESIA AQ1
MELANESIA
and we ultimately adopted American spellings the editors discovered that two distinctive regional for our central topic (paleopathology) and other traditions were represented. Paleopathology in similar terms. We retained original spellings, of Brazil is anchored by a biomedical focus that course, in the bibliographies. We cautioned our extends a Portuguese tradition. Argentina, on the authors that this was not a history of disease nor other hand, represents a paleopathology rooted in of physical anthropology, although for countries social science. " ese contrastive traditions within such as China (Chapter 41) and Mongolia (Chapter eastern South America represent an important 51), for which there is little English language lit- case study whereby colonial histories shape paleo- erature in paleopathology and related - elds, we pathology as it is conducted today. We also inte- allowed a measure of latitude. grated Germany with Austria due to their shared Where regional developments appeared to 19th century traditions, including the in6 uence have commonalities, coauthors were solicited. In of Virchow. In both countries, even though cli- pairing Brazil with nearby Argentina (Chapter 40), nicians and anatomists charted the early course
AQ1
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of paleopathology, as in most other regions, such fabric of the volume. While most of the biogra- research was usually in the context of the study of phies were written by citizens of the same coun- human variation (part of physical anthropology). try as the person of interest, this is not always We urged our regional contributors, trained the case, as with Chapter 16 (Strouhal, Czech abroad or locally, not only to identify key con- Republic, authored by Albert Zink, a German tributors to paleopathology, but also to place currently working in Italy). Binational author- them within local, national, and international ship occurs in Chapters 1, 4, 23, 41, 44, 64, 68, 69, academic developmental trajectories, as appro- 75, and 76. Global coverage is well documented priate. We asked that biographic materials focus in Part II: Regions, while the international mem- upon paleopathologists who - t the criteria used bership of the Paleopathology Association, atten- in Part I: Biographies and Moments, but we also dance at congresses devoted to mummy studies encouraged brief, perhaps tabular treatment of and investigations of infectious disease, and more recent work, e.g., Oceania (Chapter 62). As Short Courses in Paleopathology are intellectu- contributors submitted chapters, our concepts ally enriching and another indication of the vital- organically grew to suggestions that authors ity of this - eld with its long and distinguished also include brief statements about current history that we document here. training programs in paleopathology, locations of important research collections, key method- EDITORS’ NOTE ological and conceptual contributions of inter- At every stage, we have sought to avoid “histori- national signi- cance, and current and future cal presentism,” that is, judging historical - gures prospects. Some authors responded to our addi- as our contemporaries rather than considering tional requests, which we think enhance the the period in which they lived (Fischer 1978). value of this volume. Others chose to remain " erefore, we have retained terms such as “race,” focused upon key - gures in paleopathology. " e when today we would be much more likely to ref- editors do not fault the latter for their adher- erence “ancestry;” similarly, “Eskimo” rather than ence to our original vision and instructions, but “Inuit.” Some earlier paleopathologists, even emi- we want to recognize that this process explains nent ones such as T. Dale Stewart (Chapter 15), the variety of approaches taken in our regional used “prevalence” and “incidence” for frequency histories. rates interchangeably, an error we would not As noted above (Figures P.1, P.2), we have make today. Where we would reference “cranial attempted a global coverage, grouping our regional modi- cation” today, many used “cranial defor- presentations within four regions. " ese include mation” in the past. Africa, America (arbitrarily ordering chapters In other cases we have tried to standardize from north to south), Eurasia, and Oceania, terminology, recognizing that words and their including Australia and the Paci- c. In Africa and usage may change over time. Commonly accepted Eurasia, chapters tend to follow country boundar- expressions of today are introduced parenthet- ies due to distinctive historical traditions in paleo- ically in literature wherein other names were pathology and linguistic boundaries. For North applied, e.g., osteoporosis symmetrica (porotic America, we used a mixed approach, with individ- hyperostosis). In other cases, however, we have ual contributions from Mexico and Canada, and retained authors’ terms when these are synonyms, those from the United States representing regions e.g., trephination vs. trepanation. We have, how- that characterize the longest traditions in paleo- ever, encouraged authors to substitute “human pathology: the Southeast, the Midwest, and the remains” for “specimens” when speaking of pathol- Southwest. South American contributions re6 ect ogy in an individual. We feel that the latter term is both country boundaries in a uni- ed chapter: dehumanizing and demeaning to the past peoples Argentina/Brazil and an Andean complex from whom we have the privilege of studying and from Perú and northern Chile. " e Oceania section whom we learn. includes the island continent of Australia and a treatment of the many smaller islands within the ACKNOWLEDGMENTS Paci- c Ocean. We - rst wish to recognize the contributors who " us, our approach has been transnational have responded expeditiously and thoughtfully by design, beginning with the collaboration of to the editors’ many comments. To a small num- the editors, citizens of the United States and the ber of others, who met fewer deadlines—though United Kingdom, and extending throughout the all - nally came through—we say “well done, in
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Preface xi
the end.” Our contacts at OUP deserve special teaching, and in recalling valued colleagues and credit for their patience and timely responses to friends. our queries. Peter Prescott, who handled con- Jane E. Buikstra and Charlotte A. Roberts tract negotiations, le5 OUP in early February 2009, with his role being ably - lled by his former REFERENCES assistant, Tisse Takagi, now associate editor for Buckner VL. 1997. Barbara McClintock OUP. A very special thanks is owed to Stephanie (1902–1992). In: Grinstein LS, Biermann CA, McBride-Schreiner, who has assisted both editors and Rose, RK (eds) Women in the Biological enormously in both editorial tasks and in creating Sciences: A Biobibliographic Sourcebook, the biographies for Hrdlicka and Merbs. Nicole p 310–318. Westport, CT: Greenwood Press. Haas nimbly and cheerfully handled - nal edit- Buikstra JE. 1977. Biocultural Dimensions of ing and submission of the manuscript, and Sarah Archeological Study: A Regional Perspective. Harrison completed the index. In: Blakely RL (ed) Biocultural Adaptation in Prehistoric America, p 67–84. Southern " e editors would also like to acknowledge Anthropological Society Proceedings, No. 11. each other’s contributions to the volume and Athens, GA: University of Georgia Press. emphasize that we are still friends a5 er more than Buikstra JE, Beck LA (eds). 2006. Bioarchaeology: three years on task. " rough concept develop- " e Contextual Study of Human Remains. ment, recruitment, negotiations with publishers, Elsevier Inc: San Diego, CA. guidance to authors, and copy/content editing— Powell ML, Cook DC, Bogdan G, Buikstra JE, sometimes extending to - ve full reviews by both Castro MM, Horne PD, Hunt DR, Koritzer RT, editors—we have maintained a collegial relation- Mendonça de Souza SF, Sandford MK, ship. Many times our schedules were complimen- Saunders L, Malerba Sene GA, Sullivan L, tary and the one would take up responsibilities Swetnam, JJ. 2006. Invisible Hands: Women when the other was frantic for other professional in Bioarchaeology. In: Buikstra JE, Beck LA or personal reasons. While occasionally remark- (eds) Bioarchaeology: " e Contextual Study of ing that “sleep is for sissies,” we have managed to Human Remains, pp. 131–194. Elsevier Inc: San cope, due in large part to the support of friends Diego, CA. and family. Charlotte would like especially to rec- Fischer DH. 1970. Historians’ Fallacies: Toward a ognize her partner Stewart in this regard, and the Logic of Historical " ought. New York: Harper canine members of the family (Joss and Cassie), and Row. and Jane, her ever e4 ervescent canid, Abdulina Grinstein LS, Biermann CA, Rose, RK, editors. (Abby). We are proud of this product of our labors, 1997. Women in the Biological Sciences: A which we now present to you. We hope that you Biobibliographic Sourcebook. Westport, CT: will - nd this volume useful in your research, Greenwood Press.
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CONTENTS
Preface vii 8. Charles “Chuck” Merbs: Reconstructing Behavior " rough the Bones 60 List of Figures xvii .C;@@;. @00 F2@<0/, List of Tables xix 7280 0. 9:;<=>/2, 28? =>0.C28;0 E39/;?0-=3C/0;80/ PART ONE: Biographies 9. Roy L. Moodie: Pioneer Paleopathologist of Deep Time 70 1. John Lawrence Angel (1915–1986) 3 ?0@@2 3B@@;8= 3BB< 7280 0. 9:;<=>/2 28? 0@02882 ./0A0?B/B: 10. “Dr. Dan”: " e Life of George Daniel Morse (1906–1985) 82 2. Arthur C. Aufderheide (1922–) 14 70/BE0 3. /B=0 28? <0880>C 3. 8D=>/BE 28? @2//D ?B@B/0= @. 9:/<0 32/>E0@@ 11. Donald J. Ortner (1938–) 89 3. Don Brothwell (1933–) 22 E2/D @:32= .BF0@@ <0;>C ?B980D 12. Walter G. J. Putschar, MD, 4. T. Aidan Cockburn (1912–1981) Pathologist, Paleopathologist, Teacher 97 and Eve Cockburn (1924–2003) 32 ?B82@? 7. B/>80/ 28? 9/:30 ?. 3C2/@B>>0 2. /B90/>=, E2/D @:32= /2G=?2@0 .BF0@@, 28? 7280 0. 9:;<=>/2 13. Sir Marc Armand Ru4 er (1859–1917): Pioneer of Paleopathology 106 5. Jens Peder Hart Hansen and the Paleopathology of the Greenland 28?/0F >. =28?;=B8 (/0./;8>) Mummies 40 14. Shelley Rae Saunders (1950–2008) 111 8;0@= @D880/:. 28? 9/:8B 1/BC@;3C E. 2880 <2>H0890/G 6. Joseph Jones, MD, a Pioneer in 15. Contributions of T. Dale Stewart Paleopathological Di4 erential (1901–1997) to Paleopathology 119 Diagnosis 44 ?B:G@2= C. :90@2<0/ E2/D @:32= .BF0@@ 28? 16. Eugen Strouhal (1931–) 126 7280 0. 9:;<=>/2 2@90/> /. H;8< 7. Keith Manchester (1938–) 56 17. Phillip Lee Walker (1947–2009) 131 3C2/@B>>0 2. /B90/>= .2>/;3;2 @2E90/>
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#"! 3B8>08>=
18. Calvin Percival Bamfylde Wells 33. Paleopathological Studies in South (1908–1978) 141 Africa: A History 235 3C2/@B>>0 2. /B90/>= 28? 2@28 G. EB//;= 28? E2/D82 =>0D8 <0;>C E283C0=>0/ The Americas
PART II: Moments 34. History of Human Paleopathology in Canada 245 19. Trevor Anderson (1955–2005) 149 70/BE0 =. 3D9:@=<; 723I:0@;80 ;. E3<;8@0D 35. Paleopathology in the American 20. David Birkett (1934–1990) 153 Mid-Continent 259 3C2/@B>>0 2. /B90/>= 28? <0;>C ?0@@2 3B@@;8= 3BB< E283C0=>0/ 36. A History of Paleopathology in the 21. Alice Mossie Brues (1913–2007) 156 American Southeast: From Pox to E2/D <. =28?1B/?, @D88 <;@GB/0, Population 266 28? ?;280 @. 1/2830 3@2/< =.0830/ @2/=08 22. Domingo Campillo Valéro (1927–) 162 37. " e History of Paleopathology in the 3B8/2?B /B?/JG:0H-E2/>J8 28? American Southwest 285 E;G:0@ 9B>0@@[email protected] 288 @. F. =>B??0/ 23. Mahmoud Yousef K. El-Najjar 38. Conducting Paleopathology in Mexico. (1942–2009) 164 Past, Present, and Future Agendas 305 29?:@@2 2. 2@-=CB/E28 28? A0/2 >;0=@0/ 28? E2/J2 >0/0=2 72M8 70/BE0 3. /B=0 39. A History of Paleopathology in 24. Earnest Albert Hooton (1887–1954) 170 Peru and Northern Chile: From 0:G080 G;@0= Head Hunting to Head Counting 312 25. Ales ˘Hrdlička (1869–1943) 174 =B8;2 0. G:;@@M8 7280 0. 9:;<=>/2, ?B82@? 7. B/>80/, 40. Paleopathology in Argentina and Brazil 329 28? =>0.C28;0 E39/;?0-=3C/0;80/ =C0;@2 E2/;2 10//2H E08?B8N2 ?0 26. Juliet Margaret Rogers (1940–2001) 179 =B:H2 28? /;32/?B 2. G:;3CB8 @B:;=0 @B0 28? @:3D /BG0/= 27. A.T. “Sandy” Sandison (1923–1982) 186 Eurasia ?B8 9/B>CF0@@ 41. From Morphometrics to Holistics: the 28. Adolph Hans Schultz (1891–1976) 188 Emergence of Paleopathology in China 345 8283D 3. @BA0@@ 0<2>0/;82 2. .03C08<;82 29. Neglected Ancestors: Robert Wilson 42. Paleopathology in Denmark: " e Shufeldt, MD (1850–1934) 192 Pioneers Vilhelm Møller-Christensen and Johannes G. Andersen 361 ?0@@2 3B@@;8= 3BB< .;2 9088;<0 30. Lucile E. St. Hoyme (1924–2001) 197 43. " e Pioneers of Paleopathology ?2A;? /. C:8> in France 375 31. Herbert Upham Williams (1866–1938) 202 7BO@ 9@B8?;2:P, B@;A;0/ ?:>B:/, 28? ?0@@2 3B@@;8= 3BB< EB8>=0//2> =28=;@928B-3B@@;@;0:P 44. Paleopathology in Germanic Countries 387 PART III: Regions E2/;2 >0=3C@0/-8;3B@2 28? G;=0@2 G/:.0 Africa 45. A Short History of Paleopathological 32. Development of Paleopathology Research in Hungary 405 in the Nile Valley 209 GDQ/GD .R@1;, 28>B8;2 E2/3=;<, 9/08?2 7. 92<0/ 28? E2/G2/0> 2. 7:?? 28? ;@?; 000_JaneBuikstra_FM.indd0_JaneBuikstra_FM.indd xxiviv 11/31/2012/31/2012 44:04:01:04:01 PPMM OUP UNCORRECTED PROOF – FIRST-PROOF, 01/31/12, NEWGEN Contents xv 46. Paleopathology in Italy 416 61. History of the Development G;8B 1B/823;2/;, A2@08>;82 G;:11/2, of Paleopathology in the 28? =;EB82 E;8BHH; United Kingdom (UK) 570 47. Nicu Haas, Founder of Physical 3C2/@B>>0 2. /B90/>= Anthropology and Paleopathology in Israel, and His Successors: “" e Oceania Truth Is in the Eyes of the Beholder” 426 62. " e History of Paleopathology ;=/20@ C0/=C 000_JaneBuikstra_FM.indd0_JaneBuikstra_FM.indd xxvv 11/31/2012/31/2012 44:04:01:04:01 PPMM OUP UNCORRECTED PROOF – FIRST-PROOF, 01/31/12, NEWGEN #!" 3B8>08>= PART VI: Future Developments 74. A Short History of Paleohistology 740 71. Using Ancient DNA Techniques E;3C20@ 3. =3C:@>H to Study Disease 703 75. Synthesizing Parasitology with 2@;3;2 <. F;@9:/ 28? 2880 3. =>B80 Archaeology in Paleopathology 753 72. Isotope Analysis and Paleopathology: <2/@ 7. /0;8C2/? 28? A Short Review and Future 2?:2>B 2/2T7B Developments 720 76. Conclusions 767 E;<0 /;3C2/?= 28? 3C2/@B>>0 2. /B90/>= 28? 7280 0. 7280> EB8>GBE0/D 9:;<=>/2 73. Imaging: the History of Radiography, Current Issues and Future Trends 734 Contributors 780 1/28< 7. /SC@; Index 783 000_JaneBuikstra_FM.indd0_JaneBuikstra_FM.indd xxvivi 11/31/2012/31/2012 44:04:01:04:01 PPMM 5 5 Portuguese Developments in Paleopathology: an Outline History ANA LUÍSA SANTOS AND EUGÉNIA CUNHA here are many de! nitions for paleopathol- anatomical variation in di" erent human popula- Togy, all referring to the origin, evolution, and tions. As Ortner (2003:8) stated: “Much of this progress of diseases in humans and other animals early research was no more than an anatomical through time (e.g., Ubelaker 1982; Manchester 1983; account of these abnormal conditions with little Armelagos 1997; Cockburn 1997; Aufderheide if any attempt to explore the biological or patho- and Rodríguez- Martín 1998; Lovell 2000; Ortner logical signi! cance of what was being described.” 2003). However, a cuto" date for distinguishing Other workers dealt with single case studies of “paleopathology” from “pathology” is ill de! ned. skeletons with corresponding diagnoses. # is sit- How many years should separate the date of death uation is also referred to by Grauer (2008:58) in of the individual or population from the date of her discussion of international pioneers in paleo- observation in order to be considered paleopa- pathology: they “focused much of their skill and thology? For this contribution, publications were attention on the recognition of speci! c pathologi- excluded that concerned pathological evidence cal lesions in human bone and the presence of ana- in autopsy cadavers or in surgical patients, even tomical variation between human groups.” though these are described and included in patho- As in other countries, in Portugal the ! rst logical collections in faculties of medicine and/or paleopathological and archaeological studies were museums in Portugal. Nevertheless, papers written conducted as an avocational activity by physicians by physicians at the beginning of the 20th century (Santos 1999, 2000; Grauer 2008), natural philoso- analyzing contemporaneous skeletal collections phers, and geologists, among others (Umbelino and were taken into account. # us, the criteria for data Santos 2001). # e ! rst published work referring to selection are not completely uniform. Keeping human paleopathology dates back to the end of the these facts in mind, the aim of this paper is to pre- 19th century. Néry Delgado (1884), an engineer sent the history of paleopathology in Portugal and and director of the geological institute (Direcção- the state of the art today. Geral de Trabalhos Geodésicos), described a trep- anation in a skull from Casa da Moura (Cesareda) T R AC K I N G T H E PA ST: and another from Furninha Cave (Peniche), both 1884–1988 Neolithic sites (Table 55.1). He presented these # e end of the 19th century and the early 20th cen- cases to participants of the “Congrès International tury were both particularly rich for the sciences, d’Anthropologie et d’Archeéologie Préhistoriques” including paleopathology. During this period that took place in Lisbon in 1880, and he consid- several landmark studies in human paleopathol- ered possible evidence of anthropophagy (canni- ogy appeared (Ortner 1991; Armelagos 1997; balism) at Furninha Cave. # e opinion of most of Cockburn 1997; Aufderheide and Rodríguez- the participants was that it was practiced among Martín 1998). In Europe, the Americas, and Africa, the ancient inhabitants of Portuguese caves. researchers wanted to know about the antiquity of # e history of paleopathology in Portugal can- their ancestors as well as their anatomical and cul- not be separated from the existence of documented tural di" erences. By that time in Portugal, publi- collections that had been established by the end of cations in paleopathology consisted primarily of a the 19th century and continue today. In Lisbon, the corpus of descriptions wherein abnormalities were physician Francisco Ferraz de Macedo, a disciple of described against what was considered normal Broca, was the ! rst to make a collection of human BBook.indbook.indb 550303 44/11/2012/11/2012 22:31:25:31:25 AAMM !"# $%&' (((: &)*(+,- skulls in 1875 and 1877. He included skeletal mate- In 1918 he started research on the Ferraz Macedo rial from two Lisbon cemeteries (Rocha 1995). Collection and in 1924 became a second teach- However, the studies published by Ferraz de Macedo ing assistant of anthropology (segundo assistente were essentially on morphometrics and human de antropologia) in the Faculty of Sciences at the evolution. In Coimbra, Bernardino Machado began University of Lisbon (Moura 1986). According to building a medical school collection (“Colecção Moura, besides teaching anthropology, Barbosa Escolas Médicas”) of human skulls. Following Sueiro taught anatomy and the history of medicine, the scienti! c movement in other European coun- among other courses at the Faculty of Medicine, tries, he also established in 1885 the discipline of also being editor of the journal Archives of “Anthropology, Human Palaeontology and Pre- Anatomy and Anthropology (Arquivos de Anatomia Historic Archaeology” at the faculty of Natural e de Antropologia). # e studies of Barbosa Sueiro Philosophy at the University of Coimbra (Areia and and coauthors re/ ected their background in com- Rocha 1985). Besides being a professor in anthro- parative anatomy and congenital conditions. In pology, Machado was a natural philosopher and 1924 he analyzed in detail the septal aperture and politician who became president of Portugal twice. discussed its etiology, saying it occurs in adult- A. erward, Machado’s successor, Eusébio Tamagnini, hood, due to bone reabsorption, in both sexes and built the International Exchange (“Colecção de with no relation to occupation of the individuals. Trocas Internacionais”) and the Identi! ed Skeletal It is also worth mentioning that his dissertation, in (“Colecção de Esqueletos Identi! cados”) collec- the same year, was also about the septal aperture. tions (Areia and Rocha 1985). He published on the frequency of atlas occipital- A. er the creation of Machado’s course, students ization, congenital variation in vertebral number, started analyzing skeletal samples (Table 55.1). sacralisation and lumbarisation (Sueiro 1926), Studying the collection termed today the “Medical and morphological variation and spina bi! da in School Collection,” along with unidenti! ed skulls the atlas, both from the Ferraz Macedo identi! ed recovered from Coimbra Cathedral, Menezes collection and Neolithic collections (Sueiro 1930, (1898) classi! ed the anomalies of the skull into 1933, 1934). He also presented a very detailed two types: fusion and division. As an example of description of lumbarization and sacralization division anomalies, the persistence of the metopic of lumbar and coccygeal vertebrae in the sacrum suture was discussed and interpreted by the author of a Mesolithic individual (1932) and irregular as the result of a larger brain, more common in sacralization of two coccygeal vertebrae (Sueiro “superior races.” Nevertheless, some anthropolo- and Macieira 1938) in both identi! ed and archae- gists noticed a high percentage of skulls with ological collections. Based upon materials from a metopic sutures in mentally ill patients (“aliena- Neolithic site called Fontaínhas Cave, Sueiro (1934) dos”). Menezes (1898:104) questioned whether described ! ve (of nineteen) skulls with incomplete this could be a proof that madness can result in trepanations, two previously described by Néry “excessive brain development.” Another student Delgado (1884) along with three new examples. at the University of Coimbra, Ferreira (1898), Sueiro wrote about the possible techniques and related premature synostosis to abnormal cranial instruments used to perform these trepanations as shape, e.g., plagiocephaly. # is etiology was among well as synthesizing work that tried to explain this the hypotheses proposed by Teixeira (1946) for practice across Neolithic populations. In a posthu- metopism. Additional authors that published on mous publication, Sueiro (and Moura 1988) con- human paleopathology of archeological and iden- sidered the classi! cation of cranial deformation, ti! ed materials are shown in Table 55.1, which discriminating between arti! cial and pathological illustrates that trepanation was the condition most etiologies (Table 55.1). commonly identi! ed in the ! rst half of the 20th In studies of ancient skeletal remains, Sueiro century. Interest continued, however, as illustrated and Frazão (1956, 1957, 1959) also reported caries, by the fact that in 1969, Veiga Ferreira discussed ante- and postmortem tooth loss, and dental wear this practice in a paper about surgery and medi- in Mesolithic populations. So far, this is the ! rst cine in antiquity. paper, published in two journals, that employed # ese earliest Portuguese publications were the de! nition of paleopathology according to classic anthropological works, mainly based on cra- Ru" er (1914; Chapter 13) and also referenced niometry and following the lead of other countries Palès’ book (1930; Chapter 43) on paleopathol- such as France and Spain. However, the physician ogy. # e authors also reviewed, beginning with and anatomist Manuel Bernardo Barbosa Sueiro Esper (1774), paleopathological studies in both (1894–1974) may be considered an exception. humans and animals. # e word “paleopathologist” BBook.indbook.indb 550404 44/11/2012/11/2012 22:31:25:31:25 AAMM Portugal !"! TABLE 55.1 SUMMARY OF WORK IN PALEOPATHOLOGY IN PORTUGAL FOR 1884!1987 0ORGANIZED CHRONOLOGICALLY1. Skeletal series/sites Main contribution Chronology Reference Casa da Moura (Cesareda) Trepanation Neolithic Delgado, 1884 Furninha Cave (Peniche) Lapa da Galinha Trepanation Neolithic Vasconcelos, 1897/1913 IC- UC Congenital 19th–20th centuries Menezes, 1898 Coimbra Cathedral, Congenital, plagiocephaly 16th–20th centuries Ferreira, 1898 Anatomical collections, IC- UC Alqueves Cave Skull with trauma or Neolithic Carrisso, 1909 trepanation. Ante- and postmortem tooth loss and caries IC- UL, IC- UC, Anatomical Septal aperture of the Sueiro, 1924 and Archeological samples humerus (Convento Cristo de Tomar, Conv. de Jesus de Lisboa, among others) and radiographs. Mammals IC- UL Congenital conditions in Sueiro, 1926 the column IC- UC Occipitalization of the atlas 19th–20th centuries Correia, 1927 Museum of the Institute of Occipitalization of the atlas 19th–20th centuries Monteiro and Tavares, 1928 Anthropology, University of Porto IC- UL Spina bi! da Neolithic Sueiro, 1930; 1933/1934 19th–20th centuries Alcácer do Sal Discriminated between Iron Age Correa, 1931 ante and postmortem trauma in a skull Cabeço da Arruda Lumbarisation or Mesolithic Sueiro, 1932 sacralisation of lumbar and coccygeal vertebrae Fontainhas cave Five skulls with incomplete Neolithic Sueiro, 1934 trepanation IC- UL Irregular sacralization of 19th–20th centuries Sueiro and Macieira, 1938 two coccygeal vertebrae Castelo de Pragança Trepanation Bronze/Iron Age White, 1946 IC- UC, Faculty of Metopism 19th–20th centuries Teixeira, 1946 Medicine-UC Eira Pedrinha Neoplastic disease and Neolithic Júnior, 1947 trauma on skulls Silveirona Compared the thickness Visigothic Barros e Cunha, 1947 of the skull with Piltdown and Cohuna (Australia) but rejected the conjecture that this characteristic was typical of early fossil forms. Dolmen da Capela Trepanation Neolithic Rocha, 1949 (Continued) BBook.indbook.indb 550505 44/11/2012/11/2012 22:31:26:31:26 AAMM !"$ $%&' (((: &)*(+,- TABLE 55.1 0CONTINUED1 Skeletal series/sites Main contribution Chronology Reference Silveirona “[T]he femora have an Visigothic Serra et al., 1952:204; Cunha exaggerated curvature, and and Neto, 1953; 1955 the cranium presented a pathological character” Cabeço da Arruda, Moita do Caries, ante- and Mesolithic Sueiro and Frazão, 1956; Sebastião, Cova da Onça postmortem tooth loss and 1957/1959 dental wear Bugio cave (Sesimbra) Dental pathologies, a bony Neolithic Isidoro, 1964 excrescence on a humerus, exostoses in several vertebrae, and sacralization of the 5th lumbar vertebra. IC- UL Men who had died from 19th–20th centuries Olivier and Almeida, 1972 tuberculosis had longer heads and faces than the surviving populace. Gruta da Lapa do Suão Although dental wear is not Upper Paleolithic Rocha, 1978 (Bombarral) a pathological condition, it started to be seen as an occupational marker. Necropolis in Marvão Bone fractures and Fernandes and Mendes, “spondyloarthrosis” 1985:229.* Lugar do Canto (Alcanede) Trauma, infectious and Neolithic Leitão et al., 1987 joint diseases, trepanation Legend: IC- UC: Identi! ed Collection, University of Coimbra; IC- UL: Identi! ed Collection, University of Lisboa * Since images of these bones were not presented, it was impossible to con! rm these diagnoses. was used in this paper and the authors said that which was the main objective of physical anthro- (p. 198): “within certain limits, on the basis of the pological studies at that time. Among the authors knowledge of osseous lesions, both in humans and mentioned, the most relevant ! gure was Barbosa animals, we can obtain interpretations on paleopa- Sueiro, both because of the variety of pathologi- thology according for example the environmental cal conditions he reported and the number of in/ uence, diet, and other life conditions.” publications. According to Armelagos (1997), a new era of paleopathology started in the 1960s. By then inter- THE LAST TWO DECADES pretation became the key feature, the English phy- In the last twenty years, paleopathology has had sician Calvin Wells being one of the best known an important impact on other sciences (Armelagos proponents (Waldron 1994; Chapter 18). His 1964 1997). # e study of patterns of mortality and mor- book Bones, bodies and disease, was translated into bidity in past populations is essential to our evalu- Portuguese in 1971 and remains, thus far, the only ation of the susceptibility of speci! c populations to book in paleopathology ever translated in this certain diseases and disorders (Pfei" er 1991), and country. it also contributes to modern medical knowledge In the early stages of paleopathology’s devel- and diagnosis (Mǿller-Christensen 1953), includ- opment in Portugal, several isolated examples of ing the forensic sciences. pathological conditions in individual skeletons were described and diagnosed. # e majority of the Excavation authors limited their contributions to either men- # e increasing number of skeletons recovered tioning the detection of pathological lesions or from archaeological contexts has also played an excluding them from their morphological analysis, important role in the expansion of paleopathology. BBook.indbook.indb 550606 44/11/2012/11/2012 22:31:26:31:26 AAMM Portugal !"% Paleopathological analysis should ideally begin Teaching during ! eldwork since pathological lesions may Paleopathology is today considered a subdiscipline frequently only be observable when the bones are of biological/physical anthropology (Buikstra and ! rst uncovered because of their fragility and sub- Ubelaker 1994; Roberts and Manchester 2005; sequent deterioration when they are removed from Buikstra and Beck 2006) and, in Portugal, paleo- the earth (Santos 2000). In other words, since exca- pathology has developed mainly in relationship to vation is always an invasive process, some obser- the teaching of anthropology. A signi! cant event vations cannot be repeated later due to the o. en in the professional development of paleopathology fragile nature of bones a" ected by disease. Caria was the creation of a discipline of paleodemogra- Mendes (1989) published one of the very ! rst bio- phy, which included paleopathology (1995, 1996) anthropological guides in Portugal for the study of within the anthropology degree (1992, 1993+) human remains from a necropolis that included in the Faculty of Sciences and Technology at the “paleopathological aspects.” By the late 1980s, University of Coimbra. Later, paleopathology was in the extinct Serviço Regional de Arqueologia taught in the master’s course in human evolution do Sul (Évora), archeologist Rui Parreira coordi- (started in 1998) and in its successor, the master’s in nated a research team that included Teresa Matos evolution and human biology (2007/2008-), under Fernandes as a specialist in physical anthropol- the name “Paleopathology of human populations.” ogy. Among the sites excavated by these research- # e subject is also taught in short courses such as ers were S. Manços Chapel (Évora) and Santiago biological anthropology (2006- ) and in paleopar- Church (Monsaraz). # e human remains from asitology, by Adauto Araújo from the Oswaldo these two sites were later studied respectively by Cruz Foundation, Brazil (2007), in seminars at Abelho (1990) and Santos (1990), and both of these the Department of Anthropology at the University works provided brief descriptions of skeletal dis- of Coimbra, and in summer courses at the New ease. Later, in July 1999, the Portuguese Assembly University of Lisbon (2008-). At the University passed a national law (Diário da República) that of Évora it is taught in the discipline “Human required the participation of a physical anthropolo- Paleoecology and Paleopathology” in the degree gist in any excavation that reveals human remains. programs of Biology and Enviromental Sciences. Later, more intense research on past human popu- lations started and, subsequently, published studies Research of archaeological samples, including paleopatho- Partially in relationship to the increased teaching logical analyses, increased signi! cantly. More discussed above, several academic works directly than seventy unpublished, primarily descriptive and indirectly related to paleopathology have technical reports on skeletal remains have been appeared. Approximately ! . y undergraduate produced by sta" members, students, and collabo- theses, thirty master’s theses, six of them study- rators of the former Department of Anthropology ing speci! c pathological conditions (Table 55.2), (currently Department of Life Sciences) at the and nine PhD theses have dealt with paleopathol- University of Coimbra (Cruz 2012) and at the ogy to date, and another six will be ! nished in University of Évora. the next year (Table 55.3). For example, in 1993, A few international excavations and speci! c lab- Cidália Duarte studied oral pathology in indi- oratory teams should also be mentioned. For exam- viduals from the Neolithic/Chalcolithic site of ple, in Baixo Alentejo, the Archaeological Campus Tojal de Vila Chã Arti! cial Caves for her master’s of Mértola (http://www.camertola.pt/) integrates degree at the University of Alberta (Canada). # e Portuguese, Spanish, and French researchers from ! rst PhD thesis that focused on paleobiology and di" erent disciplines, including physical anthropol- paleopathology was completed in 1994 wherein ogy, to focus on paleopathological analysis of skele- Eugénia Cunha ! nished a systematic paleode- tal remains. In Alto Alentejo, Torre de Palma, where mographic and paleopathological analysis of two Roman to medieval occupations have been identi- Portuguese medieval populations. Similar studies ! ed, a team of researchers from the United States considered the Neolithic/Chalcolithic (Silva 2002) and Portugal includes American Mary Lucas Powell, and Medieval periods (Garcia 2007; Fernandes who heads the paleopathological analysis. More 2008). # us, the trend identi! ed by Roberts and recently, the most important paleoanthropological Manchester (2005:264), which suggests that since ! nd in Portugal, the Gravettian human skeleton 1995, an increasing number of “population- based from the Abrigo do Lagar Velho, was also subjected studies of heath” have been apparent and that “there to paleopathological analysis by an international is more consideration for placing health data in group of researchers (Trinkaus et al. 2002). cultural context” also applies to Portugal. However, BBook.indbook.indb 550707 44/11/2012/11/2012 22:31:26:31:26 AAMM !"& $%&' (((: &)*(+,- TABLE 55.2 MASTER’S THESES ON SPECIFIC PALEOPATHOLOGICAL CONDITIONS 0ORGANIZED CHRONOLOGICALLY1. Skeletal series/sites Main contribution Chronology Reference Tojal de Vila Chã (Carenque) Oral pathologies Neolithic/Calcolithic Duarte, 1993 Cabeço da Arruda, Cabeço da Stress indicators: Harris lines, Mesolithic Cardoso, 2001 Amoreira, Moita do Sebastião, Porotic hyperostosis, cribra Cova da Onça orbitalia, dental enamel hypoplasias IC- UL Tuberculosis 19th–20th centuries Matos, 2003 IC- UC Bone loss, trauma 19th–20th centuries Curate, 2005 São Julião Church necropolis Markers of occupational 14th–19th centuries Assis, 2007 (Constância) stress, Biocultural approach IC- UL Spondyloarthropathies 19th–20th centuries Marques, 2007 TABLE 55.3 PHD THESES DEALING WITH PALEOPATHOLOGY, COMPLETED BY PORTUGUESE RESEARCHERS 0ORGANIZED CHRONOLOGICALLY1. Skeletal series/sites Main contribution Chronology Reference S. João de Almedina Church Trauma, oral, joint, congenital and 12th–15th centuries Cunha, 1994 (Coimbra) and infectious diseases, among others Fão (Esposende) Hospital archives and IC- UC Tuberculosis 19th–20th centuries Santos, 2000 Ansião, Serro da Roupa, Paimogo Trepanations, fractures, oral, Neolithic/Calcolithic Silva, 2002 I, Abrigo da Carrasca, Cabeço da congenital, infectious and joint Arruda, Cova da Moura, São Paulo diseases, among others Muge and Sado shell middens and Paleodiets and indicators of Mesolithic and Umbelino, Abrigo da Carrasca, Hipogeu de S. nutritional stress Neolithic 2006 Paulo, Pai Mogo I, Eira Pedrinha, Gruta dos Alqueves, # olos Cabeço da Arruda IC- UC Oral disease 19th–20th centuries Wasterlain, 2006 Praça de S. Martinho (Leiria) Various diseases 13th–16th centuries Garcia, 2007 S. Miguel de Odrinhas (Sintra) Trauma, and oral, congenital, 12th–15th centuries Fernandes, infectious and joint diseases, among 2008 others IC- UC and IC- UL Degenerative joint disease, 19th–20th centuries Cardoso, 2008* musculoskeletal makers (MSM) and markers of occupational stress (MOS) St. Jørgen’s (Odense, Denmark) and Leprosy Medieval and Matos, 2009 Archives from the Hospital- Colónia 19th–20th centuries Rovisco Pais (Portugal) IC- UC and IC- UL Osteoporosis and trauma 19th–20th centuries Curate, 2010 IC- UC and IC- UL Neoplasias 19th–20th centuries Marques, [2012] Merida (Spain), Álcacer do Sal Oral and joint disease, trauma, Roman Silva, [2012] among others (Continued) BBook.indbook.indb 550808 44/11/2012/11/2012 22:31:26:31:26 AAMM Portugal !"' TABLE 55.3 0CONTINUED1. Skeletal series/sites Main contribution Chronology Reference São Julião Church necropolis Paleohistology: speci! c and 14th–20th centuries Assis, [2012] (Constância) and IC- UC nonspeci! c bone infections and IC- UL Hospital archives and IC- UC Syphilis 19th–20th centuries Lopes, [2012] Ca. 70 sites Infectious, oral, and joint diseases, 11th–20th centuries Cruz, [2012] trauma, among others. Hospital archives and IC- UC Trauma 19th–20th centuries Peneda, [2012] Legend: IC- UC: Identi! ed Collection, University of Coimbra; IC-UL: Identi! ed Collection, University of Lisboa * # esis from Durham University, U.K. theses have also focused on speci! c conditions, at the University of Coimbra (Rocha 1995; Santos such as oral health (Duarte 1993; Wasterlain 2006), 1999, 2000; Cunha and Wasterlain 2007), and more tuberculosis (Santos 2000; Matos 2003), indicators recently at the Museum Bocage within the National of “stress” (Cardoso 2001), bone loss and osteopo- Museum of Natural History at the University of rosis (Curate 2005; 2010), spondyloarthropathies Lisbon (Cardoso 2006), have been contributing (Marques 2007), markers of “occupational stress” signi! cantly to paleopathology. # e more relevant (Assis 2007; Cardoso 2008), leprosy (Matos 2009), papers based on identi! ed and archaeological skel- neoplastic disease (Marques 2012), syphilis (Lopes etal samples are summarized in Table 55.4. 2012), and trauma (Peneda 2012). Moreover, intense ! eldwork on sites from Other recent trends include the use of new periods from the Mesolithic to recent times pro- methodological approaches for understanding vides skeletal samples from the whole of Portugal. certain pathological conditions. # ese studies have # ese facilitate population- based studies, includ- developed in collaboration with foreign colleagues ing paleopathological analyses, allowing an and laboratories. # us, aDNA (Santos 2000) and evolutionary perspective to be explored. # e mycolic acids of Mycobacterium tuberculosis modern study of the history of disease follows a (Redman et al. 2009) were sought in skeletons bioarchaeological approach—biological data are from the Coimbra Identi! ed Skeletal Collection. interpreted within appropriate cultural contexts, Umbelino (2006) used trace element and stable which include relevant details of historical devel- isotope analyses to reveal the diet of Mesolithic opment, local geography, and material culture of and Neolithic/Chalcolithic populations. Roman the people whose remains are under examination cremated materials have been studied by Silva (Manchester 1983; Roberts and Manchester 2005). (2012) using three- dimensional computed tomog- # is represents a recent development of a multi- raphy, and paleohistology has been applied to disciplinary approach to paleopathology (Santos periostitis in trying to distinguish among speci! c 1999, 2000). Furthermore, di" erential diagnosis and non- speci! c infectious diseases as its etiology has become a mandatory step whenever a spe- (Assis 2012). ci! c cause for pathological lesions is considered. Since 2001, from its very beginning, Portugal However, this approach is not followed by all the has been involved with the Global History of researchers. Examples include publications by the Health Project: European Module (http://global. dentist Santinho Cunha, and colleagues, includ- sbs.ohio- state.edu/). # is is an important inter- ing the historian Rodrigues Ferreira (1998) and national research program on health in the past the geologist Telles Antunes. An example of a that emphasizes the use of a uniform methodol- paper with questionable assumptions and con- ogy for data collection and the creation of inter- clusions considered the Muge Mesolithic popula- national databases, which through a comparative tions wherein Antunes and Cunha (1992, 1993) approach allows the study of the evolution of health described, among other practices, ablation of the and disease through time in many di" erent coun- tongue, slaughter of the individuals by an “exe- tries. Research and teaching based on the well- cution platoon,” and human sacri! ce, namely documented large identi! ed skeletal collections of sterile women and young males, among other BBook.indbook.indb 550909 44/11/2012/11/2012 22:31:26:31:26 AAMM !(" $%&' (((: &)*(+,- TABLE 55.4 MAIN CONTRIBUTIONS ON PALEOPATHOLOGY PUBLISHED FROM 1993 TO 2011 0ORGANIZED CHRONOLOGICALLY1. Skeletal series/sites Main contribution Chronology Reference S. João de Almedina Di" use idiopathic skeletal Medieval and Cunha, 1993 (Coimbra) and IC- UC hyperostosis (DISH) 19th–20th centuries IC- UC Harris lines 19th–20th centuries Cunha and Gomes, 1994 IC- UC Stress indicators 19th–20th centuries Cunha, 1995 IC- UC Enthesopathies 19th–20th centuries Cunha and Umbelino, 1995 Aljubarrota Trauma Medieval Cunha and Silva, 1997 Évora Trauma Medieval Santos et al., 1998 IC- UC Tuberculosis 19th–20th centuries Santos and Roberts, 2001 Muge and Sado shell Oral disease, trauma, stress Mesolithic Cunha et al., 2003 middens indicators, trepanation, among others Eira Pedrinha Trepanation Neolithic Gama and Cunha, 2003 Furninha, Casa da Moura, Trepanation Neolithic to Bronze Age Silva, 2003 Lapa das Galinhas, Castelo de Pragança, among others Cacela Velha (Algarve) Brucellosis Medieval Curate, 2003/2004 Atapuerca (SH) Enamel hypoplasias Middle Pleistocene Cunha et al., 2004 Hipogeu São Paulo II Non-osseous Neolithic/Chalcolithic Silva, 2005 (Almada), Serro da Roupa calcaneonavicular (Columbeira) coalitions Quinta da Torrinha Trauma Roman Assis, 2005/2006 (Monte da Caparica) Alcácer do Sal Brucellosis Medieval- Modern Curate, 2006 IC- UL Tuberculosis 19th–20th centuries Matos and Santos, 2006 IC- UC Spondyloarthropathies 19th–20th centuries Martin- Dupont et al., 2006 IC- UC Tuberculosis 19th–20th centuries Santos and Roberts, 2006 Church of Sacramento Syphilis 18th century Souza et al. 2006 (Lisboa) Muge and Sado Oral and joint diseases, Mesolithic and Neolithic/ Cunha et al., 2007 shellmiddens, Cabeço da trepanation, trauma, Calcolithic Arruda, Cova da Moura, among others Dólmen Ancião, among others IC- UC Oral pathologies 19th–20th centuries Dias et al., 2007 Estremoz Klippel- Feil Syndrome Medieval Fernandes and Costa, 2007 IC- UC Oral pathologies 19th–20th centuries Wasterlain and Dias, 2007 Samarra Trauma Neolithic Calcolithic Silva and Ferreira, 2008 Cacela Velha (Algarve) Os odontoideum Medieval Curate, 2008 IC- UL Rib trauma 19th–20th centuries Matos, 2009 IC- UC Oral pathology 19th–20th centuries Wasterlain and Dias, 2009 IC- UC Oral pathology 19th–20th centuries Wasterlain et al., 2009 Constância Neoplastic disease 14th–19th centuries Assis and Codinha, 2010 Olival (Ourém) Dystocia 19th century Cruz and Codinha, 2010 Santa Clara- a- Velha Osteoporosis, trauma 14th–17th centuries Curate et al., 2010 (Coimbra) IC- UC Syphilis 19th–20th centuries Lopes et al., 2010 Lapa do Bugio (Sesimbra) Oral and neoplastic diseases Neolithic Silva and Wasterlain, 2010 (Continued) BBook.indbook.indb 551010 44/11/2012/11/2012 22:31:26:31:26 AAMM Portugal !(( TABLE 55.4 MAIN CONTRIBUTIONS ON PALEOPATHOLOGY PUBLISHED FROM 1993 TO 2011 0ORGANIZED CHRONOLOGICALLY1. Skeletal series/sites Main contribution Chronology Reference # olos of Paimogo I, Hip fractures 3000–2500 BC to 19th Curate et al., 2011 Paradela, Santarém, century Constância, Juncal, Seixal São Miguel (Castelo Infectious disease 13th and 19th centuries Matos et al., 2011 Branco) Praça do Comércio Neoplasia 15th–20th centuries Wasterlain et al., 2011 (Coimbra) IC- UC Periodontal disease 19th–20th centuries Wasterlain et al., 2011 Legend: IC- UC: Identi! ed Collection, University of Coimbra; IC-UL: Identi! ed Collection, University of Lisboa statements very di2 cult to con! rm using the skel- paleopathology associations, for example the etal remains. Another example is that of Mendes Asociación Española de Paleopatología (AEP; and Oliveira (1990) who referred to the skeletons Chapter 58), the Paleopathology Association (PPA; from an ancient necropolis as the link between Chapter 67) and the Paleopathology Club. Several archaeology and history with bioanthropology researchers have also participated in the meetings and paleopathology. Following this interesting of the PPA since 1996, in Maastricht, and later observation, the authors used the paleopatholog- in the United States and South America. Due to ical study of sixteen skeletons found in Mértola as the proximity of Portugal and Spain, the biennial an example of this interdisciplinarity, describing meeting of the AEP is particularly frequented by fractures and their medical treatment. However, Portuguese members and their students. According their conclusions must be called into question at to Gonzalez and coauthors (2007), 11 percent (38 the point when the authors said that they could see out of 343) of the papers published in the proceed- in the skeleton an “expression or feeling of horror” ings of the meetings from 1988 to 2001 were from (Mendes and Oliveira 1990:207). foreign researchers, and in particular from Portugal Apart from the study of disease from the per- (14 papers, or 37 percent). spectives of the history of medicine and archaeo- # e ! rst scienti! c meeting centered on human logical contexts, it is important to note that, since paleopathology organized in Portugal was the 1997, paleopathological studies have also been 14th European Meeting of the Paleopathology linked to work in forensic contexts. In that year, Association, held between August 28 and 31, 2002, collaboration between the National Institute of at the University of Coimbra. One hundred and Forensic Medicine (Instituto Nacional de Medicina ninety-six participants from more than twenty- Legal) and the Department of Anthropology at the t w o d i " erent countries (Cunha and Santos 2003) University of Coimbra began. Since then more presented and discussed approximately 160 papers than 100 forensic cases have been analyzed and and posters (EMPPA 2002). Twenty-one of the reported, and pathological analysis is also man- presentations were published in special issues of datory as can be seen (Cunha 2006; Cunha and Antropologia Portuguesa (volume 19, 2002) and Pinheiro 2009). Analysis of pathological condi- the International Journal of Osteoarchaeology (vol- tions has helped, in many cases, to establish a posi- ume 13(5), 2003). Six years later, on June 6, 2008, tive identi! cation. In the meantime, further e" orts the Department of Anthropology, University of to bridge the gap between past and present have Coimbra, hosted the “I Jornadas Portuguesas been achieved (Pinheiro et al. 2004). de Paleopatologia” (“1st Portuguese Meeting of Paleopathology”). Organized by seven PhD stu- Scienti! c Meetings and Associations dents in biological anthropology, thirty-three Portuguese paleopathologists are now keen to presentations were made to the eighty-eight partic- share and discuss their results with their inter- ipants (Santos 2008). # e second meeting was held national peers. # is can be witnessed by the fact in 2010 (http://www.uc.pt/en/cia/events/meetings, that many researchers are members of di" erent Santos 2011) and the third is plan for fall 2012. BBook.indbook.indb 551111 44/11/2012/11/2012 22:31:26:31:26 AAMM !() $%&' (((: &)*(+,- On July 2–3, 2009, the “Workshop in a. er the 1990s, when formal education in paleo- Musculoskeletal Stress Markers (MSM): limitations pathology began. Since then the dominant trends and achievements in the reconstruction of past have included biocultural approaches to the study activity patterns” (http://www.uc.pt/en/cia/msm/) of disease in the past. Additionally, the potential took place (Santos et al. 2009; Jurmain 2010; Santos of identi! ed skeletal collections has been explored, et al. 2011). # is was a more focused meeting that namely to attempt to create new methods for the aimed to contribute to the development and stan- diagnosis of infectious, metabolic, and neoplastic dardization of protocols in MSM research. # ree diseases. Moreover, the classic macroscopic obser- lectures, sixteen podium presentations, ten posters, vations have been complemented with new tech- and two syntheses on research in this area as well niques such as the application of stable isotope and as discussions were presented to the seventy-! ve aDNA analyses, computed tomography and paleo- researchers from twenty- one countries. # e insti- histology to skeletal remains in national and inter- tutional assistance for all these events comes from national partnerships. Above all, paleopathology the University of Coimbra, the former Department proceeds as a multidisciplinary endeavor (Roberts of Anthropology, and the Research Centre for and Manchester 2005; Cook and Powell 2006) and Anthropology and Health (Centro de Investigação “international in its scope as we begin the 21st cen- em Antropologia e Saúde, or CIAS; www.uc.pt/ tury” (Cook and Powell 2006:322). # us, it has an en/cia). # e Populations and Cultures of the Past enormous potential. As Roberts and Manchester research group of the CIAS has more than twenty- (2005:274) stated “[p]alaeopathology has an excel- ! ve members who focus on the relevance of skeletal lent future, backed up by a solid base of research remains to the study of human paleopathology. that is increasing by the day.” CONCLUSION ACKNOWLEDGMENTS A review of paleopathology in Portugal presents We would like to extend a thank you to Jane some di2 culties since a broad range of publica- Buikstra and Charlotte Roberts for the invitation tions in archaeology, anthropology, and related to participate in this project as well as for their sciences existed by the end of the 19th and the very helpful comments and English edits. # anks beginning of the 20th century. Once those sources are also due to the sta" of the Library of the former had been analyzed, the challenge was to balance Department of Anthropology. the quantity and depth of the available information on paleopathology. 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