Molly K. Zuckerman

The Origin and Antiquity of Syphilis Revisited: An Appraisal of Old World Pre-Columbian Evidence for Treponemal Infection

For nearly 500 years, scholars have argued about the origin and antiquity of syphilis. Did Columbus bring the disease from the New World to the Old World? Or did syphilis exist in the Old World before 1493? Here, we evaluate all 54 published reports of pre-Columbian, Old World treponemal disease using a standardized, systematic approach. The certainty of diagnosis and dating of each case is considered, and novel information pertinent to the dating of these cases, including radiocarbon dates, is presented. Among the reports, we did not find a single case of Old World treponemal disease that has both a certain diagnosis and a secure pre-Columbian date. We also demonstrate that many of the reports use nonspecific indicators to diagnose treponemal disease, do not provide adequate information about the methods used to date specimens, and do not include high-quality photographs of the lesions of interest. Thus, despite an increasing number of published reports of pre-Columbian treponemal infection, it appears that solid evidence supporting an Old World origin for the disease remains absent.

Anemia or scurvy: A pilot study on differential diagnosis of porous and hyperostotic lesions using differential cranial vault thickness in subadult humans

Metabolic disorders, such as scurvy, manifested in human skeletal remains provide insight into health, nutrition, and environmental quality in past populations. Porous cranial vault lesions are often used to diagnose metabolic conditions in subadult remains, but overlapping gross lesion expressions have led to over-diagnosis of anemia and under-diagnosis of scurvy. Studies by Ortner and colleagues have suggested that specific porous cranial lesions are pathognomonic of scurvy, but additional diagnostic tools are necessary. In this technical report, we offer a preliminary assessment of cranial vault thickness (CVT) at the site of porous lesions (sensu lato porotic hyperostosis, cribra orbitalia) as a method for distinguishing between scurvy and anemia in subadult crania. Computed Tomography (CT) was used to measure CVT at various landmarks associated with porotic hyperostosis and cribra orbitalia, complemented by lesion scores, from scorbutic (N=11), anemic (N=3), and non-pathological (N=28) subadult crania used as a control group. Results indicate that CVT consistently distinguishes scorbutic from non-pathological individuals, while anemic individuals overlap with both - likely a function of small sample size in this study. Despite current limitations, CVT has the potential to be an objective diagnostic tool for distinguishing scurvy and expanding reconstructions of nutritional adequacy over the life course in past populations.

The evolution of disease: anthropological perspectives on epidemiologic transitions.

Background The model of epidemiologic transitions has served as a guiding framework for understanding relationships between patterns of human health and disease and economic development for the past several decades. However, epidemiologic transition theory is infrequently employed in epidemiology. Objective Moving beyond Omrans original formulation, we discuss critiques and modifications of the theory of epidemiologic transitions and highlight some of the ways in which incorporating epidemiologic transition theory can benefit theory and practice in epidemiology. Design We focus on two broad contemporary trends in human health that epidemiologic transition theory is useful for conceptualizing: the increased incidence of chronic inflammatory diseases (CIDs), such as allergic and autoimmune diseases, and the emergence and reemergence of infectious disease. Results Situating these trends within epidemiologic transition theory, we explain the rise in CIDs with the hygiene hypothesis and the rise in emerging and reemerging infections with the concept of a third epidemiologic transition. Conclusions Contextualizing these trends within epidemiologic transition theory reveals implications for clinical practice, global health policies, and future research within epidemiology.Background The model of epidemiologic transitions has served as a guiding framework for understanding relationships between patterns of human health and disease and economic development for the past several decades. However, epidemiologic transition theory is infrequently employed in epidemiology. Objective Moving beyond Omrans original formulation, we discuss critiques and modifications of the theory of epidemiologic transitions and highlight some of the ways in which incorporating epidemiologic transition theory can benefit theory and practice in epidemiology. Design We focus on two broad contemporary trends in human health that epidemiologic transition theory is useful for conceptualizing: the increased incidence of chronic inflammatory diseases (CIDs), such as allergic and autoimmune diseases, and the emergence and reemergence of infectious disease. Results Situating these trends within epidemiologic transition theory, we explain the rise in CIDs with the hygiene hypothesis and the rise in emerging and reemerging infections with the concept of a third epidemiologic transition. Conclusions Contextualizing these trends within epidemiologic transition theory reveals implications for clinical practice, global health policies, and future research within epidemiology.

Recovering the ‘Body Politic’: a Relational Ethics of Meaning for Bioarchaeology

Bioarchaeology is fraught with profound ethical quandaries, yet it has lagged behind the larger discipline of anthropology in the development of ethical principles and a professional code of ethics. Here, we propose an additional ethical justification for bioarchaeology based on relational ethics, theoretical work on embodiment, and the produced and constituted nature of human bodies, and on deriving meaning from skeletal remains: highly contextualized skeletal data analyzed in a relational, contingent interpretive space can generate otherwise inaccessible, direct information about the constitutive, productive effects of processes like power and oppression on human bodies. This enables recovery and recognition of the agency, singularity, and meaning of past peoples through giving voice to their narratives. This justification is not universally applicable; it is best suited to skeletal remains from marginalized, disenfranchised, and impoverished individuals and communities. We conclude with a case study applying the approach to a skeletal sample from the 18 th -19 th century Mississippi State Asylum to demonstrate that the approach complements more traditional bioarchaeological research while providing an additional foundation for ethical discourses and debates in the field.

New Directions in Biocultural Anthropology

Biocultural or biosocial anthropology is a research approach that views biology and culture as dialectically and inextricably intertwined, explicitly emphasizing the dynamic interaction between humans and their larger social, cultural, and physical environments. The biocultural approach emerged in anthropology in the 1960s, matured in the 1980s, and is now one of the dominant paradigms in anthropology, particularly within biological anthropology. This volume gathers contributions from the top scholars in biocultural anthropology focusing on six of the most influential, productive, and important areas of research within biocultural anthropology. These are: critical and synthetic approaches within biocultural anthropology; biocultural approaches to identity, including race and racism; health, diet, and nutrition; infectious disease from antiquity to the modern era; epidemiologic transitions and population dynamics; and inequality and violence studies. Focusing on these six major areas of burgeoning research within biocultural anthropology makes the proposed volume timely, widely applicable and useful to scholars engaging in biocultural research and students interested in the biocultural approach, and synthetic in its coverage of contemporary scholarship in biocultural anthropology. Students will be able to grasp the history of the biocultural approach, and how that history continues to impact scholarship, as well as the scope of current research within the approach, and the foci of biocultural research into the future. Importantly, contributions in the text follow a consistent format of a discussion of method and theory relative to a particular aspect of the above six topics, followed by a case study applying the surveyed method and theory. This structure will engage students by providing real world examples of anthropological issues, and demonstrating how biocultural method and theory can be used to elucidate and resolve them.

The Science Behind Pre‐Columbian Evidence of Syphilis in Europe: Research by Documentary

This article discusses the presentation of scientific findings by documentary, without the process of peer review. We use, as an example, PBSs “The Syphilis Enigma,” in which researchers presented novel evidence concerning the origin of syphilis that had never been reviewed by other scientists. These “findings” then entered the world of peer‐reviewed literature through citations of the documentary itself or material associated with it. Here, we demonstrate that the case for pre‐Columbian syphilis in Europe that was made in the documentary does not withstand scientific scrutiny. We also situate this example from paleopathology within a larger trend of “science by documentary” or “science by press conference,” in which researchers seek to bypass the peer review process by presenting unvetted findings directly to the public.

Recovering the Lived Body from Bodies of Evidence: Interrogation of Diagnostic Criteria and Parameters for Disease Ecology Reconstructed from Skeletons Within Anatomical and Medical Anatomical Collections

Anatomical and medical anatomical skeletal collections, which are generated by physicians, morgues, and medical institutions, are central to many aspects of osteological research. These include the production and refinement of diagnostic criteria for identifying the etiology of pathological skeletal lesions. These collections are often treated as neutral bodies of evidence, representative of their original living populations. However, scholars are increasingly attending to the life histories and biosocial lived conditions of these individuals, many of whom were of lower status to impoverished during their lives. This is especially important in light of increasing empirical evidence from immunology and biodemography on the embodied synergistic effects of chronic or repeated stress and malnutrition over the life course on immune function and consequent vulnerability to disease. Accordingly, I investigate here the contingencies and considerations that should potentially be incorporated into the use of these collections to generate empirical, standardized diagnostic criteria for pathological conditions. I focus on acquired syphilis, a chronic infectious condition, and survey several of the anatomical and medical anatomical collections on which the diagnostic criteria for syphilis are based. I interrogate the utility of diagnostic criteria generated from these bodies of evidence and discuss the application of these criteria to archaeological skeletal samples.

Primates, Pathogens, and Evolution: A Context for Understanding Emerging Disease

The world is rife with potential pathogens. Of those that infect humans, it is estimated that roughly 20 % are of nonhuman primate origin. The same ease characterizes pathogen transmission in the other direction, from humans to nonhuman primates. This latter problem has increasingly serious ramifications for conservation efforts, as growing numbers of ecotourists and researchers serve as potential vectors of disease. Here, we present an analysis of major cross-species transmission events between human and nonhuman primates. In particular, we consider HIV and malaria as case studies in which nonhuman primate pathogens emerged and became permanent fixtures in human populations. The human practices that facilitate such events are considered, as well as the evolutionary consequences of these events. In addition, we describe human-to-nonhuman primate transmission events and discuss the potential of human pathogens to adapt to nonhuman primate hosts. The topic of emerging infections is addressed, in both human and nonhuman species, in light of changing patterns of contact and novel adaptations on the part of pathogens and hosts.

Response to Cole and Waldron’s “Letter to the Editor: Syphilis Revisited”

We would like to thank Drs. Cole and Waldron for their thoughtful reading of our recent article on evidence for pre-Columbian Old World treponemal disease (Harper et al.,2011). This is a very controversial subject, and we are not surprised that other investigators have critiques of our survey. We welcome their comments, and look forward to hearing the responses of others. Here we would like to respond to some of the points that Cole and Waldron (2012) made in regards to our article.

Potential Applications of Public Health Tools to Bioarchaeological Data Sets: The “Dirty War Index” and the Biological Costs of Armed Conflict for Children

In the past and present, the biosocial effects of armed conflict are increasingly well documented for combatants but are comparatively poorly understood for noncombatant civilians. Data for contemporary conflicts indicate that civilians suffer elevated morbidity and mortality above peacetime levels, but it is difficult to empirically reconstruct whether the effects were similar for premodern populations. Here, we propose and demonstrate the application of a public health tool, the “Dirty War Index” (DWI), to bioarchaeological and paleopathological data for empirically assessing the effects of armed conflict on civilians, particularly subadult children under 5 years of age. The DWI is a recently introduced, highly flexible, quantitative tool for identifying rates of undesirable or prohibited outcomes during conflict, with a “clean” conflict generating low values (e.g., 0) and a “dirty” conflict high values (e.g., 100). To demonstrate the DWI’s utility for past conflicts, its novel insights, and the theoretical and methodological issues involved in applying it to analyze past conflicts, we generate DWIs using established data for two well-documented conflicts, one modern and one historic: the early twenty-first century Syrian Civil War and the mid-nineteenth century Mountain Meadows Massacre in Utah. By applying the DWI to a modern conflict and to a historic massacre we demonstrate and explore the applicability of the DWI to bioarchaeological research, focusing on its utility for enabling quantitative comparisons of the outcomes of conflicts across time and space. The DWI enables empirical comparison of the effects of conflict on civilians using culturally specific outcomes, producing objective and culturally contingent evaluations of pain and suffering.