Arthritis
As pointed out by D. Ortner and G. Theobald in their examination of the diseases of prehistory in the West in this volume, a great many conditions can lead to inflammation of the joints.
In the Americas, most diagnostic attention has been paid to articular changes that may be characteristic of tuberculosis, treponematosis, rheumatoid arthritis, and osteoarthritis due to mechanical stress. Our current knowledge of the first two conditions is discussed in the relevant sections of this essay. Here we will focus on recent studies of osteoarthritis (degenerative joint disease) and rheumatoid arthritis.Daily activities produce stresses that over time promote degeneration of joint surfaces in the human skeleton. Thus, the “wear and tear” of ancient lifestyles can be read through an analysis of the porosity, eburnation, and lipping characteristic of arthritic joints. One of the most careful studies of extensive degenerative joint changes is that of Ortner (1968), who details the patterning discovered in Alaskan Eskimo and Peruvian skeletons. Ortner’s work is reminiscent of the methods pioneered by J. Angel (1966) and T. Stewart (1932). Stewart’s careful investigation of intraindividual patterning established the standard of comparison of vertebral osteophytosis, whereas Angel’s creative inferences concerning behavior (e.g., atlatl [spear or dart throwing stick] elbow) are oft-cited attempts to link individual activities to bone pathology.
R. Jurmain (1977) has compared arthritic patterns characterizing the Alaskan Eskimo shoulder, elbow, knee, and hip with those of Pueblo Indians and modern skeletons. Jurmain emphasizes the multifactorial nature of osteoarthritis, although he believes that functional stress is of paramount importance.
After an extensive survey of degenerative joint disease among the Native Point Sadlerimiut Eskimo from Southampton Island, Canada, C.
Merbs (1969, 1983) identified distinctive male and female activity patterns that yielded arthritic change. Typical male activities that produced upper-limb arthritis included harpoon throwing and kayak paddling. Female skeletons bore evidence of activities related to the processing of skins.Following the recording strategy developed by Ortner (1968) and Merbs (1969), J. Tainter (1980) observed distinctive arthritic patterning across status groups ofMiddle Woodland men from Illinois. He interpreted these patterns to mean that the day-to- day activities differed significantly across socially defined segments of Hopewell communities.
A more recent study (Pickering 1984) has extended Tainter’s earlier synchronic investigation to an analysis of diachronic changes associated with the development of maize agriculture. Also embedded in this work is an attempt to isolate patterns in the male upper limb that were associated with the documented shift in hunting technology between the spear, characteristic ofMiddle Woodland groups, and the bow and arrow, used by Late Woodland and Mississippian populations.
Although an altered hunting technology was indeed documented within west-central Illinois during the period in question, no significant difference in symmetry, timing of onset, patterning, or degree of arthritic expression in the upper limb was discovered in the male subsample. The arthritic costs of agricultural intensification are clearly written, however, in age-corrected severity scores for the female upper back. The demands of repetitive food production activities associated with maize agriculture and larger family size are implicated in the apparent differences in degenerative joint disease.
In provocative new work based on observations in two large prehistoric North American skeletal populations, B. Rothschild and colleagues argue that rheumatoid arthritis “is a New World disease that subsequently spread to the Old World” (Rothschild, Woods, and Turner 1987; Rothschild, Turner, and DeLuca 1988; Woods and Rothschild 1988). Their conclusions are based on the form and distribution of erosive lesions in several series of skeletons, including the Libben Late Woodland sample (900-1200 B.P.) and Archaic skeletons from Alabama that are at least 5,000 years old (Rothschild et al. 1987,1988; Woods and Rothschild 1988). A convincing case of juvenile rheumatoid arthritis in an adolescent from the Tiwanaku period (c. 1100 B.P.) in Peru has also been described (Buikstra 1991).