Treponematosis

Evidence of inflammatory response, usually appear­ing as symmetric periostitic expressions on the sur­faces of the limb long bones, is common in North American skeletal series. South American materials are said to present similar symptoms (Williams 1932; Goff 1967).

The cause of these lesions, which are characteris­tic of many cemetery samples from throughout east­ern North America, has been a matter of debate for more than a century. In 1876 J. Jones argued that the “erosions” he observed in burials from stone box graves and mounds in Tennessee and Kentucky were syphilitic, a conclusion cautiously supported by W. F. AVhitney (1883), curator of the Warren Ana­tomical Museum of the Harvard Medical School, a decade later. Such notables as the anatomist R. Virchow have disputed this conclusion, thus fueling an argument that continues today (Jarcho 1966).

The nature of the debate has changed, however. Today few would disagree with the notion that the skeletal lesions presented by these prehistoric re­mains resemble most closely the constellation of re­lated diseases collectively known as the trepone- matoses. Included within this group are venereal syphilis, yaws, and endemic syphilis. In her rigorous consideration of clinical and epidemiological pattern­ing from recent medical literature, D. Cook (1976) argues Compellingly that either nonvenereal syphi­lis or yaws is the best modern model for the observed prehistoric pathology.

Yet it is clear that, in isolated examples, venereal transmission of this disease occurred. The most con­vincing cases are two prehistoric burials that in­clude both adults and juveniles with the stigmata of venereal syphilis. In one of these, a mulberry molar was found in juvenile remains in a burial site that also included adult skeletons having treponemal long-bone lesions (Clabeaux Geise 1988). A second example is represented by the remains of a prehis­toric achondroplastic dwarf recovered from a Middle Woodland burial mound in Illinois (Charles, Leigh, and Buikstra 1988; Burgess 1988). This adult woman, whose left lower limb is heavily remodeled, died in childbirth. Her fetus presents evidence of periostitic changes, as well as dwarfing. Although the data are scant, they suggest that at least some prehistoric American women acquired treponemal infections as adults, presumably through sexual in­tercourse. The infection thus acquired would have been in an acute stage during the childbearing years, which would have facilitated transplacental infection (Grin 1956; Powell 1988).

The most recent overview of theoretical and em­pirical arguments concerning the origin of venereal syphilis is that of B. Baker and G. Armelagos (1988). After extensively reviewing current evidence, these authors conclude that pre-Columbian American skeletal materials reflect a treponematosis that spread to the Old World through nonvenereal con­tact. European social and environmental conditions favored the development of venereal transmission, and thus originated the “French disease.”

Doubtless the question of treponematosis and the development of venereal forms will remain contro­versial for some time. Eagerly awaited is further skeletal evidence from Europe, as well as the devel­opment of an immunological technique that will make it possible to identify treponemal antigens in ancient materials (Baker and Armelagos 1988).

Even though there is little evidence for venereal transmission of treponematosis in pre-Columbian American skeletons, it is important to underscore the presence on this continent of a chronic tre­ponemal disease that affected a significant number of individuals. Beginning in childhood and progress­ing throughout life, inflammations produced by the illness doubtless created a considerable health bur­den for prehistoric peoples of the Americas.