ANCIENT DISEASE IN OHIO: THE EIDEN POPULATION 1

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1 ANCIENT DISEASE IN OHIO: THE EIDEN POPULATION JOHN W. LALLO AND JOHN E. BLANK, Department of Anthropology, Clevelan State University, Clevelan, OH Abstract. Skeletal material from a protohistoric (A.D. ± years) Amerinian population which live in Lorain County provie information on one of Ohio's early Inian groups. The skeletal material inicate some categories of pathology an skeletal anomalies which were present. The frequency of occurrence of these skeletal lesions were then interprete from an cpiemiological point of view. The analyses showe the presence of the following classes of skeletal lesions: evelopmental anomalies, infectious iseases, egenerative conitions, neoplastic lesions, fractures, an a possible nutritional isorer. The results suggest that the aults have significantly (p <.) higher frequencies than the subaults for evelopmental anomalies, infectious iseases, an egenerative conitions. Also, the ault males have significantly higher frequencies than ault females for evelopmental anomalies an egenerative conitions. OHIO J. SCI. ():, Archaeological an skeletal material from the Eien site were analyze to present a escription of the patterning an frequency of occurrence of skeletal lesions. The Eien site was initially excavate between an 6 by Mr. A. A. Bungart, an amateur archaeologist (McKenzie et al ). Subsequent excavations were carrie out by Case Western Reserve University (Scarry ). The skeletal an artifactual material is presently owne an house by the Lorain County Metropolitan Parks Commission at Lorain, Ohio. Eien is locate within the present town of Sheffiel in Lorain County, Ohio an is situate on the high bluffs of the French Creek approximately. km from the confluence of the creek with the Black River. The site was raiocarbon ate to A.D. ± years an, on the basis of this chronology, material culture, an ecological aaptation, Eien was assigne to the Wolf Phase of the Late Woolan (McKenzie et al ). The excavation reveale a composite habitation an burial complex which covere an area of 6 by m. The habitation area consiste of refuse pits, mien remains, an post-mols. Burmanuscript receive November, an in revise form December, 6 (#-). ials were locate in shallow, rectangular graves which were intersperse throughout the habitation area. McKenzie et al () have provie a etaile iscussion of the artifactual remains an the ecological aaptations of the Eien population. These authors suggest that in aition to the surrouning wil flora an fauna, the inhabitants of Eien inclue substantial amounts of maize in their iets. The excavation techniques i not permit the recovery of the plant remains. McKenzie an coinvestigators note that Eien was locate near four major floral complexes that inclue an elm-ash swamp, a mixe mesophytic forest, a mixe oak forest, an an area of prairie grasslans an that the faunal remains suggeste reliance upon Freshwater Drum (Aploinotus grunniens), White-Taile Deer (Oocoileus virginianus), an Elk (Cervus canaensis). METHODS AND MATERIALS A total of human burials was reporte by Bungart in his fiel notes (McKenzie et ). From these a sample of iniviuals was selecte. The criteria use in selecting the sample inclue: a. the burial must be at least 8 anatomically complete so as to insure a reasonable estimate of the patterning an frequency of skeletal lesions; b. the osseous material of the burial must be in a state of preservation which win enable observations of skel-

2 6 J. W. LALLO AND J. E. BLANK Vol. etal lesions to be mae; an c. each burial must be age an sexe. Of the burials in the stuy. () were ientifie as subaults (uner years of age), an.6 () as aults ( years of age or oler). In the ault segment of the population. () were classifie as males, an.; (8) as females. No attempt was mae to sex the subaults. Age eterminations for the subaults were base on: their pattern of ental eruption an enamelization (Sunick ), epiphyseal closure (Krogman 6), fusion of the vertebrae (Anerson 6), an the appearance of centers of ossification (Krogman 6). The age assignments for the aults were base on: the pattern of ental eruption an enamelization (Sunick ), epiphyseal closure (Krogman 6), changes in the pubic symphysis (McKern an Stewart ), an cranial suture closure (To an Lyon, ). Sex eterminations for the Eien aults were base on: cranial ifferences (Ascai an Nemeskeri ), ental measurements (Ditch an Rose ), iscriminant function analyses of pelvic (Gustav ) an femoral measurements (VanGerven ). It shoul be note that proper caution was exercise when applying metrical measurement analyses which were stanarize on populations other than the stuy population. Of the aults stuie ha conflicting sex assignments which were resolve to the satisfaction of the investigators. The skeletal remains provie the material for the analysis of paleopathology. Skeletal lesions were iagnose by gross macroscopic examination of the external surfaces of a bone, histological sectioning with microscopic analysis, an raiographie techniques. In most cases these proceures permitte a general iagnosis of the skeletal lesions. DEVELOPMENTAL ANOMALY ANALYSIS The evelopmental anomalies ientifie on.the Eien material have been separate, for the purposes of this analysis, into Class I an Class II anomalies. Class I anomalies inclue those skeletal variants which were efine as iscontinuous biological variations that are primarily genetically etermine (Anerson 68; Berry an Berry ). These inclue: multiple exostoses on the femur an tibia (Anerson 68); fossa olecrani perforata (Weber ); absence of, incomplete, or multiple foramina of the cervical an thoracic vertebrae (Gruncberg ); inflexion or absence of the tuberculum antcrius of the cervical vertebrae (Gruneberg ); variations in the size of the processus spinosus of the vertebrae (Gruneberg ); fusion of the sacral vertebrae (Searle ); yssymphysis ischiopubica (Gruneberg ); an spina bifia (Anerson 68). Class II anomalies represente skeletal variations that may be the en result of biomechani - cal stresses applie to the skeletal or muscular system. These inclue: squatting facets on the tibia (Brothwell ), Allen's facets on the hea of the femur (Brothwell 6), an the reaction area on the hea of the femur (Lallo ). The Class I an II anomalies reporte in this stuy were confine to the postcranial skeleton. RESULTS AND DISCUSSION Of the subaults stuie,. () showe a evelopmental anomaly an in all cases the anomalies were ientifie as Class I (table ). For the aults, 6. (8) isplaye an anomaly of which. () were assigne to Class I, an 6. () to Class II. Of the ault males, 88. (8) ha a evelopmental anomaly of which 6.8 () were ientifie as Class I, an 6. () as Class II. For the 8 ault females,. () showe an anomaly of which. () belonge to Class I TABLE Frequency of occurrence of evelopmental anomalies in the Eien population. Class I Class II Age* Ni ( N (N* N (N* (N )t N (N* >T )t Total ct *Age is expresse in evelopmental years. Ni = Number of iniviuals in each age class. No = Number of iniviuals in each age class with a evelopmental anomaly (combine Class I an II). N = Number of iniviuals in each age class with a Class I anomaly. N = Number of iniviuals in each age class with a Class II anomaly. * = the frequency of iniviuals in the age class with a particular anomaly erive on the basis of Ni. f the frequency of evelopmental anomalies of each class out of the total number of evelopmental anomalies (N).

3 No. ANCIENT DISEASE IN OHIO an. () to Class II (table ). The age specific frequencies of occurrence of anomalies for the subaults, an the ault males an females, are summarize in tables an, respectively. Chi square results showe that the ifferences observe between subaults an aults for the total frequency of evelopmental anomalies were statistically significant at the level (x =.S). The ifference between subaults an aults for the frequency of Class I anomalies was not significant, however,, the ifference between subaults an TABLE Age s pacific frequency of occurrence of skeletal lesions for subaults of the Eien population. Age* Ni Devel. Anomalies Class I Periostitis Infectious Disease Osteomyelitis Nutritional Disorers T raunia Total 8 N, /<>..... N..... N o (). N 6 /v..... N r a *Age is expresse in evelopmental years. Note: Because no cases of Class II anomalies, egenerative conitions, or tumors were note for the subaults, these lesions were omitte from the table. Ni = number of subaults in each age class. N = number of subaults in each age class with the specifie lesion or isease. TABLE Age specific frequency of occurrence of skeletal lesions for males an females in the Eien population. Age* Sex Class I Class II Periostitis Osteomyelitis Degenerative Pathology Nutritional Disorer Tumors Trau ma Ni N <;; N ';;. N iy N N N N O Total Total a. 6. Gran Total *Age is expresse in evelopmental years. Ni = Number of iniviuals stuie. N = Frequency of ifferent types of lesions or isease.

4 8 J. W. LALLO AND J. E. BLANK Vol. aults for Class II anomalies was significant at the level (x =.6). The ifference observe between ault males an females for the total frequency of evelopmental anomalies was significant (x =.6). The ifference between ault males an females for Class I anomalies was not significant, however, the ifference between the sexes for Class II anomalies was significant at the level (x =.8). If the Class I anomalies were primarily genetically etermine, then the results suggest that there was little genetic ifference between the subaults an the aults an between the ault males an females. This inicates a relatively homogenous an continuous genetic population at Eien. Alternative interpretations inclue: Class I anomalies may be influence by variables other than genetic, or that the stuy sample may be biase. Since Class II anomalies were primarily stress relate (effects of wear an tear), it is suggeste that males at Eien were subjecte to greater physical stress or were more susceptible to the effects prouce by such stress. At Eien, ifferential role behavior (e.g., horticultural activity, hunting, or warfare) may account for the higher frequency of Class II anomalies among the males. IN FECTIOUS ) SHASES The infectious iseases which were tentatively iagnose for the Eien population inclue periostitis an osteomyelitis. Both of these are bacterial infections have their most frequent expression on the long bones. In the iagnosis of periostitis, we relie upon macroscopic an raiographic examination. Macroscopic analysis note both estructive an regenerative changes which occurre on the periosteal surface. Raiographically, the estructive an regenerative changes were confine to the periosteal region an i not exten into the cortex or the meullary canal. Osteomyelitis cause a much more severe estruction of the osseous material an the infection penetrate the enosteum an entere the haversian an lacunar systems. Macroscopically, we note large areas of sclerosis in the metaphyseal area of the tibia an the femur, both of which also ha sinus tracts which were clearly visible. On several of the subault specimens the sequestrum an the involucrum were ientifie. The causative agents responsible for these bacterial infections are ifficult to efine. Robbins () pointe out that some form of streptococci or staphylococci is most commonly responsible an reaches the bone through hematogenous seeing, irect extension from a neighboring focus of infection, or as a consequence of trauma which exposes the bone to bacterial contamination. For the Eien population all three pathways were potential sources of the infections. On a populational level (ages through. years), 68. (8) of the inhabitants of Eien ha some form of infectious isease (table ). Of these 8 cases,. (6) were tentatively classifie as periostitis, an.6 () as osteomyelitis. For the subaults, 8. () ha some form of infection while.8 (6) of the aults manifeste a lesion. Of the cases of infection among the subaults, 6. () were periostitis, an. (6) were osteomyelitis. For the aults, 8. (6) of the cases were iagnose as periostitis, an 8.8 () as osteomyelitis. Among the ault males, 8. () ha bony infections of which. () were ientifie as periostitis, an.. (8) as osteomyelitis. For the ault females,.8 () ha infections of which 8. () were periostitis, an. () were osteomyelitis (table ). The age specific frequencies of infectious isease for the subaults, an the ault males an females, were presente in tables an, respectively. On a populational level periostitis ha. a significantly higher (p <.) frequency of occurrence than osteomyelitis (x =.8). The aults ha a significantly higher (p <.) frequency of total infectious iseases than i the subaults (x = 8.). In aition, the aults ha a significantly higher frequency of periostitis than the subaults (x =.8). The subaults ha a higher frequency of osteomyelitis but the ifference observe between subaults an aults was not significant. Within the subault segment of the Eien population, periostitis

5 No. ANCIENT DISEASE IN OHIO TABLE Frequency of occurrence of infectious isease in the Eien population. Age* ' Fotal N, 8 N () 8 (N i)* G8. 8 N G G Periostitis (N.o* <; i,(n )t. G..8 GO.. GO.O N, G 8 Osteomyelitis /o l- N i /.. 8. G.. G G *Age is expresse in evelopmental years. Ni = number of iniviuals in each age class. \* = number of iniviuals in each age class with an infectious isease (combine frequency of Periostitis an Osteomyelitis). N;) = number of iniviuals in each age; class with Periostitis. N = number of iniviuals in each age class with Osteomyelitis. * = the frequeney of iniviuals in each age class with an infectious isease erive from the totals in column Ni. t = f ne frequency of each type of infectious isease out of the total number of cases of infectious isease for each age class in N. ha a slightly higher frequency than osteomyelitis but the ifference was not statistically significant. For the ault segment, periostitis ha a higher frequency of occurrence than osteomyelitis an the observe ifference was significant at the level (x =.). There was no significant ifference between ault males an females for the frequency of occurrence of infectious iseases. The ault males ha slightly higher frequencies for both periostitis an osteomyelitis but the ifferences were not statistically significant. Using contemporary clinical pathology an cultural anthropology concepts, it may be possible to speculate on the cultural-ecological context within which the infectious iseases at Eien may have begun. For example, Robbins () suggeste that the bacterium Staphylococcus aureus is the agent most commonly responsible for periostitis an osteomyelitis. It can be suggeste that any variable within the environment of the Eien population which brought it into contact with this bacterium, or one similar to it, may be an important agent in the etiology of the bony infections. May (6) suggeste a moel in which culture functione as a variable in the environment of a human population an also playe an important role in the isease experiences of that population. In this moel, culture can serve a ual role. It can function either as a wall or a link between human populations an the iseases or isease agents which exist in the environment. Application of May's moel to the Eien population, suggests that any aspect of culture (e.g., technology, social organization, or ieology) which ha brought the population into contact with bacterium coul result in an increase in the frequency of the bony infections. Likewise, any aspect of culture which functione to keep the people of Eien out of contact with bacterium woul result in a reuction of the frequency of the bony infections. It must be emphasize that this is only a speculative suggestion but it oes provie a moel which can be teste by aitional archaeological research at Eien. It shoul be note that for the Eien population the iscussion of infectious isease has focuse upon periostitis an osteomyelitis. There are other classes of infectious iseases which may have occurre among the inhabitants of Eien but infections confine to soft tissues or organ systems o not leave their imprint on the skeletal material. An analysis of paleopathology which is confine to bony material can only ientify lesions which leave their imprint on bone. As a result, there are numerous classes of iseases an anomalies for which ata cannot be collecte an our analyses probably ten to unerestimate the actual

6 6 J. W. LALLO AND J. E. BLANK Vol. frequency of iseases an anomalies in the Eien population. DEGENERATIVE PATHOLOGY The egenerative pathology tentatively ientifie on the Eien skeletal material was limite to probable osteoarthritis. The istribution at Eien was, in orer of ecreasing frequency: the acetabulum an the hea of the femur, the istal femur an the proximal tibia, the spinal column (cervical, lumbar, an thoracic), the proximal humerus, the istal humerus, the proximal ulna, an the raius. Surface erosion mae it ifficult to observe the small bones of the hans an feet. As a result, these observations were omitte from the report. On a populational level, 6. () of the inhabitants of Eien manifeste osteoarthritis an none were among the subaults (table ). Out of ault males, 6.8 () showe the lesion; whereas, only. () of the ault females isplaye osteoarthritis. The finings suggeste that the ault segment of the population ha a higher frequency of occurrence of osteoarthritis than the subaults an that the ault males ha a higher frequency than the females. The ifference observe between the subaults an aults was significant at the level (x =.), an the ifference between the males an females was also significant (x = 6.86). Robbins () suggeste that osteoarthritis was most commonly the result of age an/or repeate trauma acting inepenently or in conjunction. At Eien, osteoarthritis was confine to the ault segment of the population. This fining strongly suggests that the lesion was age relate. As a probable cause of osteoarthritis, the role of repeate trauma may account for the ifference observe between ault males an females. For example, ifferential cultural role behavior such as horticultural activity (e.g., the breaking of new groun) an hunting may have contribute to the occurrence of osteoarthritis among the ault males. For the ault males, the lesion ha its most frequent expression in the acetabulum an hea of the femur. These were followe in frequency by the istal an proximal tibia, the proximal humerus, an the spinal column. This pattern of istribution involve the major weight bearing complexes of the boy an may reflect the strains of male oriente activities. The ault females however, ha low frequencies of involvement for these weight bearing complexes but higher frequencies in the istal tibia an fibula. Since the pattern of role behavior cannot be known for certain, these interpretations shoul be mae with caution. A POSSIBLE NUTRITIONAL DISORDER Porotic hyperostosis is a general term for a variety of bone isorers characterize by rarification. Terms such as symmetrical osteoporosis, cribra orbitalia, cribra cranii, an hyperostosis spongiosa have been use in place of porotic hyperostosis. Armelagos (6) suggeste the use of specific terms which escribe specific lesions an reference their location. These terms are: osteoporotic pitting, spongy hyperostosis, an cribra orbitalia. Osteoporotic pitting refers to lesions which consist of small pits on the external table of the cranium an correspon to the "porotic type" of Nathan an Haas (66). Spongy hyperostosis or hyperostosis spongiosa is characterize by the appearance of osteophytes which form a network of trabecula-like bone on the external table of the cranium (Putschar 66). The term cribra orbitalia was first employe by Welcker (888) an refers to a lesion locate on the superior wall of the ocular orbit. It exhibits close ties, both raiographically an physiologically to osteoporotic pitting an spongy hyperostosis. The lesion can be characterize by tiny porous openings in the roof of an orbit (either unilaterally or bilaterally), or as an extension of cribrous bone into the area of the orbit. Although these terms are use to specifically reference the location of the lesions, all of the cranial lesions are an expression of a general marrow hyperplasia. Recently several investigators suggeste that the lesions were the result of a general ietary iron eficiency anemia (Carlson et al ; El-Najjar et al ). On a populational level, 6. () of the inhabitants of Eien showe some form of porotic hyperostosis. In all

7 No. ANCIENT DISEASE IN OHIO 6 specimens the lesion was ientifie as cribra orbitalia. In aition to the cribra orbitalia, 6. () of the cases also isplaye a postorbital involvement. That is,. () of the cases of cribra orbitalia also ha osteoporotic pitting;. () also ha spongy hyperostosis; an. () ha both osteoporotic pitting an spongy hyperostosis along with the cribra orbitalia. In. (8) of the cases of porotic hyperostosis, cribra orbitalia occurre as an isolate lesion but none of the examples of the postorbital involvement occurre without the presence of cribra orbitalia. Of the subaults in the sample,.6 (6) manifeste porotic hyperostosis whereas only. () of the aults showe the lesion (tables an ). For the ault males at Eien the frequency of the lesion (table ) was. (), while for females it was 8. (). None of the aults showe any evience of postorbital involvement but. () of the subaults isplaye the postorbital lesion. The ifference observe between subaults an aults was significant at the level (x =.6) but the ifference observe between males an females was not significant. NEOPLASTIC LESIONS The analysis of the Eien skeletal material reveale that 6.6 (6) of the aults ha some form of neoplastic lesion (table ) but none were foun in the subaults. Of the ault males,. () ha a tumor, while 8. () of the ault females showe the lesion. Four of the tumors were classifie as benign osteomas (button tumors) an as benign hemangiomas. The osteomas were locate on the parietals of four of the ault females. One of the hemangiomas was locate in the bicipital groove of the left humerus of an ault male, while the other was on the right ilium of an ault male. The ifferences observe between the subaults an aults, an between ault males an females were not statistically significant. FRACTURES On a populational level,. () of the inhabitants of Eien showe a well heale traumatic lesion. Since all of the observe fractures were heale, it was assume that they occurre long before eath. Of the fractures, ha heale without misalignment or excessive callus formation. It was ifficult to etermine if the aligne fractures were artifically set or manipulate. Of the subaults in the sample, 6. () ha fractures an in both cases the lesions were locate on the femur (table ). Of the aults,. () ha fractures,. () in males, an 6. () in females (table ). For ault males, the fractures were locate on the fibula an for the females, of the fractures were locate on the ulna. None of the observe ifferences were statistically significant. Acknowlegments. We wish to express our graitue to all of the members of the Lorain County Metropolitan Parks Commission, an especially to Mr. Henry Minert an Mr. Wallace Chapla, for permission to use the Eien skeletal material. We wish to thank Dr. M. A. Lessler for his assistance in the preparation of this paper. LITERATURE CITED Anerson, J. E. 6. The human skeleton: a manual for archaeologists. National Musseum of Canaa, Toronto, p Skeletal anomalies as genetic inicators. In: D. R. Brothwell, e., The skeletal biology of earlier human populations. Symp. Soc. for the Stuy of Human Biol., Vol. 8. Pergamon Press, Lonon, pp Armelagos, G. J. 6. Future work in paleopathology. In: W. D. Wae, e., Miscellaneous papers in paleopathology: I. Northern Arizona Soc. Science an Art. p. 8. Ascai, J. R. an J. Nemeskeri.. History of the human life span an mortality. Akaemia, Buapest, pp. 6-. Berry, R. J. an A. C. Berry.. Epigenetic variation in the human crania. Amer. J. Anthropol. : 6-. Brothwell, D. R. 6. Digging up bones. British Museum of Natural History, Lonon, pp. -. Carlson, D. S., G. J. Armelagos an D. P. VanGerven.. Factors influencing the etiology of cribra orbitalia in prehistoric Nubia. J. Human Evol. : -. Ditch, L. an J. Rose.. A multivariate ental sexing technique. Amer. J. Phys. Anthropol. : 6-6. El-Najjar, M. Y., Lozoff, B. an D. Ryan.. The paleoepiemiology of porotic hyperostosis in the American Southwest: raiological an ecological consierations. Amer. J. Roentgen. Raium Ther. Nuclear Me. : 8-.

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