3.0 Lessons from Human Palaeopathology

Human palaeopathology has long been a central element within human osteology (Aufderheide and Rodríguez-Martín 1998, 2-7). Advances in bioarchaeological method and theory have necessitated an expansion in data collection protocols within human osteology, but there has frequently been significant variation in practice between researchers. Although this is a sign of a robust and growing discipline, it has made it increasingly difficult to compare findings between investigators. One factor that has made it particularly urgent to standardise methodologies has been the increase in repatriation and reburial of human remains. There is a potential loss of information involved in every case of reburial and protocols are therefore required to ensure comparisons can be made even when the collection itself is no longer available for study (Larsen 1997, 340). In Britain, a further factor driving the move towards standardisation in recent years, following the publication of PPG16 (Department of the Environment 1990), has been the emergence and expansion of commercial archaeology, where osteoarchaeological analyses have been conducted by people working within tight budgets and short time schedules. This has had an inevitable effect on post-excavation analysis. As Roberts and Cox (2003, 84) note, many reports do not contain basic site and preservation data necessary to calculate meaningful prevalence rates, and descriptions are often not sufficient to support diagnoses. These deficiencies can compromise later comparisons between sites, and have highlighted the need to develop a standardised approach. While it must be stressed that disease processes in human and other animals are, for the most part, not directly comparable, this section seeks to consider the applicability of the generic recording systems developed within human osteology for animal palaeopathology.

In order to address increasing concern over data loss following repatriation, a recording standard (Buikstra and Ubelaker 1994) was developed by a group of biological anthropologists to serve as a guide to data collection. This protocol proceeds from the initial skeletal inventory through the determination of age and sex, measurement, pathology, non-metric traits, taphonomy, cultural modifications, biochemistry and microstructure and lays out a coding procedure for pathologies that is closely integrated with the inventory process. These numerical codes are recorded on two recording forms, one relating to alterations in shape and size, bone loss and formation, fractures and porotic hyperostosis, the other to vertebral pathology, arthritis and miscellaneous conditions. While reasonably comprehensive, this system is not intuitive and requires extensive use of a key, a criticism also voiced by Brickley and McKinley (2004, 36). This is a valid concern given the restrictive time limits and budgets imposed by contract archaeology.

Partly in response to this issue and in recognition of the problems with osteoarchaeological reporting within a commercial context, the Institute of Field Archaeologists in the United Kingdom has produced a guide outlining an appropriate minimum standard record of an assemblage (Brickley and McKinley 2004). This includes an inventory of the bones present, the prevalence and description of pathological lesions and non-metric traits, the age and sex of the individual and metric data.

With specific regard to recording palaeopathology, the authors stress the importance of description over diagnosis, and the need for unambiguous terminology (Brickley and McKinley 2004, 34). Their step by step procedure (2004, 35) is as follows:

Which bone/tooth is affected (including side)
What part of the bone/tooth (e.g. proximal shaft), and aspect (e.g. medial) is involved, using anatomical terms)
What is the nature of the lesion itself? Is it a forming, destroying or mixed lesion?
If bone has been formed, is it woven (porous, disorganised and indicating active disease at the time of death) or lamellar (smooth and organised, indicating a healed and chronic lesion) or is it in the process of healing?
If bone has been destroyed, is there any sign of healing e.g. rounding of the edges of the lesion
What is the distribution pattern of the lesions if more than one bone/tooth is involved? Different disease processes have different patterning (e.g. leprosy affects the facial, hand and foot bones)
Can the abnormality be measured and compared with the normal opposite side?
Consider all potential diagnoses for the abnormalities recorded (differential diagnosis)

Though such recording systems cannot be directly transferred into animal palaeopathology, there is still much that those specialising in animal palaeopathology can learn from their colleagues in human palaeopathology, and vice versa. Moreover, although the research questions asked by osteologists of human palaeopathological data are unquestionably different from those asked by zooarchaeologists, disease processes in humans and other animals share many of the same characteristics. As Luff and Brothwell (1993, 101) note, 'the bone of both humans and other vertebrates reacts to stress (disease) in similar ways by bone remodelling'. It thus follows that any generic guidelines for human osteology are potentially applicable within an archaeozoological context.

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