Arthritis in the prehistoric Southeastern United States Biological and cultural variables.код для вставкиСкачать
Arthritis in the Prehistoric Southeastern United States: Biological and Cultural Variables CHARLES HUDSON, RONALD BUTLER AND DENNIS SIKES Department of Anthropology, Department of Veterinary Pathology, University of Georgia, Athens, Georgia 30602 KEY WORDS Arthritis . Erysipelothrix insidiosa . Prehistoric. ABSTRACT Recent research shows that a bacterial life form, Erysipelothtix insidiosa, can produce rheumatoid arthritis in deer, swine, and dogs, and that a number of animals, including man, birds, and fish, may be infected by the organism. Examination of the archaeological record suggests that both cultural and biological variables may be interrelated in the maintenance of some forms of arthritis over long periods of time in geographically disparate populations. Re-examination of Cherokee folk beliefs concerning arthritis suggests that they had some recognition of this connection, and it also suggests that the term ‘‘magical’’ may relate more to the world view of the observer than to any actual inability of preliterate peoples to draw causal relations on the basis of their own intimate knowledge of their environments. Arthritis in its several forms is among the oldest known diseases afflicting vertebrates. The temporal range of arthritis extends from PZatecarpus, a swimming reptile of 100 million years ago (Hollander, ’62) to recent life forms. Documentation of one or more forms of arthritis in populations of Homo include Neanderthal (La Chapelle aux Saints), ancient Egyptian nobility (Harris and Weeks, ’73), and numerous others (Brothwell, ’65; Wells, ’64, for a general overview). Despite its prevalence in both recent and prehistoric populations, however, arthritis has remained something of a mystery disease, both in terms of causative factors, medical definition, and even diagnosis, especially diagnosis of skeletal material. And, although archaeologists have unearthed scores of burials showing the presence or presumed presence of the arthritides, it has not been understood how the disease is maintained and how it has continued over long periods of time in geographically disparate populations. We have examined the problem in a single area, the aboriginal Southeastern United States, from two perspectives : one focused on the belief system of the Cherokee Indians fur the light it sheds on AM. J. PHYS.ANTHROP.,43: 57-62. cultural and ecological considerations of arthritis, and the other on related biological factors such as causative factors and disease transmission and maintenance. The Cherokee Indians of the Southern Appalachian Mountains held a number of folk beliefs about arthritis. Their word for both rheumatism and arthritis is didv.le. hsgi, but arthritis is sometimes distinguished a s udhu-n didu.le-hsgi, where udhv.n means “big.” The word literally means “it breaks them,” evidently alluding to the fact that the pain of arthritis is like that of a broken bone (King, ’74). One of the central tenets of the Cherokee theory of medicine is that a fundamental enmity exists between man and animals: m a n kills animals for food, and sometimes he kills animals carelessly; i n revenge, the animals afflict m a n with various illnesses (Mooney, ’00:250-252). Consistent with this, they believed that the disease we might now classify as one of the deforming and crippling forms of arthritis was associated with animals that “hump” their backs, such as the bison, squirrel, rabbit, cat, inchworm, sunfish, buffalo fish, and speckled trout. A person suffering from arthritis was advised to abstain from eating the flesh of these animals and, for the same 57 58 C. HUDSON, R. BUTLER AND D. SIKES reason, the sufferer was required to abstain from petting dogs and cats (Mooney, ’32: 291-294). Conventional wisdom in anthropology tells us that this is homeopathic or imitative magic: it is a superficial resemblance magnified into a causal connection. The Cherokees also believed that arthritis could be caused by violating rules of sexual behavior, particularly the crime of incest (Mooney and Olbrechts, ’32: 196). Here, too, anthropological theory gives us a quick and ready answer. Namely, the belief that one can be afflicted by arthritis a s a consequence of committing incest is obviously magical and wrong-headed, but it nevertheless serves society by having a useful function: namely, it functions to discourage incest and its attendant social disruption, thus strengthening and perpetuating the social order. The Cherokees believed in yet another cause of arthritis: if a hunter killed a deer without begging pardon of the deer’s spirit, then the Little White Deer, the guardian spirit of the deer species, would follow the trail of blood to the hunter’s cabin to enter him invisibly, afflicting him with crippling arthritis (Mooney, ’00 : 250-251; Mooney and Olbrechts, ’32: 205-208). Although anthropological theory cannot explain this belief quite so readily as it can the other two, a plausible explanation can be found. That is, given the Cherokee assumption that vengeful animals cause many of man’s illnesses, it would make sense that they would make a connection between their most important game animal and one of their most dreaded diseases. Both archaeological and historical evidence attest to the paramount importance of the white-tailed deer (Odocoileus virginianus) as a game animal for the Cherokees as well as for other Southeastern Indians, both in the remote prehistoric past and throughout the colonial period. Arthritis was a particularly crushing affliction for the Cherokees. Until the coming of European diseases such as smallpox, it was perhaps the most feared of all illnesses, particularly for a man. In traditional Cherokee culture the ways in which most men won the respect of their fellows was in hunting, the stickball game (a form of lacrosse), and warfare. All of these pursuits required exceptional agility, dex- terity, and endurance, which would have been lessened or ruined by crippling arthritis. Thus, it can plausibly be argued that the Cherokees did indeed make a magical connection between (1) their most important game animal and ( 2 ) a dreaded disease. Biological and ecological variables Recently, research by one of us (D.S.) and associates in the Department of Veterinary Pathology at the University of Georgia has suggested that while the language of this belief i n deer-caused arthritis is poetic or “magical,” it may nevertheless point to a valid biological causative factor. The only known infectious agent which has been proved to produce rheumatoid arthritis in deer, swine, and dogs is a bacterial life form, Erysipelothrix insidiosa a n organism widespread in nature which infects a variety of animals, including man, birds, and fish (Sikes, ’67, ’68, ’69b). The relationship between the organism and the more severe form of arthritis i n Homo sapiens remains to be demonstrated fully, but positive serologic tests have been recorded in the blood serum of human patients suffering from rheumatoid arthritis, suggesting strongly that these individuals had been exposed to the organism (Sikes et al., ’72). The suggested relationship is reinforced by experimental work i n which rheumatoid arthritis has been produced in swine infected with isolates of E . insidiosa of human and porcine origins. Additionally, there are reported cases of humans contracting arthritic pathologies after handling infected animals and bones, although the specific etiologic agent in these cases was unknown (Sikes et al., ’56). In white-tailed deer experimentally injected with E. insidiosa, all innoculated deer joints develop acute arthritis which spreads to other joints, becomes chronic, and persists. Innoculated animals exhibit periods of clinical remissions and exacerbations just as they occur in man. During periods of exacerbation, the severity of the lameness increases in cold, damp weather (Sikes et al., ’56). I n all cases, pathologic tissue changes in the joints of arthritic deer are similar to those in man and swine with rheumatoid arthritis, and the same I ARTHRITIDES basic pathogenesis may be operative in all these species (Sikes, ’69a). I n a recent experiment, approximately 30% of a sample of wild white-tailed deer from the Southeastern United States showed low titers to the Erysipelothrix tube test (Sikes et al., ’72). This suggests that some members of this deer population are potential sources of infection which may produce arthritis. Notably, the clinical manifestation of ankylosing spondylitis i n some deer specimens is grossly and histologically indistinguishable from the same manifestations i n man. The variety of arthritis in question also is referred to variously as Marie-Strumpell’s disease, bamboo spine, or poker spine. All involve varying degrees of calcification of ligaments, ranging from the sacroiliac articulations and a few vertebrae to advanced bony fusion of the spine. Evidence of arthritis in the prehistoric Southeastern United States According t o the work of a large number of researchers, the archaeological record for the southeastern portion of North America shows a high incidence of what has been interpreted a s arthritic afflictions i n man, a record ranging from very early times up to historic populations. Further, there are few, if any, sites in this area which do not show a high incidence of deer bone a s well. In excavating the Stanfield-Worley Bluff shelter in Colbert County, Alabama, DeJarnette, Kurjack, and Cambron (’62) encountered a high incidence of white-tailed deer remains, with some dating to 5,000 years before the present. Much of the deer bone from this site seems to have been broken intentionally, probably to obtain marrow, and the frequency of recovered bone suggests that the white-tailed deer was the basic meat staple. Fragmentary human remains representing 13 individuals were recovered, and, of these, two males and one female show bone pathologies attributed to arthritis. W. D. Funkhouser, reporting on human material from the same general geographical area, observes : “One of the commonest of all types of malformations found in the Alabama material is the fusing of the vertebrae. This condition is perhaps most often noted in 59 the lumbar region, but may be found in any part of the spinal column . . . Such conditions of the vertebrae are usually assumed to indicate some form of arthritis or rheumatism, and, if so, a large number of the aborigines must have suffered from these diseases.” (Webb, ’39: 124.) Marshall T. Newman and Charles E. Snow came to much the same conclusion in their evaluation of human skeletal material from the Pickwick Basin, a n area encompassing adjacent portions of Alabama, Mississippi, and Tennessee (Webb and DeJarnette, ’42: 467) : “The most common affliction of the Pickwick Basin population seems to have been arthritis. This is most usually manifested in hypertrophic form i n the lumbar vertebrae, and in arthritic changes in the sacra. The incidence of arthritic invasions of the lumbar vertebrae was about double that of the cervical vertebrae, while the thoracic seems to be unaffected. Arthritic ankylosis is present in the lumbar vertebrae of three skeletons.” About one-third to one-half of a n adult sample from Moundville, Alabama, were afflicted with hypertrophic arthritis in the lumbar region and show some evidence of what has been interpreted as arthritic pathologies in other parts of the skeleton (Snow, ’41). In another report dealing with material from Norris Basin in East Tennessee, W. C. Funkhouser reports, perhaps with a dash of black humor, on one male of advanced years whose infirmities are rather pronounced : “This old man must have been in bad physical condition since practically all of his skeleton shows some pathological condition, His lumbar vertebrae are fused and lipped, bone destruction is evident i n the femora, radii, innominate, and wrist bones, fusing has occurred in the bones of the hand, extensive periostitis has involved most of the base of the skull, and some sort of osteomyelitis has completely destroyed the left acetabulum and the head of the left femur. In addition, he had a bad case of pyorrhea, with a n excess of bony deposit on the mandible; he had three large molar cavities and his skull was deformed. Aside from this, he was apparently all right - so far as his bones were concerned.” (Webb, ’38: 233). Evidence of what might have been arthritic pathologies also is found in the Hiwassie Island excavations (Lewis and Kneberg, ’46), from the Sours Site in Virginia (MacCord, ’SS), and from Citico on 60 C. HUDSON, R. BUTLER AND D. SIKES the Little Tennessee River (Salo, ’69). Additionally, personal observation by one of the authors (R. B.) confirms what seems to have been severe forms of the arthritides in remains from Indian Knoll, an Archaic site, from the Little Egypt site imnorth Georgia, a site with at least two components (1300-1400 A.D. and 15001700 A. D . ) , and from St. Catherine’s Island, Georgia. The latter site dates to about the 12th Century A. D. by the radiocarbon method. Deer bone is prevalent in both Little Egypt and St. Catherine’s Island. These sites do not exhaust the available reports from the Southeast, but, so far as physical anthropology is concerned, they are representative of the area. In fact, we think it would be difficult to find any excavation in the Southeast with good skeletal preservation where evidence of arthritis is not found. DISCUSSION It must be stressed that the evidence concerning the frequency of deer bone and skeletal pathology interpreted as arthritis in the prehistoric Southeast is not intended as proof of a one-to-one correlation between Odocoileus uirginianus and the presence of the disease. In fact, the data now available suggest a much more complex ecological problem, compounded by the fact that diagnosis of the arthritides from skeletal populations is not a simple and clear-cut process. Other mammals, birds, and fish carry or may be infected by E . insidiosa. Consequently, there are several hypothetical ways in which the organism might be transmitted to man. The most obvious manner would seem to be through the dressing and handling of infected game prior to cooking, which destroys the organism. Ways in which food is prepared are, of course, culturally determined, as are food preferences. Further, there is the problem of how division of labor is assigned within a given culture; that is, males may be responsible for the kill, but there may be a wide range of alternatives available as to who dresses game, or whether uncooked game is handled for ritual or distribution purposes prior to cooking. Other cultural variables, a s well, may be intricately interrelated I with biological factors. Most, if not all, cultures have rules of avoidance which impose taboos on certain types of foods, and which further impose food sanctions during various periods of crisis, as in pregnancy, menarche, preparation for initiation, preparation for war, and so forth. These factors might impose culturallydetermined limitations on the probability of exposure to E . insidiosa within specific age and sex categories in a given culture. Aside from exposure to the organism through direct contact with infected life forms, there also exists the possibility that bird or mammal feces may be responsible for transmitting the disease, and even that other life forms may acquire the organism through exposure to human waste material, as for example, near or in natural water sources, The manner in which undesirable animal parts are disposed of may also be a variable, perhaps in setting up a potential for infection in animals which feed on the waste. Whatever the precise nature of all these possible relationships, the antiquity and widespread geographical nature of arthritis suggests a rather complex nexus of variables in which culture plays a major role in maintaining the disease over a long period of time. In our consideration of the arthritides, we have focused on the severe, deforming varieties of the disease and have not included such pathologies as “osteoarthritis,” which may or may not be the result of continued trauma and skeletal stresses over the lifetime of a n individual (for a discussion of prehistoric “osteophytosis” see Chapman, ’73). Turning now to cultural considerations, these findings raise the possibility that the concept of magic is both ethnocentric and deleterious to a systematic advance of knowledge about man’s ways. If a belief or practice from another culture does not seem reasonable or efficacious with respect to our own world view, we typically declare that it is “magical;” then we search our stock of theories for some sort of “explanation.” Once this is done, we dismiss the belief or practice from further investigation, But the Cherokee belief that arthritis can be caused by a Little White Deer shows that valid knowledge based on extensive observation can be stated in a n 61 ARTHRITIDES exotic idiom (Horton, ’67: 53-58). The Cherokees and their ancestors hunted the white-tailed deer for thousands of years, and it is not difficult to see how it was that they noted a connection between exposure to deer carcasses and the disease we call arthritis, The Cherokees perhaps had some understanding of the causative factors in arthritis long ago, but because they phrased this understanding in the idiom of their own world view, we labeled it as magical and ruled it out of all serious consideration. At this point we may ask to what extent our concept of magic leads us to ignore valid knowledge and testable hypotheses in other cultures, assuming all the while that we have explained them. There is no simple solution to this problem. Instead of banishing all folk beliefs to the realm of magic, where we pay no further attention to them, we could adopt the view that all folk beliefs are scientific until proven magical. But this would be a n overreaction. Some of the beliefs and practices of people in other cultures are erroneous; some of them are erroneous even when they follow logically from assumptions in the world view of the people who hold them (Wilson, ’71). Hence, if we simply banished the word magic from our vocabulary we would have to devise another word to cover the same territory. There is no easy way out. One solution might be that we retain our concept of magic, but only on the condition that we use it with the humility that comes from the realization that we do not have a monopoly on knowledge. In this way we would be conscious of the fact that “magic” refers both to beliefs and practices which are erroneous with respect to what we know, and do not work, and also to beliefs and practices which are not erroneous, and do work, but for reasons which are not clear to us because of our limited knowledge. With this in mind, let us look at another example of magic. The Cherokees treated arthritis with various forms of ritual treatment, but also by giving the patient decoctions made from fern fronds. A Cherokee doctor explained to James Mooney that “the fronds of the young fern are coiled up, but unroll and straighten out as the plant grows;” therefore, a decoction of ferns will give the rheumatic (arthritic) patient the power to straighten out the contracted muscles of his limb (Mooney and Olbrechts, ’32: 53-54). Should we conclude that this use of ferns is yet another example of homeopathic or imitative magic and let it go at that? From the biological perspective, we feel justified in resorting to the hoary ritualistic commentary to the effect that much more remains to be done in clarifying the many interchangeable and inconclusive terms used in defining arthritis and its various manifestations. While we do not detract from the efforts of earlier workers, it is obvious that many of them use the term “arthritis” in a vague manner and usually without giving the bases for their diagnoses. Some of the diagnoses may prove to be incorrect. We do feel that the available data justify drawing a tentative causal relationship between E. insidiosa and rheumatoid arthritis, and possibly between the organism and the variety of arthritis known as Marie-Strumpell’s disease, although there may be other, possibly interrelated etiologies as well. For the time being, there seems to be no reason to attempt direct relationships with so-called osteoarthritis. Finally, we feel justified in suggesting a n integrated attempt to set up biological guidelines for the interpretation of arthritic pathologies in skeletal material, including other vertebrate remains. LITERATURE CITED Brothwell, D. 1965 Digging Up Bones. British Museum, London. Chapman, F. E. 1973 Osteophytosis in prehistoric Brazilian populations. Man 8 : 93-99. DeJarnette, D. 1962 J. Alabama Arch. 7, No. 1-2. DeJarnette, D., E. Kurjack and J. W. Cambron 1962 Stanfield-Worley bluff shelter excavations. J. Alabama Arch. 7, No. 1-2. University of Alamaba. Harris, J . E., and K. R. 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