Paleopathology in an Iroquoian ossuary, with special reference to tuberculosis

Pathological skeletal remains from the Uxbridge Ossuary (1490 +/- 80 A.D., N = 457) are classified into four broad categories: trauma, congenital disability, tumor, and infection. Traumatic injuries are relatively common (fractures in 5-9.4% of total), considering the date and subsistence pattern of the population. Congenital disabilities and tumors are rare, affecting approximately 2% of the population. Nonspecific periosteitis and osteitis affect 5% of the sample. By far the most common pathological skeletal changes are lytic lesions leading to cavitation of cancellous bone, especially in the lower vertebral and sacro-iliac regions. It is argued that the changes seen and their distribution are most consistent with a diagnosis of tuberculosis. Applying clinical observations regarding bone involvement, it is estimated that a minimum of 26 skeletons were affected. This in turn indicates a very high population tuberculosis incidence. The Uxbridge sample is neither the only nor the earliest Iroquoian ossuary to display apparent tuberculosis (Hartney 1981). The common presence of this disease in some communities and its low incidence in others are discussed in the context of the epidemic wave phenomenon. There is strong evidence for warfare at Uxbridge, and this warfare may have produced crowding, poor hygiene and diet, such that the disease could flourish.