Kitty Ford

SE569 - Autumn 2013

Can bone trauma provide palaeopathological evidence of care and

conflict in the past?
Introduction
Bones can tell us much about that individuals life and also inform us
of the lifestyle, behaviours, traits and demographic of the broader
population (Roberts and Manchester, 2010). When studied in the
historical context, the skeletal remains of humans, and of our close
relatives in the genus Homo, provide unique evidence of the lives of
those in the past and the diseases and tribulations that affected
them

(Owens

2007;

Dettwyler,

1991).

Palaeopathological

assessment can often shed light on pre-historic populations where

little was previously known due to the lack of written or artistic
artifacts (Owens, 2007). This essay will use four such examples from
Iraq, Egypt, the Canary Islands and Vietnam, to assess how
palaeopathological analysis of skeletal trauma can offer insight into
whether the individual or population experienced conflict or on the
other hand, if care giving was present.
Trauma, according to Roberts and Manchester (2010), can be
defined as any bodily injury or wound (p. 84), they go on to divide
trauma into four categories (after Ortner and Putschar 1981: p. 55):
fractures (including amputation and trepanation), dislocation of a
bone, disturbance to the nerves or circulation and purposeful
deformation of the skeleton (Roberts and Manchester, 2010: p. 84).
Roberts

and

Manchester

continue

by

saying

that

the

palaeopathological evidence of antemortem trauma that remains in

the archaeological record is but a small part of the total spectrum
of injury affecting populations (2010: p. 85) and represents only
severe injury that has affected the bone, as described above. The
majority of soft tissue trauma will leave no evidence on the bone,
and if the lesion does affect the metabolism of the bone, the

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SE569 - Autumn 2013

evidence left can often only act as the basis of inference rather than
a direct conclusion of the injury (Roberts and Manchester, 2010: p.
85).

Discussion
A

commonly

cited

example

of

antemortem

trauma

in

the

osteological record is that seen on the remains of the Shanidar

Neandertals (Homo neanderthalensis) of Iraq (Dettwyler, 1991;
Trinkaus and Zimmerman, 1982). I believe the trauma experienced
by these individuals gives rise to evidence of care giving, and
possibly interpersonal conflict in the past. Of the seven adult
Neandertal, four had evidence of antemortem trauma: Shanidar 1,
3, 4 and 5 (Trinkaus and Zimmerman, 1982: p. 61). Shanidar 1,
dating to around 45,000 years ago, exhibits multiple trauma as well
as degenerative joint disease (DJD) (Trinkaus and Zimmerman,
1982: p. 62). Shanidar 1 would have been without the use of his
right arm, due to paralysis with hypotrophy/atrophy (1982: p. 64)
of the right humerus, clavicle and scapula, and would have also had
problems with mobility, or at least pain, due to a the DJD in his right
ankle and knee (Trinkaus and Zimmerman, 1982: p. 62). Shanidar 1
also suffered a crushing fracture to his left orbit possibly causing
blindness (Trinkaus and Zimmerman, 1982: pp. 68 70) as well as
scalp wounds that damaged the periosteum but did not fracture
the frontal bone (p. 68). Shanidar 3, also an adult male of 35 50
years old, but from an earlier date in time (p. 62), sustained an
antemortem injury to the superior margin of his 9 th rib, caused by a
penetrating instrument (p. 71), that Trinkaus and Zimmerman
interpret as a result of interpersonal conflict due to the angle of
entry (p. 72). Although there is evidence of healing, Shanidar 3 may
only have lived a few weeks after sustaining this injury, as it is
highly likely to have caused pulmonary trauma (Trinkaus and

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SE569 - Autumn 2013

Zimmerman, 1982: p. 72).

According to Trinkaus and Zimmerman, the trauma observed on
Shanidar 1 and Shanidar 3 (see pp. 70 72) provides direct
evidence of conspecific care in Neandertal populations due to their
inferred incapacitation, but also due to the amount of healing and
resorption of the calluses (1982; p.69 and 75). Shanidar 1
specifically, lived many years after his injuries occurred, despite
their seemingly debilitating affect. (Trinkaus and Zimmerman,
1982).

When combined with the evidence of trauma provided by

the other Shanidar Neadertal remains, Trinkaus and Zimmerman

conclude, this elevated level of risk suggests that life among the
Neandertals was indeed harsh and dangerous (p.75). I would go on
to infer that the high occurrence of trauma in all known Neandertal
specimens

(Trinkaus

and

Zimmerman,

1982:

p.75)

suggests

interpersonal conflict was present in Neandertal society.

The work of Trinkause and Zimmerman on the Shanidar Neandertals
does provide much insight into the trauma and possible care giving
in past Neandertal populations, but I think it is important to share
the critical sentiment of those such as Dettwyler (1991) when
considering how Anthropologists of many sub-disciplines infer past
behaviour from fossils and bones, especially the behaviour of the
broader social group. It is possible, for instance, in the case of the
Shanidar Neandertals that there was no care given, and these
individuals fended for themselves. Perhaps a comparative approach,
such as that used by David DeGusta (2001) to compare trauma in
hominins and non-human primates, could help clarify the Shanidar
picture.
Wheeler et al. discuss an example of trauma in Egypt dating to the
first half of the first century CE (2013). In this case, the excavated
skeleton of a young child shows significant evidence of abuse,

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SE569 - Autumn 2013

almost certainly leading to its death. The trauma present in the

skeleton is in line with modern clinical studies of child abuse related
trauma (Wheeler et al., 2013). This is a rare example of nonaccidental child trauma in the archaeological record (Wheeler et al.,
2013: p. 71) and gives sound evidence that children suffered at the
hands of abusers in Egyptian society at the time, something that is
unlikely to be recorded in artifacts or scripts from the period.
L.S.

Owens

provides

an

almost

unequivocal

example

of

interpersonal conflict on a more military scale, supported by

palaeopathological evidence of trauma in the pre-historic Canary
Islands, which is validated by written evidence from Europeans
scribes from the time of colonisation in the 15 th Century (2007). Of
the 662 cranial specimens that where examined 16% (n=106) were
found to have suffered at least one traumatic lesion and four
unequivocally perimortem lesions were noted (Owens, 2007: p.
469). Furthermore, Owens examinations also determined that
cranial lesions were more common that facial trauma, that the left
side of the cranium was more likely to be host to trauma than the
right and that 25% of male crania showed evidence of lesions,
apposed to only 13% of female crania (pp. 469, 472-475). Of the
non-fatal (healed) fractures, the majority were depression fractures
which would be in keeping with the historical accounts of the
weapons used by Pre-Hispanic Canary Islanders (PCIs), particularly
clubs and slingshots (Owens, 2007). Owens infers from this data,
and results from an ecological profiling, that the trauma was due to
purposeful acts of interpersonal violence (social reasons), rather
than

accidents

(ecological

reasons),

and

differences

in

the

occurrence of trauma between the sexes means domestic violence

is an unlikely cause (Owens, 2007: p.475). He says cranial
trauma is more closely linked to interpersonal conflict, both with
and without weapons. (p.475). Two cranium from the PCI sample
that stand out are those of an adult female and an adult male who

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SE569 - Autumn 2013

suffered fatal blows to the frontal and parietal bones from a metal
blade, which were not used by PCIs. I feel Owens has presented
almost indisputable evidence of interpersonal conflict in a past
population, helped by a large sample size and historical writings
from the time, which give us an insight into how Pre-Hispanic Canary
Islanders fought between themselves, and with Europeans when
contact was made (Owens, 2007).
One of literatures strongest examples of care giving in the past
based on palaopathological evidence comes from Tilley and
Oxenham. Man Bac Burial 9 (M9) was a male between 20 and 30
years old (p.36) who had lived without the use of his limbs for
around 10 years before death. Tilley and Oxenham describe his
pathologies as such:
extreme disuse atrophy of lower and upper limbs, full
ankylosis of all cervical and the first three thoracic
vertebrae,

permanent

torticollis,

and

bilateral

temporomandibular joint degeneration. A diagnosis of

Klippel-Feil Syndrome (KFS) Type III has been proposed
(Oxenham et al., 2009) (2011: p.36)
It is certain that M9 would have been unable to care for himself after
the onset of KFS, as he had no use of his limbs and would have had
limited head movement. This, as Tilley and Oxenham have inferred,
means he would have needed high levels of care and would have
been entirely dependent on others in every aspect of life, from
hygiene to transport, feeding to keeping warm (2011). Interestingly,
the lack of trauma evident in M9s skeleton despite its gracility is
an indicator of such attentive care giving (Tilley and Oxenham,
2011: p.39). Two of the biggest risks to quadriplegic individuals are
infection due to pressure sores and bone fracture (p.39), neither of
which are present in the skeleton. Tilley and Oxenham provide an

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SE569 - Autumn 2013

example of prehistoric care giving to an individual who could not

actively contribute to the community, but survived for around 10
years

because

of

the

help

of

others.

In

this

example

palaeopathological evidence provides information about the social

realm of a prehistoric population, and inferences can be made about
altruism in the Man Bac community at the time (Tilley and
Oxenham, 2011).
Conclusion
Palaeopathological evidence does provide evidence of care and
conflict in the past, but researchers should be careful about how the
physical information presented by a skeleton is inferred as
behavioral information (Dettwyler, 1991). The Neadertal skeletons
presented by Tinkaus and Zimmerman may provide evidence of
conflict and care giving, but it is difficult to say for absolute certain.
Owens example from the crania of PCIs is substantial evidence of
conflict in a past population that is present in both the osteological
and written record. On the other hand Wheeler et al. provide
evidence on an unseen side of conflict: child abuse (2013). Tilley
and Oxenham (2011) provide almost indisputable evidence that
ancient peoples provided care to others, and it this specific case,
altruistically in terms of material resources. What this essay has
shown is that skeletal remains can provide evidence of past social
behaviour, but care must be taken when inferring what life was like
for past peoples. It must also be considered that not all traumas as a
result of conflict, and not all evidence of care giving, will be retained
in the skeleton.
Word Count excluding references and reference list: 1568
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SE569 - Autumn 2013

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Care

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Middle

Pleistocene

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