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Bull. Mm. Soc. Anthropol.

Paris (2011) 23:70-82

DOI 10.1007/s13219-011-0033-3


Paleoepidemiology of pre-Columbian and Colonial Panam Viejo:

a preliminary study
Palopidmiologie Panam Viejo, ltat sanitaire des habitants prcolombiens et coloniaux :
une tude prliminaire

C.M. Rojas-Seplveda J. Rivera-Sandoval J.G. Martn-Rincn

Socit danthropologie de Paris et Springer-Verlag France 2011

Abstract Panam Viejo, a coastal site in the Panamanian hyperostosis and the cultural anomalies. Further investiga-
Pacific, was occupied from ca. AD 850 to 1200 and from tions using an enlarged series should clarify the impact of
the arrival of the Europeans in AD 1519 to 1671. This European contact in this region. To cite this journal: Bull.
paper describes the bone anomalies observed and recorded Mm. Soc. Anthropol. Paris 23 (2011).
in the pre- and post-contact skeletal series from the site.
The bone anomaly frequencies were calculated, taking Keywords Bioarchaeology Gran Darin
their observability into account. A number of changes Paleopathology Pre-contact Post-contact
were found between the two periods, concerning MSM
(Musculoskeletal Stress Markers), DJD (Degenerative Joint Rsum Panam Viejo, un site ctier sur le Pacific pana-
Disease), porotic hyperostosis and trauma, as well as mien, a t occup entre le 850 et le 1200 aprs J.-C. et
changes that are classified as cultural. However, these partir de larrive des europens en 1519 jusquau 1671
differences were significant only in the case of porotic aprs J.-C. Nous avons observ et recens les anomalies
osseuses des sries ostologiques issues du site de la priode
antrieure au contact europen ainsi que de la priode
C.M. Rojas-Seplveda (*) postrieure. Leurs frquences ont t calcules selon
Unit danthropologie : adaptabilit biologique et culturelle, lobservabilit. Plusieurs changements osseux entre les
UMR 6578, facult de mdecine, secteur Nord, deux priodes ont t reprs en ce qui concerne les MOA
universit de la Mditerrane, CS80011,
(marqueurs osseux dactivit), la MAD (maladie articulaire
51, boulevard Pierre-Dramard,
F-13344 Marseille cedex 15, France dgnrative), lhyperostose poreuse, le trauma et les change-
e-mail : clarosepul@gmail.com ments classs comme culturels . Cependant, des diffrences
significatives ont t trouves seulement pour les hyperostoses
Programa de Antropologa, Facultad de Humanidades,
poreuses et pour les anomalies dites culturelles . Dautres
Universidad del Magdalena,
Carrera 32 No. 22-08 Sector San Pedro Alejandrino, tudes et notamment llargissement de la srie devraient
Santa Marta, Colombia claircir limpact du contact europen dans cette rgion.
Pour citer cette revue : Bull. Mm. Soc. Anthropol. Paris
J. Rivera-Sandoval
23 (2011).
Universidad Nacional del Centro de la Provincia
de Buenos Aires, Av. Del Valle 5737, Olavarria,
Provincia de Buenos Aires, Argentina Mots cls Bioarchologie Gran Darin Palopathologie
Prcontact Postcontact
Fundacin Erigaie, Calle 10 No. 3-76,
Bogot D.C. Colombia

J.G. Martn-Rincn
Departamento de Historia y Ciencias Humanas,
Universidad del Norte,
Km 5 va a Puerto Colombia, The site known today as Panam Viejo is located on the
Barranquilla, Colombia Pacific coast of the Isthmus (Fig. 1) in the archeological
area known as Gran Darin [1], a zone with abundant
Secretara Nacional de Ciencia,
Tecnologa e Innovacin-SENACYT, Apdo, natural resources and alternating dry and wet periods
0835-00590, Ciudad de Panam, Panam (1300 to 1500 mm of precipitation in nine months of
Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82 71

Fig. 1 Location of the Panam Viejo site / Localisation du site Panam Viejo

the year). Tidal variations that also affect the nearby river Secondary burials in urns or bundles are the most frequent
frequently cause flooding in the Panam Viejo site [2]. in the pre-Columbian contexts at Panam Viejo (66%). They
Panam Viejo is considered to be the first Hispanic settle- frequently include several individuals (44%), although single
ment in the South American Pacific and was used as a naval burials are the most common (56%) [4,5]. Before contact
base for the conquistadors and for warehousing the treas- with Europeans occurred, the burial sites were usually adja-
ures looted from the Incas before they were shipped to Spain. cent to domestic units [2], and individuals were buried with
However, archeological excavations at the site since 1995 stone artifacts, ceramics, food and sometimes human skulls
have shown that it was occupied by humans for over a thou- [4,5].
sand years before the first contact with Europeans [1,35]. Reduced burial was frequent in Colonial times (84%),
Pre-Columbian coastal occupation of the Panam Viejo arche- when individuals were mostly buried in churches (75%)
ological site may have lasted from AD 500 until the arrival of and chapels, along with crucifixes and medals [4].
the Spaniards in AD 1519 [1,5,6]. This paper presents the findings from a paleoepidemiolo-
Large concentrations of sea shells, many ceramic artifacts gical study of the Panam Viejo osteological series, which is
and stone objects such as metates, manos (for grinding helping to reconstruct the lifestyles of early inhabitants of
cereals) and knives have been found in pre-contact burial this coastal site.
sites. However, shell, bone or metal objects are not frequent
and they differ in style from the ceramics, indicating a
foreign origin and, probably, the privileged treatment of Methods and materials
some individuals [2].
Three types of burials have been identified in Panam The study used bioarcheological methods [813], in which
Viejo. Primary burials are where a complete fresh body particular attention is given to relationships between human
was deposited and then decomposed without being disturbed beings and the environment [9,10,1416].
until archaeological excavation; secondary burials are where Sex determination and age estimations were made in
a previously defleshed body was buried; reduced burials, accordance with conventional anthropological methods
finally, are defined as primary burials that were subsequently [12,1721].
disturbed as the site was continually re-used for further The bone abnormalities or anomalies were observed
burials [7]. macroscopically and recorded [8,9,11,14,2226]. Abnormal
72 Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82

bone formation (periostosis and subperiosteal formation), Although marine resources are rich in proteins and iron, a
abnormal bone destruction (osteolysis and osteoporosis), high frequency of anemia was found in one population,
abnormal bone density, abnormal bone size and abnormal whose diet was based on seafood [27,29]. This can be
bone shape were observed as expressions of disease [11]. explained by the phosphorus content of seafood, which can
Care was taken to differentiate antemortem from postmortem reduce iron absorption, as well as by other factors such as
bone anomalies [11]. The location of each abnormality was parasites and diseases like tuberculosis [33].
carefully described in each individual record. Although hereditary anemias (sickle-cell anemia and
It is very important to investigate multiple indicators thalassemia) may produce porotic hyperostosis, the lesions
when reconstructing health profiles from skeletal remains seem much more pronounced and asymmetrical than those
[14]: this paper presents six different indicators of health produced by nutritional anemia [14].
and disease. Four of them are specific indicators of stress: Anemia has highly negative effects on disease resistance,
nutritional deficiencies (porotic hyperostosis), some infec- capacities for activity and cognition in individuals and
tious diseases, trauma and degenerative pathologies [15]. populations. It may not be lethal, but in combination with
The other two are non-pathological, but are potentially other factors, it can contribute to poor health [14,15]
very important because they may reveal lifestyle features: and predispose children to infection, which can increase
musculoskeletal stress markers inform us about physical mortality [33].
activity; while so-called cultural abnormalities (defined However, recent research has brought a new and interest-
below) inform about behavior. ing perspective: Walker et al. have presented evidence sug-
gesting that a vitamin-B12-deficient diet is more likely to be
Porotic hyperostosis the key nutritional component in porotic hyperostosis and
cribra orbitalia [30]. They argue that well-documented clini-
Porotic hyperostosis is diagnosed by the observation of very cal studies have proved that maternal diets lacking foods of
porous lesions on the cranium, the roof of the eye orbits and animal origin, and therefore vitamin-B12-deficient, have
the ends of long bones [11,14,15,24]. These lesions are effects on nursing infants such as the development of mega-
produced by marrow proliferation caused by expansion of loblastic anemia [30].
the diploe, which makes the outer layer of bone thinner,
exposing the porous trabecular bone [14,15]. Infectious diseases
Porotic hyperostosis was recorded in this study because it
has been shown to be a valuable tool for reconstructing the The main skeletal response to many kinds of infection or
health profiles of past populations [11,14,15,24]. inflammatory conditions is an elevation of the fibrous outer
This indicator has been associated with anemia [14,15]; periosteal layer of the bone, or periosteal reaction [11,14,15].
nutritional anemia is the main etiological factor in documen- Most prehistoric cases are nonspecific because lesions can
ted prehistoric cases [14]. However, other causes such as be caused by a number of pathological conditions but the
infections, neoplastic or metabolic diseases can produce exact etiology is unknown [14,15]. As bone is constantly
similar lesions [11]. Iron-deficiency anemia seems particu- being remodeled, resorption of old bone and accretion of
larly prevalent [11,14,15,24,27]. This type of anemia new bone are also common reactions [14]. Destruction and
may be caused by repetitive bleeding, parasitic infection, necrosis may also occur in response to infection [11,14,15].
dietary deficiencies, diarrheal disease, iron absorption Periosteal reactions may also be a response to trauma,
deficiencies and chronic inflammatory or infectious diseases and to endocrine-metabolic or circulatory dysfunction
[14,15,27,28]. The frequency of these lesions increased with [11,12,24,29]. These reactions produced by infectious dis-
sedentism, agriculture and increased population density ease may be distinguished from those produced by trauma,
[14,15,27,28]. They first appear in childhood but are present because the latter are small, localized and non-destructive,
until adulthood [27,29]. while the former are generalized, destructive and bilateral,
Care must be taken when studying this indicator [30], and affect multiple long bones [14,24]. According to Good-
because the presence of genetic hemolytic anemias, parasite mann and Martin, when a tibia presents periosteal reactions,
exposure, hemoglobinopathies [31] and other associated other long bones should be carefully assessed [14]. If other
pathological conditions such as inflammation, osteoporosis bones are involved, the tibia is considered to display a
and the pseudopathologies [32] must be assessed. Wapler et reaction to systemic infectious disease. If only the tibia is
al. have shown that only 44% of the cribra orbitalia cases affected, this should be classified as a localized response to
observed in their study had histological features indicating trauma [14].
changes due to anemia [32]. The real meaning of the Specific infections such as tuberculosis and treponemal
presence of porotic hyperostosis is therefore yet to be infections can be diagnosed through careful observation.
clarified [33]. Tuberculosis produces a bone-destroying response in the
Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82 73

vertebral column, the joints and the cranium. Treponemal Trauma can have functional repercussions, for example
infections, such as syphilis, produce saber shins, polydacty- by disabling and deforming individuals and thus reducing
litis and osteolytic lesions of the external nasal vault and the their autonomy [14], or by causing complications such
nasopalatal region [11,14]. However, because of the small as misalignment, traumatic osteoarthritis, osteoporosis,
size of the series studied, all infections, both specific and non-union, joint fusion, traumatic myositis ossificans or
nonspecific, were taken together in this case. infection, which may eventually cause death [11,24,29,38].
Infectious disease combined with malnutrition is the main Trauma also has behavioral implications. For example,
contributor to morbidity and mortality in human popula- specific activities can predispose individuals to recognizable
tions, particularly during childhood [11,14,24,29]. The fre- types of accidental or intentional trauma; for this reason, this
quency of infectious lesions increases with sedentism and indicator can be very useful for interpreting past lifestyles
higher population density [14,24,29,34]. [14,15,29].
The study of infectious disease in skeletal remains raises a Some specific kinds of trauma must be carefully observed
number of problems [35,36]. One of the most important is as they can give important insights into lifestyles. For exam-
that only some infectious episodes leave diagnostic markers ple, clay-shovellers fractures, which are fractures of the
on the skeleton [14], because healing or death can occur transverse processes in the seven cervical and first thoracic
before the bone reaction, potentially leading to underestima- vertebrae, are produced by combined trapezius and rhom-
tions of infectious disease frequencies in the past boid muscle action on bone, and may help to identify the
[11,14,24,29]. Chronic (usually non-lethal) conditions can occupations of people in the past [29]. Amputation, trepan-
therefore reveal aspects of lifestyle, such as nutritional ning, intentional deformation and scalping can also reveal a
adequacy, diet, waste disposal and hygiene, while virulent great deal about a particular society [14,15,24,29].
and epidemic infections do not [14]. In this study, particular attention was given to distinguish-
On the other hand, the osteological paradox proposed ing fractures from post-mortem bone breakages [11,24,29].
by Wood et al. argues that it is impossible to determine
whether an absence of infectious bony reactions is accounted
for people who were very resistant to infectious diseases, or Degenerative Joint Disease (DJD, Osteoarthritis)
by people who were very frail and died before any bony
response was possible [36]. However it is worth studying The breakdown of the cartilage and lubricating systems of the
infectious lesions from human skeletal remains in combina- articular surfaces of joints is a common and easily discerned
tion with other indicators because they tell us about the condition [14]. When the subchondral bone is exposed, pit-
living conditions of past population [37]. ting, lipping, erosion and possibly eburnation may occur
[14,15]. Thus, deformation of the joint is caused by two
Trauma kinds of DJD processes, one of bone formation (osteophytes)
and one of bone destruction (sclerosis, eburnation, porosity,
Traumatic lesions are caused by physical force. Trauma is cysts) [24,3941]. Consequently, joint and bone degeneration
defined as any bodily injury or wound [29]. They are pro- are clearly recognizable in skeletal remains [29].
duced by external impacts, either accidental or intentional, Although osteoarthritis is multifactorial and related to
on the skeleton. Trauma frequency and profiles in the past nutrition, genetics and viral infections [11,12,15,24,26,29,
are associated with culture and lifestyles [11,14,15,24,29]. 40,4248], it has been argued that it is primarily caused by
Ortner has described four types of trauma: partial to com- biomechanical wear and tear and functional stress associated
plete breakage of a bone (fracture), abnormal displacement with activity patterns that habitually put strain on joint tissues
or dislocation of joints, disruption in nerve and/or blood sup- [14,15]. For this reason, the study of osteoarthritis provides
ply and artificially induced abnormal bone shape1 or contour clues to the life of individuals in the past, because DJD is
[11]. Deformation, scalping, mutilation, amputation, trepan- connected to the way humans relate to their environment
ning [11,24], crushing injuries, wounds caused by weapons [14], reflecting cumulative and repetitive motions (strain
or other devices and biomechanically induced pathologies caused by repetitive use of the musculoskeletal system). It
such as exostoses, osteochondritis dissecans and spondy- may therefore be considered as an indicator of lifestyles and
lolysis are also classified as traumatic lesions [14]. work habits in prehistoric populations [14,15,29].
Bone will always respond to any kind of fracture by form- In this study, attention was given to discard septic and
ing new bone through the release of calcium salts to form the secondary (post-trauma) DJD [29,48]. Osteophytes, mar-
callous matrix [14,15]. ginal lipping and eburnation were recorded as diagnostic
signs of DJD. However, pitting on its own was not included
In this study skull deformation was classified apart, as a cultural as an indicator of DJD because of its diagnostic weakness
anomaly. [41,49,50].
74 Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82

Musculoskeletal Stress Markers (MSM) overuse. This methodology has been widely applied
[5966], with very low inter-observer error [53].
A MSM or enthesopathy is an osseous change in the site
where a muscle, ligament or tendon is inserted; conse- Cultural anomalies
quently, it has been related to muscular hyperactivity
[43,45,5158]. However, the relationship between MSM The following were grouped together as cultural anoma-
and activity has to be studied with some care to avoid over- lies: deformation of the skull, cut marks showing possible
simplification [52,58]. defleshing and a very particular bone anomaly in the skull.
Because MSM can occur in association with seronegative The latter is a very circumscribed area of extreme porosity in
spondyloarthropathies, traumatic injuries and diffuse the scalp, delineated by marked temporal lines in the parie-
idiopathic skeletal hyperostosis-DISH [58], individuals with tals. The upper temporal line provides an attachment to the
any of these conditions were discarded from the statistics. temporal fascia and the lower temporal line indicates the
The presence or absence of large MSM was recorded for upper limit of the muscular origin of the temporalis, one of
all limb bones. In accordance with the methodology devel- the muscles involved in mastication (Fig. 2).
oped by Hawkey and Merbs [53], individuals with MSM The presence, absence or non-observability of each
above 3 in the scale were included in the study. Although anomaly in the paleopathological data was recorded. Simple
this methodology has been criticized [57,58], it makes it statistical analyses were performed, mainly based on
possible to see where an osseous change reveals muscular frequency calculations. Prevalence values were calculated

Fig. 2 Cultural anomaly: extreme porosity in the scalp circumscribed by very marked temporal lines. Top: Parque Morelos, Burial C4,
Individual 1. Bottom: Plaza Mayor, Burial 1, Individual 2 / Anomalie culturalle : microporosit intense sur la voute limite par des
lignes temporales trs marques. En haut : Parque Morelos, Tombe C4, Individu 1. En bas : Plaza Mayor, Tombe 1, Individu 2
Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82 75

by taking only observable aspects into account [26,67]. The Results

proportion n/N was used, n being the number of indivi-
duals presenting the anomaly or indicator considered, and The proportion of individuals less than 15 years old in Pan-
N the number of individuals with the relevant anatomical am Viejo is high in the Pre-Columbian context compared to
parts preserved [26,67]. the Colonial period (Table 2), while the proportion of old
Comparisons between groups were made by period, sex individuals is low in both periods.
and age, and the significance of the differences between fre- At least one bone anomaly was observed in 27 individuals
quencies was calculated by applying the chi-square test. of the 47 observable pre-Columbian skeletons (57%); in the
When the sample was too small to apply the chi-square Colonial contexts, at least one bone change was apparent in
test, the Fisher exact test was used instead (P < 0.05). 32 individuals out of 64 (50%). Table 3 shows the frequen-
The Panam Viejo series comprises at least 65 individuals cies and percentages of anomalies observed by period of
from the pre-Columbian period and 240 from Colonial times time and by sex. At the top of the table are the frequencies
[4]. Unfortunately, the bone material was not in an optimum for all the individuals observed; the bottom of the table
state of preservation, because of the acidity of the soil and shows frequencies for the adults only.
repeated re-use of the burial sites [4]. For these reasons, of In both the Pre-Columbian and Colonial contexts,
the total number of individuals analyzed, we were able to Musculoskeletal Stress Markers (MSM), Degenerative
assess 52 from the pre-Columbian contexts for anomalies, Joint Disease (DJD), trauma and infectious reactions are
and 64 for the Colonial period. The post-contact contexts, the most frequently observed bone changes (Table 3). In
as mentioned above, produced reduced burials, making indi- Pre-Columbian males, there are noticeably high frequencies
vidualization difficult in many cases. Table 1 summarizes of so-called cultural bone changes (see methodology for
the distribution of the series by period and sex, while more details).
Table 2 shows the distribution by period and age. MSM and DJD were more frequently recorded in the
Colonial than the pre-contact sample. Trauma and porotic
hyperostosis were more frequent in the pre-Columbian sam-
Table 1 Sex composition of the samples / Distribution des
ple. The frequencies of infectious reactions recorded were
chantillons par sexe
similar in both periods (around 15%).
Pre-Columbian Colonial These differences were tested with the Chi-square proce-
n % n % dure, or the Fisher exact test when needed (Table 4). The first
section of Table 4 compares the total sample for the two
Female 4 7.7 12 18.7
periods, showing a significant difference only in the compar-
Probable female 4 7.7 4 6.2
ative frequencies of cultural anomalies. For the adults (bot-
Male 23 44.2 11 17.2
tom), significant differences appear between the frequencies
Probable male 4 7.7 9 14.1
of porotic hyperostosis and cultural anomalies. The second
Indeterminate 17 32.7 28 43.7
section compares females and males within each period and
Total 52 64
shows no significant difference. The third section compares
n: number of individuals. females from the two periods and males from the two peri-
ods. Significant differences appear only in the frequencies of
porotic hyperostosis and cultural anomalies in males, when
Table 2 Age composition of the samples / Distribution des
all are taken together (top), and also when only adult males
chantillons par ge
are taken (bottom).

Pre-Columbian Colonial
n % n %
Total Younger than 15 years 18 34.6 10 15.6 Although a number of interesting features were observed in
Young (15-30 years) 17 32.7 30 46.9 this study, poor preservation was a major issue (as is usually
Middle age (30-45 years) 14 26.9 8 12.5 the case in bioarchaeological studies). The material analyzed
Old (45+ years) 0 0 1 1.6 is poorly preserved because of the acidity of the soil in this
Adult (unclassifiable) 3 5.8 15 23.4 region of the Isthmus and disturbance due to repeated use of
Total adults 34 65.4 54 84.4 the same burial sites. These factors made observation of the
TOTAL 52 64 bones difficult, and reduced the sample size. However, care-
fully recording the presence, absence and non-observability
n: number of individuals.
of each anomaly and using the frequency calculation
76 Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82

Table 3 Observed bone anomalies by period, by sex and by whole samples (top) and observed anomalies in adults only (bottom) /
Anomalies osseuses par priode, par sexe et pour les sries compltes (en haut) et anomalies exclusivement chez les adultes (en bas)

Pre-Columbian Colonial
Female Male Indet. Whole Female Male Indet. Whole
n % n % n % n % n % n % n % n %
MSM 2 28.6 5 19.2 0 0.0 7 14.9 5 31.3 7 35.0 7 25.0 19 29.7
DJD 3 42.9 3 11.5 2 14.3 8 17.0 5 31.3 4 20.0 5 17.9 14 21.9
Trauma 3 42.9 6 23.1 0 0.0 9 19.1 3 18.8 4 20.0 3 10.7 10 15.6
Infectious dis. 1 14.3 3 11.5 3 21.4 7 14.9 3 18.8 4 20.0 3 10.7 10 15.6
Porotic hyp. 1 14.3 7 26.9 1 7.1 9 10.6 1 6.3 0 0.0 1 3.6 2 3.1
Cultural 0 0.0 8 30.8 0 0.0 8 17.0 0 0.0 0 0.0 0 0.0 0 0.0
Pre-Columbian Colonial
Female Male Indet. Whole Female Male Indet. Whole
n % n % n % n % n % n % n % n %
MSM 2 40.0 5 23.8 0 0.0 7 21.9 5 33.3 7 36.8 7 35.0 19 35.8
DJD 3 60.0 3 14.3 2 28.6 8 25.0 5 33.3 4 21.1 5 25.0 14 26.4
Trauma 3 60.0 6 28.6 0 0.0 9 28.1 3 20.0 4 21.1 3 15.0 10 18.9
Infectious dis. 1 20.0 2 9.5 2 28.6 5 15.6 3 20.0 4 21.1 2 10.0 9 17.0
Porotic hyp. 1 20.0 6 28.6 0 0.0 7 21.9 1 6.7 0 0.0 1 5.0 2 3.8
Cultural 0 0.0 8 38.1 0 0.0 8 25.0 0 0.0 0 0.0 0 0.0 0 0.0

n: number of individuals. Indet: Indeterminate. MSM: Musculoskeletal Stress Markers. DJD: Degenerative Joint Disease. Infectius
dis: Infectious disease. Porotic hyp: Porotic hyperostosis.

method, which takes only observable elements into account graphical area, reflecting seemingly high levels of MSM at
[67], should help to reduce possible biases. Panam Viejo. However, another specific study on the pre-
The proportion of male pre-Columbian individuals is Columbian period has shown that the frequencies in Panam
higher than that of females. This could be due to sampling Viejo are comparatively lower than in the other observed
issues as the site has not been exhaustively excavated, but series from the north of South America [73], although the
could also be explained by cultural reasons such as a proba- same study also shows that the size of the Panam Viejo
ble preference of the site for male burials, a practice already series is a major limiting factor in drawing robust conclu-
documented in other archaeological sites on the Isthmus sions [73]. A tendency towards an increase in physical activ-
[6871]. However, it is very interesting to note that the ities with the arrival of the Europeans was observed in
most complex funerary contexts are related to women [5]. Panam Viejo, similar to that observed in other contact con-
Individuals less than 15 years old seem very numerous in texts in the Americas [75]. In the pre-Columbian sample,
the pre-Columbian Panam Viejo sample (35%), indicating female individuals show higher frequencies of MSM,
high mortality in childhood. However, these figures are com- possibly indicating a more strenuous life for women. How-
parable to those obtained for other pre-Columbian popula- ever, no significant differences were found. Further study of
tions from the north of South America, which range from MSM profiles and body mass using an enlarged sample
40 to 60% [72], and in a typical archeological sample where could clarify the differences between the two archaeological
around 50% of individuals are less than 15 years old [11]. periods.
Although paleoepidemiological studies have major lim-
itations [11,26,36,37,67], the indicators analyzed here have DJD
brought out interesting features that can help to reconstruct
aspects of the lifestyles of the early inhabitants of Panam There are few publications on the paleoepidemiology of
Viejo. DJD in South American osteological series [49,73]. Some
studies on general paleopathology provide some data, but
MSM comparisons are difficult because the diagnostic criteria
used are unclear [49,73]. However, it is worth comparing
Information on MSM in the north of South America is scarce data even if only in a general way (see Table 5 for reported
[73,74]. Table 5 shows data reported for series in this geo- data [74,7681]).
Table 4 Chi-square, Fisher and P-values for anomalies observed in the samples as a whole (top) and in adults only (bottom) / Chi2 et Fisher pour les diffrences de frquences
entre groupes, pour les sries compltes (en haut) et exclusivement pour les adultes (en bas)

Differences between
Periods Sexes by period Period by sexes
Pre-Columbian Pre-Columbian Colonial Pre Colombian Pre Colombian
and Colonial Females and Females and and Colonial and Colonial
Males Males Females Males
X2 p-value X2 p-value X2 p-value X2 p-value X2 p-value
MSM 3.3065 0.069 0.6228 0.0562 0.8125 - 1.4579 0.2273
Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82

DJD 0.4017 0.5262 0.0929 0.4697 0.6570 0.6816

Trauma 0.2372 0.6262 0.0929 - 0.3185 -
Infectious dis. 0.0112 0.9158 - - - 0.6816
Porotic hyp. 0.1314 0.6516 0.444 0.5257 0.0137
Cultural 0.0007 0.1543 - - 0.0201
Differences between adults
Periods Sexes by period Period by sexes
Pre-Columbian Pre-Columbian Colonial Pre- Colombian Pre- Colombian
and Colonial Females and Females and and Colonial and Colonial
Males Males Females Males
X2 p-value X2 p-value X2 p-value X2 p-value X2 p-value
MSM 1.8351 0.1755 0.5875 0.0452 0.8317 - 0.8068 0.3691
DJD 0.0208 0.8852 0.0624 0.4620 0.3473 0.6889
Trauma 0.9851 0.3209 0.3022 - 0.1313 0.7209
Infectious dis. 0.0267 0.8703 0.4885 - - 0.3976
Porotic hyp. 0.0235 - 0.4412 0.4474 0.0212
Cultural 0.0002 0.2805 - - 0.0036

df = 1. Italic: Fisher exact test. Bold: Significant. MSM: Musculoskeletal Stress Markers. DJD: Degenerative Joint Disease. DJD: Degenerative Joint Disease. Infectius dis:
Infectious disease. Porotic hyp: Porotic hyperostosis.
78 Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82

Table 5 Reported data from earlier American series / Donnes reportes pour des sries anciennes du continent

Series Date Reported data Reference

Ancn (Central Coast of Peru) 8% [74]
Highlands of Peru a rather common disease [76]
Mummies from Chile and Peru elevated frequencies [77]
(young individuals)
Ancn (Central Coast of Peru) low presence [78]
Ancn (Central Coast of Peru) 76% [74]
Villa el Salvador (Central Coast of Peru) 79% male, 76% female [80]
Pre-Columbian Mochica 50% (56/112) [79]
Post-contact Mochica 75.6% (34/45) [79]
Muisca series (Andes in Colombia) 41.9% (31/74) [81]
Ancn (Central Coast of Peru) 0% [78]
Ancn (Central Coast of Peru) 13% (15/116) [74]
Villa el Salvador (Central Coast of Peru) 10-20% cranial trauma [80]
Villa el Salvador (Central Coast of Peru) 22-29% post-cranial trauma [80]
Shamans from Peru and Chile 0% [77]
Male commoners from Peru and Chile 35% [77]
Female commoners from Peru and Chile 16% [77]
Santa Elena (Ecuador) BC 600 9% [83]
Guangala (Ecuador) BC 100 33% [83]
Ayaln without urn (Ecuador) AD 710 18% [83]
Ayaln with urn (Ecuador) AD 1230 13% [83]
Pecos Indians (USA) 4% long bones and hip fractures: [24]
Pecos Indians (USA) 7% cranial trauma added: [24]
North American pre-Columbian populations BC 4000-1000 10% postcranial factures [38]
North American pre-Columbian populations BC 1000-AD 1000 5% postcranial factures [38]
North American pre-Columbian populations AD 1000-1600 1-4% postcranial factures [38]
Central California 10% long bones fractures [82]
Central California 4% cranial fractures [82]
Central California 2% weapon wonds [82]
Central California 1% traumatic hip dislocation [82]
Infectious disease
Ancn (Central Coast of Peru) 36% (41/115) [74]
La Paloma (Central Coast of Peru) 8000-4500 BP 10-16% osteolysis [84]
La Paloma (Central Coast of Peru) 8000-4500 BP 22-25% periosteal reactions [84]
Peruvian shamans 9% osteolysis [77]
Peruvian males 20% osteolysis [77]
Peruvian females 18% osteolysis [77]
Santa Elena (Ecuador) BC 600 7% (9 bones/127 individuals) [83]
Guangala (Ecuador) BC 100 44% [83]
Ayaln without urn (Ecuador) AD 710 4% [83]
Ayaln with urn (Ecuador) AD 1230 14% [83]
Villa el Salvador (Central Coast of Peru) 43% periosteal reactions, males [80]
Villa el Salvador (Central Coast of Peru) 13% periosteal reactions, females [80]
North American mixed-economy populations 5% (59/1260) [34]
Pre-Columbian and postcontact Pecos Pueblo 0.8% (4 cases) osteomyelitis [24]
Pre-Columbian and postcontact Pecos Pueblo 2.6% (13 cases) periosteal reactions [24]
Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82 79

Series Date Reported data Reference

Porotic hyperostosis
Ancn (Central Coast of Peru) 7% [74]
Peruvian coast more frequent than in the highlands [27]
Villa El Salvador (Central Coast of Peru) 23% cribra: (N=402) [33]
Villa El Salvador (Central Coast of Peru) 11% cribra males; 19% females [80]
Villa El Salvador (Central Coast of Peru) 23% porotic hyperostosis males, [80]
6% females
Santa Elena (Ecuador) BC 600 0% porotic hyperostosis, 0% cribra [83]
Guangala (Ecuador) BC 100 23% porotic hyperostosis, 10% cribra [83]
Ayaln without urn (Ecuador) AD 710 8% porotic hyperostosis, 0% cribra [83]
Ayaln with urn (Ecuador) AD 1230 7% porotic hyperostosis, 2% cribra [83]

The difference in frequencies between the two studies from Infectious diseases
Ancn [74,78], in the Peruvian Central Coast, has been
attributed to the high proportion of young individuals in Table 5 shows the frequencies reported in previous studies on
Kauffmanns study sample [78]. early populations from the Americas [24,34,74,77,80,83,84].
According to the reported data (Table 5), the frequency of The frequencies found in Panam Viejo for the pre-
DJD found in the Panam Viejo series seems comparatively Columbian and Colonial samples seem comparatively moder-
low (17% for the pre-Columbian sample and 22% for the ate to low (around 15% for both periods), which may reflect a
Colonial sample). This could be partially explained by the low population density and less harsh environmental condi-
low proportion of old individuals and a moderate level of tions than previously thought, at least before and at the begin-
physical activity; but again, comparisons are difficult ning of the Spanish presence in the region.
because of the sample size and poor preservation [73].
A tendency towards an increase in DJD (physical activi- Porotic hyperostosis
ties?) with the arrival of Europeans was observed in Panam
Viejo, as also reported for other contact contexts in the Data from several South American series are summarized in
Americas [75]. Table 5 [27,33,74,80,83]. Blom et al. have argued that anemia
was related more to environmental factors such as parasites
and chronic diseases than to diet [33]. They consider that El
Nio had a substantial influence on the Peruvian Coast
because it could weaken the populations living there [33].
Table 5 shows data from previous studies on trauma in the
Comparatively, the frequency from Panam Viejo seems
Americas [24,38,74,77,78,80,82,83].
moderate to low. Since it has been considered as a marker of
The drop in fracture frequency reported by Steinbocks anemia, this disease would also have a low frequency at this
study in 1976, cited by Merbs, may suggest changes in site. If the new perspective proposed by Walker et al. [30] is
behavior when subsistence patterns shifted from hunter- accepted, our data would show that consumption of animal
gathering to agriculture [38]. Jurmain concluded that the food was high in both periods. Although a significant differ-
high frequencies he observed compared with other studies ence was found between males from the pre-Columbian
were due to very intense interpersonal violence in the Cen- period and males from the Colonial period, this difference
tral Californian population studied [82]. may be the result of a cultural practice among some males of
Our data from Panam Viejo show a comparatively high the pre-Columbian period (see paragraphs concerning cul-
frequency for both the pre-Columbian and Colonial periods tural anomalies). However, isotopic studies (in preparation)
observed. Trauma is more frequent in the group of pre- will provide more material for discussion of the nutritional
Columbian females, which could be associated with their status of the early inhabitants of Panam Viejo, helping to
occupations and with violent events (warfare?). However, clarify this point.
the differences between sexes and periods are not signifi-
cant. Further specific analysis of trauma in the Panam Cultural anomalies
Viejo series would help to better understand the lifestyle of
the people who inhabited this site before and after the arrival As mentioned in the methodology section, skull deforma-
of the Spaniards. tion, traces of cuts indicating possible defleshing and a
80 Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82

very particular bone anomaly in the skull (a circumscribed Acknowledgments This research study was financed by the
area of extreme porosity in the scalp, between marked Proyecto Arqueolgico Panam Viejo, the Patronato Panam
temporal lines) have been grouped together as cultural Viejo and SENACYT (Secretara Nacional de Ciencia,
abnormalities. Tecnologa e Innovacin, Panam). Thanks from the first
Concerning this particular bone anomaly in the skull, two author to the French Ministry of Higher Education and
things were observed: intense porosity and marked temporal Research, which sponsored the research grant. We are
lines. These two anomalies have been very frequently indebted to Dr. Toms Mendizbal, who kindly revised our
observed in association, suggesting the hypothesis that the manuscript. The authors also thank two anonymous reviewers
porosity in the scalp could be a mechanical consequence of for their comments, which greatly improved our manuscript,
hyperactivity in the masticatory muscle [85]. In our study, as well as the corrector, I. Bossanyi who revised the English.
this abnormality appears in four male skulls; three of these
belong to a very particular archaeological context as they
were among nine male skulls offered as grave goods to one References
young female, who shows evidence of a very physically
demanding lifestyle (fractures, very high MSM, DJD). The 1. Martn-Rincn J (2002) Panam la Vieja y el Gran Darin. In:
presence of anomalies classified as cultural has brought out Rovira B, Martn-Rincn J (eds) Arqueologa de Panam la
significant differences between the pre-Columbian and the Vieja: Avances de investigacin. Patronato de Panam Viejo,
Colonial periods in Panam Viejo, particularly in males, Panam, pp 23050
2. Martn-Rincn J (2002) Excavaciones arqueolgicas en el Parque
showing differences in lifestyles and practices that concur Morelos (Panam La Vieja). In: Rovira B, Martn-Rincn J (eds)
with historical data [4]. Arqueologa de Panam la Vieja. Avances de investigacin.
The study of these bone indicators has demonstrated its Patronato de Panam Viejo, Panam, pp 20329
usefulness in obtaining new information about early popula- 3. Biese L (1964) The prehistory of Panam Viejo. Smithsonian
Institution, Bureau Am Ethnology Bull 191 Anthropological
tions in the Panamanian Isthmus, despite the limitation of the Papers 68:175
small size of the series. The analysis of stress indicators from 4. Martn J, Rivera-Sandoval J, Rojas-Seplveda C (2009) Bioar-
teeth and diet may help to clarify the picture regarding queologa. Su aporte al Proyecto Arqueolgico Panam Viejo.
the state of health of the early inhabitants of the Panam Canto Rodado 4:11744
Viejo site. 5. Mendizbal T (2004) Panama Viejo: an analysis of the construc-
tion of archaeological time in Eastern Panama, London Univer-
sity, London, 322 p
6. Martn-Rincn J (2007) La cermica prehispnica del parque
Morelos, Panam Viejo. Canto Rodado 2:4568
Conclusion 7. Duday H (1997) Antropologa biolgica de campo, tafonoma
y arqueologa de la muerte. In: Malvido E, Pereira G, Tiesler
Although the statistical tests failed to prove significant dif- (eds) El cuerpo humano y su tratamiento mortuorio. Instituto
ferences between subgroups of individuals for some of the Nacional de Antropologa e Historia-Centro de Estudios Mexica-
nos y Centroamericanos, Mxico D.F, pp 91126
anomalies considered, the percentages nevertheless show
8. Larsen CS (1987) Bioarchaeological Interpretations of Subsis-
discernible trends. The differences were not statistically con- tence Economy and Behavior from Human Skeletal Remains.
firmed, probably because of the small size of some groups, In: Schiffer M (ed) Advances in Archaeological Method and The-
particularly females. These results are complementary to ory. Volume 10. Academic Press, Orlando, pp 339445
those initially presented [4], but our conclusions here have 9. Larsen CS (1999) Bioarchaeology: interpreting behavior from the
human skeleton, Cambridge University Press, Cambridge, 461 p
been refined. Some changes in lifestyle with the arrival of
10. Larsen CS (2002) Bioarchaeology: the lives and lifestyles of past
Europeans at Panam Viejo have been confirmed. Neverthe- people. J Archaeol Res 10:11966
less, more specific studies must be carried out to shed more 11. Ortner D (2003) Identification of pathological conditions in
light on the history of contact in this region. A study of the human skeletal remains. Academic Press, San Diego, 645 p
profiles and frequencies of MSM, DJD and trauma could 12. Ubelaker DH (1989) Human skeletal remains. Excavation, analy-
sis, interpretation, Taraxacum, Washington D.C., 172 p
clarify our understanding of changes over time in physical
13. Wright L, Yoder C (2003) Recent progress in Bioarchaeology:
activities and other behavior. The analysis of teeth anomalies approaches to the Osteological Paradox. J Archaeol Res 11:4370
could also help to produce more robust interpretations of 14. Goodman A, Martin D (2002) Reconstructing health profiles
these data. Finally, these results support the need to enlarge from skeletal remains. In: Steckel R, Rose J (eds) The backbone
the series and consequently to extend the archeological exca- of history: Health and nutrition in the Western hemisphere. Cam-
vations at Panam Viejo. Given the characteristics of the soil bridge University press, Cambridge, UK, pp 1160
15. Goodman A, Martin D, Armelagos G (1984) Indicators of stress
in this region, in situ analyses of human remains by an expe- from bone and teeth. In: Cohen M, Armelagos G (eds) Paleopa-
rienced bioanthropologist would be a positive step to avoid thology at the origins of agriculture. Academic Press, Orlando,
further losses of information. pp 1438
Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82 81

16. Goodman A, Thomas R, Swedlund A, et al (1988) Biocultural 39. Bourke JB (1967) A review of the paleopathology of the arthritic
perspectives on stress in prehistoric, historical and contemporary disease. In: Brothwell D, Sandison AT (eds) Diseases in antiquity.
population research. Yrbk Phys Anthropol 31:169202 Charles C Thomas, Springfield, Illinois, pp 35270
17. Brothwell D (1965) Digging up bones. The excavation, treatment 40. Resnick D (2002) Degenerative disease of the spine. In: Resnick
and the study of human skeletal remains, Oxford University D (ed) Diagnosis of bone and joint disorders. WB Saunders
Press, London, 208 p Company, Philadelphia, pp 1380409
18. Isan MY, Loth SR, Wright RK (1984) Age estimation from the 41. Rothschild B (1997) Porosity: a curiosity without diagnostic
rib by phase analysis: white males. J Forensic Sci 29:10941104 significance. Am J Phys Anthropol 104:52933
19. Isan MY, Loth SR, Wright RK (1985) Age estimation from the 42. Bridges P (1992) Prehistoric arthritis in the Americas. Annu Rev
rib by phase analysis: white females. J Forensic Sci 30:85363 Anthropol 21:6791
20. Suchey JM, Brooks ST (1988) Skeletal age determination based 43. Capasso L, Kennedy K, Wilczack C (1999) Atlas of occupational
on the male os pubis. 12th International Conference of Anthro- markers on human remains, Associazione Antropologica
pological and Ethnological Sciences, Zagreb Abruzzese-Journal of Paleopathology, Edigrafital S.p.A., Teramo,
21. White T, Folkens P (2000) Human Osteology, Academic Press, 183 p
San Diego, 563 p 44. Jurmain R, Kilgore L (1995) Skeletal evidence of osteoarthritis: a
22. Buikstra J, Ubelaker D (1994) Standars for Data Collection from paleopathological perspective. Ann Rheum Dis 53:44350
Human Skeletal Remains, Arkansas Archeological Survey 45. Kennedy K (1989) Skeletal markers of occupational stress.
Research Series No 44, Arkansas, 206 p In: Isan MY, Kennedy K (eds) Reconstruction of life from the
23. Dutour O, Ardagna Y (2005) La palopathologie humaine. In: skeleton. Alan R. Liss, Inc, New York, pp 12960
Dutour O, Hublin J-J, Vandermeersch B (eds) Objets et mthodes 46. Peyron J (1986) Osteoarthritis the epidemiologic viewpoint. Clin
en paloanthropologie. Comit de travaux historiques et scientifi- Orthop Related Res 213:139
ques, Paris, pp 31541 47. Rogers J, Shepstone L, Dieppe P (1997) Bone formers: osteo-
24. Ortner D, Putschar W (1981) Identification of pathological con- phyte and enthesophyte formation are positively associated. Ann
ditions in human skeletal remains. Smithsonian Institution Press, Rheum Dis 56:8590
Washington D.C., 479 p 48. Rogers J, Waldron H (1995) A field guide to joint disease in
25. Thillaud P (1994) Lsions ostoarchologiques : recueil et identi- archaeology. John Wiley and Sons Ltd, Chichester, 120 p
fication. Kronos B.Y. Editions, 79 p
49. Rojas-Seplveda C, Ardagna Y, Dutour O (2008) Paleoepide-
26. Waldron T (2009) Paleopathology, Cambridge University press,
miology of vertebral degenerative disease in a Pre-Columbian
New York, 298 p
Muisca series from Colombia. Am J Phys Anthropol 135:41630
27. Stuart-Macadam P (1989) Nutritional deficiency diseases: a sur-
50. Sofaer J (2000) Sex differences in activity-related osseous change
vey of scurvy, rickets and iron-deficiency anemia. In: Isan MY,
in the spine and the gendered division of labor at Ensay and
Kennedy K (eds) Reconstruction of life from the skeleton. Alan
Wharram Percy, UK. Am J Phys Anthropol 111:33354
R Liss, Inc, New York, pp 20122
51. Dutour O (1986) Enthesopathies (Lesions of Muscular Insertions)
28. Roberts C, Betsinger T, Steckel R, et al (2009) The history of
as indicators of the activities of Neolithic Saharan populations.
European infectious diseases: skeletal evidence of tuberculosis,
Am J Phys Anthropol 7:2214
leprosy, and treponematosis. Am J Phys Anthropol 138:2223
52. Dutour O (1992) Activits physiques et squelette humain : le dif-
29. Roberts C, Manchester K (1995) The archaeology of disease,
Alan Sutton publishing limited. Cornell University press, Ithaka, ficile passage de lactuel au fossile. Bull Mem Soc Anthropol
240 p Paris n.s. 4(34):23341
30. Walker P, Bathurst R, Richman R, et al (2009) The causes of poro- 53. Hawkey D, Merbs C (1995) Activity-induced Musculoskeletal
tic hyperostosis and cribra orbitalia: a reappraisal of the iron- Stress Markers (MSM) and subsistence strategy changes among
deficiency-anemia hypothesis. Am J Phys Anthropol 139:10925 ancient Hudson Bay Eskimos. Int J Osteoarchaeol 5:32438
31. Rothschild B (2000) Porotic hyperostosis as a manifestation of 54. Kennedy K (1998) Markers of occupational stress: conspectus
iron deficiency? Chungar (Arica) 32:859 and prognosis of research. Int J Osteoarchaeol 8:30510
32. Wapler U, Crubzy E, Schultz M (2004) Is cribra orbitalia synon- 55. Robb J (1998) The interpretation of skeletal muscle sites: a statis-
ymous with anemia? Analysis and interpretation of cranial tical approach. Int J Osteoarchaeol 8:36377
pathology in Sudan. Am J Phys Anthropol 123:3339 56. Stirland A (1998) Musculoskeletal evidence for activity: pro-
33. Blom D, Buikstra J, Keng L, et al (2005) Anemia and childhood blems of evaluation. Int J Osteoarchaeol 8:35462
mortality: latitudinal patterning along the coast of pre-Columbian 57. Villotte S (2008) Enthsopathies et activits des hommes prhis-
Peru. Am J Phys Anthropol 127:15269 toriques. Recherche mthodologique et application aux fossiles
34. Kelley M (1989) Infectious disease. In: Isan MY, Kennedy K europens du Palolithique suprieur et du Msolithique. Thse
(eds) Reconstruction of life from the skeleton. Alan R. Liss, de doctorat, Universit de Bordeaux 1, Bordeaux, France, 381 p
Inc, New York, pp 1919 58. Villotte S, Castex D, Couallier V, et al (2010) Enthesopathies as
35. Dutour O (2008) Archaeology of human pathogens: palaeopatho- occupational stress markers: evidence from the upper limb. Am J
logical appraisal of palaeoepidemiology. In: Raoult D, Drancourt Phys Anthropol 142:22434
M (eds) Paleomicrobiology: past human infections. Springer- 59. Eshed V, Gopher A, Galili E, et al (2004) Musculoskeletal Stress
Verlag, Berlin Heidelberg, pp 12544 Markers in Natufian hunter-gatherers and Neolithic farmers in the
36. Wood J, Milner G, Harpending H, et al (1992) The osteological Levant: the upper limb. Am J Phys Anthropol 123:30315
paradox: problems of inferring prehistoric health from skeletal 60. Lovell N, Dublenko A (1999) Further aspects of fur trade life
samples. Curr Anthropol 33:34370 depicted in the skeleton. Int J Osteoarchaeol 9:24856
37. Mendona-de-Souza S, Maul-de-Carvalho D, Lessa A (2003) 61. Molnar P (2006) Tracing Prehistoric activities: musculoskeletal
Paleoepidemiology: is there a case to answer? Mem I Oswaldo stress marker analysis of a Stone-Age population on the island
Cruz 98:217 of Gotland in the Baltic Sea. Am J Phys Anthropol 129:1223
38. Merbs C (1989) Trauma. In: Isan MY, Kennedy K (eds) Recon- 62. Molnar P (2008) Patterns of physical activity and material culture
struction of life from the skeleton. Alan R. Liss, Inc, New York, on Gotland, Sweden, during the Middle Neolithic. Int J
pp 16189 Osteoarchaeol 20(1):114
82 Bull. Mm. Soc. Anthropol. Paris (2011) 23:70-82

63. Munson Chapman N (1997) Evidence for Spanish influence on 74. Rojas-Seplveda C, Dutour O (2009) Premire valuation palo-
activity induced musculoskeletal stress markers at Pecos Pueblo. pidmiologique dune srie ostoarchologique de la Cte cen-
Int J Osteoarchaeol 7:497506 trale Pruvienne : Le site dAncn I. Bull Mem Soc Anthropol
64. Steen S, Lane R (1998) Evaluation of habitual activities among Paris t. 21(34):127
two Alaskan Eskimo populations based on musculoskeletal stress 75. Larsen CS, Griffin M, Hutchinson D, et al (2001) Frontiers of
markers. Int J Osteoarchaeol 8:34153 contact: Bioarchaeology of Spanish Florida. J World Prehist
65. Weiss E (2003) Understanding muscle markers: aggregation and 15:69123
construct validity. Am J Phys Anthropol 121:23040 76. MacCurdy G (1923) Human skeletal remains from the highlands
66. Weiss E (2004) Understanding muscle markers: lower limbs. of Peru. Am J Phys Anthropol 6:217329
Am J Phys Anthropol 125:2328 77. Allison M (1984) Paleopathology in Peruvian and Chilean popu-
67. Waldron T (1994) Counting the dead: the epidemiology of skele- lations. In: Cohen M, Armelagos G (eds) Paleopathology at the
tal populations. John Wiley and Sons Ltd, Chichester, 101 p origins of agriculture. Academic press inc, Orlando, pp 51529
78. Kauffmann F (1996) Proyecto Arqueolgico Tumbas de Ancn
68. Briggs PS (1989) Art, death and social order: the mortuary arts of
(1), Arqueolgicas 23, Museo Nacional de Arqueologa, Antro-
pre-Conquest Central Panam, Bar International Series 550,
pologa e Historia del Per, Lima, 167 p
Oxford, 263 p
79. Klaus H, Larsen CS, Tam M (2009) Economic intensification and
69. Briggs PS (1993) Fatal attractions: interpretation of prehistoric
degenerative joint disease: Life and labor on the postcontact
mortuary remains from lower Central America. In: Graham MM
North Coast of Peru. Am J Phys Anthropol 139:20421
(ed) Reinterpreting prehistory of Central America. University
80. Pechenkina E, Delgado M (2006) Dimensions of health and
Press of Colorado, Niwot, CO, pp 14068
social structure in the early intermediate period cemetery at
70. Cooke R, Snchez L (2004) Las sociedades originarias: Panam Villa El Salvador, Peru. Am J Phys Anthropol 131:21835
prehispnico. Panam indgena: 15011550. In: Castillero A (ed) 81. Rodrguez JV (1987) Anlisis osteomtrico, osteoscpico, dental
Historia General de Panam. Comit nacional del centenario de la y paleopatolgico de los restos seos de Soacha. Informe
Repblica de Panam, Panam, pp 391 (report). Instituto Colombiano de Antropologa, Bogot
71. Cooke R, Snchez L (2004) Arqueologa en Panam (18882003). 82. Jurmain R (2001) Paleoepidemiological patterns of trauma in a
In: Comisin-Universitaria-del-Centenario-de-la-Repblica (ed) prehistoric population from central California. Am J Phys
Panam: Cien aos de la Repblica. Manfer S.A, Panam, 96 p Anthropol 115:1323
72. Rodrguez JV (2006) Las enfermedades en las condiciones de 83. Ubelaker DH (1984) Prehistoric human biology of Ecuador: pos-
vida prehispnica de Colombia, Universidad Nacional de Colom- sible temporal trends and cultural correlations. In: Cohen M,
bia, Facultad de Ciencias Humanas, Departamento de Antropolo- Armelagos G (eds) Paleopathology at the origins of agriculture.
ga, Bogot, 299 p Academic press inc, Orlando, pp 491513
73. Rojas-Seplveda C (2009) Relations HommeEnvironnement en 84. Benfer R (1984) The challenges and rewards of sedentism: the
Amrique du Sud prcolombienne. Approche palopidmiologi- preceramic village of Paloma, Per. In: Cohen M, Armelagos G
que de la maladie articulaire dgnrative et des marqueurs (eds) Paleopathology at the origins of agriculture. Academic
osseux dactivits chez des populations anciennes des rgions press inc, Orlando, pp 5318
andines septentrionnales et panamennes. Thse de doctorat, 85. Dutour O (2007) Rponse au cas (Personal communication by
Universit de la Mditerrane, Marseille, France, 369 p mail to Rojas-Seplveda)