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THEBIOARCHAEOLOGYOFTUBERCULOSISAGlobalViewonaReemergingDisease Charlotte A. Roberts and Jane E. Buikstra UniversityPressofFlorida Gainesville/Tallahassee/Tampa/Boca Raton Pensacola/Orlando/Miami/Jacksonville/Ft. Myers FROB FM ppi-xxiv 8/5/03 10:00 AM Page iii THEBIOARCHAEOLOGYOFTUBERCULOSISFlorida A&M University, Tallahassee Florida Atlantic University, Boca Raton Florida Gulf Coast University, Ft. Myers Florida International University, Miami Florida State University, Tallahassee Universityof Central Florida, Orlando Universityof Florida, Gainesville Universityof North Florida, Jacksonville Universityof South Florida, Tampa Universityof West Florida, Pensacola FROB FM ppi-xxiv 8/5/03 10:00 AM Page i FROB FM ppi-xxiv 8/5/03 10:00 AM Page ii THEBIOARCHAEOLOGYOFTUBERCULOSISAGlobalViewonaReemergingDisease Charlotte A. Roberts and Jane E. Buikstra UniversityPressofFlorida Gainesville/Tallahassee/Tampa/Boca Raton Pensacola/Orlando/Miami/Jacksonville/Ft. Myers FROB FM ppi-xxiv 8/5/03 10:00 AM Page iii Copyright 2003 by Charlotte A. Roberts and Jane E. Buikstra Printed in the United States of America on acid-free paper All rights reserved 08 07 06 05 04 03 6 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data Roberts, Charlotte A. Thebioarchaeologyof tuberculosis: aglobalviewonareemergingdisease / Charlotte A. Roberts and Jane E. Buikstra. p. cm. Includes bibliographical references and index. ISBN 0-8130-2643-1 (cloth: alk. paper) 1. Tuberculosis–History. 2. Tuberculosis–Epidemiology. 3. Paleopathology. I. Buikstra, Jane E. II. Title. RA644.T7R58 2003 616.9′95′009–dc21 2003042635 TheUniversityPressofFlorida is the scholarly publishing agency for the State University System of Florida, comprising Florida A&M University, Florida Atlantic University, Florida Gulf Coast University, Florida International University, Florida State University, Universityof Central Florida, Universityof Florida, Universityof North Florida, Universityof South Florida, and Universityof West Florida. UniversityPressofFlorida 15 Northwest 15th Street Gainesville, FL 32611–2079 http://www.upf.com FROB FM ppi-xxiv 8/5/03 10:00 AM Page iv To the women of Africa burdened by both tuberculosis and HIV; Keith Manchester, whose enthusiasm for palaeopathology at the outset guided Charlotte into this field; and Gerrett B. (Grandpa) Buikstra, whose encouragement was essential to Jane’s choice of career. FROB FM ppi-xxiv 8/5/03 10:00 AM Page v FROB FM ppi-xxiv 8/5/03 10:00 AM Page vi CONTENTS List of Figures ix List of Tables xiii Preface xvii Acknowledgments xxi 1. Reemerging Infectious Diseases Tuberculosis Is One of Many 1 2. TuberculosisADiseaseof Poverty and More 44 3. Tuberculosis in the Old World Absence of Evidence Is Not Evidence of Absence 87 4. Tuberculosis in the New World An Interpretative Challenge 187 5. To Cure Sometimes, to Relieve Often, to Comfort Always The Written and Illustrative Evidence for Tuberculosis, Its Diagnosis, and Its Treatment 214 6. The White Plague Continues 262 Glossary 273 Bibliography 279 Index 333 FROB FM ppi-xxiv 8/5/03 10:00 AM Page vii FROB FM ppi-xxiv 8/5/03 10:00 AM Page viii ix FIGURES .. Tuberculosis alert campaign 3 .. Person sneezing showing the droplets created 7 .. “No Spitting” sign, Oakworth Station, West Yorkshire 8 .. Possible course of events following primary infection with the tubercle bacillus 9 .. U-shaped curve of concern 18 .. The types of tuberculosis, risk factors, and vulnerable groups (Vietnamese population) 27 .. The Piot model ofthe treatment process in tuberculosis 33 .. Personal and environmental factors affecting drug compliance in India 38 .. Estimation ofthe protection effect of BCG vaccination 41 .. The Brontë sisters, Charlotte, Emily, and Anne 53 .. Relationship between four indices of poverty and rate oftuberculosis 59 .. Average number of hours of bright sunshine per day in the British Isles 65 .. Mean daily sunshine: England and Wales, Scotland, and Northern Ireland 66 .. Seasonal trends in deaths in London, 1845–74 66 .. Relative movement oftuberculosis across the globe, 1800–1850 67 .. Relative movement oftuberculosis across the globe, 1950–90 67 .. Temporary accommodation for migrant workers in India 68 .. Miners of Kuttenberg, by Matthaus of Kuttenberg, c. 1490 70 .. Collecting cocoons and weaving silk 73 .. Dairy produce for pastoralists in Xingjiang, China 76 .. Dung piles and yurts, Xingjiang, China 77 .. Skeletal distribution oftuberculosis 90 FROB FM ppi-xxiv 8/5/03 10:00 AM Page ix [...]... E Tuberculosis (TB) as adisease has caused so much human suffering, and so much has been written already about it, over such a long time, that readers may be wondering why we want to write yet another book onthe subject In a way, the study of how disease affects human populations has always had a fascination for us The reconstruction of past human behavior does not stop at death because, as Dormandy... (Poland); Gyorgy Pálfi (Hungary); Rimantas Jankauskas (Lithuania); Andreas Nerlich, Michael Schultz, and Albert Zink (Germany); Anthea Boylston, Don Brothwell, Andrew Chamberlain, Mary Lewis, Simon Mays, Ann Stirland, and Bill White (U.K.); Alexandra Buzhilova (Russia); Ann Katzenberg and Shelley Saunders (Canada); Michael Pietrusewsky and John Verano (United States); Miho Tanihata (Japan); Soren Blau... (Finland); George Maat (the Netherlands); Philip Masy (Belgium); Joel Blondiaux, Olivier Dutour, Gyorgy Pálfi, and Marc Pavaut (France); Maria Teschler-Nichola and Karin Witschke-Schrotta (Austria); Elisabeth Langenegger and Frank Ruhli (Switzerland); Alessandro Canci (Italy); Joaquim Baxarias, Lourdes Herrasti, and Ana Luisa Santos (Spain); Marija Djuric-Srejic (Yugoslavia); Judyta Gladykowska-Reczecka... identification of the infection in the skeleton needed refining (Roberts et al 1998) Jane Buikstra's interest in thedisease also arises from a combination of personal engagement and intellectual enquiry Her paternal grandfather, Gerrett B Buikstra, immigrated as a boy from Friesland in the Netherlands to the United States following the death of his father from tuberculosis Buikstra's study of the infection... nonhuman primates, and Keith Dobney and Angela Gernaey (U.K.) on archaeologically derived nonhuman tuberculosis Kevin MacDonald (U.K.) helped onthe date of cattle domestication in Egypt, and Clara Lau pointed us to a recent paper on botanical remedies for tuberculosis Jacqui Huntley (University of Durham, England) also helped on identification of common names for some botanical remedies Peter Atkin... Conventional drugs used in TB treatment 34 Components ofthe deprivation indices and weightings on each component 61 Anxiety through the year ofthe Massa and Mussey of Africa 72 Workload distribution through the year ofthe Massa and Mussey, Africa 72 Cattle tuberculosis figures for 1997–March 2000 for England, Wales, and Scotland 75 Survival times of M bovis under different environmental conditions... a common interest, and it seemed reasonable to come together and to collate information on the history of tuberculosis into a book In addition, it became apparent that tuberculosis was again becoming a problem Indeed, in 1993 the World Health Organization declared that TB was aglobal emergency (Grange 1999: 3) Reemergence of infectious disease has, since, become a hot topic of discussion and has highlighted... began in the late 1960s, when she was engaged in the investigation oftuberculosis among historic period skeletal remains ofthe Caribou Eskimo from the Barrengrounds of Canada as part ofa project directed by Charles J Merbs (Buikstra 1976) Since that time she has extended her research to midcontinental North America and the west-central Andes, particularly focusing on where, why, and when the disease. .. did their spinal deformity lead to disability or even a handicap? (A question that is always hard to answer when dealing with just a skeleton; people are very good at adapting.) We can only infer how devastating this disease was on human populations in the past by using multiple forms of evidence Clearly (and just as applicable to the present problem of tuberculosis) , we perhaps see just the tip of the. .. bovis, along with M africanum, M canettii, and M microti, make up the “M tuberculosis complex” and are closely related organisms Vincent and Gutierrez Perez (1999) further define M tuberculosis as an agent oftuberculosis in humans and a small number of animals, M bovis as the agent oftuberculosis in animals and in some humans, M africanum as the agent oftuberculosis in humans in some African countries, . THE BIOARCHAEOLOGY OF TUBERCULOSIS A Global View on a Reemerging Disease Charlotte A. Roberts and Jane E. Buikstra University Press of Florida Gainesville/Tallahassee/Tampa/Boca Raton Pensacola/Orlando/Miami/Jacksonville/Ft ii THE BIOARCHAEOLOGY OF TUBERCULOSIS A Global View on a Reemerging Disease Charlotte A. Roberts and Jane E. Buikstra University Press of Florida Gainesville/Tallahassee/Tampa/Boca Raton Pensacola/Orlando/Miami/Jacksonville/Ft Boca Raton Florida Gulf Coast University, Ft. Myers Florida International University, Miami Florida State University, Tallahassee University of Central Florida, Orlando University of Florida, Gainesville