Introduction: Scientific rigor in paleopathology.

This introductory chapter to the Special Issue on "Scientific Rigor in Paleopathology" serves to orient and introduce the chapters that follow through a detailed consideration of paleopathology as a 21st century intellectual field. In this vein, we first make the significant point that paleopathology is a profoundly interdisciplinary endeavor, encompassing aspects of the biomedical science, the humanities, and the social sciences. Thus, we suggest that no one practitioner can personally command the range of skills necessary for a 21st century paleopathologist. To maintain rigor in differential diagnosis, we emphasize collaborations and consider key concepts that illustrate the basic knowledge from each of these fields that any paleopathologist should command. We then address the manner in which disease diagnosis should proceed as a scientific endeavor. To illustrate scientific rigor in differential diagnosis, we present two case studies drawn from 1970s contributions by Cook and by Buikstra. Finally, we introduce Chapters 2-6, which address differential diagnosis in contexts ranging from specific conditions (scurvy, trepanation) to broader field-wide considerations (paleoparasitology, historical paleopathology, imaging, animal paleopathology).

Biological and social implications of a medieval burial from Cyprus for understanding leprosy in the past.

An early 15th-century burial from a basilica at Polis Chrysochous provides the first archaeological evidence of leprosy in Cyprus, extending the temporal depth and illuminating the biological and social history of this disease on the island. The skeletal remains of a young adult female (age 20-34 years) display pathognomonic features of lepromatous leprosy including maxillary alveolar resorption with antemortem loss of all but one incisor, remodeling of the margin of the nasal sill and resorption of the anterior nasal spine, with diaphyseal remodeling of hand and foot phalanges and the distal third through fifth metatarsals of both feet. Periosteal reaction on distal tibiae and the majority of both fibulae demonstrates tracking of inflammation from the feet to lower legs. Use wear on the remaining maxillary incisor signals participation in common occupational activities in life. Although disfigured and debilitated, burial inside the narthex of the basilica indicates that the community did not ostracize this woman in death. This contextualized analysis provides insight into the biological and social consequences of living with leprosy and illustrates the changing attitudes toward those afflicted with this disease in Cyprus.