Paper Menu >>
Journal Menu >>
Home | About SCIRP | Sitemap | Contact Us
Copyright ? 2006-2013 Scientific Research Publishing Inc. All rights reserved.
Advan ces in Anthropology
2011. Vol.1, No.2, 15-18
Copyright © 2011 SciRes. DOI:10.4236/aa.2011.12003
Virgin Texas: Treponematosis-Associated Periosteal Reaction
6 Millenia in the Past
Bruce M. Rothschild1, Christine Rothschild2, Glen Doran2
1Northeastern Ohio Medical School, Rootstown, USA;
2Florida State University, Tallahassee, USA.
Received August 21st, 2011; revised October 7th, 2011; accepted October 18th, 2011.
In bioarchaeology, skeletal biology and paleopathology, periosteal reaction has been variably considered as a
non -speci fic sign of tra uma and alt ernat ively as ha vin g potenti ally dia gnostic implic ati ons. Exa mination of s ixth
millen n i um b efore p r es en t Texas c emet eri es f a lsi fi es th e n on - sp eci f ic tr au ma h ypo th es i s, wh ile exa m i n ati on of a
second millennium before present site reveals a new (at least to Texas) population phenomenon. In contrast to
isola ted bumps and osteomyelit is, the stu dy of periosteal rea ction in ea rly Texas is th e stud y of “virgin s,” indi-
viduals spa red the phenomenon that cause s uch bone altera tion. It is only in th e second millen nium before pre-
sent that periosteal reaction becomes widespread, both in population penetrance and in extent of skeleton af-
fected. That pattern has previously been documented for the treponematosis yaws, similar to what has been
found in other areas of Archaic North America.
Keywords: Treponematoses, Yaws, Periosteal Reaction
The tenet of “in vivo veritas” directs that the etiology of at-
tributed phenomena be established by comparison of criteria
with those established in validated populations. That is espe-
cially important for treponemal disease. Repetition of specula-
tive ideas has in th e past achieved prominence in t he “collect ive
consciousness” of the field, so much so that it is often over-
looked that such “di agnostic criteria” si mply represent un tested
thoughts. Will Rogers stated that it ain’t so much what we don’t
know th at gets us in to troub le, as what we “kno w” that ain ’t so
The suggestio n t hat periost eal reactio n has disease sp ecificit y
as a population phenomenon is well documented (Rothschild &
Martin, 1993, 2006; Rothschild & Rothschild, 1996, 1998a).
Cook’s (1976a-b, 1984) attribution of non-focal periosteal reac-
tion to trauma has been falsified, except in the presence of
complicating osteomyelitis or stress fracture (Resnick, 2002;
Rothschild & Martin, 1993, 2006).
Pathology can provide valuable clues to population origins
and migrations (Rothschild & Rogers, 2010). It is therefore
essential that pathology be accurately recognized and that its
implications be validated. The concept that periosteal reaction
is non-specific apparently had it origins in variable skills of
examiners (Byers, 1998; Cook, 1998; Katzenberg, 1992; Pow-
ell & Eisenberg, 1998; Rose, 1985; Rothschild & Rothschild,
1995b) and preconceived notions as to its significance/deriva-
tion (Goodman et al., 1988) and as to the nature of disease
(Buikstra & Cook, 1980; Cook, 1976a-b, 1998; Powell &
Eisenberg, 1998; Power, 1992; Sanford et al., 1998; Spirov,
1991). The speculation that current distribution of disease im-
plies climatic restriction was never actually tested by those
involved in its promulgation (Cook, 1998; Powell & Cook,
2005; Powell & Eisenberg, 1998). Their attribution of perio-
steal reaction to trauma has impeded progress in our under-
standing of peoples and the disease with which they were af-
flicted. The work described herein further evidences the fallacy
of the trauma hypothesis and removes periosteal reaction as
simply a stress marker (Cook, 1998; Sanford et al., 1998). In
vivo veritas replaces speculation with a new opportunity for
clarification of the anthropologic record.
Treponemal disease, in the form of Yaws, has been docu-
mented on the basis of periosteal reaction in much of North
America (Rothschild & Rothschild, 1994, 1998, 2000; Roths-
child et al., 1995a). This pattern extends from the Cascade
mountains to the east coast of Florida, dating from 8 - 9 millen-
nia before present (bp). Its distribution has been contiguous
across North America east of the Cascade mountains, with sev-
eral notable exceptions (Rothschild & Rothschild, 1998, 2000):
The Northwest territories of Canada were unaffected, as was
Ontario prior to invasion by the Iroquois. This caveat must
considered for some areas (e.g., Saskatchewan, Nebraska, Iowa,
Kansas, Oklahoma) which have not had skeleton populations
available for analysis in the post-1987 time period for which
data-based criteria have been available (Rothschild & Roths-
chil d, 1995 ).
Texas skeletal populations were therefore examined for evi-
dence of periosteal reaction.
Materi als and Me tho ds
The Texas and other North American sites delineated in Table
1 were chosen to assess the population frequency and nature,
extent and character of any non-focal (e.g., bump) periosteal
reaction pr e s e nt.
Skeletal remains were subjected to visual examination of all
articular and cortical surfaces—to identify all occurrences of
alterations throughout each skeleton, specify the types of bony
alterations at each occurrence, and map the distribution of oc-
currences in each skeleton. In sites where preservation was
fragmentary, the sample size (denominator) was determined on
the basis of sufficient tibial preservation for assessment, as the
tibia is the sentinel bone for recognition of treponemal disease
as a populat ion ph eno menon (Roth schi ld & Rot hschi ld, 1995 ;
B. M. ROTHSCHILD ET AL.
Texas and North American eviden ce of non-fo cal periosteal re action*.
Site Century BP** # Periostitis Sabre shin
Buckeye Knoll (41VT98) Texas 60 37 0 Absent
Bird Island (8DI52) Florida 45 19 0 Absent
Kamarvik (LeHv-1) NW Territories 8 79 Absent
Kulaituijavik (LaHw-1) NW Territories 8 22 0 Absent
Sadlermuit (KkHh -1) NW Territories 8 25 0 Absent
Port Au Chaux, Newfound land 34 - 51 124 0 Absent
Glen Williams, Ontario 9 90 0 Absent
Maurice Ossuary (BeHa-1), Ontario 10 50 0 Absent
Hind (AsdHk-1), Ontario Archaic 18 0 Absent
Fairty Ossuary, Ontario 11 147 0 Absent
Rankin (CK6) Tennessee Woodland 21 0 Absent
Big Sandy (Hy16), Tenn essee Archaic 35 0 Absent
Oakview Landing (40DR1) Tennessee Archaic 56 0 Absent
Hatte n Mound (23MN275) Missouri 28 23 0 Absent
Anderson Minnesota 30 30 12 (40%) Present***
Younge, Michigan 10 23 9 (39%) Present***
Galbreath Mounds (33FR58) Ohio 22 26 7 (27%) Present***
McMurray (15Fa313) Ohio Woodland 33 7 (21%) Pre sent***
Sidner Mound (Franklin County) OH Woodland 46 10 (22%) Present***
Palmer (8OS2) Florida 11 92 28 (30%) Present***
Windover (Titusville) Florida 79 112 30 (27%) Present***
Grant Mound (8BR56) Florida 18 - 24 12 3(25%) Present***
Olmos Dam, Texas 11 - 18 8 3 (38%) Present***
Carrier Mills (11SA86088) Illin ois 6 3 159 57 (36%) Present***
LU-25 (Alabama) 43 89 36 (40%) Present***
Ward (15MCL11) Kentucky 43 203 73 (36%) Present***
Ghost Warrior and Nevada 10 - 90 51 13 (26%) Present***
Note: * Derived from Rothschild and Martin, 2005; Rothschild and Rothschild, 1998c, 2000; **BP = before present; *** Without visible surface periosteal reaction.
Rothschild & Martin, 2006). Periosteal reaction in treponemal
disease invariably affects the tibia (Rothschild & Rothschild,
1995; Rothschild & Rothschild, 1996; Rothschild et al., 1995a).
Examination of the skeletons of 37 (number determined on
basis of sufficient tibial preservation) individuals from 6000
year bp Texas revealed evidence of isolated bumps and occa-
sional cases of osteomyelitis, but no diffuse periosteal reaction
(Table 1) and no sabre shin reaction. This was similar to obser-
vations in the Florida 4500 year bp Bird Island (8DI52) site, in
which th e 19 individuals presen t were similarly spared.
This sparing phenomenon contrasted with the east Florida
8000 year bp Windover and 1800 - 2400 ybp Grant mound sites
and the 1800 - 2000 year bp Texas Olmos Dam site in which
periosteal reaction was common (Table 1). Tibial involvement
in th e east Florida and Olmos Dam sites was invariable bilateral.
Disease was predominantly poly-ostotic (>3 bone groups af-
fected). Hand and foot invo lvemen t was common and ju veni les,
Actually, most of early North Americans manifested the
phenomenon observed in the east Florida sites and Olmos Dam,
but with other notable exceptions (Table 1). Periosteal reaction
was also rare in the northwest territories of Canada, the Atlantic
provin ces and eastern Ontari o and from Archaic Tennessee an d
Early Texas as a Virgin State for Treponematoses
Absence of periosteal reaction (unassociated with osteomye-
litis and exclusive of isolated bumps) from the 6000 year bp
Texas site examined documents a greater degree of population
virginity, with respect to exposure to the entities that commonly
cause periosteal reaction. Periosteal reaction occurring as a
population phenomenon (e.g., more 1% of population mani-
festing diffuse involvement of more than one bone) has only a
very limited number of etiologies: Treponematoses and hyper-
trophic osteoarthropathy (McCarty & Koopman, 1993; Resnick,
2002; Rothschild & Martin, 1993, 2006; Rothschild & Roths-
child, 2005). While hypertrophic osteoarthropathy (as a compli-
cation predominantly of intrathoracic disease) is actually quite
rare in unselected populations (Resnick, 2002; Rothschild &
Rothschild, 1998b) and as noted in the populations studied
herein, treponemal disease has a unique population signature, if
it is present. That population signature is in the form of perio-
steal reaction, affecting 2% - 13% of skeletons with syphilis
and 20-40% of skeletons with yaws or bejel (Rothschild &
Martin, 2005, 2006; Rothschild & Rothschild, 1995).
The rarity of periosteal reaction in 191 individuals in a zone
extending from western Florida to Texas and North to Tennes-
see and Missouri, and in 619 individuals from Northern and
eastern Canada, clearly documents this region as virgin territory
or at least that the lo cal Native American s were not afflict ed b y
B. M. ROTHSCHILD ET AL. 17
any known treponematosis in the time periods studied. It also
falsifies the speculation (Goodman et al., 1988) that periosteal
reaction represents a no n-specific stress reaction.
This contrasted with observations in eastern Florida and
more recent Texas and outside of the above defined trepone-
matosis-free areas. Periosteal reaction was prominent outside
that catch ment area (Table 1), in a frequen cy and pattern ind is-
tinguishable from what is seen in yaws (Helfet, 1944; Hudson,
1958; Hunt & Johnson, 1923; Moss & Bigelow, 1922; Roths-
child & Rothschild, 1995; Rothschild & Martin, 2005). This
disease is easily distinguished from the more pauci-ostotic
syphilis (Chi square = 3.973, p < 0.05), in which hand and foot
and subadult affliction are so rarely observed in skeletal popu-
lations (Rothschild and Rothschild, 1994, 1995a-b); Rothschild
et al., 1995a). Other evidence for syphilis (in the form of com-
plete sab er shin surface remodelin g and unilateral tibial disease)
was also lacking. This was also easily distinguished from the
more pauci-ostotic bejel, which infrequently affects hands and
feet (Hershkovitz et al., 1995; Rothschild & Rothschild, 1995b).
Sabre shin reaction is not found in hypertrophic osteoarthropa-
thy, predominantly a disease of distal diaphyses (Resnick, 2002;
Rothschild, 1982; Rothschild & Martin, 1993). Thyroid acro-
pachy spares the proximal appendicular skeleton, pred ominantly
producing hand and foot bone periosteal reaction (Resnick,
2002; Rothschild, 1982; Rothschild & Yoon, 1982). Infantile
cortical h yperostosi s is a disorder afflictin g clavicles, scapulae,
and ribs (Resnick, 2002). Hypervitaminosis A is predominantly
an enthesial disease, and fluorosis produces highly characteris-
tic trabecular alterations (Resnick, 2002; Rothschild & Martin,
1993; Seawright & English, 1967).
Possible Reasons for a Treponematosis-Free Zone in
Early Texas Native Americans
Although there is clear evidence for treponematosis in North
America, in t he form o f yaws, it is also clear t hat a zo n e existed
in which the inhabitants were not afflicted. Given that yaws is a
population phenomenon (afflicting essentially the entire popu-
lation) and given the evidence (e.g., Windover and Ghost war-
rior) that it had a long history, anteceding the Buckeye Knoll
and Bird Island sites, it would appear that these were distinct
populations. As yaws is contiguous in distribution in Archaic
and Woodland North America, it appears to have arrived with
an immigrant population from Asia. The absence of Yaws in
specific Canadian and Southern zones suggests that these may
have de rived from a se pa r a te imm igr a tion (m igr a tion).
This report further demonstrates how paleoepidemiology can
be used to identify population distinctiveness in paleopopula-
Anderson , J. E. (1968). The peop le of Fairt y: An Osteol ogical an alysis
of an Iroquois ossuary. National Museum of Canada Bulletin, 193,
Buikstra, J. E., & Cook, D. C. (1980). Paleopathology: An American
account. Annual Review of Anthropology, 9, 433-470.
Byers, S. N. (1998 ) The skelet al b iology of th e lower M issis sippi River
valley. American Journal of Physical Anthropology, Supplement 26,
Cockburn, E. (1995). Forty years on: Are Aidan Cockburn’s theories
still valid? In O. Dutour, G. Palfi, J. Berato & J.-P. Brun (Eds.),
L’Origin de la syphilis en Europe avant ou apres 1493 (pp. 23-26).
Toulon: Centre Archeologique du Var.
Cook, D. C. (1998) Syphilis? Not quite: Paleoepidemiology in an evo-
lutionary context in the Midwest. American Journal of Physical An-
thro po lo gy, Sup pleme nt 26, 70.
Cook, D. C. (1984). Sub sistenc e and health in the lower Illin ois va lley:
Osteological evidence. In M. N. Cohen & G. J. Armelagos (Eds.),
Pale opatho logy a t th e o rigin s of a gricul tur e (pp. 235-269). Orlando:
Cook, D. (1976 a ). The ep i d emi ology of p erios ti ti s in preh i stori c Illin ois .
American Journal of Physical Anthropology, 44, 171.
Cook, D. C. (1976 b ). Pa thologi c states and di sease p rocesse s in ill inois
woodland populations: An epidemiologic approach. Ph.D. Thesis,
Chicago: University of Chicago.
Goodman, A. H., Brooke Thomas, R., Swedlund, A. C., & Armelagos,
G. J. (1988). Biocultural perspectives on stress in prehistoric, his-
torical and contemporary population research. Yearbook of Physical
Anthropology, 31, 169-2 0 2. doi :10.1002/ ajpa.1330310509
Helfet, A. J. (1944). Acute manifestations of Yaws of bone and joint.
Journal of Bone and Joint Surgery, 26B, 672-685.
Hershkovitz, I., Rothschild, B. M., Wish-Baratz, S., & Rothschild, C.
(1995). Natural variation and differential diagnosis of skeletal
changes in Bejel (endemic syphilis). In O. Dutour, G. Palfi, J. Berato
& J.-P. Brun (Eds.), The origin of syphilis in Europe (pp. 81-87).
Toulon: Centre Archeologique du Var.
Hudson, E. H. (1958). The treponematoses-or treponematosis? British
Journ a l of Vener ea l Diseas e, 34, 22-24.
Hunt, D., & Johnson, A. L. (1923). Yaws a study based on over 2000
cases treated on American Somoa. United S tates Na val Bull etin, 18 ,
Hurley, M. F., Scully, O. M., & McCutcheon, S. W. (1994). Late Vi-
king age and medieval waterford. Excavations 1986-1992. Water-
ford: Waterf ord Corpora tion.
Ishai A., Bikle P. C., & Ungerleider L. G. (2006). Temporal dynamics
of face repetition suppression. Brain Rese ar c h B u ll etin, 70 , 28 9- 2 95.
Katzenberg, M. A. (1992). Changing diet and health in pre- and proto-
historic Ontario. University of Pennsylvania MASCA Research Pa-
pers in Science and Archeology, 9, 23-31.
Manchester, K. (1988). Cannington. Journal of Archaeological Science,
15, 51 .
McCarty, D. J., & Koopman, W. J. (1993). Arthritis and allied con-
ditions. Philadelphia: Lea & Febiger.
Moss, W. L., & Biegelow, G. H. (1922). Yaws: An analysis of 1046
cas es in th e Domi ni ca n Repu b lic . Bull e tin of th e John s Hopk in s Hos -
pital, 33, 43-47.
Powell, M . L., & Cook , D. C . (2 005 ). The myth of syphilis: The natural
history of treponematosis in North America. Gainsville: University
Press of Florida.
Powell, M. L., & Eisenberg, L. E. (1998). Syphilis in mound builders'
bon es: Treponema tosis in the pr ehistori c Southwest. American Jour-
nal of P hysical A n thropo logy, S up pl ement 26, 180.
Power, C. (1992). The spread of syphilis and a possible early case in
Waterford. Archaeology of Ireland, 6, 20-21.
Resnick, D. (2002). Diagnosis of bone and joint disord ers. Phi lad elp hi a :
Rose, J. C. (1985). Gone to a better land. Arkan sas Archeol ogical Sur -
vey Research Series, Fayetteville, 25, 1-216.
Rothschild, B. M. (1982). Rheumatology: A primary care approach.
New York: Yorke Medical Press.
Rothschild, B. M., & Martin, L. D. (1993). Paleopathology: Disease in
the fo ssil record. London: CRC Press.
Rothschild, B. M, & Martin, L. D. (2006). Skeletal impact of disease.
Albuquerque: New Mexico Museum of Natural History Press.
Rothschild, B. M., & Rogers, R. (2010). Climate and New World pe-
riosteal reaction patterns: Implications for migration routes into the
Western Hemisphere. Historical Biology, 21, 115-122.
doi:10.1080 /0891296 090328150 4
Roth schild , B. M., & Roth schild , C. (2000). Occurren ce an d tran siti ons
among the treponematoses in North America. Chungara, Revista de
Antropologia Chil ena, 32, 147-155.
Rothschild, B. M., & Rothschild, C. (1998a). Pseudoscience and tre-
ponemal disease in the Western Pacific. Current Anthropology, 40,
Roth schild , B. M., & Roths child, C. (1998b ). Recogniti on of hypert ro-
phic osteoarthropathy in skeletal remains. Journal of Rheumatology,
B. M. ROTHSCHILD ET AL.
25, 22 2 1- 2 22 7.
Rothschild, B. M., & Rothschild, C. (1998c). Skeletal examination-
based recognition of treponematoses: A four continent odyssey of
denouement, transition and spread. Bulletin de la Memoire Sociéte
Anthropologie de Paris, 10, 29-40. doi:10.3406/bmsap.1998.2500
Roth schild, B. M., & Roth schild, C. (1 996). Trepon emal diseas e in the
ne w wo r l d . Current Anthropology, 37, 555-561. doi :10.1086/204519
Rothschild, B. M., & Rothschild, C. (1995a). Distinction des maladies
treponemiques: Syphilis, Pian et Bejel a partir des differences de
leurs atteintes osseuses respectives. In O. Dutour, G. Palfi, J. Berato
& J.-P. Brun (Eds.), L’Origin de la Syphilis en Europe—Avant ou
Apres 1493 (pp. 68 -71). Toulon: Centre Archeologique du Var.
Rothschild, B. M., & Rothschild, C. (1995b). Treponemal disease re-
visited: Skeletal discriminators for Yaws, Bejel and venereal syphi-
lis. Clinical Infectious Disea se , 20, 1402-14 08.
doi :10.1093/clinids/20.5.140 2
Rothschild, C., & Rothschild, B. M. (1994). Syphilis, Yaws and Bejel:
Population distribution in North America. American Journal of
Physical Anthro pology, 94, 174-175.
Rothschild, B. M., & Yoon, B. H. (1982). Thyroid acropachy com-
plicated by lymphatic obstruction. Arthritis & Rheumatism, 25, 588-
Rothschild, B. M., Rothschild, C., & Hill, M. C. (1995a). Origin and
tran siti on of vari eti es of trep onema l disea se in the New World . Ame-
rican Journal of Phy sical Anthropology, Supplement 20, 185.
Roth schild , B. M. , Hershkovi tz, I., & Rot hschi ld, C. (1995b). Origin of
yaws in the P leistocene. Nat ur e , 37 8, 343-344.
Sanford, M. K., Bogdan, G., & Kissling, G. E. (1998) Treponematosis
in the prehistoric Caribbean, North Carolina coast and Kentucky:
Diagnostic considerations. American Journal of Physical Anthropo-
logy, Supplement 26, 194.
Seawright, A. A., & English, P. B. (1967). Hypervitaminosis A and
deforming cervical spondylosis of the cat. Journal of Comparative
Pathology, 77, 29-43. doi:10.1016/S0021-9975(67)80004-5
Spirov, G. (1991). Endemic syphilis in Bulgaria. Genitourinary Medi-
cine, 67, 428-435.
Stirland, A. (1995). Evidence for pre-Columbian treponematosis in
Medieval Europe. In O. Dutour, G. Palfi, J. Berato & J.-P. Brun
(Eds.), L’Orig in de la Syph ili s en Europe—Ava nt ou Apre s 1493 (pp .
109-115). Toulon: Centre Archeologique du Var.
Spodick, D. H. (1983). Q-wave infarction versus S-T infarction. Non-
specificity of electrocardiographic criteria for differentiating trans-
mural and nontransrnural lesions. American Journal of Cardiology,
51, 91 3- 9 1 5. doi:10.1016/S0002-9149(8 3)80160-X
Home | About SCIRP | Sitemap | Contact Us
Copyright ? 2006-2013 Scientific Research Publishing Inc. All rights reserved.