Chapter 24
Postscript Jane E. Buikstra Arizona State University, Tempe, AZ, United States
Throughout the process of reworking the chapters for this edition, many authors, including myself, were concerned about maintaining an appropriate attribution to Don’s previous work. Don’s seminal explorations of paleopathology did not require rewriting just to paraphrase, and we did not want to plagiarize. The publishers, however, emphasized the problems attendant to posthumous authorship. Deciding to name this volume Ortner’s Identification of Pathological Conditions in Human Skeletal Remains signifies Don Ortner’s fundamental and enduring contributions to the field of paleopathology, much as we link Henry Gray and John C. Boileau Grant to their anatomy text and atlas, and Donald J. Resnick to multiple volumes on bone and joint disorder. It is with a sense of relief and calm that we have decided upon this title, which symbolizes both permanence and transformation. The permanence reflects not only Don’s fundamentally important contributions, but also the field of paleopathology. This discipline has developed from an avocational interest of medical professionals to an interdisciplinary subject explored by biomedical and social scientists, along with humanists. As modern practitioners, we hold active international and national meetings and publish and present research in dedicated journals and conferences. Paleopathology therefore is established as an interdisciplinary field of substance, addressing research questions about the past that are relevant to a number of issues relating to host pathogen evolution, species transfer of disease, and the ecology of health. Settling upon the name for this volume also brought this editor a sense of calm. While wanting to make this effort the best it could possibly be, knowing that it represents a moment in the history of paleopathology rather than a “last word” has eased a tension inherent in this monumental task. With time, this effort, too, will require updating—it will and must be superseded. In this volume and elsewhere, I (Buikstra et al., 2017) have argued that modern paleopathology requires practitioners who both acknowledge and integrate knowledge
from across the sciences and humanities. The vast breadth of relevant biomedical knowledge alone is daunting and well beyond that commanded by single individuals. Adding to that, the historical and archeological information, historiography, and archeological theory required in paleopathology well illustrates the need for scholarly collaboration. As practitioners, we must therefore engage in interdisciplinary research that recognizes expertise beyond one’s own. Similarly, as we argue in Chapter 3 (see also Buikstra et al., 2017; Grauer, 2012; Ortner, 2003), there is a core interdisciplinary knowledge and scholarly approach that we should foster within ourselves, within our research groups, and transmit to students. These core topics include evolutionary and social theory, basic bone biology, and knowledge of pathological processes derived from texts and clinical reports. Within this volume, we have included and updated the core knowledge of bone pathology initially presented in Ortner and Putchar (1981) and Ortner (2003). Review of basic human osteology has been removed, as this topic is the subject of many other texts. Chapters on bone biology and pathogenesis have been significantly updated. Chapters on methods, such as imaging and histology, have also been revised. Given the immensely important contributions of molecular approaches to knowledge of past diseases, we have added a chapter on ancient DNA, including sufficient information on methodology to sufficiently inform our readership about the importance of carefully evaluating earlier approaches that used PCR techniques. Dental anthropology and dietary assessments, including biomolecular approaches, also appear here, as does a specific focus upon parasitic diseases, through the lens of archeoparasitology. Finally, we have added chapters on mummy science and animal paleopathology. As illustrated here and in those publications cited in Chapter 23, mummy science is an important aspect of our overall goal of learning about the human condition in the past. And though the separation of animal disease studies from those of humans has been an archeological
Ortner’s Identification of Pathological Conditions in Human Skeletal Remains. DOI: https://doi.org/10.1016/B978-0-12-809738-0.00024-7 © 2019 Elsevier Inc. All rights reserved.
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convention for separating human from faunal remains, the evolutionary history of disease(s) so frequently links humans to other hosts that this artificial separation seems increasingly counterproductive.
THE FUTURE OF PALEOPATHOLOGY So, what further 21st century advances shimmer before us through the lens of our crystal ball? Clearly, we have only begun to tap the knowledge available through molecular approaches. Truly fulfilling such promise will require full collaborations between historians, archeologists, and molecular scientists, as moving from description to general explanatory models will require nuanced contextual interpretations along with increasingly intricate methodologies. We can describe changing patterns of disease through time simply through molecular and radiocarbon study, yet exploring the agency of humans in the spread of disease requires knowledge of specific physical and social environments. Bringing our deep time perspectives to today’s global health issues also will assume increasing significance. Knowledge of the behavior of disease in different environmental and social contexts through time should enhance the efficacy of healthcare delivery. Similarly, knowledge of the manner in which humans have inadvertently altered microbiomes should also affect 21st-century diets and our pharmacopeia. Finally, knowledge of crossspecies disease transfer, so visible in evolutionary studies, is important in animal conservation efforts.
A further underdeveloped aspect of paleopathology involves ethical behavior, not only in clinical sampling but also in our interactions with descendent communities. We should be addressing questions of interest to such groups, being respectful of wishes regarding the treatment of their ancestors. Such collaborations require effort, but these are responsible actions that also enrich knowledge. Quite clear in the advancement of our field is that our previous dilettante interest of medical men has become a specialty that requires focus and collaborative efforts. Knowledge today is advanced in many scholarly fora— ranging from classrooms to international symposia. Global information exchange is facilitated not only by electronic journals but by less formal internet interactions. Our field is thus transformed daily and knowledge will be advanced in ways we can only imagine today. Our collaborative volume here is offered as a waystation along this ladder to the future.
REFERENCES Buikstra, J.E., Cook, D.C., Bolhofner, K.L. 2017 Scientific rigor in paleopathology. In: Buikstra, J.E., (Ed.), Rigor in Paleopathology, pp. 80 87. Special issue of the International Journal of Paleopathology, 19, 80 141. Grauer, A.L., 2012. A Companion to Paleopathology. Blackwell, New Jersey. Ortner, D.J., 2003. Identification of pathological conditions in human skeletal remains. Academic Press, San Diego, CA. Ortner, D.J., Putschar, W.G.J., 1981. Identification of pathological conditions in human skeletal remains. Smithsonian Institution Press.