Ortner's Identification of Pathological Conditions in Human Skeletal Remains

Jane E. Buikstra, Jane E. Buikstra

• Publisher: Academic Press
• Year: 2019
• ISBN:
  9780128099018
• Edition: 3
• Topic: Law
• Subtopic: Forensic Science
• Index: Law

Ortner's Identification of Pathological Conditions in Human Skeletal Remains, Third Edition, provides an integrated and comprehensive treatment of the pathological conditions that affect the human skeleton. As ancient skeletal remains can reveal a treasure trove of information to the modern orthopedist, pathologist, forensic anthropologist, and radiologist, this book presents a timely resource. Beautifully illustrated with over 1, 100 photographs and drawings, it provides an essential text and material on bone pathology, thus helping improve the diagnostic ability of those interested in human dry bone pathology.

• Presents a comprehensive review of the skeletal diseases encountered in archaeological human remains
• Includes more than 1100 photographs and line drawings illustrating skeletal diseases, including both microscopic and gross features
• Based on extensive research on skeletal paleopathology in many countries
• Reviews important theoretical issues on how to interpret evidence of skeletal disease in archaeological human populations

Chapter 1

Introduction

Jane E. Buikstra, Arizona State University, Tempe, AZ, United States

Abstract

This chapter includes the histories of the first two editions by Don Ortner, along with a statement outlining the development of this third edition, including the manner in which it builds on the fundamental concepts of the earlier volumes. Acknowledgments for all three editions appear, along with the abbreviations for the institutions at which the images reproduced in this volume were taken.

Keywords

Diagnosis; history; human paleopathology; Ortner; Putschar

This third edition of the Identification of Pathological Conditions in Human Skeletal Remains updates and expands upon the topical coverage of earlier works published by Ortner and Putschar (1981) and Ortner (2003). In this chapter, we develop a “roadmap” for the structure and organization of this volume. First, we present the history of this landmark volume from the perspectives of Donald J. Ortner (first and second editions) and Jane E. Buikstra (third edition). In these sections, and elsewhere, our goals have included retaining Don’s voice, so there are many portions of the second edition that are retained throughout the volume. We also acknowledge those individuals and institutions who have contributed to its development over the past 30+ years. We then introduce the objectives for this third edition, outlining those chapters that have been reorganized as well as those chapters that have been added to this edition, which cover a new range of related fields integral to the development of 21st century paleopathology. Finally, we will introduce and review the format of the volume and its organization.

History of the First Edition From Donald J. Ortner

The first edition of this book was the result of a joint collaboration between Dr. Walter G. J. Putschar and me. Dr. Putschar was an internationally known, consultant pathologist at Massachusetts General Hospital in Boston, MA, who had a special interest in diseases of the human skeleton. We began our professional relationship in 1970 when he accepted my invitation to be the principal lecturer in a seminar series on human skeletal paleopathology that I was organizing at the Smithsonian Institution. The first Paleopathology Seminar Series was held in 1971 and brought several leading authorities on skeletal disease, paleopathology, and related subjects to the Smithsonian Institution to present a series of lectures to a select group of scholars interested in skeletal paleopathology.

The seminar series was held yearly through 1974. By that time the logistics of obtaining funds to offer the series, arranging for students to come from many universities, including those outside the United States, and assembling an outstanding faculty for the 10-week series of lectures and laboratory sessions raised serious questions about whether this was the most cost-effective method for enhancing the quality and direction of research in skeletal paleopathology. It also highlighted the need for a comprehensive reference work on diseases of the skeleton that might be encountered in archeological skeletal remains. I discussed this issue with Dr. Putschar and we decided that many more scholars interested in skeletal paleopathology would have access to the substance of the seminar series if the information in the lectures and laboratory sessions was incorporated into a well-illustrated and comprehensive reference work on pathological conditions that affect the human skeleton.

In the summer of 1974, with the support of a grant from the Smithsonian Research Foundation (now the Smithsonian Scholarly Studies Program), Dr. Putschar and I, accompanied by our wives, Florence Putschar and Joyce E. Ortner, and my three children, traveled extensively in Great Britain and several European countries for more than three months visiting educational and research centers that had significant collections of documented human skeletal pathology. In selecting these centers, we leaned heavily on the advice of the late Dr. Cecil J. Hackett, a physician who had worked for several years in Uganda where he had treated hundreds of patients suffering from yaws. This experience led to a research interest in treponematosis, and Dr. Hackett wrote his doctoral dissertation on the clinical, radiological, and anatomical manifestations of yaws (Hackett, 1947). Following his career in Uganda, Dr. Hackett settled in England where he continued his research on treponematosis, its history and skeletal manifestations. As part of this research he visited many of the major European collections of anatomical pathology that contained documented cases of syphilis. Hackett’s research on these cases resulted in the publication of his classic monograph (Hackett, 1976) on the skeletal manifestations of syphilis, yaws, and treponarid (bejel). His knowledge of these collections and which ones were likely to serve the objectives Dr. Putschar and I had set out to achieve was an invaluable asset.

During our visit to these institutions, Dr. Putschar and I studied and photographed hundreds of cases of skeletal disease. In addition to the photographic record we made of these cases, we often were able to obtain autopsy or museum records that provided descriptive details and a diagnosis for the cases. Radiographic films were acquired for some of the cases. Dr. Putschar dictated his observations about each case and these observations were subsequently transcribed and organized by Mrs. Putschar. In some cases, Dr. Putschar’s diagnostic opinions were at variance with the diagnosis given in the catalog and this difference was duly noted in his observations. Most often, however, the diagnosis given in the catalogs was plausible if not reasonably certain.

We began the task of writing the book shortly after completing our European research in 1974. In 1979, we submitted the completed manuscript to the Smithsonian Institution Press for publication as part of the Smithsonian Contributions to Anthropology series. The manuscript was reviewed by the Department of Anthropology, external reviewers, the Director’s office of the National Museum of Natural History, and the Press. After approval on all levels, editing and production took an additional several months and the book was published in December of 1981 as Smithsonian Contributions to Anthropology, Number 28. A hard-cover edition was published in 1985 that was identical to the first edition except for the addition of an index.

Acknowledgments for the First Edition

The initial research conducted for the first edition of this book was an extensive survey in 1974 by Dr. Putschar and me of documented skeletal pathology in 16 European pathology and anthropology collections in six countries. This survey was supported by the Smithsonian Research Foundation and Hrdlička Fund. The following list of these institutions and the staff members who assisted our survey of their collections is inadequate recognition of the many courtesies extended during our work. Sadly, many colleagues who provided this assistance have since retired or died. Furthermore, some of the collections have been moved from the site where we studied them and some probably no longer exist. However, it remains appropriate to acknowledge the contribution they have made to both editions of this book. Austria: Federal Pathologic-Anatomy Museum, Vienna (Dr. Karl von Portele and Dr. Alexander Müller); Pathology Museum of the University of Graz (Prof. Dr. Max Ratzenhofer); Pathology Museum of the University of Innsbruck (Prof. Dr. Albert Probst and Prof. Dr. Josef Thurner, Salzburg, Austria). Czechoslovakia: National Museum, Department of Anthropology, Prague (Dr. Emanuel Vičk, Dr. Milan Sfloukal and Dr. H. Hanākovā). England: The Natural History Museum, London (Dr. Theya Molleson and Rosemary Powers); Guy’s Hospital Medical School, Gordon Pathology Museum, London; The Royal College of Surgeons of England, Wellcome Museum, London (Dr. Martin S. Israel); The Royal College of Surgeons of England, Hunterian Museum, London (Elizabeth Allen); St. George’s Hospital Medical School, Pathology Museum, London; Westminster Hospital School of Medicine, Pathology Museum, London. France: (Prof. Y. Le Gal and Prof. Andrè Batzenchlager). Scotland: The Royal College of Surgeons of Edinburgh (Prof. Eric C. Mekie, Dr. Andrew A. Shivas, Violette Tansy, Turner, McKenzy). Switzerland: Anthropological Institute of the University of Zurich (Dr. Wolfgang Scheffrahn); Historical Museum, Chur (Dr. H. Erb); Institute of Pathological Anatomy of the University of Zurich (Prof. Dr. Erwin Uehlinger, Prof. Dr. Christoph E. Hedinger, and Aschwanden); Natural History Museum, Bern (Prof. Dr. Walter Huber). Dr. Cecil J. Hackett, an associate of the Royal Orthopaedic Hospital, did much to expedite our work in London, England, and offered several helpful suggestions regarding collections in other countries that proved valuable to our study.

The product of this 1974 survey was more than 1200 photographs, both black and white and color (taken by me) of approximately 500 pathological specimens jointly studied. For some cases, we were able to obtain x-ray films as well. Dr. Putschar described the specimens in detail on tape, and included original autopsy and clinical data where available. This collection of photographs, radiographs, and the transcripts of case descriptions is available for study at the Department of Anthropology, National Museum of Natural History, Smithsonian Institution, Washington, DC. Many of them are used as illustrations in this book.

A number of people made significant contributions during the preparation of the manuscript. Paula Cardwell, Elenor Haley, and particularly Katharine Holland typed initial drafts. Marguerite (Monihan) Guthrie and Elizabeth Beard typed the final draft. Marcia Bakry prepared some of the drawings. A special note of appreciation goes to Jacqui Schulz for the many unpaid hours spent preparing the remaining drawings and getting the photographic illustrations ready for publication. Photographic enlargements were prepared by H.E. Daugherty and Agnes I. Stix. Stix also assisted in editing and typing the manuscript. David Yong, Edward Garner, and Dwight Schmidt provided valuable technical assistance. The staff of the library of the Smithsonian Institution, particularly Janette Saquet, was most helpful. Dr. J. Lawrence Angel, Dr. T. Dale Stewart, and Dr. Douglas H. Ubelaker, members of the Department of Anthropology, Smithsonian Institution, have made valuable suggestions, as have Dr. Saul Jarcho (New York City) and Dr. George Armelagos (University of Massachusetts, Amherst, MA). The staff of the Smithsonian Institution Press, particularly Albert L. Ruffin, Jr., managing editor, series publications, and, Joan B. Horn, senior editor, deserve special recognition for their assistance from the conceptualization through publication of the book. Finally, the wives of both authors have been intimately involved with the preparation of the book. Florence Putschar spent hundreds of volunteer hours organizing photographs, typing, preparing the bibliography, editing, and otherwise making her remarkable abilities available to the project. Joyce Ortner has also assisted in obtaining illustrative material and skeletal specimens.

History of the Second Edition From Donald J. Ortner

Since Dr. Putschar and I completed the manuscript for the first edition, much has changed in the study of ancient skeletal diseases. The Paleopathology Association, established in 1973 with fewer than two dozen members, is now a thriving international scientific association with more than 600 members worldwide that holds annual meetings in the United States and biennial meetings in Europe. There is now a scientific journal devoted to paleopathology¹ and another new journal in which this subject is an important emphasis. A bibliography of paleopathology (both the published edition and the supplements) contains more than 26,000 citations, many of which were published in the last 20 years (Tyson, 1997).

My own research interest and experience has developed as well. In 1984 I received a 3-year grant from the National Institutes of Health (NIH; grant AR 34250) to conduct a survey of pathological cases in the human skeletal collections at the National Museum of Natural History (NMNH). This survey was superimposed on a major effort by the Museum to create an electronic data base of our catalog that required that the anthropological collections be inventoried. Several people were involved in this inventory, but three members of the technical staff deserve particular mention: Marguerite (Monihan) Guthrie, who typed much of the manuscript of the first edition of this book, was responsible for creating, editing, and maintaining the data base. Dwight Schmidt and Stephen Hunter were responsible for doing the actual inventory of the human skeletal collection. This inventory required that all human remains in the collection be compared with the catalog record to ensure that the skeleton had been cataloged and that the catalog record was accurate. This meant opening thousands of drawers and handling more than 36,000 partial to complete human skeletons.

While they were engaged in this task, Schmidt and Hunter were encouraged to identify any cases of skeletal pathology and bring them to my attention. Both Schmidt and Hunter were enthusiastic and highly motivated. They became skilled at identifying pathological cases and ...