The Science Behind Pre-Columbian Evidence of Syphilis in Europe: Research by Documentary
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Evolutionary Anthropology 21:50–57 (2012)
ISSUES
The Science Behind Pre-Columbian Evidence of
Syphilis in Europe: Research by Documentary
GEORGE J. ARMELAGOS, MOLLY K. ZUCKERMAN, AND KRISTIN N. HARPER
This article discusses the presentation of scientific findings by documentary, with- in paleopathology. The origin and
out the process of peer review. We use, as an example, PBS’s ‘‘The Syphilis Enigma,’’ antiquity of syphilis are among the
in which researchers presented novel evidence concerning the origin of syphilis that greatest historical and scientific
had never been reviewed by other scientists. These ‘‘findings’’ then entered the world questions in the history of medicine.
of peer-reviewed literature through citations of the documentary itself or material Did Columbus and his crew bring
associated with it. Here, we demonstrate that the case for pre-Columbian syphilis in syphilis from the New World to the
Europe that was made in the documentary does not withstand scientific scrutiny. We Old World in 1493, as suggested by
also situate this example from paleopathology within a larger trend of ‘‘science by the timing of the first reported epi-
documentary’’ or ‘‘science by press conference,’’ in which researchers seek to demic in Europe just years after
bypass the peer review process by presenting unvetted findings directly to the public. their return (Fig. 1)?3–5 Or did syphi-
lis originate in the Old World, simply
going unrecognized until the early
fifteenth century or, perhaps, notice-
George J. Armelagos is Goodrich C. The foundation of science is the ably increasing in prevalence or viru-
White Professor of Anthropology at peer review process.1 Within this pro- lence at this time?6–8 These rival the-
Emory University, Atlanta, Georgia. His
research has focused on diet and disease cess, research findings are vetted by ories regarding the origin of syphilis
in prehistory. He was the Viking Medal peers who are experts in the field and in the Old World have been named,
Medalist (Wenner-Gren Foundation) in can attest to the scientific worthiness
2005, received The Franz Boas Award for respectively, the Columbian and
Exemplary Service to Anthropology from of the authors’ assertions. Following pre-Columbian hypotheses. In this
the American Anthropological Association publication in a scholarly venue, the article, we focus on ‘‘The Syphilis
in 2008, and The Charles Darwin Award
for Lifetime Achievement to Biological popular press may disseminate the Enigma,’’ a documentary in the Pub-
Anthropology from the American Associa- results of this research. Popular docu- lic Broadcasting Service (PBS) series
tion of Physical Anthropologists in 2009.
Email: antga@emory.edu
mentaries and press conferences fol- Secrets of the Dead,9 which presents
Molly Zuckerman is an assistant professor lowing publication are two outlets the controversy surrounding the
in the Department of Anthropology and Mid- that have gained a prominent role in Columbian hypothesis, and a more
dle Eastern Cultures at Mississippi State realizing the obligation of scholars to
University. Her research centers on the bio- recent British Broadcasting Com-
social determinants of health inequalities bring their research to the public. pany (BBC) documentary, ‘‘Pompeii:
among past populations, with a particular However, a new genre of research has Life and Death in a Roman Town,’’
focus on social identity and gender, and on
the evolution of infectious disease, with a emerged that circumvents the process which reports the discovery of pre-
focus on syphilis. She is associated with of peer review. In ‘‘research by docu- Columbian European skeletons bear-
ongoing bioarcheological research projects mentary,’’ controversial results are ing evidence of syphilis in ancient
in the UK, Mongolia, and St. Croix.
Email: mkz12@msstate.edu not initially presented to colleagues in Rome.10 We discuss discrepancies
Kristin Harper is a postdoctoral fellow in the field for evaluation but are, between the findings described to
the Department of Environmental Sciences instead, presented directly to the pub-
at Columbia University. Her research cen-
the media and the results that, over
ters on the genetic and epigenetic path- lic without having undergone peer time, have filtered out into the
ways that lead from common environmen- review. These unevaluated results research community. We conclude
tal exposures to disease. Currently, she is
investigating several possible mechanisms then become part of the body of peer- with an overview of the origin and
underlying the development of arsenic- reviewed research through reviews, antiquity of syphilis in Europe in
induced cancer in Bangladesh. news stories, or personal communica- the light of data that have been
Email: kh2383@columbia.edu
tions. While this process has been presented in the peer-reviewed
called a ‘‘deviation’’ by some, it is literature.
becoming an increasingly common ‘‘The Syphilis Enigma’’ documen-
practice.2 tary pits one of the authors (G. J. A.)
V
C 2012 Wiley Periodicals, Inc. Here we present a few prominent against another paleopathologist,
DOI 10.1002/evan.20340
Published online in Wiley Online Library examples of this phenomenon that Charlotte Roberts, as the protago-
(wileyonlinelibrary.com). come from a controversial problem nists in a debate wherein RobertsISSUES The Science Behind Pre-Columbian Evidence of Syphilis in Europe 51
documentary’s blurb, ‘‘turns the pre- tive of syphilis is mentioned only
vailing Columbian theory on its briefly, and none of this evidence is
head.’’ The key to Roberts’ argument presented for evaluation. In fact, this
is skeletal material recovered from high reported prevalence of ‘‘syphilis-
the Hull Magistrate’s Court site in like’’ lesions, which would substan-
Hull, England, a friary founded in tially bolster the pre-Columbian hy-
AD 1316-1317 and occupied until pothesis, has yet to be discussed in a
1539, which she states reveals indis- peer-reviewed publication on the fri-
putable evidence of syphilis. The nar- ary site.
rator in the documentary specifies Moreover, an unpublished draft
that the skeletons in question have report,16 which provides the only
been radiocarbon dated to AD 1300- available comprehensive discussion
1450. To support her position, Rob- of skeletal remains from the site,
erts cites ancillary skeletal data from notes only several disarticulated long
Pompeii and Metaponto, Italy, which bones bearing ‘‘treponemal-like
she argues provide additional evi- lesions’’ and a solitary skull with
dence of syphilis appearing in caries sicca.16,50 The date ranges for
Europe before 1492. All of this evi- these finds are not indicated. While
dence is presented authoritatively, approximately 70% of adult skeletons
even though it has never been eval- from the site do indeed have lesions
uated in the peer review process. In on their postcrania, Holst and col-
addition to the documentary, ‘‘The leagues16,44 correctly note that peri-
Syphilis Enigma’’ is represented by a osteal lesions, the type of lesions
PBS web site reaffirming the mate- observed, are very common in an-
rial presented in the film, as well as cient skeletons. New bone can be de-
making it available to a wider audi- posited in response to irritation and
ence than may have seen the film.11 inflammation, among other triggers.
Finally, an additional and more bal- Thus, periosteal reactions can be
anced treatment of the subject can caused by numerous conditions,
be found in Hugh Miller’s12 chapter ranging from treponemal disease and
on the syphilis enigma in the com- varicose veins to trauma and tuber-
panion book, The Secrets of the Dead. culosis.17–20 Periosteal reactions
The documentary primarily focuses caused by treponemal disease char-
on four skeletons from the Hull friary acteristically result in thickening or
that are reported to bear indisputable expansion of the affected bones,
evidence of syphilis. Roberts gives a especially when accompanied by os-
detailed description of skeleton 1216, teitis, the deposition of new bone
a young adult male with lesions that within the marrow cavity, with local-
Figure 1. This woodcut, ‘‘The French Dis- are undeniably due to some form of ized enlargements (nodes) and shal-
ease,’’ is dated to August 1, 1496, and is
treponemal disease (that is, syphilis, low pitting on their exterior surfaces.
attributed to Albrecht Dürer. It is one of the
earliest known depictions of the disease now
yaws, or bejel). However, the other However, because of the wide range
recognized as syphilis. The illustration was three skeletons Roberts mentions as of possible causes of periosteal reac-
originally accompanied by a text commen- having ‘‘syphilis-like’’ lesions (skele- tions, lesions of this kind are by no
tary written by Theodoricus Ulsenius, city phy- tons 805, 932, and 1121) are not means diagnostic of syphilis.21,22
sician of Nuremburg, remarking on the described in any depth in the docu- The key importance of skeleton
recent emergence of the syphilis epidemic mentary. 1216 in the documentary is primarily
in Europe and attributing the origins of the
Syphilis and the other treponema- due to the pre-Columbian dates pre-
new disease to the conjunction of Jupiter,
Mars, and Saturn in 1484, as indicated by toses manifest on the skeleton in sented for it. The radiocarbon date
the signs of the zodiac above the figure. The diverse ways, but characteristically reported is in the range of AD 1300-
close temporal proximity of the production cause caries sicca lesions, a series of 1430. The film also presents a cogent
of this illustration to the return of Columbus confluent pits and star-like radial case for dendrochronological dating
and his crew provides support for the Colum- scars on the skull, along with thick- of skeleton 1216, based on Baltic for-
bian hypothesis. [Color figure can be viewed
ening of the skull and periosteal est wood taken from coffins found at
in the online issue, which is available at
wileyonlinelibrary.com.] reactions, or deposition of new bone the site. Wood from these coffins
on the exterior surface of a bone, gives a date of AD 1340-1369. The
presents evidence on the origins of accompanied by surface pitting and documentary’s narrator interprets
syphilis, which, according to the thickening of the bones.13–15 The these dates as evidence of syphilis in
documentary’s claim that 60% of the Europe 150 years before the return
other 245 skeletons recovered at the of Columbus from the New World.
site have postcranial lesions indica-52 Armelagos et al. ISSUES
But how solid is the evidence under- date ranges of AD 1408-1611 for the stratigraphic relationship is never
lying these dates? first date and AD 1492-1657 for the mentioned, which reinforces in the
Let us start with the radiocarbon second, more recent date. Both cor- viewer’s mind a pre-Columbian date
dates. Skeleton 1216 has been radio- rected dates include a span of more for skeleton 1216.
carbon dated twice, once in 2000 and than 100 years after the return of What of the three other skeletons
again in 2003. We presented both Columbus and the first recorded syph- reported to show ‘‘syphilis-like’’ lesions
dates to the public for the first time in ilis epidemic in Europe. and to have definite pre-Columbian
2011 as personal communications in The dendrochronological dating of dates? According to the Secrets of the
a critical review of reported cases of the coffins is also reported to place Dead web site, as of 200211 Charlotte
Old World, pre-Columbian trepone- the affected individuals in the pre- Roberts was working to obtain new
mal disease.23 The first radiocarbon Columbian period. In the documen- radiocarbon dates on these three skel-
date for skeleton 1216 gives a range tary, the stratigraphic relationship of etons, as well as some of the other
of AD 1310-1435; the second, a range bones recovered from the Hull friary
of AD 1428-1611. These two dates, site with ‘‘treponemal-like’’ lesions.
performed on the same skeleton, give Indeed, in 2003, Roberts obtained
ranges that barely overlap one radiocarbon dates for two of the skele-
another. This difference is most likely A very conservative tons, 932 and 1121. Independent eval-
due to error inherent in the process of adjustment suggests that uation of these cases shows that nei-
AMS dating which is poorly under- ther of them exhibit lesions that are
stood and consequently not included
approximately 30% of diagnostic of syphilis or another trepo-
when generating 95% confidence skeleton 1216’s diet nemal disease. Also, the new radiocar-
intervals.23 The latter date is consist- bon dates for the skeletons, when cor-
ent with an individual who contracted
came from marine rected for their consumption of ma-
syphilis after 1493. sources. Corrections for rine resources and the marine effect,
Moreover, neither of these date the marine reservoir stretch to 150 years after Columbus’s
ranges takes into account an impor- return: AD 1478-1647 and 1497-1671,
tant source of uncertainty in radiocar- effect yield adjusted respectively.23
bon dating: the marine reservoir date ranges of AD 1408- Thus, none of the ‘‘evidence’’
effect. In ‘‘The Syphilis Enigma,’’ Rob- reported in this widely viewed docu-
erts is quoted as saying that since Hull 1611 for the first date mentary holds up under scrutiny.
was a port city, many of its residents and AD 1492-1657 for However, even though it became pro-
may have consumed a lot of fish, ‘‘and gressively more clear, after the docu-
that high marine content in the diet the second, more recent mentary aired, that the evidence was
can affect the accuracy of the radio- date. Both corrected faulty, updated and correct informa-
carbon results.’’ That is, a diet high in tion was never presented to either the
marine or lacustrine content can gen-
dates include a span of scientific community or the public
erate radiocarbon dates for the orga- more than 100 years because there was no article to
nism that can be hundreds or even retract. As the research discussed in
thousands of years older than its
after the return of the documentary had never been pub-
actual age.24 This effect is caused by Columbus and the first lished, it took years for the authors of
delayed exchange rates between recorded syphilis this article, as well as other interested
atmospheric CO2 and ocean biocar- researchers, to obtain and assess in-
bonate, together with the dilution epidemic in Europe. formation that should have been eas-
effect caused by the mixing of surface ily accessible in a peer-reviewed jour-
waters with upwelling deep water that nal article. Unfortunately, during this
contains ‘‘old carbon.’’25–27 To correct period, the conclusions presented in
for this effect, the relative proportion the dated coffins to skeleton 1216 or the documentary began to enter the
of marine content in an organism’s the other three skeletons is never body of peer-reviewed literature,
diet is assessed, typically using d13C clearly presented. However, personal unquestioned. How did this happen?
values, because, relative to terrestrial communications in 2007 with the In von Hunnius and coworkers’33
protein sources, marine foods are typ- archeologist in charge of the excava- article ‘‘Histological Identification of
ically enriched in d13C.28,29 Correcting tions at the Hull friary site, David Syphilis in Pre-Columbian England,’’
for the effect is complicated, as d13C Evans, have firmly contradicted any in the American Journal of Physical
values yield only rough approxima- close stratigraphic, and thus tempo- Anthropology, a date range of AD
tions of marine dietary content.30–32 ral, relationship between 1216 and 1300-1450 was reported for the four
However, a very conservative adjust- these medieval coffins. Problemati- skeletons from the Hull friary site.
ment suggests that approximately cally, a description of the archeology von Hunnius and colleagues stated
30% of skeleton 1216’s diet came from and stratigraphy of the site has never that the range was based on radio-
marine sources.23 Corrections for the been published. Nonetheless, in the carbon dating, dendrochronology of
marine reservoir effect yield adjusted documentary, the ambiguity of the the aforementioned coffins, and stra-ISSUES The Science Behind Pre-Columbian Evidence of Syphilis in Europe 53
tigraphy. However, no specific radio- Another example of how the sus- test, however, is unlikely to succeed,
carbon date ranges were provided. pect findings in ‘‘The Syphilis since in tertiary treponematosis,
The article also lacked all of the Enigma’’ have become part of the when bone changes occur, very little
other information traditionally pro- peer-reviewed literature is through antigen is present and antibody levels
vided for such dates, including labo- the process of review. In an article in are lowered. These facts leave little
ratory IDs, uncalibrated dates, and the peer-reviewed journal Sexually hope of success when coupled with
d13C values. While the authors noted Transmitted Infections, Morton and the expected partial decomposition of
that, given the possibility that the Rashid35 reported on the PBS docu- antigens and antibodies after death
dates may incorporate uncertainty mentary and posed this question: and during the centuries in the soil.’’
from the marine effect, the radiocar- ‘‘The syphilis enigma: the riddle Two years later, in their contribu-
bon dates alone cannot confirm a pre- resolved?’’ While they were careful to tion to Dutour and coworkers’s vol-
Columbian date for the skeletons, use neutral language such as ‘‘It is ume, the Hennebergs37 state that
they stated that stratigraphy and den- claimed,’’ they ultimately accepted skeletal evidence for syphilis at Meta-
drochronology place the skeletons the evidence that the 245 skeletons ponto includes such features as
firmly within the pre-Columbian pe- from the Hull friary site represented thickening of diploë, a layer of bone
riod.33 It should be noted that several evidence compatible with pre-Colum- in the cranial vault; bowed ‘‘saber-
years before this article was pub- bian treponemal disease. At the time shin’’ tibiae; and cranial lesions. How-
lished, the second radiocarbon date of this writing, this article has been ever, as they acknowledge, the poor
for skeleton 1216, which substantially cited twenty times according to Goo- preservation of the remains prevents
overlapped the post-Columbian time gle Scholar. definitive diagnosis of caries sicca in
period even when uncorrected for the The skeletons from Hull were not the cases of cranial thickening,38 and
marine reservoir effect, had already the only evidence in favor of the pre- the other types of lesions are not spe-
been obtained by one of the authors Columbian hypothesis presented in cific to syphilis. The authors also note
(C. A. R.). This second date, however, ‘‘The Syphilis Enigma.’’ Skeletal mate- the presence of dental stigmata on
is not mentioned. Although this arti- rial reported to bear evidence of syph- several of the teeth recovered from
cle reiterated the information stated ilis from Metaponto, Italy, a large the site, including enamel hypoplastic
in the documentary, that archeologi- Greek colony dated to 580-250 BC, defects and ‘‘mulberry molars,’’ which
cal evidence places the four skeletons was also discussed. The evidence they regard as evidence for congenital
in the pre-Columbian time period, from Metaponto has been presented syphilis. Skeletal evidence of congeni-
David Evans, the source of the perso- by Maciej and Renata Henneberg in tal syphilis is widely regarded as con-
nal communication cited by von Hun- archeological site reports, The New firmation that syphilis existed in a
nius and colleagues, later stated that York Times, National Geographic Ex- given region and time period39; it is
this was not the case. This resulted in ploration (a non-peer- reviewed peri- critical to the argument for Old
a he-said, she-said situation that odical published by National Geo- World, pre-Columbian syphilis.40,41
could not easily be resolved because graphic), and Dutour and colleagues’3 However, neither enamel hypoplastic
of the lack of a peer-reviewed publica- influential conference proceedings defects nor mulberry molars are diag-
tion detailing the dating and archeo- volume on Old Word, pre-Columbian nostic of congenital syphilis, a fact
logical context of these skeletons. syphilis, L’Origine de la Syphilis en that the Hennebergs do not acknowl-
Thus, information from ‘‘The Syphilis Europe: Avant ou Après 1493? How- edge. Hypoplastic defects are pro-
Enigma’’ appeared almost word-for- ever, because Dutour and coworkers’ duced by incomplete development of
word in a peer-reviewed publication. findings have never been peer the tooth enamel and can be due to
This occurred even though the docu- reviewed, there is no objective way to any number of causes. Mulberry
mentary itself had never been eval- evaluate their findings. In ‘‘The Syphi- molars, also produced by incomplete
uated by peer review and had, by the lis Enigma,’’ the Hennebergs state development, have an irregular for-
time of publication of the article by that there is indisputable evidence of mation of the cusps, which makes the
von Hunnius and coworkers, been syphilis in skeletal remains found at chewing surface resemble a mulberry.
shown to be questionable by a Metaponto and Pompeii. However, A rigorous analysis by Hillson, Grig-
researcher involved in both works (C. they are more cautious in print. For son, and Bond42 demonstrated that
A. R.). In this form, it could now be instance, in an evaluation of the mulberry molars morphologically
easily cited in respectable, peer health of residents of Metaponto, overlap with several forms of enamel
reviewed publications — and this is Henneberg, Hennenberg, and Car- hypoplastic defects. As a whole, con-
exactly what has happened. At the ter36:458 cautiously stated that the evi- ditions that disturb range of growth
time of this writing, von Hunnius and dence for syphilis within the populace can cause these defects. Thus, mul-
coworkers33 have been cited fourteen is ‘‘based on macroscopic observa- berry molars are not diagnostic of the
times according to Google Scholar. tions and analysis of frequency distri- disease either.
Moreover, other researchers have butions of symptoms that in isolation Unfortunately, disregard for the
now used the spurious dates given for are not indisputably pathognomonic peer review process by researchers
the Hull friary site as the basis for for treponematosis. The ultimate delving into the origin of syphilis did
their own analyses.34 proof would have to be provided by a not end with ‘‘The Syphilis Enigma.’’
direct immunochemical test. Such a In late 2010, a documentary named54 Armelagos et al. ISSUES
‘‘Pompeii: Life and Death in a Roman
Town’’ aired on the BBC.10 During
the film, the recovery from the site of
a pair of adolescent twins displaying
what are ‘‘almost certainly the signs
of congenital syphilis’’ was reported.43
Unfortunately, the nature of these
signs was not described. However,
this announcement echoed the earlier
suggestion made in ‘‘The Syphilis
Enigma’’ and elsewhere by the Henne-
bergs,44 that there was abundant evi-
dence, in the form of skeletal lesions,
written documents, and artistic depic-
tions, for cultural practices in Pom-
peii that supported the spread of sexu-
ally transmitted infections, including
syphilis. Given the fact that a peer-
reviewed paleopathological survey of
250 skeletons from the nearby city of
Herculaneum, preserved by the same Figure 2. This illustration was originally featured in a broadsheet in verse, De Pestilentiali
volcanic eruption, found no evidence Scorra siue Mala de Franzos Eulogium, published in September, 1496, in Germany, by
of treponemal disease,45 the discov- Sebastian Brant. According to Gilman,66 the image shows a closed community of syphi-
eries reported at Pompeii certainly litics, three male and one female, being punished by the flagellum Dei (the ‘‘whip of
deserve a healthy dose of scrutiny. God’’) for their sexual transgressions. The arrows emanating from the hands of Jesus func-
Whether the vague findings reported tion as agents of infection and signify the martyrdom of the victims, who suffer as a con-
sequence of the fall from Eden. Later reworkings of this illustration place more emphasis
in ‘‘Pompeii: Life and Death in a on the male sufferer, emphasizing that he, and thus men, overall, are the true victims,
Roman Town’’ will also make their whereas women, through their sin, are to blame for the illness. The black spots or ‘‘blat-
way into the peer-reviewed literature, terns’’ (blisters) on their faces symbolize infection with the disease now known as syphilis
having never undergone review them- and are an indicator of moral blight.
selves, remains to be seen.
These examples show that one dan-
ger associated with ‘‘science by docu- tiquity of syphilis shifted some years environment that resulted in the birth
mentary’’ is that faulty research can be ago, when the pre-Columbian hypothe- of the T. pallidum subspecies that
presented as valid. Another, less sis faced a new, modified Columbian causes syphilis (T. pallidum subsp.
obvious risk is that the interpretation hypothesis, one that better fit available pallidum). Thus, in this modified
of both the problem and the results are evidence and also absolved the New Columbian hypothesis, Columbus
placed in the hands of media professio- World of being the birthplace of syphi- and his crew could have transported a
nals aiming for high ratings rather than lis.49,50 Skeletal evidence from many New World, nonvenereal treponemal
researchers seeking clarity. Thus, am- pre-Columbian sites in the New World infection to Europe upon their return,
biguous evidence and intentionally indicates a high prevalence of trepone- which, once there, could have
polarizing presentations intersect to mal disease paired with a low age of responded to dramatically different
muddy real scientific debates. For infection and an apparent absence of selection pressures with a new sexual
example, the narrator of ‘‘The Syphilis lesions attributable to congenital syph- transmission strategy. Today, neither
Enigma’’ states that the Columbian hy- ilis.5 This suggests that a nonvenereal of the major competing hypotheses
pothesis ‘‘blames’’ ‘‘dirty American In- form of the disease, similar to modern- regarding the origin of syphilis
dian women’’ for the transmission of day yaws or bejel, one not passed assigns blame or makes moral judg-
syphilis to the Old World. Similarly, through the placenta was present. ments upon Native Americans, as was
Mary Lucas Powell states in the film Due to differences in climate, cloth- suggested by ‘‘The Syphilis Enigma.’’
that ‘‘for almost 500 years, native North ing, and sexual practices, Renaissance Given the conflicting information
Americans have been blamed for giving Europe would have represented a very presented by these documentaries
the world syphilis and by implication, different environment than that pres- and our discussion here, the reader
accused of sexual immorality.’’ ent in Hispaniola, the location of may wonder which, if any, hypothe-
Certainly, debates on the origins of Columbus’s first arrival in the New sis the peer-reviewed evidence sup-
sexually transmitted infections are World. The bacterium responsible for ports. It is clear that treponemal dis-
morally loaded, and powerful groups treponemal disease, Treponema pal- ease existed in the pre-Columbian
often blame more vulnerable popula- lidum, would thus have encountered a New World; unmistakable skeletal
tions for spreading diseases such as very new set of selective pressures lesions are found at sites throughout
syphilis (Fig. 2).46–48 However, the tone upon arrival in the Old World. Per- the Americas, and they stretch back
of the debate over the origins and an- haps it was exposure to this novel host for thousands of years.4,5 In contrast,ISSUES The Science Behind Pre-Columbian Evidence of Syphilis in Europe 55
though a number of cases of pre-
Columbian, Old World treponemal
disease have been reported, all seem
to have a problematic diagnosis or
date.23
To illustrate, let us consider only
radiocarbon-dated cases of treponemal
disease. In the New World, there are
few such cases, both because the antiq-
uity of the disease is less controversial
there and because radiocarbon dating
and other types of destructive analysis
of indigenous human remains is often
impossible or inadvisable because of
the Native American Graves Protection
and Repatriation Act (NAGPRA), as
well as other social, ethical, and politi-
cal concerns.51–54 Nonetheless, those
cases that do exhibit definitive, diag-
nostic signs of treponemal disease and
have been radiocarbon dated to the
pre-Columbian period confirm that the
disease existed in the Americas for mil-
lennia (Fig. 3). Radiocarbon dates are
available for many more of the
reported Old World cases, since inva-
sive sampling is often permitted in
these regions. Once radiocarbon dates
are adjusted for the marine reservoir
effect, all cases of Old World trepone-
mal disease with a definitive diagnosis
overlap 1493, the date of Columbus’s
return (Fig. 3). These results, the lack
of treponemal lesions in huge, pre- Figure 3. A timeline showing the radiocarbon dates for reported pre-Columbian Old
Columbian European and North Afri- World and New World cases of treponemal disease. This demonstrates that the earliest
Old World cases with skeletal lesions that are diagnostic of syphilis or another treponemal
can samples, and the sudden appear-
disease (for example, bejel or yaws) cluster tightly around the year AD 1493. This contrasts
ance of characteristic lesions in many with reported Old World cases that are not diagnostic of treponemal disease and New
of the same samples after 149323 all World cases with lesions that are diagnostic, both including specimens that can be
indicate that treponemal disease securely dated to much older periods. The solid lines represent 95% confidence intervals
existed since ancient times in the New for the radiocarbon dates, unadjusted for the marine reservoir effect. The dashed lines
World, but appeared in Europe and indicate the range of dates that must be considered after adjusting for the marine
effect. Freshwater reservoir effects and some other sources of uncertainty were not incor-
North Africa only after Columbus’
porated into the adjustments.23
return voyage.
Nevertheless, this area of investiga-
tion is still open and it is probable that tives were two yaws-causing strains col- natural and social sciences suggests
novel molecular data will help close the lected from indigenous inhabitants of that the strategies of ‘‘science by doc-
book on the history of syphilis. Guyana, in South America50,55 (but see umentary’’ or ‘‘by press conference’’
Recently, for example, it was possible to Mulligan, Norris, and Lukehart56). are often used, especially to announce
obtain phylogeographic data to help These results are consistent with highly controversial findings. One
elucidate the evolutionary trajectory of the modified Columbian hypothesis strategy results in a complete circum-
this family of bacteria by sequencing described earlier. Future sequencing vention of peer review and direct dis-
modern strains of T. pallidum subsp. efforts are likely to further clarify T. pal- semination of findings to the press
pallidum, as well as strains of the sub- lidum’s shared past with humans. and thence to the public. This strat-
species responsible for the nonvenereal In conclusion, there has been a bla- egy, used in the reports of pre-Colum-
human diseases yaws and bejel from all tant disregard for the peer review pro- bian Old World evidence at Meta-
over the world. The results, obtained by cess in making the case for pre- ponto, was used in 1989, when two
sequencing twenty-one different genetic Columbian syphilis in the Old World. chemists from the University of Utah,
regions, suggested that syphilis strains Unfortunately, this is not an isolated Stanley Pons and Martin Fleischman,
diverged more recently than did their example of that phenomenon. A cur- announced by press conference that
nonvenereal relatives. Their closest rela- sory survey of important finds in the they had achieved cold fusion. This56 Armelagos et al. ISSUES
finding was disseminated to the scien- directly to the public, it generally sug- bone lesions, part II: periosteal reactions.
Radiol Clin N Am 19:749–783.
tific community only by way of news- gests that the presented findings are
18 Ragsdale B. 1993. Morphologic analysis of
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formed by independent researchers entific experts. Slow but steady pro- and pathologic findings. Adv Pathol Lab Med
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Books Received
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