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Dubbed the “New Archaeology,” it emerged during a time of fundamental methodological
reassessment within the small community of scholars interested in assessing skeletal
pathology (e.g., Goldstein, 1963; Jarcho, 1966; Putschar, 1966; Stewart, 1966; Stewart and
Quade, 1969 ).These scholars argued for a shift towards skeletal sample-based (i.e., rather
than individual case-based) analysis, better bone-based criteria for differential diagnosis
(defined later on), and greater visibility of paleopathological research (as it was consistently
buried in the appendix of site reports).
A directional shift was already underway as (1) the study of disease was analytically being
linked with culture history (e.g., Angel, 1966 ), (2) diagnostic texts such as D.R. Brothwell's
Digging up Bones (1963), Calvin Wells' Bones, Bodies, and Disease (1964), and D.R. Brothwell
and A.T. Sandison's Diseases in Antiquity (1967) were published, and (3) skeletal sample-based
analysis was being conducted (e.g., Angel, 1981; Armelagos, 1968 ). By 1970, the methodolog-
ical merging of processual archaeology, analytical paleopathology, and the biocultural
approach had redefined skeletal analysis.
A pivotal decade for skeletal analysis was 1970 e 1980. Within this decade, a number of key
studies revealed unexpected co-associations of subsistence strategy and the health preva-
lence of certain pathologies (e.g., porotic hyperostosis, cribra orbitalia, linear enamel hypo-
plasia, and nonspecific infection), which indicated that the transition to agriculture was not
the presumed surplus-producing, population increase facilitating, cost e benefit basis for civi-
lization as had been thought (e.g., Armelagos, 1968; Armelagos and Dewey, 1970; Lallo 1972;
Cassidy, 1972; Cook, 1976; Lallo et al., 1977, 1978; Buikstra, 1977b; Lallo and Rose, 1979; Buik-
stra and Cook, 1980; Diamond, 1987 ). Indeed, this first generation research culminated in
must-read titles such as Disease and Death at Dr. Dickson's Mounds ( Goodman and Armelagos,
1985 ) and Paleopathology at the Origins of Agriculture ( Cohen and Armelagos, 1984 ). By the end
of the decade, analytical paleopathology had been subsumed under a new label: bio-
archaeology ( Buikstra, 1977b ). Paleopathology as currently defined focuses on disease
diagnostics, quantification, and antiquity; analytical paleopathology (in addition to paleode-
mography, mortuary analysis, trace element analysis, etc.) is part of bioarchaeology.
The growth of bioarchaeology in the ensuing decades has been exponential ( Larsen, 1997;
Steckel and Rose, 2005; Buikstra and Beck, 2006; Grauer, 2012 ). Every year new studies build
piecemeal toward a more comprehensive socioeconomic and temporal picture of various
regional historic and prehistoric human populations. For most cultural contexts, this is an
ongoing research trajectory that has not yet reached, much less exceeded, its probative limits.
The Osteological Paradox
There are several interpretive cautions in analytical paleopathology with respect to the
community health implications, social meaning, and economic context of any given
pathology. The first of these cautions is outlined in a publication entitled “The osteological
paradox: Problems of inferring prehistoric health from skeletal samples”( Wood et al., 1992 ) and
addressed in subsequent discussions ( Wood et al., 1992; Jackes, 1993; Byers, 1994; Cohen
et al., 1994 ; Mendon¸a de Souza et al., 2003; Wright and Yoder, 2003 ). Wood and colleagues
outline three issues: (1) the demographic meaning of the skeletal sample (Konigsberg and
Frankenberg [Chapter 11], this volume); (2) congruence of the pathological state of the
dead and the population they derive from; and (3) the differential vulnerability e frailty of
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