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For more than two centuries, lack of sunlight has been understood to cause vitamin D deficiency and documented as a primary cause of rickets. As such, evidence of rickets in the archeological record has been used as a proxy for vitamin D status in past individuals and populations. In the last decade, a clinical global consensus has emerged wherein it is recognized that dietary calcium deficiency also plays a role in the manifestation of rickets and classic skeletal deformities may not form if dietary calcium is normal even if vitamin D is deficient. This disease is now clinically called "nutritional rickets" to reflect the fact that rickets can take calcium deficiency-predominant or vitamin D deficiency-predominant forms. However, there are currently no paleopathological studies wherein dietary calcium deficiency is critically considered a primary etiology of the disease. We review here the interplay of calcium, vitamin D, and phosphorous in bone homeostasis, examine the role of dietary calcium in human health, and critically explore the clinical literature on calcium deficiency-predominant rickets. Finally, we report a case of rickets from the late Formative Period (~2500-1500 years ago) of the Atacama Desert and argue the disease in this infant is likely an example of calcium deficiency-predominant rickets. We conclude that most archeological cases of rickets are the result of multiple micronutrient deficiencies that compound to manifest in macroscopic skeletal lesions. For clinicians, these factors are important for implementing best treatment practice, and for paleopathologists they are necessary for appropriate interpretation of health in past communities.

During the nineteenth century, New Zealand was promoted as a land of plenty, promising a ‘better life’, to encourage families to settle and develop the growing colony. This paper characterises the ...

This paper presents a case study of a young adult from the late Neolithic Yangshao cultural period site (∼3300–2900 years BC) of Guanjia (关家) located in Henan Province on the Central Plains of China, who has evidence for skeletal dysplasia characterised by proportional stunting of the long bones and a small axial skeleton, generalised osteopenia, and non-fusion of epiphyses. We provide a detailed differential diagnosis of skeletal dysplasia with paediatric onset and conclude that this is likely a form of hypopituitarism or hypothyroidism, an extremely rare finding within the archaeological context. This paper highlights the issues of distinguishing the forms of proportional dwarfism in palaeopathology because of the considerable variation in manifestation of these conditions. Finally, we assess whether there were any health and social implications for this person and community through the consideration of a bioarchaeology of care approach across the lifecourse, burial context, and information on social perceptions of ‘difference’ in the community. 标题：中国新石器时代不同的成长历程：一个青壮年骨发育异常案例的情景分析及鉴别诊断 本文以中国中原地区河南省新石器时代晚期仰韶文化关家遗址（公元前3300年～2900年）的一个青壮年为研究对象。该个体表现出骨骼发育异常，包括长骨成比例发育不良，较小的中轴骨，全身骨质稀少，及骨骺不融合。我们对该个体进行了儿科骨骼发育不良的详细鉴别诊断，并得出结论，这可能是垂体功能减退或甲状腺功能减退的一种形式。这在考古学背景下是极为罕见的发现。由于各矮化疾病的表现形式有较大的变异性，本文着重讨论了在古病理学中分辨不同形式的成比例矮化的问题。最后，我们结合对整个生命历程的生物考古护理研究、埋葬背景、“差异”个体的社会认知等信息，评估是否对该个体和社区有健康或社会影响。

Objectives In this brief communication we discuss issues concerning scientific rigour in palaeopathological publications, particularly studies published in clinical or general science journals, that employ skeletal analysis to elucidate the lives and deaths of historical figures or interpret “mysterious” assemblages or burials. We highlight the relationship between poor methodological rigour and lack of interdisciplinary communication, and discuss how this can result in scientifically weak, sensational narratives being presented to the public. Conclusions Although most high profile publications involving analysis of archaeological human remains are methodologically sound and well interpreted, others have suffered from poor scientific rigour stemming from an apparent lack of awareness of anthropological methods and ethics. When these publications are highlighted by the press, sensationalistic narratives are perpetuated which may reflect poorly on our discipline and give the public unrealistic expectations about our work. Suggestions for future research We suggest that best practice in high-profile paleopathological research include recruitment of a range of authors and reviewers from clinical sciences, anthropology, and the humanities, consideration of the ethical issues surrounding retrospective diagnosis, and transparency with the press in regards to the limitations inherent in this kind of work.

The South Island of New Zealand saw several major waves of migration in the mid-nineteenth century, predominantly from Europe but also with an ethnically distinct Chinese presence. The rural community of Milton, Otago, was a settler community established primarily by immigrants from the United Kingdom in search of a better quality of life. However, these settlers faced unique challenges related to surviving in an isolated location with very little infrastructure compared to their origin populations. In 2016, excavation was undertaken at St. John’s burial ground, Milton, with the object of using bioarchaeological methods to elucidate the lived experience of the first organized European settlement of this region, particularly in terms of health and disease. Here we present a case study of Burial 21 (B21), a male individual of known identity and a documented cause of death. We use biochemical and paleopathological methods to ground-truth his written history, which includes a period of invalidism due to tuberculosis, and discuss the implications of our findings for the community, provision of care, and quality of life in rural colonial New Zealand. He maha tonu ngā hekenga tāngata ki Te Waka a Māui i ngā tau kei waenga pū o te rau tau 1800, ko te nuinga nō Ūropi, heoi he tokomaha tonu nō Haina. Nā ngā manene nō Peretānia te hapori o Milton i whakatū ki Tokomairaro, i Ōtākou, i tō rātou hiahia ki tētehi oranga kounga ake i tō rātou oranga i Peretānia. Heoi, ko ētehi o ngā wero nui i tau ki ngā manene nei i ahu mai i te noho pūreirei ki tētehi wāhi kāore rawa ngā ratonga i rite ki ngā wāhi i ahu mai ai rātou. I te tau 2016, i hahu kōiwi i te urupā o Hato Hone, i Milton, hei whakamātau i te kaha o te ora me ngā momo mate i pā atu ki ngā tāngata whai i noho i te rohe nei. Nei rā he ripoata mō tētehi kua hahua, kua tapaina ko B21, he tāne ia, ko tōna ingoa kua mōhiotia, ko tōna mate kua āta tuhia. Kua āta whakamātauria ōna kōiwi me ōna toenga kiko mō ngā tohu ora me ngā tohu mate, kia mārama ai mena rānei e hāngai ana ngā tuhinga rongoā mōna, ngā mea i tuhia nōna e takatū ana, tae atu ki te wā i tūroro ia i te mate kohi, ki ngā tohu e puta ana i te mātauranga Rongoā-Koiora ō nāianei. Ka matapakina ngā hīrautanga o ngā kitenga me te māramatanga kua puta i tēnei rangahau e pā ana ki te hapori, ki ngā ratonga hauora, me te kounga o te oranga mō te hunga noho tuawhenua i tērā wā i Aotearoa.

Experiences of childhood in colonial New Zealand are difficult to reconstruct from the historical record alone. Many of those who came to the colony were illiterate, and the Victorian tendency to avoid discussion of pregnancy and breastfeeding practices restricts our understanding of this important period. Bioarchaeological investigation, however, has the potential to illuminate the life stories of these first-generation Pākehā (European) settlers. Here we use isotopic evidence combined with dental pathology from children interred in a historic cemetery from Otago, New Zealand, to examine colonial childhood. We show how weaning practices in the colony differ from those experienced by their emigrant parents, highlight periods of illness likely associated with the weaning process, and bring to light the potential problems caused by maternal Vitamin D deficiency in the colony.

The histological identification of interglobular dentine (IGD) in archeological human remains with macroscopic evidence of rickets has opened a promising new avenue for the investigation of metabolic disease in the past. Recent paleopathological studies have shown that histological analysis of archeological human teeth may allow the identification of periods of vitamin D deficiency occurring within very narrow developmental windows, yielding new information on the seasonality or even maternal-fetal transmission of this disease. However, currently available techniques for recording IGD rely on subjective scoring systems or visual estimations, potentially leaving them open to inter and intra-observer error and rendering comparisons of datasets difficult. Here we describe a new imaging protocol that utilizes open access software and may yield more objective and quantitative data on the amount of IGD present within a dentinal region of interest. We demonstrate that grayscale histograms in FIJI (R)/ImageJ (R) might be used to provide less subjective estimates of the percentage of a region of interest affected by IGD. Application of this technique may enable more accurate comparison of datasets between researchers.

Studies of contemporary populations have demonstrated an association between decreased dietary diversity due to resource scarcity or underutilization and an increase in diseases related to poor micronutrient intake. With a reduction of dietary diversity, it is often the women and children in a population who are the first to suffer the effects of poor micronutrient status. Scurvy, a disease of prolonged vitamin C deficiency, is a micronutrient malnutrition disorder associated with resource scarcity, low dietary diversity, and/or dependence on high carbohydrate staple-foods. The aim of this paper is to assess the potential impact of nutritional transition on the prevalence of diseases of nutritional insufficiency in an archaeological sample. Here, we report palaeopathological findings from an Early Formative Period transitional site located in coastal Northern Chile (Quiani-7). The subadult cohort from this site is composed of four perinates who exhibit a number of non-specific skeletal changes suggestive of a systemic pathological condition. One of these is associated with an adult female exhibiting diagnostic skeletal lesions of scurvy. We argue that the lesions exhibited by these perinates may represent maternal transmission of vitamin C deficiency but acknowledge that there are difficulties in applying current diagnostic criteria for scurvy to individuals this young.

Vitamin D deficiency has traditionally been viewed as a metabolic bone disease by bioarchaeologists and considered primarily in terms of the development of specific musculoskeletal changes used for diagnosis in paleopathological research. These skeletal manifestations are usually interpreted as representing general ill-health. Clinical research shows that vitamin D is also integral to a number of extra-skeletal physiological processes including immunoregulation, blood pressure homeostasis, cell division, and programmed cell death. Vitamin D deficiency and sub-clinical insufficiency are thought to be risk factors for infectious and autoimmune diseases, as well as certain cancers and cardiovascular diseases. Epidemiological work indicates that the skeletal manifestations of vitamin D deficiency represent the extreme end of a spectrum of morbidity associated with negative health outcomes, including increased risk for secondary tuberculosis. This article provides a review of clinical research on the extra-skeletal roles of vitamin D and the pathological consequences of poor vitamin D status. Additionally, it presents an interpretive model for bioarchaeological analyses of rickets and osteomalacia for consideration of the whole-body impact of poor vitamin D nutriture and possible comorbidities that may have affected the wider population. Am J Phys Anthropol 160:183-196, 2016. © 2016 Wiley Periodicals, Inc.

Interpreting early life experience in the past is of considerable interest to archaeologists, yet remains fraught with difficulty. Children are sensitive barometers of population health in general. In addition, infant feeding practices, and stresses experienced during infancy and childhood, have important effects on adult health and demographic changes. Understanding how diet and physiological stress interact is therefore of significance, but most bony indicators of stress have non‐specific etiologies that cannot be tied to events during childhood. The recent advent of incremental isotopic techniques means we now have the potential to identify periods of stress and dietary change during childhood through changes to stable carbon and nitrogen isotopic ratios during tissue formation. Being able to establish these individual weaning trajectories allows us to consider individuality in past weaning choices, giving the bioarchaeologist a more nuanced picture of the past. Here, we investigate whether combining paleopathological and isotopic data can give insight into the synergy between infant feeding and stress. We present a case study of a 5‐year‐old child from an early agricultural period archaeological site in the northern Atacama Desert, Chile. We show that, despite physiological stress likely affecting isotopic ratios in this individual, a weaning curve is visible and the interpretation of weaning behaviour is possible. In addition, we suggest that there is isotopic evidence for a micronutrient deficient weaning diet that may be correlated with bony evidence for pathology.

The past two decades have seen a proliferation in bioarchaeological literature on the identification of scurvy, a disease caused by chronic vitamin C deficiency, in ancient human remains. This condition is one of the few nutritional deficiencies that can result in diagnostic osseous lesions. Scurvy is associated with low dietary diversity and its identification in human skeletal remains can provide important contextual information on subsistence strategy, resource allocation, and human‐environmental interactions in past populations. A large and robust methodological body of work on the paleopathology of scurvy exists. However, the diagnostic criteria for this disease employed by bioarchaeologists have not always been uniform. Here we draw from previous research on the skeletal manifestations of scurvy in adult and juvenile human skeletal remains and propose a weighted diagnostic system for its identification that takes into account the pathophysiology of the disease, soft tissue anatomy, and clinical research. Using a sample of individuals from the prehistoric Atacama Desert in Northern Chile, we also provide a practical example of how diagnostic value might be assigned to skeletal lesions of the disease that have not been previously described in the literature.

Vitamin D deficiency has traditionally been viewed as a metabolic bone disease by bioarchaeologists and considered primarily in terms of the development of specific musculoskeletal changes used for diagnosis in paleopathological research. These skeletal manifestations are usually interpreted as representing general ill-health. Clinical research shows that vitamin D is also integral to a number of extra-skeletal physiological processes including immunoregulation, blood pressure homeostasis, cell division, and programmed cell death. Vitamin D deficiency and sub-clinical insufficiency are thought to be risk factors for infectious and autoimmune diseases, as well as certain cancers and cardiovascular diseases. Epidemiological work indicates that the skeletal manifestations of vitamin D deficiency represent the extreme end of a spectrum of morbidity associated with negative health outcomes, including increased risk for secondary tuberculosis. This article provides a review of clinical research on the extra-skeletal roles of vitamin D and the pathological consequences of poor vitamin D status. Additionally, it presents an interpretive model for bioarchaeological analyses of rickets and osteomalacia for consideration of the whole-body impact of poor vitamin D nutriture and possible comorbidities that may have affected the wider population. Am J Phys Anthropol 160:183-196, 2016. © 2016 Wiley Periodicals, Inc.