Parasites, Porotic Hyperostosis, and the Implications of Changing Perspectives

Abstract

Cribra orbitalia and porotic hyperostosis traditionally have been viewed (at least by archaeologists) as indicators of chronic iron deficiency anemia resulting from a dependency upon maize. Recent interpretations, however, have sought to explain these conditions as an evolutionary, adaptive response to intestinal parasites rather than as a consequence of poor nutrition. Thus diet is eliminated as a contributing factor. This model, however, adopts too simplistic a view of evolution. Furthermore, it concomitantly severs the well-documented link that exists between cranial lesions and cereal-based subsistence. A more realistic approach would be to incorporate both diet and pathogens (bacterial as well as parasitic) into a symbiotic model that acknowledges the important role of parasites in the etiology of cribra orbitalia and porotic hyperostosis, while maintaining the diagnostic value of these conditions as hallmarks of early agriculture.