The Bioarchaeology of Tuberculosis:
A Global View on a Reemerging Disease

Charlotte A. Roberts and Jane E. Buikstra

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"With their evolutionary story of one of nature's most enduring and adaptable human pathogens, Mycobacterium tuberculosis, two eminent paleoepidemiologists lay to rest the misconception that our medical technology has and will continue to conquer infectious disease."--El Molto, Lakehead University, Ontario

Tuberculosis has plagued humans and animals for thousands of years. Though apparently in decline with the advent of effective chemotherapy and improved living conditions, sanitation, and diet during the first half of the 20th century, TB has reawakened in both developed and developing countries, particularly among susceptible populations with immunodeficiency disorders. These authors offer a detailed study of the history of this persistent and important infectious disease, covering its etiology, epidemiology, and pathogenesis.

Beginning with a discussion of the epidemiology, clinical signs and symptoms of tuberculosis, and skeletal changes associated with it, Roberts and Buikstra examine evidence for the disease through time in both human and nonhuman populations. They devote particular attention to the paleopathological evidence of tuberculosis throughout human history found in both Old and New World archaeological sites. With a review of the hard evidence of tuberculosis from the archaeological record (skeletons showing evidence of the disease), they focus on how and why the disease developed in antiquity, its evolutionary routes, and how past populations treated it. The authors augment clinical data with evidence from a variety of sources including art and documentary materials. A concluding chapter addresses the current reemergent status of the disease and its future prospects.

The authors reveal that tuberculosis has repeatedly increased over time as societies have become more complex socially, economically, and politically. Their detailed presentation of the clinical data on tuberculosis and its many causative factors brings together information from a wealth of sources worldwide and mounts an argument rich in paleoepidemiological and historical data that challenges accepted dogma about the conquest of TB by modern technology. Their account will be of interest to anthropologists, archaeologists, biologists, and sociologists as well as clinicians and medical historians.

Charlotte A. Roberts is a professor of archaeology at the University of Durham. Jane Buikstra is Leslie Spier Distinguished Professor of Anthropology at the University of New Mexico.

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"Roberts and Buikstra have compiled what is for now the definitive work on the subject." Journal of the History of Medicine

"An excellent book on a topic of more than academic interest." "A useful adjunct to health workers, those studying the history and prehistory of disease, and anyone interested in updating their own knowledge of what has been, continues to be, and is, increasingly so, one of the major health problems of modern times." Anthropological Science

"A lot of hard academic grind has gone into this compilation, and it will remain a major reference work for decades to come. The bibliography is excellent and the glossary useful for the general reader." Antiquity

"A useful addition to the literature . . . Of value both to graduate students and to professionals." "A key reference work for those interested in tuberculosis in ancient skeletons." American Journal of Physical Anthropology

"an important addition to the field." "A significant volume, presenting a fairly complete review of knowledge on many areas of TB." "This important book is especially, but not only, of interest for palaeopathologist eyes, as it is full of interesting and useful information for medical historians and the general public." International Journal of Osteoarchaeology

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