Leprosy and tuberculosis in Iron Age Southeast Asia?

The recent excavation of a sample of 120 human skeletons from an Iron Age site in the valley of the Mun River, a tributary of the Mekong River on the Khorat Plateau in northeast Thailand, has provided the largest sample from this period in the region to date. This paper reviews three individuals from the sample with pathological changes for which the differential diagnosis includes systemic infectious disease. In two of these, both males with lesions of the hands and feet, leprosy and psoriatic arthritis are discussed as differential diagnoses, with leprosy the most probable. In the third, a female with lesions of the spine, the differential diagnosis includes tuberculosis and nonspecific osteomyelitis. Tuberculosis is the most probable diagnosis. Although the focus of this paper is a presentation of the evidence for infectious disease at Noen U-Loke, the significance of probable diagnoses of mycobacterial diseases for the history of the diseases and for prehistory in mainland Southeast Asia is also briefly discussed.

Missing lateral incisors in Iron Age South-East Asians as possible indicators of dental agenesis.

The absence of lateral incisors is generally a reflection of agenesis or hypodontia, with a significant genetic basis and possibly environmental influence on the phenotypic expression. A human skeletal sample from the Iron Age cemetery of Noen U-Loke in Thailand has a very high prevalence at 79% of adults (30/38) with at least one incisor missing in either maxilla or mandible. If the cause of this high rate is genetic, it may be indicative of homogeneity, and, therefore, endogamy and probably isolation, of the population represented. Supporting agenesis as the explanation for this is the lack of space between the central incisors and canines in more than half the cases. An alternative explanation is that the teeth may have been lost during life through pathology or deliberate removal (ablation). There is no evidence in the form of remodelled lesions for pathological loss of the teeth. Although there were no significant differences between males and females in the numbers of teeth missing, there were significant differences in the patterns of loss, with males having more missing teeth on the right and females more on the left. No evidence was found in the clinical literature of agenesis involving side preference by sex, so this may indicate deliberate removal of the teeth. Males were also more likely than females to have no space for the missing teeth. Ablation of teeth has been recorded in other prehistoric South-East Asian populations but in these cases the evidence was much clearer. Agenesis seems to offer the most likely explanation for the missing teeth at Noen U-Loke and if so, indicates that a small, isolated population may develop a very high rate of hypodontia, with a side preference dependent on sex.

Anemia, genetic diseases, and malaria in prehistoric mainland Southeast Asia.

The analysis of a sample of skeletons from the 4,000-year-old site of Khok Phanom Di on the coast of central Thailand has identified a number of individuals with skeletal evidence suggestive of severe anemia. The differential diagnosis of the lesions is discussed and the presence of one of the thalassemia syndromes is proposed. The implications of this for southeast Asian prehistory are discussed. The presence of these conditions has been suggested in previous analyses of prehistoric southeast Asian populations, but this is the first population in which the evidence, including postcranial responses, is presented in detail.