Review of ‘Palaeopathology of Aboriginal Australians: Health and disease across a hunter-gatherer continent’ by Stephen Webb

09th January 2014

Knuckey and Pate Book Review Cover 1996‘Palaeopathology of Aboriginal Australians: Health and disease across a hunter-gatherer continent’ by Stephen Webb, 1995, Cambridge University Press, 324 pp. ISBN: 0-521-46044-1 (hbk).

Review by Graham Knuckey

Any book of this type is going to be popular by the very nature of the material involved. We are all interested in our own mortality and research into the mortality of others provides some link to the biggest event that will be part of life for all of us. Our interest as archaeologists and palaeoanthropologists however, goes beyond this; how was it that people subsisted in prehistoric times, what sorts of things affected their daily lives? Ultimately, I suppose the most basic question of all is, how much like us were they?

Palaeoanthropology is arguably the most engaging means of studying prehistoric human populations and this book looks at a particularly poignant area of the discipline: the diseases that affected humans on this continent in the prehistoric past.

Stephen Webb’s main aims are to document the sorts of diseases that occurred throughout this continent and to provide a contrast through time and space of the health of its prehistoric inhabitants. He is also keen to explore the links that may occur between personal health, culture and the natural environment. Webb directs Palaeopathology of Aboriginal Australians toward not only professional palaeoanthropologists but hopes also to target everyday Australians who might not necessarily have any background in this area of research. He has, however, set himself a difficult task; the database available to him is small and restricted in its geographical origin, and writing for the general public requires particular allowances, the most important of which I don’t think he has made. These are discussed further below.

The book can be broken down into five sections. Section 1, comprising Chapters 1-2 includes the requisite introduction to the topic, a survey of the previous research completed, a brief explanation of the data set and where it originated from, and a discussion of the analytical methods involved. The author refers to other sources for more in-depth discussion of the sexing and ageing techniques used (p. 12-13), reinforcing my impression that the importance of these methods to this study is not adequately defined.

Section 2, including Chapters 3-4, theorises about what diseases may have occurred in the Upper Pleistocene period; a discussion of the sorts of conditions these diseases exist in would seem to be more appropriate considering the lack of physical evidence, yet, even then this assumes the pathogens involved haven’t changed through time and space. In Chapter 4 he argues the existence of particular pathologies during the early Holocene, based on physical evidence but the database he works from compromises this argument. The reader needs to be constantly aware of the scarcity of archaeological material available for study, not only for this project, but for Australian palaeoanthropology in general.

Palaeopathology of Aboriginal Australians is an example of the paradox researchers in palaeoanthropology are constantly confronted by – the use of small amounts of data to explain wide ranging theories. Webb mentions this problem in his introduction and returns to it in more depth later in the book (Chapter 12), but this doesn’t stop him from extrapolating what are essentially regionally specific data to the continent as a whole. He says (p.41) he wants to develop an understanding of ancient health in this part of the world, but then states that most of the evidence available originates from southeast Australia, and then mainly from the Murray River corridor and western New South Wales. Considering the climatic and environmental variation apparent throughout the continent, such a broad aim, based on such regionally specific data, is open to question.

Section3 is the crux of the book. It includes Chapters 5 to 10 and this is where the worth of the text is shown. These chapters deal with the physical manifestation of pathological diseases in the physical remains of prehistoric humans on this continent. In Chapter 6 the author presents a provocative argument concerning endemic strains of treponemal infections such as yaws and syphilis. Basing his argument on the pioneering work of Cecil Hackett (see the book’s reference section for a list of Hackett’s publications), Webb suggests it may have been the more active and virulent venereal syphilis that arrived with European colonists and that less active forms of syphilis and yaws were probably endemic.

Section 4 (Chapter 11) looks at the pathology of a small sample of prehistoric human remains from New Guinea. Assurances that this material provides a significant comparative sample to the mainland Australian sample are unconvincing. In fact the lack of any repeatable statistical analysis seems to handicap the book’s scientific credibility in general.

Finally, Section 5 (Chapter 12) presents Webb’s conclusion. The first half of paragraph 1 (p.272) underpins the whole book. The use of restricted amounts of data to explain wide ranging theories should be at the back of every reader’s mind whilst (s)he reads any text of this sort. Only with a clear knowledge of the problems involved can anyone assess the real value of the contents in a more meaningful way.

Overall, some minor irritations include: the text on pages 78-87 discusses Spec. number 38586, directing the reader to Plates 4-29 to 4-33, when these plates present Spec. 38587; on page 124 Swanport is described as being at the Murray River mouth, whereas it’s actually 60 km to the north; there are references to statistical significance but the tests used are never specified, for an example see page 179; and only one photograph in the whole book has arrows (p.190) indicating what is being discussed.

In general Palaeopathology of Aboriginal Australians is well worth the attention of archaeologists/palaeoanthropologists and non-professional readers, though it fails in some areas when the requirements of both-these groups are considered. Scientifically, the book is not rigorous enough in establishing a firm database for all its assumptions and suggestions, and its statistical analysis of the database is inadequate. When considering the needs of non-professional readers there are two major omissions. Firstly, when looking at the photographs, a person not acquainted with pathological diseases would have difficulty identifying what is being discussed in the text. The inclusion of arrows pinpointing the manifestation of each condition would have been beneficial. Secondly, a glossary of terms would have been a welcome addition for interested readers bogged down in alien terminology and also for professionals since it’s not uncommon for the desired meaning of a term to vary between researchers. Webb acknowledges this (p.239): Occasionally it is worth taking some time to reassess exactly what we mean by the definitions we use in palaeopathology.

This book is a worthy addition to the literature on Australian palaeoanthropology. For a variety of reasons it is the only text that attempts to bring together a comprehensive view of all the palaeopathological data available. The photographs are important representations of Australian examples of palaeopathological conditions known worldwide, but in my view the reference list is the most valuable resource in this text. Within this list is a mine of information pertaining to the study of palaeopathological disease, both Australian and international.

Palaeopathology of Aboriginal Australians has various shortcomings that need to be clearly defined before any true scientific value can be assessed, and I have attempted to do this here. Ultimately, however, its scientific value will be determined by those that use it in the pursuit of their research, not by reviewers, and its public value by those who read it for personal interest.

Review by F. Donald Pate

Webb’s honours and postgraduate studies (Webb 1981, 1984, 1989) played a major role in establishing palaeopathology as a research area in Australian archaeology. This volume expands Webb’s previous research by providing a regional overview of palaeopathological studies in upper Pleistocene Sunda and Sahul and Holocene Australia and New Guinea. In addition, it provides a critical examination of both the limitations and potential contributions of palaeopathological research in Australasia.

Chapters 1 and 2 offer a brief history of Australian palaeopathological research. Unlike the Americas and Europe where palaeopathology is a well established field of study in biological anthropology and archaeology, systematic palaeopathological research did not commence in Australia until the early 1980s. Webb’s PhD thesis (1984) was the first attempt to document variability in pre-contact Aboriginal health status across the continent via palaeopathological techniques. As inferences about pre-contact Aboriginal health status, settlement patterns and population densities from historic accounts of contact conditions are limited by the social disruptions and depopulation associated with colonisation and introduced diseases, Webb argues that palaeopathological studies should be an essential component of archaeological research addressing prehistoric Aboriginal behavioural variability.

Although not all stresses, diseases and trauma experienced during life leave diagnostic signatures in osseous tissues, those that are recorded in the skeleton provide sufficient data to infer the general health status of past populations. As health is intimately related to diet, nutrition and social environment, palaeopathological information may also contribute to archaeological reconstructions of past social systems, e.g. inferences about population density, degree of sedentism, social differentiation, and status.

Webb concedes that the primary limitations to Australian palaeopathological research are:

l . the small number of large skeletal samples available for study, and

2. the poor chronological control associated with most of these samples.

One of the major strengths of this volume is that Webb recognises these sample limitations and does not make unreasonable inferences from the skeletal database.

Due to the scattered and fragmentary nature of the upper Pleistocene fossil remains from the Sunda region, palaeopathological information for Homo erectus and early Homo sapiens is virtually non-existent. Thus, the general health of upper Pleistocene populations cannot be determined from these materials (Chapter3). However, based on the long-term isolation of Sahul from southeast Asia and the Sunda region to the northwest, Webb makes predictions regarding what types of diseases would have accompanied small founder populations arriving in Australia. Due to the small human population sizes in Sundaland and the short incubation periods associated with crowd diseases such as measles, smallpox, chickenpox, herpes, influenza and cholera, Webb argues that these acute infections would not have been transmitted across the water barrier into Australia. He suggests that poor health and disease among the early Australian colonists would have resulted primarily from bacterial infection, parasitism and secondary host infections. Many of these would have been associated with animal hosts.

Homo sapiens fossil sample sizes improve somewhat for the late Pleistocene and early Holocene period, ca. 50,000-8000BP (Chapter4). Consequently, Webb is able to provide a series of case studies for these materials. The sample is derived mainly from southeastem Australia. The Murray River corridor and western New South Wales are particularly well represented. Skeletal remains discussed include materials from the Willandra Lakes region, Kow Swamp, Coobool Crossing, Murrabit, Keilor, Burke’s Bridge, Mossgiel and Green Gully. Pathological conditions noted include dental enamel hypoplasia, Harris lines, osteoarthritis, localised and generalised periostitis, cranial and post-cranial fractures, cranial thickening, humeral bowing and pre-mortem tooth loss.

The larger sample sizes and greater geographical distribution associated with the middle-late Holocene skeletal material allows Webb to address general health differences between Aboriginal populations from various ecological zones across the Australian continent (Chapters 5-8). Ecological zones included in the study are:

1. South Coast,

2. East and Southwest Coasts,

3. Central Murray,

4. Rufus River,

5. Desert and Arid Area, and

6. Tropical Area.

Pathological conditions assessed include:

1. chronic and acute stress (cribra orbitalia, dental enamel hypoplasia, Harris lines),

2. infectious disease,

3. osteoarthritis, and

4. trauma.

Chapters 9- 10 provide additional case studies that document the presence of rare neoplastic disease (bone tumours) and congenital malformations in pre-contact Aboriginal populations. Chapter 11 addresses health status in pre-contact Papua New Guinea by examining a skeletal sample from Motupore Island dated between AD 1200-1700.

Webb’s findings are summarised in the final chapter. According to the pathological indicators employed, Holocene Aboriginal populations that occupied the arid continental interior were generally the healthiest, whereas those from the Central Murray region were the least healthy. Arid-land inhabitants had the lowest incidence of cribra orbitalia (anaemia), dental enamel hypoplasia, and Harris lines. Thus, chronic malnutrition, parasitic infection, and population aggregation would have been minimal in the arid zone. The formation of Harris lines in arid populations suggests the presence of acute stress such as short-term food inadequacies.

In contrast, the Central Murray shows a high incidence of cribra orbitalia and dental enamel hypoplasia in children and adults, but a low incidence of Harris lines. This pathological profile indicates that Central Murray populations were subject to chronic stress. Harris line formation was most likely suppressed by this persistent stress. In addition, high frequencies of dental caries and dental calculus suggest the use of carbohydrate staples, e.g. Typhroot. After considering the archaeological evidence relating to the dense occurrence of large oven mounds in the Central Murray, Webb argues that the health pattern for this region reflects that of large, sedentary populations with high frequencies of malnutrition, parasitism, non-specific infection, and endemic (non-venereal) treponematoses.

Papua New Guinea, the Eastern and Southwestern Australian Coasts and the Rufus River show similar pathological patterns to the Central Murray. However, the stress levels appear to be less severe in the Coastal and Rufus River samples. The major health difference between the Motupore Papua New Guineans and the Australian samples is the higher incidence of infectious disease among the former. According to Webb, the large villages of closely spaced permanent dwellings found in Papua New Guinea would have facilitated the transmission of infectious diseases such as endemic trepanemotoses.

In contrast, results from the South Coast Australian sample indicate the presence of regular acute stress, such as seasonal food shortages. The South Coast has the highest percentage of sub-adults displaying Harris lines and the highest incidence of multiple lines. The regular spacing of the Harris lines suggests periodic stress.

Unfortunately, the post-cranial sample size for the Australian Tropical region was so small that pathological analyses were restricted to cranial examinations. Consequently, inferences regarding general health status are limited for this region and inter-regional comparisons are restricted. The incidence of cribra orbitalia and dental enamel hypoplasia are both relatively high in children, but decrease dramatically in adults. Thus, from this limited sample, it appears that children in the tropics experienced chronic stress, whereas adults were relatively healthy.

The skeletal evidence suggests that prehistoric treponemal infection was much more widespread across Australia than previously thought. High frequencies of treponemal cranial lesions occurred in the Central Murray, Rufus River, Desert and Tropical regions. Because yaws, endemic syphilis(erkincha) and venereal syphilis produce similar cranial lesions, it is difficult to differentiate the various treponemal diseases using dry bone examinations. However, as the non-venereal treponematoses yaws and erkincha were endemic to tropical northern Australia and the arid interior, respectively, Webb suggests that these forms are most likely responsible for the cranial lesions observed in the prehistoric Aboriginal samples. Furthermore, the endemic treponematoses provide immunity to venereal syphilis. Thus, Aboriginal populations in south- eastern Australia would have been more susceptible to the introduction of venereal syphilis than would Aboriginal population occupying the tropical north and arid interior, suggests that aggressive behaviour was common in most Australian hunter-gatherer societies. In contrast, post-cranial fixtures were relatively rare. However, 76% of those observed occurred in the upper limbs and on the left side of the body. Most of these were parrying fractures to the ulna. Thus, the types of fractures observed in post-cranial remains also indicate aggressive behaviour.

In conclusion, this volume provides a valuable database for both archaeologists and biological anthropologists. It will be of particular interest to those working in Australasia and the Pacific but also provides opportunities for comparative analyses with other regions of the world. Webb’s research highlights the important contributions that skeletal analyses can make to archaeology. When used in association with conventional archaeological methods, multivariate skeletal studies involving pathological, non-metric and chemical analyses improve our ability to make meaningful behavioural inferences from prehistoric and historic remains.


Webb, S.G. 1981 Palaeopathology and its future use in Australian prehistory. Unpublished BA(Hons) thesis, The Australian National University, Canberra.

Webb, S.G. 1984 Prehistoric stress in Australian Aborigines. Unpublished PhD thesis, The Australian National University, Canberra.

Webb, S.G. 1989 Prehistoric stress in Australian Aborigines: A palaeopathological study of a hunter-gatherer population. Oxford. British Archaeological Reports, International Series, No. 490.

Knuckey, G. and D. Pate
Review of 'Palaeopathology of Aboriginal Australians: Health and disease across a hunter-gatherer continent’ by Stephen Webb
December 1996
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