REVISIÓN DE LIBROS

La salud de nuestros antepasados. Una mirada sobre la paleopatología
Autor: Jorge A.
Suby Quequén, Buenos Aires: Laboratorio de Ecología Evolutiva Humana. 2012. 190 pp. ISBN 978-987-28931-0-1

 

This book comes from a paleopathologist of the new generation, with free access to internet and the significant amount of literature that flourished after the eighties. In spite of that, the author declares his impossibility to finding holistic and systematic approaches to the study of health and disease of ancestors. Paleopathology literature, as in so many other scientific fields, became more and more narrow in topics and very specific analysis providing insights on health and disease. Focusing is part of the investigation process in science, of course, but somehow even the scientific investigators, and perhaps the students, feel they need to discussing in a more contextual and holistic perspective. This book was drawn to fill the gap: it is neither a compendium of diseases of the past, nor a guide for diagnosis, but a promenade from paleopathology to different fields related to the understanding of health in human populations. A more philosophical and pleasant time to the reader is assured by a special thought, picked up from good literature, from Mark Twain to Stephen Gould, that head each chapter, helping the readers to prepare themselves for the following pages.
After presenting the book and his goals, the author discusses why to study health in thepast. Contrasting contemporaneous epidemiology to the study of health of past populations, Jorge Suby reminds us that, ideally, both must follow the same principles. After discussing the complexity of the concept of health, he claims to consider systemic and evolutionary approaches, important concerns to this field of research. Discussing the limits of paleoepidemiology, he gives some examples of the changing behavior of some infections and chronic diseases along the time, and proposes the models of transition in health, demography among others, as good to help understanding past and present of human health.
In the following chapters the author discusses the basis of the investigation in paleopathology. Assuming that the possibility of identifying a past event related to health/disease is based on the assumption that things never change. But we must be ready for the exceptions to the rules, when evolutionary events affecting pathogens as well as hosts, modify the trajectory of illnesses. Other misinterpretations in paleopathology can occur when similar conditions are caused by different processes, besides the paradox of negative data, which does not mean negation of disease.
A reflection about the richness of such an interdisciplinary field of paleopathology is proposed in this book. Today, the field of paleopathology receives the contribution of many different specialists, companions to paleopathology. Considering the multidisciplinary contribution to the field he invites his readers to think about the complexity of health studies involving biomedical, as well as human sciences. Techniques from different fields can be used to support bioarchaeological inference, but it is also true that the etiologic diagnosis is not the main goal in many paleopathological investigations. This is not only because etiologic diagnosis is a far distant goal, but also because the diagnosis may not be essential to the interpretation of the past. Here we come back to the ultimate goal of the investigations in paleopathology: to contribute to reconstruct the way past people lived based on their health/disease.
Another chapter is dedicated to present how the investigation in paleopathology is developed, the challenge to identifying signs of health disturbances, physiological disruptions, pathology in fact, anomalies and so on, in the past evidence of living beings. Conceptualization for normal & abnormal; limits of differential diagnosis, mortality as a paradox, are some of the problems facing bones and teeth analysis.
Being the most frequently preserved kind of human remains, those pieces of evidence are presented as having an important potential, but as an extraordinary window to the past, the archaeological series of bones, teeth, complete or partial skeletons, mummified remains, coprolites, etc also impose their challenges. Methodological and technical limits must be face with much more innovation and research, based or not in modern biomedical techniques.
Speaking about taphonomy and zooarchaeology the author remembers that both are scientific fields, very closely related to the field of paleopathology. Paleopathology has a starting point in the study of extinct animal fossils, and for a long time was dedicated to them. Human paleopathology is a relatively new field, and animal paleopathology still contributes a lot to the archaeological discussions as well. Taphonomy must be considered all the time, when a paleopathological investigation is in course.
Finally the book opens a space to discuss the past human remains in Argentina, from the origin and manipulation of collections of human remains to Ethics. In this 21^st century, reburial of remains, restrictions to different ways of sampling, consequences of unveiling the true stories of people, are among the concerns of profession professionals within the field. Argentina, as other countries, is progressing fast in the study of the past, including paleopathology. Academic facilities and institutional support is increasing fast, in spite of other problems. Paleopathology is helping pointing to the future, through a past insight.
At the end of this book we can find a list of carefully selected references that will certainly help students and other people interested in the field to follow complementary readings. The book by Jorge Suby is pleasant, and makes us to think about what we do, and also about how and why we do what we do.

Sheila M.F. Mendonça de Souza
Escola Nacional de Saúde Pública Sérgio Arouca
Fundação Oswaldo Cruz Rio de Janeiro, Brasil