Treponematosis: a possible case from the late prehistoric of North Carolina.

The skeleton of an adult female exhibiting evidence of treponemal infection was recently recovered from the Hardin site in the piedmont region of North Carolina. Archaeological indicators suggest a late prehistoric affiliation. The skeleton is affected by a diffuse process resulting in surface changes, both destructive and appositional, node formation and shaft expansion, medullary encroachment and filling, cortical thickening, and fracture. There is both cranial and postcranial involvement. While treponemal infection is indicated, the atypical nature of the total pattern raises the possibility of multiple pathological processes operating simultaneously. The significance of this case is threefold. It provides information on the ability of prehistoric peoples to cope with disease. It reminds the paleopathologist of the dangers inherent in attempts at singular and specific diagnoses. It sheds new light on the epidemiology of the treponemal diseases.