A Bioarchaeological Assessment of Cranial Modification and Health in Ancient Highland Peru

Danielle Kurin and Aubree Gabbard

Department of Anthropology, Vanderbilt University; Department of Anthropology, Bryn Mawr College

Introduction
This poster reports on the relationship between cranial modification and physiological health among the Chanka of highland Peru (AD 1000-1400). Human crania (N=263) were examined to see if cranial modification (an indicator of ethnic identity) is associated with porotic hyperostosis (PH) and cribra orbitalia (CO), cranial lesions indicative of poor nutritional health and/or disease. Initial results demonstrate significant health differences between modified and unmodified individuals within this population following the disintegration of the Wari Empire and subsequent drought ca. AD 1000. These data suggest that Wari collapse and drought did not create worse conditions for everyone in Andahuaylas. Instead, shifts in sanitation and resource availability and access may have been socially mediated by ethnic divisions, which in turn contributed to the development of pathological lesions on the cranium. Cranial and postcranial remains were recovered from burial contexts at four sites in Andahuaylas, but only data from the crania are reported here: Turpo (N= 15 crania), Cachi (N =172 crania), Ranracancha (N= 40 crania), and Pucullu (N= 27 crania). Crania from Qasiachi burial cave (N= 27 crania), currently stored in the Natividad Community Museum, were also examined. At Turpo, the Wari era (AD 600-1000) site, crania were recovered from a circular cist tomb. The other four sites (Pucullu, Natividad, Ranracancha, and Cachi) date to the post-imperial Chanka Period (AD 1000-1400). Chanka populations interred their dead collectively in small caves, known as machays.
%

Temporal and Geographic Distribution

If the socio-political disintegration of the Wari empire and ensuing climactic changes (drought) significantly impacted the diet, nutrition, and general welfare of individuals, then we would expect to see a significant increase in rates of PH and CO among stressed post-imperial Chanka populations. CO and PH increase from Wari to post-Wari times, but the difference is not significantly different (Fishers exact, p=0.2435) (Table 1).This suggests that the health status of people did not significantly diminish in the wake of state collapse and severe drought. The geographic distribution of PH and CO during the post-imperial Chanka period was also assessed. For the most part, rates of CO and PH were similar across contemporaneous sites. The Natividad Museum sample had significantly less PH than other contemporaneous sites (Fishers exact, p<0.0001), but the problematic provenience of this collection makes it difficult to draw conclusions regarding the expression of cranial lesions across space. In sum, there were no significant differences in rates of PH and CO at different sites. These data suggest that in Andahuaylas, bio-cultural stressors (including dietary or nutritional deficiencies brought about by resource scarcity, or parasites and diarrheal disease caused by unsanitary conditions) were similar across different locales.
Table 1. CO and PH in Andahuyalas CO PH
N

Ethnicity
Post-imperial Chanka society was composed of nested moieties of ethnic groups called ayllus, whose members claimed decent from a common ancestor and maintained corporate landholdings. Cranial vault modification was likely used by the Chanka to conspicuously demarcate members of the same ethnic ayllu. This was a novel practice, as there is no evidence of modification during the Wari era. In this study, modified and unmodified individuals were compared in order to determine if prominently denoting ethnic membership thorough the manipulation of head shape are correlated with differences in the frequency of cranial porosities.
Unmodified N=78 (31.2%) N=250

Modified N=172 (68.8%)

1330S Pucullu Ranracancha

Chanka Period (ca. AD 1000-1400)

Natividad Cachi Turpo

Legend
1340S
Chanka Site (AD 1000 1400) Wari Site (AD 600-1000) River Provincial Boundary
0 km 30 km 60 km

While the difference between CO frequencies in the unmodified and modified groups are not statistically significant, modified men, women, and subadults demonstrate evidence of PH at a significantly higher rate than their unmodified counterparts (Fishers exact, p<0.0001) (Fig. 12). Ninety-two percent (63/68) of all individuals with PH have lesions on occipital and posterior parietals. Areas of the vault on modified individuals that would have been impacted by bindings (e.g., just posterior to bregma) do not have significantly more evidence of porosity than areas that were free of binding pressure (Fishers exact, p=1.000). Thus, although cranial modification may have caused acute loci of porosities in some individuals, overall, the practice of cranial modification does not significantly contribute to the expression of PH in Andahuaylas populations. More likely, asymmetry in PH rates stem from differences in the general well-being of distinct Chanka ethnic groups. Other correlates also suggest unequal lifestyles. For example, higher rates of compromised health within the modified sub-sample follow trends in cranial fractures (a proxy for physical violence); Chanka individuals with modification were victims of both lethal and sub-lethal trauma at a significantly higher frequency than their unmodified neighbors (ante-mortem trauma: 2=11.826; p<0.001; peri-mortem trauma: 2 =7.984, p<0.01). Ultimately, these results suggest that unmodified individuals were healthier overall than their unmodified neighbors.
Table 3. Cranial Modification

Fig. 11. Modified and Unmodified Individuals

Fig. 12. PH Frequencies of Modified and Unmodified Individuals

Standard bioarchaeological methods (Buikstra and Ubelaker 1994) were employed in the analysis of crania. Age was based on dental eruption, dental wear, and cranial suture closure, and skeletal sex was determined based on standard morphological traits (the size and shape of glabella, the mastoid process, nuchal crest, and supraorbital margin). Cranial modification- the intentional reshaping of an infants malleable skull was also assessed for absence or presence. Porotic hyperostosis and cribra orbitalia were coded as present or absent; visible lesions were coded as healed or unhealed. The degree to which PH and CO were expressed and the location of porosity on the cranium were coded using Standards (Buikstra and Ubelaker 1994).

7330W

730W

Wari Era (ca. AD 600-1000) Fig. 1. Diagnostic Ceramics

Fig. 6. Andahuaylas Province, Apurimac Department, Peru Fig. 5. CO and PH in Andahuaylas

Demography
To facilitate future analysis and comparisons with other studies in the region, individuals over 15 years old were categorized as Adults, while those individuals under 15 years old were classified as Subadults (Tung and del Castillo 2005). To determine the skeletal sex of an individual, sexually dimorphic attributes on the crania were scored. The adult population (N=194) is equally split between males and females; a pattern mirrored in the sub-sample with PH, where 50% (16/32) of affected individuals were females. Specifically, 32/104 of males (30.8%) and 32/90 of females (35.6%) exhibit PH (Fig. 7). This demonstrates that males and females were equally likely to suffer from physiological stressors that led to pathological changes on the cranial vault. The ages-at-death of the general population and the sub-sample with PH were also similar (Fig. 9). Although children are underrepresented in Chanka burials, the trend suggests that Individuals who had PH survived into adulthood at the same rate as the general healthy (no PH) population.
Sex Distribution in General Population in Andahuaylas
N= 194 sexed adults

Fig. 13. CO Frequencies of Modified and Unmodified Individuals

Documenting Compromised Health

Following the fall of the Wari Empire, ca. AD 1000, the Chanka emerged as a formidable presence in the south-central highlands of Peru. Although reasons for Waris decline remain unclear, the ensuing Late Intermediate period is characterized by striking and prolonged climactic changes (drought), the collapse of infrastructure and exchange networks, resource scarcity, increasing isolation, and intense physical conflict (See Tung 2008). These bio-cultural stressors may foreshadow changes in the health of hinterland populations eking out an existence on the post-imperial landscape. Cranial porosities--pathological lesions that appear on the vault and orbital bones --are one such class of indicators that suggest comprised health. The characteristic diploic appearance of porotic hyperostosis is caused by marrow hyperplasion. Similar to PH, porotic bone in the orbits is referred to as cribra orbitalia (CO). The most likely cause of PH in prehistoric Andahuaylas was megaloblastic anemia, primarily acquired by nursing infants and young children (see Walker et. al. 2009). Chronic dietary deficiencies and malabsorbtion of vitamin B12 and/or B9 (folic acid) are the most common causes of megaloblastic anemias. This type of anemia may be a consequence of mostly vegetarian diets that lack iron (which can lead to iron-deficiency anemia (El-Najjar et. al. 1976)) and other nutrients derived from animal products (Walker et. al. 2009), and/or gastro-intestinal parasites and infectious diseases which lead to nutrient malabsorbtion and diarrhea (Stuart-Macadam 1992; Blom et.al. 2005). Like PH, cribra orbitalia (CO) may be osseous evidence of anemia. However, orbital roof porosities may also be caused by subperiosteal inflammation provoked by deficiencies in vitamin C or from traumatic injury (Wapler et. al 2004).

Sex Distribution of Individuals with PH

N= 64 sexed adults

Males n=104 (53.6%)

Females n=90 (46.4%)

Males n=32 (50%)

Females n=32 (50%)

Fig. 8. Adult Sex Distribution in General Population vs. Adults with PH Age-at-Death of the General Population in Andahuaylas
N= 253 individuals

Age-at-Death of Individuals with PH

N= 76 individuals

NO MODIFICATION

Subadults n=37 (14.6%)

Subadults n=10 (13.2%)

Fig. 2. Mestizo chornicler Guaman Poma de Ayala depicts the Chanka (with turban-like head bindings), fighting Spanish forces [1615:432(434)].

CO PH

Adults n=216 (85.4%)

Adults n=66 (86.8%)

Fig. 9. Age-at Death in General Population vs. Individuals with PH Table 2. Age Distribution Fig. 14. The range of cranial modification in Andahuaylas.

Fig. 15. Right and left views of the same child mummy. Without the headband, cranial modification is visible.

Some scholars have also proposed that the physical compression from bindings used to modify crania may spur subperiosteal reactions that are manifested as acute loci of porosities on the cranial vault (Mendoa de Souza et. al. 2008). To address these debates, this study specifically compares patterns in CO and PH between modified and unmodified individuals from both the imperial and post-imperial eras, and between contemporaneous postimperial Chanka sites. The prevalence of lesions is also compared between adults and children (under 15 years old), and between males and females.

Fig. 7. Age-at-Death and Sex Distribution of CO and PH in Andahuaylas

Discussion
This study evaluated the health of imperial Wari (ca. AD 600-1000) and postimperial Chanka (ca. AD 1000-1400) populations in highland Andahuaylas, Peru. Porotic hyperostosis and cribra orbitalia, evidence of diminished health during childhood, impacted about a third of the total population. Males and females were equally likely to exhibit these cranial porosities, and perhaps by extension, equally impacted by physiological stressors that led to pathological changes on the cranial vault. While the ratio of CO to PH was equal among sex and age groups, the vast majority of individuals had either PH or CO, but not both. These results correspond with previous studies which suggest that the discrepancy between CO and PH prevalence may signal differences in etiology, disease severity, and age-related lesion manifestation loci and rates. With respect to cranial modification, given that adults and subadults have the same frequency of PH, and that loci of vault porosities do not correspond to loci of head bindings, the physical compression from bindings probably did not cause cranial vault porosities. Importantly, throughout Andahuaylas, modified individuals suffered from anemia at significantly higher rates than their unmodified counterparts. The asymmetry in PH rates among these two subgroups signals important differences in the general well-being of distinct Chanka ethnic groups. Because the underlying causes of anemia stem from poor sanitation, dietary and nutritional deficiencies, and infectious diseases, it appears that Wari imperial fragmentation and deleterious climactic changes may have helped instigate striking social inequalities in food access and living conditions among postimperial Chanka populations.

Fig. 3. Acute loci of cranial porosities with different etiologies. Left: Porosity associated with a lytic lesion (possibly cancer). Center: Porosity associated with trepanation. Right: Porosity associated with healing antemortem fracture

Fig. 10. Examples of active and healed PH from crania in Andahuaylas

References Cited
Blom DE, Buikstra JE, Keng L, Tomczak P, Shoreman E, Stevens-Tuttle D. 2005. Anemia and childhood mortality: latitudinal patterning a100g the coast of pre-Columbian Peru. Am J Phys AnthropoI 127:15Z-169. Buikstra, JE, Ubelaker, DH. 1994. Standards for data collection from human skeletal remains: proceedings of a seminar at the Field Museum of Natural History. Research series No. 44. Fayetteville: Arkansas Archeological Survey. El-Najjar MY, Ryan DJ, Turner CG, II, Lozoff B. 1976. The etiology and porotic hyperostosis among the prehistoric and historic Anasazi Indians of Southwestern United States. Am J Phys Anthropol 44:477-487. Mendoa de Souza, SMF, Reinhard, KJ, Lessa, A. 2008. Cranial deformation as the cause of death for a child from the Chillon River Valley, Peru. Chungara 40(1):41-53. Stuart-Macadam PL. 1992. Porotic hyperostosis: a new perspective. Am J Phys AnthropoI 87:39--47. Tung, TA. 2008. Violence after imperial collapse: a study of cranial trauma among Late Intermediate Period burials from the former Huari capital, Ayacucho, Peru. Nawpa Pacha. 29:101-118. Tung, TA, del Castillo, M. 2005. Una visin de la salud comunitaria en el Valle de Majes durante la poca Wari. In: Muerte y evidencias funeraria en los Andes centrales: avances y perspectivas. Lima: Universidad Nacional de Federico Villareal. 149-172. Walker, PL, Bathurst, RR, Richman, R, Gjerdrum, T, Andrushko, VA. 2009. The causes of porotic hyperostosis and cribra orbitalia: a reappraisal of the iron-deficiency-anemia hypothesis. Am J Phys Anthropol 139:109-125. Wapler U, Crubezy E, Schultz M. 2004. Is cribra orbitalia synonymous with anemia? Analysis and interpretation of cranial pathology in Sudan. Am J Phys Anthropol 123:333-339.

Fig. 4. Examples of CO from crania in Andahuaylas

Acknowledgments
Research by AG was supported by a grant from the Department of Anthropology, Bryn Mawr College. Research by DK was supported by a Fulbright-Hays Doctoral Dissertation Research Aboard Fellowship, award #P022A090074. Special thanks to Enmanuel Gomez Choque, and the entire Proyecto Bioarqueologico Andahuaylas crew.

76th Annual Meeting of the Society for American Archaeology March 30- April 3, 2011 Sacramento, CA

The schema (top) shows where the Chanka would have placed the bindings to modify the vault. The child cranium (bottom) shows healing lesions in the post-bregmatic depression caused by modification (inset).

Fig. 16. Cranial Vault Porosity at the Loci of Binding.