The Poor Iron Health of the Pre-Columbian Amerindians

Were pre-Columbian Amerindians healthy people? If not, which were the prevalent diseases in these ancient cultures and civilizations?

Within the great list of problems, and if they suffered from infectious diseases, which were they?

Arawak Woman. By Christoforo dall’Acqua? Photo: The JCB Libary

Were the infections locals, or were they imported by the European newcomers?

Lastly, where about endemic infections and epidemics?

Paraphrasing Bob Dylan, one can say that many questions about the subject are still blowing in the wind; nonetheless, there are short precise answers. But several disciplines provide us beneficial information.

Until recently, we disposed of some documentary sources in which inquiring: the original stories of natives themselves; the chronicles of the first monks, writers, chroniclers, medical doctors, and other colonizers who knew, in situ, the oral relates from the ancient guardians of the indigenous collective memory; and, later, it is necessary to sum the modern paleontological studies (plus other disciplines, like genetics).

Writers and scholars (experts in demography, epidemiologists, and medical historians) write, step by step, a great book about the New World’s medicine. That is now possible thanks to the information gathered throughout the years. One disposes nowaday of an open and never-ending volume about the first Amerindians’ health problems and those of their successors. As it is well known, everything changed dramatically after Europeans’ arrival. First of all, infectious diseases.

Many questions about the subject are still blowing in the wind; nonetheless, there are short precise answers.

In light of many studies, it can say with certainty that the natives suffered from:

―Various types of anatomical malformations.

―Many injuries accidental, and others caused by wars, fights, and animal attacks.

―Some disorders in the context of poor nutrition.

―Anemias of probable multifactorial origin (low diet, parasitic infections).

―Poisoning by insect and snake bites.

―Several types of tumors.

―In women: gravid and puerperal pathology.

There is evidence, at least in the central Peruvian Andes, of neoplastic, endocrine and metabolic diseases, and several signs of nutritional stress (dental hypoplasia). Of course, it detected some infections (treponematosis, parasitic infections, and tuberculosis), thanks to the excellent conservation of mummies on the coast and forests of Chachapoyas province (Department of Amazonas, northern Peru).

In this sense, a Peruvian anthropologist, Roberto C. Parra, writes the following in his work La antropología como ciencia forense en el Perú: Una perspectiva desde la aplicación a los derechos humanos:

“For example, in the central Andes, infectious diseases such as treponematosis and tuberculosis have been demonstrated, with other infections. There was a certain incidence of gastrointestinal parasitosis, neoplastic, endocrine, and metabolic diseases. Also, there were indicators of nutritional stress.”

On the other hand, more than six hundred mummies in the Arica region (Chile) showed malformations (prognathism and spina bifida), lesions of the osteoarticular system; cardiac pathology; nutritional alterations; and some infections. There are remains of skeletons, dated 5000 years ago, in the Tehuacan Valley, with evident signs of osteoarthritis and treponematosis (venereal Syphilis and “yaws”).

A female skeleton (2700-year-old). Chiapa de Corzo (México). Photo: BBC News

Some old remains (from 3,000 years ago) showed signs of tuberculosis. Other bone had signs suggesting anemia of multifactorial etiology. A curious and disturbing fact was some findings of facial bone lesions more frequently in women than in men. It not tricky to suppose the existence of some “domestic” violence.

Ancient Chibchas, the eastern Andes inhabitants, suffered degenerative joint diseases of the cervical spine and temporomandibular joint. The inflammatory changes were probably due to an excessive weight load on the head. It seems that this anomaly did not respect anyone person above the age of 30–40. Could one think about a remote form of occupational disease?

The domestic infectious diseases, timidly pointed out in the previous paragraphs, still were not very well known, although its knowledge expanded throughout the years. There is an idea dominating among the general public and among some scholars too. It is the following: In ancient times, there were very few and not very serious infectious diseases due to the Amerindians’ epidemiological isolation. Some experts claim that the natives enjoyed remarkably good health, free from endemic and epidemic threats. But the reality of the issue is a bit different.

Some experts claim that the natives enjoyed remarkably good health, free from endemic and epidemic threats. But the reality of the issue is a bit different.

The two worlds’ epidemiological pattern that will encounter each other in October 1492 was not as different as the general belief supposed. It is a consideration that prevailed until recently. However, there was a possible exception: the absence of viral diseases associated with human agglomerations.

All things changed when microbes arrived in the New World from Europe. Europe’s micro colonialists (viruses, bacteria, protozoans, fungi) encountered abundantly, concentrated, and non-immune human populations (nobody knew what the hell immunity is). The First Encounter between microscopic invaders and human beings was the epidemiological catastrophe beginning.

That was the ideal situation for the settlement and the spreading of infectious diseases (viral, although bacterial infections, too) prevalent on the other side of the ocean. Albeit, one knows that certain microbial conditions existed in the New World from much time before Spanish’s arrival.

For example, there were infections caused by bacteria, mycobacteria, protozoa, and fungi. These illnesses existed since the Paleolithic period, during the Neolithic, and in the centuries preceding the European invasion.

However, there was a possible exception: the absence of viral diseases associated with human agglomerations.

As it is said previously, the idea of the non-existence of viral infections was predominant among some scholars until recently. It does not mean that they were not present, only that nobody knew. A very recognized authority on the subject, Professor Francisco Guerra, in his work Los virus antes que las armas diezmaron a los indígenas (Excelsior, Nº 12. México, 1992.) wrote:

“In America, investigators identified some diseases typical of the pre-Columbian indigenous people, others familiar with the European visitors one and also the absence of some illnesses of an infectious nature, particularly those produced by viruses. Similarly, favorable environmental conditions that existed during migrations from Siberia to the New World can explain the absence of vectors, and the non-existence of tropical diseases, which were then endemic in the Old World.”

The First Encounter between microscopic invaders and human beings was the epidemiological catastrophe beginning.

It is worth making a brief review on the occurrence of some infectious diseases.

Microorganisms have evolved throughout history alongside the insect vectors (fleas, lice, mosquitoes, flies, ticks), reservoirs animals (big mammals, rodents, bats, birds), and humans themselves. This circumstance happened from the first pre-hominids to the last evolutionary step of the species (Homo sapiens sapiens).

In the Old World (Asia and Europe), the evolutionary epidemiological way of infections started in small hunter-gatherers. It carried out slowly until reaching the big developed cities of Mesopotamia, Egypt, or Greece. Much later, they also appeared at all the capitals, cities, and towns of Europe; that is, infectious diseases started spreading and settling in Eurasia, according to a different epidemiological pattern.

Microorganisms have evolved throughout history alongside the insect vectors (fleas, lice, mosquitoes, flies, ticks), reservoirs animals (big mammals, rodents, bats, birds), and humans themselves.

Viral infections, such as, for example, measles, require the concurrence of a minimum number of people (several hundred thousand, probably never less than a quarter of a million) to surge as an outbreak, spreading, and later following the epidemiological chain (usually, remaining as an endemic infection). This type of viral infection emerged because of the inclusive development of agriculture. It was a fact that allowed the agglomeration of large masses of individuals conforming to the large cities of antiquity.

The same argument or one similar is valid for bacterial infections (bubonic plague, cholera, typhoid) and the rickettsial diseases (exanthematic typhus, murine typhus): all they arise and spread with great ease under certain circumstances.

These infectious diseases ravaged the bests and strongest armies, ancient and modern, and big cities, towns, and villages; and the prisons, monasteries, and hospitals of Asia and Europe during the last twenty centuries of ours Era.

A Native American medicine man is caring for an ill Native American, 1857. Engraving by Captain Samual Eastman. Photo: Wikimedia Commons.

Zoonoses are a similar behavior. The term zoonoses is a composed word derived from Greek (-zoon, animal; -nósos, disease); or, in other words, they are infections whose reservoirs are the animals. They affect the human being following the pattern of contagion from the animals to humans. Sixty or seventy percent of infectious diseases that affect human beings are of zoonotic origin.

Many animals’ biological products (milk, hair, skin, excrements such as feces and urine) or the contagious dust that some herds mobilize in their movements) maintain the epidemiological chain of many bacteria and viruses, the microorganisms responsible for a significant number of diseases.

Agricultural practices led to the sedentariness of the former nomads. An evolutionary fact that facilitated human agglomeration led to the appearance of irrigation, the storage of crops, and a closer and more prolonged contact among thousand or million of people.

Agricultural practices led to the sedentariness of the former nomads

North American Medicine Pipe Stem Dance-Paul Kane. Photo: Art-Prints.

And also of the little and very prolific animals, of course: Near to farmworkers usually can surge an overpopulation of small rodents. Its excrements can transmit many and different microorganisms. Still more, it appears new ecological niches: for example, sites of mosquitoes breeding in the humid areas, what it usually entails very high risk for malaria and of other grave infections vehicled by insects: while writing this article, mid-August 2020, a West Nile meningoencephalitis outbreak is occurring in Seville province, Spain’s Andalusia.

Centuries before Christopher Columbus arrived, the environmental circumstances were very different. The privileged situation, and almost total geographical isolation from Eurasia and Africa, were the cause. The evolutionary dynamics: for millennia, there was a significant territory inhabitable, but not inhabited by humans. Slowly, the small transhumant groups of humans began to move, although a very low population density characterized them.

They were like little groups of ants moving in the middle of an infinite geographical area. This circumstance did not gather the necessary epidemiological conditions for the surge and spreading of certain infections, some of which we have pointed out before.

How the Indians Treat Their Sick, from “Brevis narration…”. Engraving by Theodore de Bry. Photo: Art-Library

These diseases can be considered infections associated with immigration, remote examples of one of the most thriving chapters of current Infectiology.

There were also other local infectious diseases. They already existed when the first settlers arrived. They were infections affecting people when the occasion arose and remained unknowns in their place of origin for millennia.

Several examples are New World Leishmaniasis (Leishmania spp.), Chagas’ disease (or American trypanosomiasis by Trypanosoma cruzy), an infection very different from African type (caused by Trypanosoma brucei), and Carrion’s disease (caused by Bartonella spp.). It seems that there were rare fungal infections or mycoses, such as blastomycosis and coccidioidomycosis.

These diseases can be considered infections associated with immigration, remote examples of one of the most thriving chapters of current Infectiology.

Mycobacterium tuberculosis (Cause of tuberculosis). Photo: Public Health Image Library/CDC.

Tuberculosis, a romantic disease that ruled in not romantic times
Tuberculosis is a disease that gets special prominence in any historical analysis. It deserves a separate chapter.

Did it exist in the New World before the arrival of Columbus? The answer is yes. A few decades ago, the idea prevailing considered tuberculosis a disease originating in the Old World and imported to the Indies. But there is Amerindians’ human remains with evidence of the infection dated back some 5000 years B.C.

In the Old World, tuberculosis began among the humans after the domestication of cattle. It happened between 10,000 and 5,000 years B.C. Studies of Ruffer, in 1910, showed tuberculosis of the spine (Pott’s disease) and secondary abscess (pus) of the psoas muscle in Nespereham, a priest of the XXI Egyptian dynasty (dated between 1085 and 945 B.C.). Zimmerman, also described (1977) the infection in a five-year-old boy with scoliosis (Pott) and pulmonary tuberculosis.

In the New World ―the scenario of the tragedy― some authors have gone farther: tuberculosis accompanied the first colonizers of old America, thousands of years before Columbus’ arrival. The discovery of some remains with tuberculosis lesions took on higher value when the presence of the causal bacterium, Mycobacterium tuberculosis complex, could be demonstrated in Nazca mummies’ lungs.

Definitive data detected deoxyribonucleic acid (DNA) of the bacterium M. tuberculosis in some Peruvian and Chilean pre-Columbian mummies. The conclusion is that pulmonary tuberculosis and other clinical forms of the disease were present in old America much time before the Encounter.

Tuberculosis is a disease that gets special prominence in any historical analysis.

In addition to pulmonary tuberculosis, as the paradigm of all respiratory infections, acute bacterial pneumonia was also present. In some cases, the bacterial infection occurred in the underlying context of lungs affected by pneumoconiosis, that is, respiratory organs lacerated by the inhalation of dust from mines, fumes, cotton, and other inhaled particles. The availability of more scientific data permits to venture the existence of a tubercular infection profile very similar, in general, to that of the Old World. Nothing new under the sun.

Treponema pallidum (Cause of Venereal Syphilis). Photo: Public Health Image Library/CDC.

Other diseases are also worth mentioning here due to their importance. One very prevalent infection was treponematosis (from spirochetes bacterial group). Pinta and “yaws” were prevalent. From a historical point of view, the most important is a venereal infection (Syphilis). It is a fact of importance because many scholars accept that Syphilis was the first and most grave disease imported to Europe from the New World.

The New World theory, also known as Columbus’ hypothesis, about the origin of syphilis, is prevailing in the international literature for the last five centuries. However, I modestly have defended the opposite opinion somewhere else. And I will try to demonstrate this discussed idea in the next collaboration on this platform. It is an opinion based on solid documentary arguments.

Other bacterial infections (leptospirosis, and two types of Borrelia recurrent fever transmitted by lice and ticks, with very high mortality: 50%), also existed in the pre-Columbian New World.

The New World theory, also known as Columbus’ hypothesis, about the origin of syphilis, is prevailing in the international literature for the last five centuries.

Florida Native American Indian 16th Century Engraving by DeBry. Photo: rubylane.

Sometimes, telling the truth of history depends on a simple adverb.

Professor Angélica Mandujano (University of Mexico), and colleagues, say, in their work Historia de las epidemias en el México Antiguo, that there is a tendency to weigh up the good health existing before the arrival of the conquerors. This supposition shock with the grave epidemics that devastated Mexico years later. They killed around 90% of the indigenous people through the following decades.

But there were other medical problems, as has been said before. In addition to numerous natural disasters (volcanoes, earthquakes, hurricanes, tsunamis, storms) that devastated the populations before the Spaniards’ arrival to the American territory. The previous cited Mexicans authors stated as a conclusion of their work:

“By the time the Spaniards arrived, several urban centers had been abandoned, perhaps by famine, perhaps by epidemics.”

I agree. Sometimes, telling the truth of history depends on a simple adverb. Perhaps.

EXPLANATORY NOTE: In a previous article published on this platform (The Statues of Christopher Columbus don’t have Syphilis), I alluded to the presumed syphilis of Christopher Columbus. If this fact were actual, it would support the hypothesis that the Admiral and his men imported the venereal infection to old Europe ending the 15th century (since March 1493).

The subject, so highly debated in international literature for five centuries, is so impressive that it worth special attention in a specific article. Some recent genetic findings have reactivated the ever-live fire of controversy.

It is the reason why I previously wrote other articles about mythological, geographical, environmental, ideological, microbiological, and human existential space discovered by the Spanish adventurers. The place (The American continent before Columbus arrival) where historical facts (The Encounter/The Discovery) happened.

The New World (“Las Indias”) was the existential theater’s stage (physical and mental) where Christopher Columbus — the Renaissance’s man and the character of the historical drama — performed a unique role that changed humanity’s history.

Christopher Columbus, by Ridolfo di Ghirlandaio (1483–1561). Photo: WikimediaCommons.

Medical Doctor (Infectious Diseases specialist/Professor of Medicine) and writer (narrative, theater).