vilians had no equivalent until Christians in the east began to
establish shelters for the poor, the sick, and travelers, which
spread under the emperor Julian in the third century c.e.
Th e organization of the Roman household did not ob-
serve basic principles of sanitation. Latrines were oft en situ-
ated in kitchens; wells were dug near cesspits. Public works
projects made the city cleaner but did not always improve hy-
giene. Rome’s sewer system, the Cloaca Maxima, was fi rst laid
out in the sixth century b.c.e. by the Etruscans and covered
in the third century b.c.e. Th e statesman Marcus Agrippa
(64–12 b.c.e.) directed extensive repairs to the system in 33
b.c.e. and had it paved and vaulted. Sewage emptying into
the Tiber was, however, a source of pollution for those down-
stream and could back up with changes to the water level.
Although water from the aqueducts provided residents
with a relatively safe water supply, opportunities for contami-
nation remained—some as a result of the use of lead pipes.
Aqueducts also supplied public latrines and baths. Across
the empire, baths were popular social hubs. Physicians also
prescribed them for their patients, and medical services,
massages, and beauty treatments would have been available
onsite. While they were unhygienic by modern standards,
the baths ensured a relatively high level of cleanliness in the
population.
THE AMERICAS
BY KIRK H. BEETZ
Of the many controversies involving the interpretation of an-
cient American history, the matter of health and disease is
one of the most heatedly debated, more because of what the
history may mean to modern politics and society than what
it may mean in terms of the actual archaeological evidence.
At present historians believe that syphilis originated in the
Americas, and there is skeletal evidence that indicates that
syphilis affl icted ancient Mayans by 1000 b.c.e. Still, a mi-
nority of archaeologists suggest that syphilis already existed
in Europe when Columbus reached America in 1492, though
documents indicate a spread of syphilis from Columbus’
home port in Spain through Spain and then to the rest of Eu-
rope. What gives the debate its heat is the notion that some-
one is to blame for the disease, an issue that matters nothing
to the facts of the disease itself.
Not as contentious an issue is the origin of tuberculo-
sis. Th is disease seems to have affl icted ancient Americans as
well as people in the Old World; its DNA has been found in
naturally mummifi ed corpses in Peru dating from the 900s
c.e., and lesions are evident on lungs of ancient peoples. Some
archaeologists argue that the disease could have started in
only one place or the other and thus disagree about whether
tuberculosis began in the Old World or the New World. One
possibility is that tuberculosis was carried into the Americas
by people during one of the ancient migrations from north-
east Asia into Alaska. Another is that it was carried by an
unknown contact between ancient Americans and Asians or
Europeans. Perhaps the likeliest possibility is that tuberculo-
sis fi rst developed in rodents and eventually developed into a
disease that could pass from rodents to humans in both the
New World and the Old World, perhaps at diff erent times.
Many severe diseases developed in the Old World that
were unknown in the New World until the coming of Colum-
bus, but ancient Americans were affl icted various diseases
anyway. Th ere were vitamin defi ciencies, especially of vita-
min C. Some North Americans of the Southwest learned to
eat wild garlic cloves to treat the problem, but it seems to have
affl icted Mayans without successful treatment. Other vitamin
defi ciencies caused poor tooth enamel growth, a problem de-
tected by archaeologists more among ancient Mesoamericans
than among other ancient Americans. By 7000 b.c.e. Chagas
disease aff ected early settlers in the Andes. Chagas, a disease
that leads to fever and swelling of the lymph glands and can
progress to serious nervous system and heart damage, among
other symptoms, is caused by a protozoan and carried from
host to host by mosquitoes. Th e protozoan burrows into body
tissues, eventually overwhelming the body and causing death.
About 41 percent of tested mummies from about 7000 b.c.e.
had the disease. Another disease was yaws, a tropical skin in-
fection that causes infection of the skin, bones, and joints.
Some of the health problems suff ered by ancient Ameri-
cans were caused by their own activities. For instance, ar-
chaeologists have reported throughout the Americas that
ancient Americans had trouble disposing of human waste.
From large settlements in North America to South America,
communities were troubled by the buildup of human waste,
though aft er the ancient era some cultures developed sewer
systems. Archaeologists debate the cause of the collapse of
Mayan cities, and one theory is that disease made their cities
unlivable, forcing them out of lowland cities into highland
cities and then out of cities altogether. Poor disposal of hu-
man waste is oft en cited as a possible source of diseases of the
skin that would make life in the cities unbearable. Further,
poor disposal of waste may have attracted animal carriers
of disease. American rodents carried, for example, viruses
that could attack human hearts and cause severe fevers. Poor
nutrition may have resulted from expanding human popula-
tions that put too much stress on the land’s ability to provide
enough food for everyone, which would have resulted in vita-
min-defi ciency diseases. Studies of Mayan skeletons indicate
that prior to 400 b.c.e. Mayans were taller than those aft er
400 b.c.e., which may indicate poor nutrition caused by over-
population aft er 400 b.c.e.
Th e ways in which ancient Americans dealt with their
health problems are best known for the regions of the Andes,
Central America, eastern North America, and southwestern
North America. Th e peoples of southwestern North America
may have been infl uenced by the cultures of Mesoamerica.
Th e use of smoke for curative power seems to be very old in
ancient American cultures. A large smokehouse dating to
about 3700 b.c.e. has been found in Canada. At its center was
a large hearth. Inhaling fumes thick with smoke may havehealth and disease: The Americas 555