RHEUMATIC CLIFF DWELLERS
by
T. Alan Casey

For the majority of us it would be difficult to picture the American Indian as a fellow "bent double" with the aches and pains of rheumatism, hobbling along with the aid of some crudely fashioned cane or crutch, or possibly so tortured as to be unable to get about. It would be a tax on our imagination, for we are accustomed to think of Indians as being tall, straight and robust; scarcely short of physical perfection, and in a state of health that nearly smacks of immortality. But no matter this, for a series of studies recently conducted shows us that some of the Pueblo Indians who lived in the Mesa Verde during the twelfth and thirteenth centuries were afflicted, among other things, with a condition identical with one of the many types of "rheumatism" from which many present-day people suffer.

Strictly, in the medical sense, "rheumatism" is not rheumatism at all times, because the symptoms by which the laity knows this disease may be due to a great variety of causative factors and agents. If our joints are stiff, knuckles swollen and painful, back stiff and aching, or if we are bent forward as the result of a paining back, we have "rheumatism." But stiff, sore backs and swollen, painful joints may be due to a myriad of causes; a few of these are: strains and sprains, infections, heart disease, prolonged lung diseases, trichinosis, overfatigue, lead poisoning, alcohol poisoning, arsenic poisoning, diabetes, kidney disease, gout, tuberculosis, and social diseases. To the medical man rheumatism implies rheumatic fever, which is primarily a heart disease, with accompanying joint involvements and such other symptoms as St. Vitus dance, etc. The doctor speaks of joint diseases, regardless of cause, as arthritis. And too, arthritis may be subdivided in to many different types on the basis of cause and result.

It is not our purpose here to discuss rheumatism or arthritis in detail or to make a detailed differentiation between the two. Therefore, suffice it to say that there are many forms and types of arthritis and that the lay term for the symptoms of these and a number of other conditions is "rheumatism." The Mesa Verde Indians of prehistoric times were troubled with arthritis in various forms and, as the aforementioned studies show, arthritis of the spine was quite a common ailment among them.

One of the most interesting of these specimens in the Mesa Verde museum is a spine which is so definitely arthritic that even those of the visitors who know nothing of the normal appearances of bones and the changes in them due to disease, immediately recognize the abnormality. Merely a glance at this spine shows the observer that a number of the lowermost vertebrae possess peculiar outgrowths of bone from their front margins. This is spoken of as "lipping" or "hypertrophy" and from this the disease derives its name—Chronic hypertrophic osteo-arthritis of the spine. Later it will be brought out that these bony processes give rise to the symptoms of rheumatism.

Let us go back to the thirteenth century, to the heyday of the Pueblo occupation of the Mesa Verde, and imagine that this particular fellow, of whom the spine was once a part, was just beginning to develop his arthritis. He would probably not be aware that anything was amiss for some time following its onset. He would most likely be 50 or 60 years old, for the disease is most common at this age. After some time, ten months to two years, perhaps, he would be annoyed by discomfort, but not acute pain in the lower part of his back. This would be most noticeable to him at a time while he was resting, for his mind would be "at ease" and introspection, subconscious though it might be, would tell him that his back did not feel quite "up to par."

As time went on the discomfort would become more and more evident to him, and certain positions assumed during the day or night would cause him to wince with pain or fret because his leg tingled or developed a burning or "prickling" sensation. These symptoms could be explained by the fact that when his back was held in certain positions one or more of the bony outgrowths pressed on a nerve supplying the leg. After some years of this sort of tribulation his back would become constantly painful and he would find that he could not assume certain positions because of stiffness or excruciating pain. Therefore, he would be rather careful to hold and move his back "just so." Possibly, because of even more severe pain, he might be "bent" forward into a position so often assumed by elderly men who have rheumatism.

We might well and correctly picture our "elder" of the Pueblos as hobbling along cautiously to the kiva council, steadying himself with a stout cane he had fashioned from a scrub oak, and holding one hand quite firmly against the lower part of his back, just above the hip. Later he might find the movements of walking "too much for him" and be content to "putter around the house" for an hour or two each day. The rest of the day he would spend sitting outside the door of his cliff house home, chatting with his cronies or watching the turkeys feed on the talus slopes below the cave. Or he might stay within the little, stone home and dream to himself, through half-closed eyes, of the "many moons ago" when he was a straight, wiry lad, who helped his father with the farming and hunting, and aided in the defense of his home and loved ones against the raids of nomadic Indians.

No doubt this pueblo man of the thirteenth century would be most stoic in all his suffering, but nevertheless he would make some attempt, or solicit it, to obtain relief or a cure. He would probably, if he were not a Medicine Man himself, call upon one for aid, and many methods of treatment might have been instituted. It is believed by many that the Cliff Dwellers used sweat baths for such purposes, and this man may have been placed in one of the small rooms and given hot, steamy baths. This would have been excellent treatment, even in the light of present day medical knowledge, for heat would do much to relieve the pain and stimulate good nutrition to the joints and surrounding parts. One can also be reasonably sure that many incantations were said for him and many appeals made to the gods to drive the devils out of this man's back that he might again walk straight and resume his corn planting and his hunting. He probably took potions of many kinds, brewed from native plants. Some of these treatments may have aided; others may have been so disagreeable as to cause his mind to momentarily center not upon his plight but upon the cure, and thus allay the symptoms for a short time. Progressively, though, his condition became worse until finally death came, perhaps from old age, possibly from a more violent cause.

No doubt you find yourself sympathizing with this old Pueblo man, thankful that you have the benefits of modern medicine to soothe your aches and pains and effect a cure. Many drugs and treatments do ease the suffering of painful, swollen joints and bothersome backaches, but no treatment has been devised that will cure them. Therefore, though we may be justified in "patting ourselves on the back" because of our medical knowledge, in the case of arthritis we are actually not far ahead of the Mesa Verde people of 1200 A.D.

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The museum exhibit that has proved to be most popular with the visitors is the one that shows the diseases and injuries from which the Cliff Dwellers suffered. The exhibit shows bones that were affected by arthritis, periostitis, Calve-Legge-Perthes disease, and such dental troubles as attrition, caries, abscesses, pyorrhea, impactions, benign growths, loss of teeth, and resorption of the alveolar processes. In addition, there are a number of bones that show healed fractures; evidences of falls and injuries suffered by the Cliff Dwellers. People usually feel that Indians are very healthy and they are always surprised to learn that they suffered from such a variety of diseases. As a result each evening finds more finger and nose prints on the glass of this case than on any other case in the museum.