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Aspects of Health Status in Pre-Sedentism Populations of Southwestern Asia

Evidence from Qafzeh Site, Lower Galilee
Anne-Marie Tillier
p. 31-34

Résumés

Le site de Qafzeh en Basse Galilée a livré un corpus unique de premiers Homo sapiens modernes datés d’environ 100 BP qui représentent toutes les classes d’âge depuis le stade périnatal jusqu’à l’âge adulte. Nombreuses et diverses anomalies du développement, lésions dentaires et osseuses ont été décrites et informent sur le déroulement de la vie au sein d’un groupe de chasseurs cueilleurs nomades du Paléolithique moyen en Asie du sud-ouest. Plusieurs pathologies affectant des jeunes individus permettent d’appréhender la mortalité des immatures au sein des populations du passé. De plus, quelques-unes d’entre elles informent sur le traitement social et les pratiques mortuaires de la part des occupants de Qafzeh, il y a environ 100 ka BP.

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The Qafzeh skeletal collection originates from early discoveries made in 1932-1935 by R. Neuville and M. Stekelis and from new excavations (1965 to 1979) conducted by Bernard Vandermeersch who kindly entrusted me with fieldwork and study of the anthropological assemblage. The National Center for Scientific Research in France (CNRS) and the Irene Sala Care Archaeological Foundation financially supported laboratory studies. I am grateful to students, colleagues and friends from Tel Aviv, Jerusalem, Paris and Pessac who provided help and technical assistance throughout the development of this research over many years. I am also deeply grateful to Janet Monge who gave her time to improve the English version of the manuscript.

1The Qafzeh site in Lower Galilee yielded an important collection of human remains (Vandermeersch 1966, 1969a, 1981, 1995; Vallois and Vandermeersch 1972; Tillier 1999; 2014a; Courtaud and Tillier 2005; Schuh et al. 2017; Coutinho Nogueira 2019) that are associated to a Middle Palaeolithic archaeological context. The collection of hominin fossils consists of virtually complete skeletons, partial skeletons, cranial and postcranial fragments and finally isolated teeth corresponding to at least 28 individuals. These individuals represent both subadults and adults that document a broad range of morphological variation, including both non-pathological variations and pathological conditions. Given the elevated frequency of pathological bone alterations, the Qafzeh human sample holds a key position in the reconstruction of health status of Late Pleistocene hunter-gatherers in Southwestern Asia, prior to the emergence of sedentism. Here we present a summary of pathological features previously described in detail, with reference to these Qafzeh individuals, in the context of this special thematic issue devoted to Late Pleistocene Levantine populations that confronted new life-way conditions.

Brief archaeological context of the Qafzeh Hominins

2The Qafzeh site shows a spatial and temporal concentration of hominin remains that is intriguing. The human remains were unearthed on the terrace in Layers XVII to XXIII that contained a faunal assemblage indicating a prevalence of red deer (Cervus elaphus) and fallow deer (Dama mesopotamica), followed by a lower frequency of Bovids, Caprids and Equids (Rabinovitch and Tchernov 1995). Animal bones represent the sole information source in the reconstruction of subsistence strategies (Rabinovich and Tchernov 1995; Vandermeerch and Bar-Yosef 2017), since site formation processes and continuous karstic activities produced some layer brecciation that did not allow for the preservation of plant remains. The lithic Mousterian assemblages published in detail (Hovers 2009) indicate evidence of a preference for Levallois production with less than 10% of retouch pieces, with side- scrapers being the common tool type. The site provides additional evidence for unique Middle Palaeolithic funerary practices, the presence of an engraved artifact, the use of ochre and marine shells associated with the area of the human remains and burials (Vandermeersch 1969a, 1969b, 1970; Tillier 1995; Hovers et al. 1997, 2003; Bar-Yosef et al. 2009; Vandermeersch and Bar-Yosef 2017).

  • 1 Application of Gamma-ray non-destructive spectrometry to the adult Qafzeh 6 skull (Yokohama et al. (...)

3The Qafzeh hominin sample was assigned to Oxygen Isotope Stage 5 by radiometric dates together with biostratigraphic evidence (Bar-Yosef and Vandermeersch 1981; Tchernov 1981; Schwarcz et al. 1988; Valladas et al. 1988). Thermoluminescence (TL) and Electron Spin Resonance/Linear Uptake (ASR/LU) set the range of the Mousterian sequence (layers XVII to XXII) from 92 ± 5 ka BP (TL dates), and 96 ± 13 to 115 ± 15 ka BP (ESR datesÑearly uptake and late uptake respectively).1

4The Qafzeh hominins document the early stage of anatomically modern human occupation in the Southern Levant (e.g. Howell 1959; Vandermeersch 1981; Tillier 1999). Within this group of remains, individuals who failed to attain reproductive adulthood were present in a high frequency and represent an important component in evaluating the social and overall conditions of health within the community. Several of the adult individuals offer insights into more ephemeral aspects of life conditions in Late Pleistocene hunter-gatherers. Growth-related disturbances as well as traumatic lesions and oral pathologies have been previously described and discussed for each individual (table 1). This high incidence of skeletal and dental anomalies offers a unique opportunity to integrate relevant information on the health status to aspects of social behaviour in a group of nomadic foragers prior to Neolithization in Southern Levant.

Table 1 Dental anomalies, bone lesions and pathological conditions by individual within the Qafzeh hominin sample. For the stratigraphic provenance of the human remains, layer L from Neuville excavations is equivalent to layer XVII from Vandermeersch. Dental age of the children is based upon radiographic data: ca. (circa) indicates an estimated age using charts of dental development from recent human populations and not an individual’s chronological age. PEIR=Pre-eruptive intracoronal resorption. Harris Lines and Linear enamel hypoplasia (LEH) are markers of physiological stress episodes during childhood.

Table 1 – Dental anomalies, bone lesions and pathological conditions by individual within the Qafzeh hominin sample. For the stratigraphic provenance of the human remains, layer L from Neuville excavations is equivalent to layer XVII from Vandermeersch. Dental age of the children is based upon radiographic data: ca. (circa) indicates an estimated age using charts of dental development from recent human populations and not an individual’s chronological age. PEIR=Pre-eruptive intracoronal resorption. Harris Lines and Linear enamel hypoplasia (LEH) are markers of physiological stress episodes during childhood.

Growth-related disorders

5At ca. 100 ka BP, skeletal and dental anomalies have affected Qafzeh individuals in childhood to varying degrees (table 1). A few children showed severe skull pathological conditions that prevented normal growth, development and survival processes, and that might be associated with young-age mortality in those individuals (n = 3).

Infectious diseases

6A determination of infectious diseases processes on human skeletal remains relies on the recognition of bone changes that are distinct from post-mortem taphonomic modifications. Two young individuals, Qafzeh 11 (ca. 13 years at death) and Qafzeh 12 (ca. 3 years old at death) display clear evidence of inflammatory disease of the middle ear. In the case of Qafzeh 11, alteration of auditory ossicles associated with inflammation of the left mastoid process support the previous diagnosis of otitis media, a common childhood disease of the middle ear (Arensburg and Nathan 1972; Tillier 1999; Quam and Rak 2008).

Benign bone tumors

7The analysis of micro-CT images of the Qafzeh 9 mandible reveals the presence of a benign tumor located near the mandibular angle of the left ramus that corresponds to a non-ossifying fibroma (Coutinho Nogueira et al. 2019: 106, fig. 4). This bone alteration can develop during growth, and effects both regions of the mandible and long bones. Since non-ossifying fibroma is asymptomatic, its frequency in recent populations is probably underestimated with only 20 cases reported in the literature since 1964.

8Most of the skeleton of Qafzeh 10, ca. 6 years of age at the time of death (fig. 1), is preserved. The right femur presents a spherical cavity showing well-defined bony margins (fig. 2A-C) on the disto-lateral surface indicating the location of an epi-physeal tumor. Previously attributed to an osteoid osteoma (Tillier et al. 2004), on further analysis this benign tumor is more likely a chondroblastoma (Dutour and Tillier 2018) that may have caused pain and the temporary restriction of movement (fig. 2B). Harris Lines (markers of physiological stress episode during long bone growth) are visible on the femur X-ray in the metaphyseal area (fig. 2C). Chondroblastoma has a low frequency in extant children (about 1% of bone tumors and 3% of benign tumors) and is not lethal, being more frequent in boys than in girls (e.g., Maroteaux 1982; Resnick et al. 2005).

Fig. 1 Qafzeh 10 child skeleton in situ.

Fig. 1 – Qafzeh 10 child skeleton in situ.

Cast M. Chech, photo M. Barazani.

Fig. 2 Radiographic views of the Qafzeh 10 right femur. A. A rounded osteolytic defect, with well-defined margins, can be seen on the disto-lateral part of the epiphysis; B. Magnification of the X-ray of the distal femur part showing the bone lacuna (10.3 × 7.8 mm) opening to the articular surfaceindicating presence of a pathological lesion (chondroblastoma); C. Location (arrows) of Harris Lines in the metaphyseal area.

Fig. 2 – Radiographic views of the Qafzeh 10 right femur. A. A rounded osteolytic defect, with well-defined margins, can be seen on the disto-lateral part of the epiphysis; B. Magnification of the X-ray of the distal femur part showing the bone lacuna (10.3 × 7.8 mm) opening to the articular surfaceindicating presence of a pathological lesion (chondroblastoma); C. Location (arrows) of Harris Lines in the metaphyseal area.

Disorders of skull growth

9Qafzeh 10 shows a single premature closure of the coronal suture (fig. 3A-B) that did not affect the intracranial volume, but this early fusion during cranial development (fig. 3C) caused plagiocephaly (Tillier 1999). The position of the coronal suture fusion, along a short distance of its right trajectory, raises questions concerning the aetiology of the synostosis. The presence of an external depressive surface adjacent and posterior to the synostosis is intriguing and suggests a probable link between the two bone alterations.

Fig. 3 Skull of Qafzeh 10 child, ca. 6 years at death. A. Norma superior; B. Partial radiographic view with local premature closure of right coronal suture; C. Norma lateralis illustrating plagiocephaly.

Fig. 3 – Skull of Qafzeh 10 child, ca. 6 years at death. A. Norma superior; B. Partial radiographic view with local premature closure of right coronal suture; C. Norma lateralis illustrating plagiocephaly.

10The Qafzeh 12 skeletal remains manifest a serious developmental disorder that explains the young age at death of the child who clearly could not have survived without major medical intervention. The individual shows evidence of several cranial and related postcranial changes associated with hydrocephalus. Evidence of hydrocephalus in the cranium includes: a large anterior fontanelle (fig. 4), patent metopic suture, accentuated sagittal curvature of the frontal bone, increase in skull size, numerous lambdoid suture ossicles and asymmetry in the occipital region (Tillier et al. 2001: 167; fig. 2). The preserved postcranial bones displayed overall hypotrophy and shortness of the upper limb bones (Tillier et al. 2001: 169; fig. 3). Qafzeh 12, who died in early childhood, around 3 years (dental age), offers the earliest evidence of hydrocephalus among prehistoric populations. Hydrocephalus is not unusual in extant populations (2‰ of the children) while reported cases in the archaeological literature remain relatively scarce (Richards and Anton 1991).

Fig. 4 – Superior view of the frontoparietal region of Qafzeh 12 child skull (ca. 3 years old at death, dental age). Margins of the large (39 mm wide, 27 mm long) and asymmetric anterior fontanelle are characterized by long indentations.

Fig. 4 – Superior view of the frontoparietal region of Qafzeh 12 child skull (ca. 3 years old at death, dental age). Margins of the large (39 mm wide, 27 mm long) and asymmetric anterior fontanelle are characterized by long indentations.

Bone traumatic lesions

  • 2 Arensburg B., Duday H. and Tillier A.-M. 2006 – Approche paléopathologique de la sépulture double d (...)

11Bones may show breaks that occurred during life (ante-mortem, and referred to as fractures or trauma) or due to taphonomic processes after death (post-mortem; Waldron 2009). Pathological conditions in two Qafzeh skeletons originally were identified as ante-mortem (Dastugue 1981): a fracture of the calcaneus in Qafzeh 8 adult and the presence of a hallux valgus of the right foot of Qafzeh 9. However, a re-examination of these two individuals found evidence that the changes occurred post-mortem, not ante-mortem as originally described (H. Duday pers. communication; Arensburg et al. 20062).

12Cranial and postcranial ante-mortem trauma of varied severity exist on four other Qafzeh individuals. These result from either minor or major traumatic events.

Minor traumatic insults

13The Qafzeh 6 adult skull shows a short straight indentation (depressed fracture) on the outer surface of the left supraorbital area. This minor insult appears to be a completely healed wound (Tillier et al. 2004). Qafzeh 9 presents minor traumatic lesions on the right calcaneus and third proximal foot phalanx (Arensburg et al. 2006) that might have produced temporary difficulties in prolonged standing and walking. The mandible of the same individual shows a small rounded defect located on the articular surface of the right condylar process. This defect studied through analysis of micro-CT images appears to be an osteochondritis dissecans (Coutinho Nogueira et al. 2019: 105; figs. 2, 3) which results from micro-recurrent trauma on the temporomandibular joint, due to malocclusion associated with a misalignment of the upper left lateral incisor (fig. 8).

Severe skull injuries

14Two immature individuals, Qafzeh 10 and 11, experienced serious difficulties in childhood. On the Qafzeh 10 immature skull, a link between the depressed surface expanding behind the coronal suture and the premature closing of this suture on the right side (as mentioned above) cannot be excluded, in spite of post-mortem damage on these cranial remains (fig. 1). Medical imaging techniques and especially updated 3D rendered images might enable us to better explore the right frontoparietal area, and determine if both cranial alterations are the consequence of a traumatic injury that the child suffered before his/her death at ca. 6 years.

15Qafzeh 11 suffered from severe injury on the right side of the skull (fig. 5) previously attributed to healed trauma (Dastugue 1981). The use of 3D rendered images and virtual reconstruction of the skull and endocast enabled a re-evaluation of the impact of the skull lesion (fig. 6), and established both brain growth delay and neurological damage (Coqueugniot et al. 2014). Although Qafzeh 11 survived the injury for a few years (with motor and psychological disorders), one can reasonably speculate about the disabling conditions that this young individual had to face, which resulted in death at ca. 13 years of age (Tillier 1999; Coqueugniot et al. 2014). The nature of the trauma, accidental or deliberate, remains unknown, although evidence of special treatment of the deceased might exclude interpersonal violence.

Fig. 5 Qafzeh 11 skull in norma facialis and norma superior indicating location of the frontal trauma.

Fig. 5 – Qafzeh 11 skull in norma facialis and norma superior indicating location of the frontal trauma.

3D virtual reconstruction H. Coqueugniot 2014.

Fig. 6 Close-up view of Qafzeh 11 skull 3D reconstruction showing in transparency the virtual endocranial cast in the trauma area. 1. Anterior part of the frontal bone depressed fracture penetrating the endocranial volume; 2. Irregular shape of virtual endocranial surface indicating brain damage; 3. Diastasis of the right coronal suture.

Fig. 6 – Close-up view of Qafzeh 11 skull 3D reconstruction showing in transparency the virtual endocranial cast in the trauma area. 1. Anterior part of the frontal bone depressed fracture penetrating the endocranial volume; 2. Irregular shape of virtual endocranial surface indicating brain damage; 3. Diastasis of the right coronal suture.

3D virtual reconstruction H. Coqueugniot 2014.

Tooth anomalies and oral pathological conditions

16Analyses of dentition reveal developmental variants (hypodontia, tooth misalignment or rotation, carious lesions) and age-related changes that affected the oral health of Qafzeh individuals.

Hypodontia

17Qafzeh 15, ca. 8-10 years at death, documents a case of dental agenesis (Tillier et al. 1998: 5; fig. 4). In present-day modern people, congenital absence of teeth in the permanent dentition can occur in the mandible and/or maxilla, and can be uni- or bi-lateral, afecting single or multiple teeth (Alt et al. 1998). Hypodontia or tooth agenesis is the most frequent hereditary dental anomaly, and the most usual missing teeth are the third molar and second premolar. In the case of Qafzeh 15, the left lower second premolar did not develop. It is possible that the right lower second premolar is anagenetic as well, but post-mortem mandible bone breakage in the region of this tooth precludes this assessment. Thus, the presence of a bilateral agenesis of the mandible second premolars remains an open question. The Qafzeh 15 maxillary dentition retains all its teeth.

Tooth malposition and rotation

18There is no evidence of ante-mortem tooth loss on sufficiently preserved dental arches of Qafzeh hominins (vs. Tillier et al. 2004). At least five individuals (Qafzeh 9, 10, 11, 15 and 25; Tillier 1999; Sarig and Tillier 2014; Schuh et al. 2017) show anomalies of premolar or molar rotation (fig. 7) or position (table 1). Qafzeh 9 manifests a unique case of mesio-occlusion of the upper second left incisor (fig. 8), while the Qafzeh 10 child shows an ectopic germ of the same tooth. Tooth rotation is often considered to be genetically determined in extant populations (see references in Schuh et al. 2017: 57). Multiple incidents at Qafzeh (table 1) might address the question of broad familial relationships among members of the human group.

Fig. 7 Superior view of Qafzeh 11 mandible showing the mesio-buccally orientation of left second premolar.

Fig. 7 – Superior view of Qafzeh 11 mandible showing the mesio-buccally orientation of left second premolar.

Photos A. Pinchasov and H. Duday.

Fig. 8 Qafzeh 9 palate. A. Superior view indicating the mesio-occlusion of left lateral incisor; B. Buccal magnificated view of the tooth with the arrow pointing the wear facet impacted by malocclusion.

Fig. 8 – Qafzeh 9 palate. A. Superior view indicating the mesio-occlusion of left lateral incisor; B. Buccal magnificated view of the tooth with the arrow pointing the wear facet impacted by malocclusion.

Photos A. Pinchasov and H. Duday.

Periodontal disease and dental calculus

19Recession of the mandibular and maxillary alveolar margin and periodontal disease are common features in extant populations. At least three Qafzeh adults (Qafzeh 3, 6 and 8; Tillier et al. 2004) exhibit alveolar bone resorption. In addition, the preserved upper molars of Qafzeh 3 display evidence of mineralized plaque (dental calculus), together with cervical polished grooves resulting from the use of a tooth pick (Tillier et al. 2004: 138; fig. 1).

Enamel and dentine hypoplasias

20Linear Enamel Hypoplasia (LEH; a dental indicator of early life stress episodes) are identified on 2 isolated teeth (Qafzeh 26 and 27; Tillier 2014: 16, 19; figs. 2, 5). A low incidence of LEH may indicate either that stressful events occurred late in growth (i.e. after tooth crown completion) or that young immature individuals died before the body had time to respond to the systematic cause (developmental disturbance, infection, trauma, nutritional deficiency etc.) responsible for the formation of such enamel defects. However, additional data brought from an application of micro-CT analysis allowing virtual reconstruction of permanent tooth germs might challenge this conclusion.

21Exploration of micro-CT images of the Qafzeh 9 mandible indicates a defect on the second permanent molar crown; this defect below the dentin-enamel junction (fig. 9) corresponds to a pre-eruptive intra-coronal resorption (PEIR). The aetiology of this type of defect is still debated in extant populations due to its low frequency (Coutinho Nogueira et al. 2019). However, the usual consequence is a weakening of the dental structure and tooth defects such as caries.

Fig. 9 A. Micro-CT slice of Qafzeh 9 lower right second molar with arrow pointing the dentine defect; B. 3D reconstruction of the tooth and pre-eruptive intracoronal resorption; C. 3D reconstruction of the defect.

Fig. 9 – A. Micro-CT slice of Qafzeh 9 lower right second molar with arrow pointing the dentine defect; B. 3D reconstruction of the tooth and pre-eruptive intracoronal resorption; C. 3D reconstruction of the defect.

3D virtual reconstructions D. Coutinho Noguera 2019.

Caries rate

22A multi-factorial and complex aetiology for the occurrence of caries in modern people is currently accepted (Caselitz 1998). Yet most paleoanthropologists and archaeologists often considered caries dietary in origin, and changes in subsistence practices over time as the major category of cariogenic agents. Accordingly, low caries rates in Pre-Neolithic populations are routinely accepted.

23Four Qafzeh individuals (table 1) show carious lesions on deciduous (Qafzeh 4) or permanent teeth (Qafzeh 3, 7 and 9). More than one defect is found in each individual (Tillier et al. 2004: 138; figs. 1, 10). The number of affected teeth (11 incisors and molars) is notable in association with four other cases reported from other Middle Palaeolithic hominins in Southern Levant Amud 1, Skhul II, Kebara 27 and Hayonim 20 (Sognnaes 1956; Tillier et al. 1995, 2004, 2014a, 2014b).

Fig. 10 Micro-CT slice of the lower left first molar of Qafzeh 9 with arrow pointing the carious lesion.

Fig. 10 – Micro-CT slice of the lower left first molar of Qafzeh 9 with arrow pointing the carious lesion.

3D virtual reconstructions D. Coutinho Noguera.

24From a paleopathological perspective, comparative data from more recent individuals might produce a more synthetic work on caries rates in Southwestern Asia before the onset of food production. As yet there are very few, and often fragmentary, human remains from the early phases of the Upper Palaeolithic, according to either lithic assemblages or uncalibrated 14C BP dates, or both. These sites include Ksar Aqil in Lebanon (Ewing 1947; Bergman and Stringer 1989; Tillier and Tixier 1991), Hayonim, El Wad, Qafzeh and Manot Caves in Israel (McCown and Keith 1939; Arensburg et al. 1990; Vandermeersch et al. 2013; Sarig et al. 2019) but individuals from these sites do not include comparative data on caries. The human fossil record dated to late Upper Palaeolithic and early Epipaleolithic (23,000-14,500 BP) is unfortunately also sparse (Hershkovitz et al. 1995). Two carious lesions on the right upper third molar were recently reported from the Ohalo II H2 adult specimen dated to 19,000 BP (Willman and Lacy 2020).

25Therefore, the data collected from the Qafzeh dental remains is the only comparative material that can be used for the Late Epipaleolithic (Natufians) and Neolithic populations of the Near East in the context of paleobiological research (Bocquentin 2003; Chamel 2014 and present volume: 83-96; Le Mort 2017). In the latter sample, the recorded dental caries rates document inter-population variation among social groups who have experienced new dietary habits influenced by food production (table 2). Therefore, the frequency of carious lesions at Qafzeh deserves special attention in conjunction with the comparative data (table 2) assessed from the Natufians (Bocquentin 2003) or Neolithic inhabitants from Cyprus (Le Mort 2017).

Table 2 Diachronic variation in caries rates among Near Eastern past populations.

Table 2 – Diachronic variation in caries rates among Near Eastern past populations.

Concluding remarks

26The Qafzeh hominins are one of the richest Middle Palaeolithic samples ever recovered from Southwest Asian sites. This group of nomadic hunter-gatherers living in the Near East prior to sedentism and invention of agriculture display several growth anomalies, oral and bone pathological conditions, and traumatic lesions. Indeed, Qafzeh people occupy a key-position by the elevated number of recorded pathological conditions (minor and major), by comparison with the few pathological features described for other Mousterian inhabitants of the Mediterranean Levant, at Skhul (McCown and Keith 1939) and Kebara (Duday and Arensburg 1991).

27Dental decay is observed on Qafzeh teeth, eleven show lesions that are mostly in the enamel, one (Qafzeh 9, see above) shows a carious lesion located at the dentine-enamel junction. The number of caries-affected individuals is substantial given the six dental cases reported for all Neanderthals in Europe (Arnaud et al. 2017). Finally, these findings point to a potential difference in immune response from dental disease between the two populations.

28Several bone lesions and pathological cases (e.g. ossifying fibroma, osteochondritis dissecans, chondroblastoma, hydrocephalus, plagiocephaly) are for the first time identified in a Pre-Neolithic population. In three documented cases (Qafzeh 10, 11 and 12), relationships between the aforementioned bone lesions and the death of the individuals are strongly associated. Furthermore, few skeletal and dental variants are either exceptional in present-day modern people, or are known to have a strong genetic component (see above). This occurrence indicates probable isolation and/or an endogamic component of the Qafzeh inhabitants during the Middle Palaeolithic. Interestingly, in contrast with other Levantine sites, the radiometric dates seem to favour a relatively short Mousterian occupation span at Qafzeh (Valladas et al. 1988). With regard to the nature of human occupation, “the predominance of micromammals suggest a period when the site was used only occasionally for special activities” (Bar-Yosef 2000: 122). Indeed, the archaeological documentation from the Qafzeh site provides a wealth of information about behaviour patterns of Late Pleistocene nomadic hunter-gatherers, with the presence of deliberate burials (Vandermeersch 1969a, 1970; Tillier 1995, 2009) that shed light on the care taken for the deposition of the deceased.

  • 3 Coutinho Nogueira D., Coqueugniot H. and Tillier A.-M. n.d. – Qafzeh 9 early modern human from Sout (...)

29The inhabitants might have used Qafzeh Cave as their burial ground, while their basecamp might have been located somewhere near the cave (Bar-Yosef 1989). In addition, the paleopathology survey in the Qafzeh skeletal remains provides insights into the social system and care of unhealthy individuals within the group. Unfortunately, in the case of Qafzeh 12, the hydrocephalous young child, questions concerning the taphonomic effects on the human remains are difficult to address since diagenetic processes certainly altered the skeletal remains to some degree. Interestingly, Qafzeh 9 and 10, both of whom exhibited tooth and bone lesions, were disposed together in a narrow, filled grave (fig. 11), documenting the earliest case of deliberate multiple burial in past populations. Due to the lack of successful aDNA, a familial relationship between these two deceased individuals can only be postulated by using phenotypic traits genetically driven (epigenetic dental and skeletal variants) that are present on both individuals (Tillier 1999). This excludes a maternal filiation since Qafzeh 9 whose age at death is estimated between 18.5 and 20.5 years is of male sex (Coutinho Nogueira et al.3). Finally, Qafzeh 11, the injured subadult individual, was clearly subject to a unique ritual treatment at death (fig. 12): his/her hands were placed near the face during burial, with two fallow deer antlers intentionally placed in close contact. The hands location in conjunction with the uniqueness of the position of the animal bones, support the interpretation of a funerary offering.

30In sum, the unusually high concentration of human remains at Qafzeh offers a unique opportunity to associate relevant health status information to aspects of social behaviour in a group of nomadic foragers prior to Neolithization in Southern Levant.

Fig. 11 The double primary burial associating Qafzeh 9 and 10. The two deceased were buried in a narrow pit (ca. 1.5 m long and 0.5 m large) and the corpses decomposed in a filled space.

Fig. 11 – The double primary burial associating Qafzeh 9 and 10. The two deceased were buried in a narrow pit (ca. 1.5 m long and 0.5 m large) and the corpses decomposed in a filled space.

After a drawing by D. Visset in Tillier 1995.

Fig. 12 Partial view of Qafzeh 11 burial showing the deposit of the red deer antlers in close contact with the hands of the deceased (cast).

Fig. 12 – Partial view of Qafzeh 11 burial showing the deposit of the red deer antlers in close contact with the hands of the deceased (cast).
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Notes

1 Application of Gamma-ray non-destructive spectrometry to the adult Qafzeh 6 skull (Yokohama et al. 1997) reached similar results.

2 Arensburg B., Duday H. and Tillier A.-M. 2006 – Approche paléopathologique de la sépulture double de Qafzeh (Israël). Communication au Colloque du Groupement des Paléopathologistes de Langue Française, Lille, 25-26 mars 2006.

3 Coutinho Nogueira D., Coqueugniot H. and Tillier A.-M. n.d. – Qafzeh 9 early modern human from Southwestern Asia: a re-evaluation of age at death and sex estimation, submitted.

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Table des illustrations

Titre Table 1 Dental anomalies, bone lesions and pathological conditions by individual within the Qafzeh hominin sample. For the stratigraphic provenance of the human remains, layer L from Neuville excavations is equivalent to layer XVII from Vandermeersch. Dental age of the children is based upon radiographic data: ca. (circa) indicates an estimated age using charts of dental development from recent human populations and not an individual’s chronological age. PEIR=Pre-eruptive intracoronal resorption. Harris Lines and Linear enamel hypoplasia (LEH) are markers of physiological stress episodes during childhood.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-1.jpg
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Titre Fig. 1 Qafzeh 10 child skeleton in situ.
Crédits Cast M. Chech, photo M. Barazani.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-2.jpg
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Titre Fig. 2 Radiographic views of the Qafzeh 10 right femur. A. A rounded osteolytic defect, with well-defined margins, can be seen on the disto-lateral part of the epiphysis; B. Magnification of the X-ray of the distal femur part showing the bone lacuna (10.3 × 7.8 mm) opening to the articular surfaceindicating presence of a pathological lesion (chondroblastoma); C. Location (arrows) of Harris Lines in the metaphyseal area.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-3.jpg
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URL http://journals.openedition.org/paleorient/docannexe/image/873/img-4.jpg
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URL http://journals.openedition.org/paleorient/docannexe/image/873/img-5.jpg
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Titre Fig. 3 Skull of Qafzeh 10 child, ca. 6 years at death. A. Norma superior; B. Partial radiographic view with local premature closure of right coronal suture; C. Norma lateralis illustrating plagiocephaly.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-6.jpg
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URL http://journals.openedition.org/paleorient/docannexe/image/873/img-7.jpg
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URL http://journals.openedition.org/paleorient/docannexe/image/873/img-8.jpg
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Titre Fig. 4 – Superior view of the frontoparietal region of Qafzeh 12 child skull (ca. 3 years old at death, dental age). Margins of the large (39 mm wide, 27 mm long) and asymmetric anterior fontanelle are characterized by long indentations.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-9.jpg
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Titre Fig. 5 Qafzeh 11 skull in norma facialis and norma superior indicating location of the frontal trauma.
Crédits 3D virtual reconstruction H. Coqueugniot 2014.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-10.jpg
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Titre Fig. 6 Close-up view of Qafzeh 11 skull 3D reconstruction showing in transparency the virtual endocranial cast in the trauma area. 1. Anterior part of the frontal bone depressed fracture penetrating the endocranial volume; 2. Irregular shape of virtual endocranial surface indicating brain damage; 3. Diastasis of the right coronal suture.
Crédits 3D virtual reconstruction H. Coqueugniot 2014.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-11.jpg
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Titre Fig. 7 Superior view of Qafzeh 11 mandible showing the mesio-buccally orientation of left second premolar.
Crédits Photos A. Pinchasov and H. Duday.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-12.jpg
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Titre Fig. 8 Qafzeh 9 palate. A. Superior view indicating the mesio-occlusion of left lateral incisor; B. Buccal magnificated view of the tooth with the arrow pointing the wear facet impacted by malocclusion.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-13.jpg
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Crédits Photos A. Pinchasov and H. Duday.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-14.jpg
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Titre Fig. 9 A. Micro-CT slice of Qafzeh 9 lower right second molar with arrow pointing the dentine defect; B. 3D reconstruction of the tooth and pre-eruptive intracoronal resorption; C. 3D reconstruction of the defect.
Crédits 3D virtual reconstructions D. Coutinho Noguera 2019.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-15.jpg
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Titre Fig. 10 Micro-CT slice of the lower left first molar of Qafzeh 9 with arrow pointing the carious lesion.
Crédits 3D virtual reconstructions D. Coutinho Noguera.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-16.jpg
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Titre Table 2 Diachronic variation in caries rates among Near Eastern past populations.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-17.jpg
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Titre Fig. 11 The double primary burial associating Qafzeh 9 and 10. The two deceased were buried in a narrow pit (ca. 1.5 m long and 0.5 m large) and the corpses decomposed in a filled space.
Crédits After a drawing by D. Visset in Tillier 1995.
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-18.jpg
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Titre Fig. 12 Partial view of Qafzeh 11 burial showing the deposit of the red deer antlers in close contact with the hands of the deceased (cast).
URL http://journals.openedition.org/paleorient/docannexe/image/873/img-19.jpg
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Anne-Marie Tillier, « Aspects of Health Status in Pre-Sedentism Populations of Southwestern Asia »Paléorient, 47-1 | 2021, 31-34.

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Anne-Marie Tillier, « Aspects of Health Status in Pre-Sedentism Populations of Southwestern Asia »Paléorient [En ligne], 47-1 | 2021, mis en ligne le 01 décembre 2021, consulté le 13 juin 2025. URL : http://journals.openedition.org/paleorient/873 ; DOI : https://doi.org/10.4000/paleorient.873

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Anne-Marie Tillier

PACEA, UMR 5199, Université de Bordeaux, CNRS, ministère de la Culture, Pessac – France

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