Until a few years ago the bioarchaeology of care was a topic very rarely touched upon. Stimulated in large part by the innovative work by Tilley and colleagues, which provides a socially contextualised model to interpret the implications of health care in the past (Tilley & Oxenham Reference Tilley and Oxenham2011; Tilley Reference Tilley2015), this is now a burgeoning field in bioarchaeology. The two volumes on care in the past under review here showcase leading research in this emerging field, emphasising the social aspects of care in palaeopathological cases of disability. These volumes also illustrate the value of bioarchaeological consideration of the social implications of care provision, abuse and neglect of infants and children, as well as a consideration of care for animals in the past.
The stated aim of Tilley and Schrenk's volume is to extend the approaches developed in Tilley's earlier book, Theory and practice in the bioarchaeology of care (2015). This new edited volume arose from a symposium entitled ‘Building a Bioarchaeology of Care’ at the 2015 Annual Meeting of the Society for American Archaeology. The 19 chapters cover topics including the explanation of the ‘bioarchaeology of care’ approach, case studies of care from different parts of the world and over time, and new theoretical developments in the field and the ethical dimensions of such research. The first substantial chapter of the collection (Chapter 2) by Tilley explains in detail the ‘bioarchaeology of care’ model and provides examples of the application of this approach, including several diagrams for the steps to be taken.
Next come seven chapters grouped as ‘Case studies: applying and adapting the bioarchaeology of care methodology’. Schrenk and Martin (Chapter 3) apply the ‘bioarchaeology of care’ model to a severely disabled young adult female from the Bronze Age United Arab Emirates, and also provide a useful approach for dealing with uncertainty in palaeopathological diagnoses in care interpretation. Chapter 4 by Willett and Harrod, and 5 by Worne present cases of women with severe pelvic injuries and other pathologies from pre-contact sites in New Mexico and Tennessee respectively. Chapters 6–8 consider care in three historical case studies. Roberts (Chapter 6) discusses a middle-aged man with leprosy from late medieval England, and makes an important point about the individualised response to disease in the interpretation of care. Matczak and Kozłowski (Chapter 7) present the pathological assessment of two females, one with lepromatous leprosy, and one with gigantism. Both these chapters consider mortuary treatment and traumatic injuries in order to interpret the care and social responses to disease. Conlogue et al. (Chapter 8) present a multidisciplinary approach to the investigation of a young adult male from London with severe kyphoscoliosis, incorporating medical imaging, bioarchaeological approaches and interpreted within a social and historical context. Jolly and Kurin (Chapter 9) discuss the case of a young adult male with evidence for trephination and head trauma from the Late Intermediate Period in Peru.
Part 2 on ‘New directions for bioarchaeology of care research’ illustrates innovations in the assessment of care in the past in early life and old age, including at the population level, and with the integration of contextual evidence. Nystrom and Piombion-Mascali (Chapter 10) investigate care in the field of mummy studies, exploring surgical intervention, therapeutic tattooing and medicinal plants, and they present a case study of a mummy of an adult male from the Piraino Mother Church in Sicily. In the following chapter, Oxenham and Willis analyse childcare, a valuable topic that has been hitherto unexplored employing Tilley's care model, using an investigation of a Neolithic site in northern Vietnam. Although Oxenham and Willis seem ambivalent about the value of a ‘bioarchaeology of care’ approach in relation to children, I argue that caring for infants is as taxing as caring for the severely disabled due to their immature development. Gowland (Chapter 12) provides a sophisticated theory-led paper that will be useful for all researchers interested in the bioarchaeology of disability and care in later life. In this piece, she approaches later-life care, or lack thereof, through an integration of life-course theory, disability research and sociological perspectives. Wesp (Chapter 13) explores how bioarchaeology may investigate intangible evidence from historical documentation of care, coupled with analyses of skeletal individuals from the first hospital for the care of indigenous people in Mexico. Tremblay Critcher (Chapter 14) continues the theme of institutional care using a modification of Tilley's approach to assess care at a population level of 80 individuals associated with the Oneida State Custodial Asylum in New York. Milella (Chapter 15) looks at care behaviour in modern hunter-gatherers using an ethnographic dataset to model prehistoric care, focusing on infant and child mortality. Although mortality is arguably a crude indicator of care, this approach provides an alternative to population-level analysis. Wilson et al. (Chapter 16) demonstrate how their web-based 3D resource ‘Digitised diseases’ can be used with Tilley's ‘index of care’ approach.
In Part 3, on ‘Ethics and accountability in the bioarchaeology of care’, Doat provides a philosophical argument for the moral duty of bioarchaeologists to include disability in the interpretation and recreations of past societies, and to provide the most accurate account of this as possible. The final chapter of this section by Mennear argues that bioarchaeologists have an important job to bridge past and present populations through the sharing of their work on social media, using two case studies of care to illustrate their impact of public understandings of care in the past. Buikstra concludes this book by describing the impact that the ‘bioarchaeology of care’ model has had on the discipline, and a frank appraisal of the contributions to the book.
The second volume under review, Care in the past: archaeological and interdisciplinary perspectives, edited by Powell et al., comprises 12 chapters that explore care in the past from archaeological, bioarchaeological, historical and philosophical perspectives. Importantly, this volume assesses care throughout the life course including infants, children and the elderly, as well as care for those who are disabled. This book was a product of a session on ‘Disability and archaeology: critical perspectives and inclusive practices’ held at the Theoretical Archaeological Group conference, and it is pleasing to see the inclusion of work of emerging scholars showcased alongside that of established leaders in the field.
Roberts's preface to the volume provides an important reminder for the reader of the individual experience of disability, the difficulties in the reconstruction of care from the bioarchaeological record and the need to address these issues with a multi-disciplinary approach. The first section of this volume, ‘Care and the life course’, explores aspects of care from infancy through to the aged. The first three chapters assess care of infants and children. Lewis (Chapter 2) explores the mortuary, cultural and palaeopathological evidence for care and maltreatment of children in the past, focusing on congenital disease and trauma in different cultures and periods. Although she cautions against the extrapolation into the past of modern sensitivities of infant and child care, she argues that the analyses of the care of children can provide an important contribution to understanding social relationships in the past. Kendall's chapter serves as a novel exploration of the relationship between theory and method in palaeodietary research of infants and children, and interrogates assumptions of homogeneity in infant feeding and weaning practices in past societies. Dawson explores the relationship between the provision of care and social status of children in late medieval England using a combination of mortuary analyses and bioarchaeological evidence for physiological stress and infectious disease. This section concludes with Gowland's chapter on the care of the elderly in Roman Britain, with a focus on abuse and marginalisation of this age group. This chapter theorises an approach to the investigation of elder abuse through the exploration of a social concept of old age, the integration of risk factors and the diagnoses of elder abuse from present-day research. Gowland then presents a case study, which is interpreted within the historical context of the elderly in Roman times.
The next section, ‘Care, impairment and disability’, begins with Thorpe's critical analysis of the recent evidence for impairment and care in the Palaeolithic, arguing that palaeoanthropologists should not maintain the null hypothesis that we can never know if there was care amongst these groups. Doat (Chapter 7) engages with care in the past using a philosophical approach that explores issues of exclusion and inclusion of disability in archaeological research, and proposes an intriguing evolutionary biology argument for the development of caregiving in the past. Phillips (Chapter 8) assesses disability and care in a nineteenth-century US asylum using bioarchaeological and historical evidence. He argues that the physically disabled were not afforded the same treatment as other patients and gives evidence for shortened lives, poor oral health and infection. Willows (Chapter 9) presents an isotopic study of mobility and a palaeopathological investigation of individuals from the medieval period from the Isle of May, Scotland, a place of pilgrimage that has also been argued to be a place of healing.
In Section 3, on ‘Care and non-human animals’, Thomas (Chapter 10) outlines the contribution that zooarchaeological evidence can make to our understanding of human perceptions and the care of animals through an investigation of palaeopathology. King (Chapter 11) gives an overview of the historical and archaeological evidence for insect use in healing practices over the past two millennia. Gowland et al. conclude the volume with a chapter carefully drawing together the main themes of the contributions, including: the interconnectivity of age identity, dependency and disability; the value of a multidisciplinary approach to elucidate aspects of care in the past; and the usefulness of population or larger-scale approaches to the study of care in the past, which serve to disentangle the relationships between social identity and the provision of care in the community.
Both these works are sophisticated texts that present cutting-edge research at the forefront of the study of care in the past. They will be required reading for any academic or postgraduate in the field. Powell et al. will be particularly attractive to students, coming with a very reasonable price. Both volumes successfully illustrate the application, and more importantly, the development of the ‘bioarchaeology of care’ model advanced by Tilley (Reference Tilley2015), which will in turn encourage others to investigate aspects of care, not just in the context of disability, but also for the very young and very old of past societies.
