Disease and Healing in the Indus Civilisation

Disease and Healing in the Indus Civilisation presents a synthesis of what is currently known about health, disease and healing in the Indus Civilisation in the third to early second millennia BCE, underpinned by original research. It is the result of a detailed study of published human skeletal remains and material culture, with an increasing awareness of the natural environment. When combined with a knowledge of palaeoepidemiology and the natural history of disease, ancient climate change, and what is known of healing and health in contemporary Bronze Age societies of the Near East, with which the Indus Civilisation was in contact, it has been possible to piece together a picture of diseases in the period, the practice of healing and the development of public health. For the first time, the book illustrates the health, life expectancy, and the illnesses and injuries from which those at the bottom of society suffered, both at work and at home. Cover 1 Title Page 3 Copyright Page 4 Contents Page 7 List of Figures and Tables 10 Figure 1. Map of principal Indus Civilisation sites (after A. Uesugi, University of Wisconsin-Madison). 13 Figure 2. Harappa site plan showing phases of occupation (© Harappa Archaeological Research Project). 14 Table 1. Chronology of the Indus Civilisation to 1700 BC. 28 Table 2. Characteristics of the Mature Harappan Phase (after Smith, M.L. 2006: 97-142). 34 Table 3. Archaeological criteria for determining urbanism (after Childe 1950: 3-17). 39 Figure 3. The Indus Script: seals and tablets (© J.M. Kenoyer/Harappa.com and courtesy of the Department of Archaeology and Museums, Government of Pakistan). 51 Figure 4. Steatite seal from Mohenjo-daro depicting a likely religious scene of a deity surrounded by animals (DK5175); Mature Harappan Phase, National Museum, New Delhi (5075/123). 53 Table 4. Characteristics of the Late Harappan Phase (after Indus Ethnobiology: 1-20). 54 Table 5. Life expectancy at Harappa (male and female) (after Dales and Kenoyer 1989: 94-106 (contribution by Kennedy and Lovell)). 69 Table 6. Physical stature of the known population of Harappa (1965) (after Chatterjee and Kumar 1965: 4-5). 70 Table 7. Age and sex distribution of the Harappa skeletal sample (includes a skeleton excavated in 1966 and displayed in the Harappa Museum, where it was examined in 1988 (after Lovell 1997: Table 1). 70 Figure 5. Skeleton from Balthal, presenting with evidence of leprosy (1997-1); Ahar Banas Culture (after Robbins et al. 2009). 86 Table 8. Skeletal markers commonly associated with sickle-cell disease (adapted from Lovell 1998: Table 2). 98 Figure 7. Sickle haemoglobin haplotype distribution in the Middle East and India. 102 Figure 8. The female mosquito Anopheles Culcifacies. 103 Figure 9. Disarticulated skeletons from Mohenjo-daro, found above southern wall of Room 74, House V; Late Harappan Phase (after Mohenjo-daro: plate XLVI(b)). 109 Table 9. Trauma in human remains at Harappa (1987 and 1988), (after Lovell 2014a: 1-4, Table 1). 111 Table 10. Incidence of dental pathology at Harappa and Mohenjo-daro (after Lukacs 1982: Table 28.4). 116 Table 11. Diseases or conditions identified from Indus Civilisation sites. 118 Figure 10. Dyer’s workshop at Mohenjo-daro, VS Area (after Mohenjo-daro: pl. LIV(a)). 131 Figure 11. Large well at Mohenjo-daro, HR Area: detail of brick construction; Mature Harappan Phase (© J.M. Kenoyer/Harappa.com and courtesy of the Department of Archaeology and Museums, Government of Pakistan). 149 Figure 12. The ‘Great Bath’ at Mohenjo-daro, SD Area, looking north; Mature Harappan Phase (© J.M. Kenoyer/Harappa.com and courtesy of the Department of Archaeology and Museums, Government of Pakistan). 150 Figure 13. Latrine at Mohenjo-daro, HR Area; Mature Harappan Phase (© J.M. Kenoyer/Harappa.com and courtesy of the Department of Archaeology and Museums, Government of Pakistan). 153 Figure 14. U-shaped cross section of the corbelled drain from Mohenjo-daro exiting the ‘Great Bath’; Mature Harappan Phase (© J.M. Kenoyer/Harappa.com and courtesy of the Department of Archaeology and Museums, Government of Pakistan). 154 Table 12. Cranial trepanation (after Arnott 2013: 23-34). 167 Figure 15. Trepanned cranium of an adult male from Harappa (Cemetery R-37) (H802/B): (a) the left lateral view showing the trepanned hole; (b) the postero-lateral view showing the horizontal linear traumatic fracture on the occipital bone; and (c) an enla 169 Figure 16. Joined spatula or toiletry gadget from Mound AB Harappa; Mature Harappan Phase; Harappa E3 No. 1. National Museum, New Delhi (E3/26000). 177 Introduction 12 Earlier Work 14 Human Skeletal Remains: Problems and Challenges 15 Ancient Healing and Medicine 18 Sources 19 This Book 19 Acknowledgements 20 Finally 20 Abbreviations 22 1. The Indus Civilisation 25 Chronology 27 Pre-Harappan Phase 29 Early Harappan (or Pre-Urban) Phase 31 Mature (or Urban) Harappan Phase 32 Elites and State Formation 34 Regionalism 37 Urban and Rural Settlements 38 Technology and Craft Industries 40 Burial Customs 43 Transportation, Trade and Overseas Contacts 45 Agriculture 48 Writing and Literacy 50 Religion 52 Late Harappan (or Post-Urban) Phase 52 Continuity and Decline 55 Climate 57 2. Health and Population 61 Introduction 61 Disease, Parasites and Sedentism 62 Nutrition 65 Migration 66 Urbanisation 67 Women 71 Children 72 Health and the Late Harappan Phase 72 Climate change, health, disease and migration in the Late Harappan Phase 73 3. Disease and Trauma 75 Childbirth 77 Congenital and Other Deformities 78 Infections and Infectious Diseases: an overview 79 Zoonotic Diseases and Diseases of Agriculture 80 Tuberculosis 81 Tuberculosis and the Indus Civilisation 83 Infections 84 Tetanus 85 Leprosy (Hansen’s Disease) 86 Other Diseases of Urbanisation 89 Smallpox 90 Metabolic and Nutritional Disease 91 Ophthalmic Diseases 91 Rabies 91 Environmental Disorders and Famine 93 Neoplastic Disease 94 Malaria 95 Falciparum malaria 97 Sickle-cell Disease 98 Vivax Malaria 98 Human Skeletal Evidence of Sickle-cell Disease 99 Genetic Evidence 101 The Anopheles Culcifacies Mosquito 102 Malaria and Climate 103 Effects of Malaria 104 Summary 105 Traumatic Injuries 106 The Mohenjo-daro Skeletons 108 Skeletal Trauma at Harappa – telling a different story? 109 Non-Specific Periosteal Reactions and Infection Related to Trauma 110 Osteoarthritis and other Degenerative Diseases of Bone 112 Dental Disease 113 Conclusion 116 4. Diseases of Occupation 119 Physical Stress 119 Craft Specialisation 121 Smaller Trading and Craft Centres 123 Textile Workers 125 Wool and Anthrax 126 Cotton 128 Jute 129 Weaving and Spinning 129 Dyeing 131 Leather Workers 133 Metal Workers 134 Smelters and Handlers 134 Arsenic 135 Other Hazards and Injuries 138 Melting, Alloying and Metal Processing 139 Mining and Metalworking in the Indus Civilisation 139 Mining 140 Bead Makers 140 Seal Carvers 143 Sewer Cleaners 143 Builders, Carpenters and Bricklayers 145 Herders 145 Other Occupations 146 5. Public Health and Sanitation 147 Water Supply 148 The Great Bath of Mohenjo-daro 150 Domestic Bathing and Toilet Facilities 152 Urban Drainage and Sewage 153 Discharge 156 Other Sites 156 6. Healing and Medicine 158 Healing and Religion 159 Healing Cult 160 Indus Civilisation Healing Votives 163 Medical Practice 164 Cranial Trepanation 165 Surgery 165 Orthopaedics 172 Other Surgery 174 Dentistry 174 Medical and Surgical Instruments and Equipment 176 Bandages 178 The Materia Medica 178 Plant Remedies 179 Mineral Remedies 182 Animal Product Remedies 183 Food and Drink 184 Other Therapeutics 185 7. Epilogue 186 Bibliography 189 Indus Civilisation,Harappan Civilisation,Disease,Health,Healing,Medicine