Number 27, Fall 1997
©Department of History, University of Minnesota
Posted December 30, 1997

The Great Killers in Precolumbian America
A Hemispheric Perspective

Suzanne Austin Alchon

[ed. note: accepted for publication December 4, 1995]


This paper surveys the recent literature on disease and health in the Americas before 1492, drawing some general conclusions regarding the major causes of mortality in various regions of the hemisphere. The paper adopts a comparative perspective, examining patterns of mortality in areas sparsely populated by societies of hunter-gatherers and those of the more densely settled regions including Mesoamerica and the Andean highlands. It also compares causes of mortality in different geographical zones ranging from the tropical latitudes of the Caribbean and Central America to the temperate zones of North and South America.

Analysis of mortality among ancient Americans dispels the long-cherished myth of a precolumbian paradise. Like their Old World counterparts, before 1492, residents of the New World died as a result of disease, famine, and violence. While the disease environment of the Americas differed from that of the Old World in terms of particular diseases, the leading causes of mortality among humans in all parts of the world were basically the same--acute respiratory and gastrointestinal infections. Residents of the Old World were exposed to a wider variety of epidemic diseases, but typhus and influenza may have been universal among agricultural populations. Similarly, periodic famines attended by high rates of mortality, were a regular occurrence for agricultural populations around the world. And certainly there is ample evidence to suggest that native Americans were just as violent as their counterparts in other regions of the globe.


The Incas, rulers, commoners, as well as the ancient people of these kingdoms, lived long and healthy lives, many reaching the age of 150 to 200 years because they had an ordered and methodical regimen for living and eating (Guaman Poma 1956:1:89).

There was then no sickness; they had no aching bones; they had then no high fever; they had then no smallpox; they had then no burning chest; they had then no abdominal pain; they had then no consumption; they had then no headache. At that time the course of humanity was orderly. The foreigners made it otherwise when they arrived here (Roys 1967:83).

The preceding passages, the first by a seventeenth-century Inca chronicler, the second by an oft-quoted eighteenth-century Maya, paint an idyllic picture of native life and health in the Americas before the arrival of Europeans. According to these authors, before the beginning of the sixteenth century, no serious diseases ravaged native populations, people consumed a balanced diet, and as a result, many individuals lived long, healthy lives. Other New World peoples also remember pre-colonial times as halcyon days when life was longer and happier (Nabokov 1991). According to these and many other native writers, beginning in 1492 this earthly paradise was shattered forever by the arrival of conquistadors, colonists, and microbes from the Old World. From one end of the Americas to the other, native societies reeled under the exactions of European colonialism, and Indian populations declined catastrophically. But while the depredations of Spaniards, Britons, Dutch, and French were responsible for much destruction of native lives and cultures, it was the introduction of Old World diseases, especially smallpox and measles, that claimed the majority of the native inhabitants of the hemisphere.

Because the suffering and mortality occasioned by these epidemics was so great, one can easily understand why native writers looked back on the past as a time relatively free of disease, and ultimately as a time when peoples' lives were longer and happier. While this tendency to romanticize life in the Americas before 1492 may be understandable, it does not make it so. And during the last twenty years, growing numbers of scholars have begun to challenge the image of paradise enshrined in native lore. Nevertheless, some have continued to perpetuate this myth, painting a benign portrait of the disease environment of the New World (Ortiz de Montellano 1990:120; Dobyns 1983:34; Thornton 1987:39; and Sale 1990:160). In fact, in an earlier work, I too failed to appreciate the degree of sickness prevalent in this hemisphere before contact, despite a rather detailed analysis of the disease environment (Alchon 1991:19-31). Most recently, historical geographer Linda Newson also underestimates the degree and severity of illness and mortality prevalent during the precolumbian era (Newson 1995:144). But with advances in paleopathology and paleodemography, a very different picture of the length and quality of life in precolumbian America has emerged. Epidemics, famines, and wars occurred with regularity throughout the hemisphere, reducing life expectancies and raising mortality rates. In fact, far from an earthly paradise, the profile that emerges of life and death in the New World resembles that of the Old in several important respects.

The purpose of this paper, then, is to survey the recent literature on disease and health in the Americas before 1492 and to draw some general conclusions regarding the major causes of mortality in various regions of the hemisphere. In so doing, the paper will adopt a comparative perspective, examining patterns of mortality in areas sparsely populated by societies of hunter-gatherers and those of the more densely settled regions including Mesoamerica and the Andean highlands. It will also compare causes of mortality in different geographical zones ranging from the tropical latitudes of the Caribbean and Central America to the temperate zones of North and South America. Thus, the paper seeks to provide a more accurate interpretation of patterns of health and mortality in the New World before 1492.


Our knowledge of human mortality in the precolumbian Americas comes from a variety of sources. Indian chroniclers such as Felipe Guaman Poma de Ayala and Garcilaso de la Vega, and the Aztec physician Martin de la Cruz recorded a wealth of information concerning all aspects of life in Aztec and Inca society. Their descriptions of health and disease before the arrival of Europeans reveal the occurrence of devastating epidemics, famines, and wars. Guaman Poma, for example, attributed the Inca conquest of the Indian societies of northern Chile to "the ravages of plague, which lasted for ten years." He also alluded to other periods of epidemic disease, famine, war, and natural disasters (Guaman Poma 1978:26, 40, and 42). In addition, the writings of colonial European observers such as Father Pablo Joseph de Arriaga in Peru and Father Bernardino de Sahagun in Mexico provide much useful data on disease, healing, and death. According to Sahagun's chronology of the Aztec rulers of Tenochtitlan:

Moctezuma the Elder [1440-1469] was fifth, and ruled Tenochtitlan thirty years. He conquered and made war on all the people of Chalco; and on Quauhnauac and on all who were subject to Quauhnauac; and Macauacan. And in his reign there came a great famine, which spread over the land for four years (Sahagun 1954:9:2).

While colonial documents are useful for establishing the existence of epidemics, famines, and wars, and while they sometimes contain information on timing and even vague descriptions of the degree of mortality, with regard to disease they do not provide sufficient information to determine with certainty the cause of these incidents.

Recent discoveries in the fields of paleopathology and paleodemography are revealing valuable data about life and death in the precolumbian Americas. During the last twenty years, the number of prehistoric sites surveyed for skeletal materials has expanded rapidly. These, combined with the development of new techniques of chemical and biomechanical analysis, including stable isotope ratios of carbon and nitrogen and DNA analysis, allow paleopathologists and bioarchaeologists to arrive at a clearer understanding of dietary and disease patterns (Larsen 1994:115 and 125). One project in particular, "Health and Nutrition in the Americas," coordinated by the economic historian Richard Steckel, promises to reveal much about the health of New World residents both before and after 1492.

In many instances, skeletal materials reveal signs of illness, nutritional deficiencies, and violence. Disruptions in bone growth, called Harris Lines, suggest periods of acute physiological stress caused by disease or malnutrition. Likewise, disruptions in the formation of tooth enamel, Wilson's bands, indicate periods of physical distress, while a high incidence of dental caries suggests a diet overly dependent on carbohydrates, probably corn.

Skeletal remains from prehistoric burial sites also reveal valuable information on the level of mortality in particular societies. For example, mortuary evidence from Teotihuacan, the Classic Period (150 BC-750 AD) center located north of Mexico City, indicates mortality rates as high or higher than those of European cities in the preindustrial era. Infants and children succumbed in especially large numbers and the city's population maintained or expanded only as a result of in-migration (Storey 1992:238-266).

Despite advances, serious problems remain with skeletal analysis. First, many infections leave no trace on human bones; in fact, most acute, epidemic diseases leave no specific marker because the human host either dies or recovers before any serious skeletal damage can take place. Furthermore, most infectious diseases affect soft tissue, and except for a few notable exceptions in extremely dry areas of the southwestern United States and coastal Peru and Ecuador, soft tissue remains are scarce. Those diseases affecting the human skeleton are often chronic bacterial infections such as treponematosis or degenerative conditions such as rheumatoid arthritis. Both of these infections are long-term, hence their opportunity to alter skeletal tissues, and only rarely would they have been the primary cause of death. Yet another shortcoming of skeletal analysis is the difficulty of identifying an infectious agent; in many cases, several conditions may affect bone tissue in the same way. For example, porotic hyperostosis, the porous enlargement of areas of the skull, can result from several circumstances including anemia, scurvy, and infection (Ortner 1992:7). Lack of standardization in the identification and recording of bioarchaeological data hinders comparative analysis and further complicates the findings (Kiple 1992:7 and Larsen 1994:116). Nevertheless, our understanding of health and mortality patterns in the New World before 1492 is expanding rapidly; and the picture that emerges is definitely not that of an earthly paradise.

Patterns of Mortality among Hunter-Gatherer Populations

Based on the notion of healthy, precolumbian populations, many scholars believed that the disease environment of the Americas differed significantly from that of the Old World: that few serious diseases existed and those that did occurred rarely. Kirkpatrick Sale's The Conquest of Paradise summarizes this view:

One reason that the Indian populations, in the Caribbean as elsewhere, were so vulnerable to diseases of any kind [after 1492] is that, to an extraordinary extent, the Americas were free of any serious pathogens. The presumed passage of the original Indian populations across the Bering Strait tens of thousands of years before served to freeze to death most human disease carriers except a few intestinal ones, it is thought, and there were apparently none established on the continents previously, so in general the Indians enjoyed remarkably good health, free of both endemic and epidemic scourges (Sale 1990:160).

But recent findings indicate that the disease environments of the New and Old Worlds were more alike than not, the biggest difference being the absence of several specific crowd-type diseases including smallpox, measles, and bubonic plague. The origins of these particular infections will probably never be known, but if they existed among human populations in the Old World before waves of migration to the Americas began, they would not, as Sale stated, have survived the cold temperatures of the far north. And if they had, the low population levels of early hunter-gatherer societies would have precluded their permanent establishment in this hemisphere.

In addition, because of the absence of several species of quadrupeds, including cattle, horses, swine, goats, and sheep, native Americans domesticated fewer species of animals than did their contemporaries on other continents. Many Old World infections, such as smallpox and measles, originated as zoonoses among animal populations, and--although New World inhabitants eventually domesticated several species, including dogs, turkeys, ducks, and South American cameloids--smallpox, measles, bubonic plague, and cholera did not develop in the Americas.

In spite of these differences, patterns of mortality in the New and Old Worlds shared many similarities. Infant and child mortality was high and life expectancies low. The primary causes of mortality were acute respiratory and gastrointestinal infections and periodic outbreaks of epidemic disease. In light of recent findings that reveal high levels of morbidity and mortality among precolumbian populations, it becomes increasingly difficult to argue that ancient Americans somehow managed to escape the scourge of epidemic disease so common in the rest of the world. Based on osteological, documentary, and circumstantial evidence, this paper contends that the New and Old Worlds may have shared at least two serious epidemic diseases before 1492--typhus and influenza.

Between the period when humans first arrived in the western hemisphere some 40,000 years ago and the end of the fifteenth century, complex disease environments developed in response to specific regional conditions. Prior to the domestication of various food crops and the transition to sedentary, agricultural societies, a process that began in many areas between 7000-5000 BC, human inhabitants of the Americas lived in small groups, migrating periodically in search of game and wild plant materials. At the end of the fifteenth century, the Arctic and Subarctic regions of Canada and Alaska, the Great Basin and southwestern areas of the United States, northern Mexico, the Amazon Basin, Patagonia, and Tierra del Fuego in southern South America all continued to support small hunter-gatherer populations. In these regions, patterns of morbidity and mortality resembled those of the earliest human inhabitants of the hemisphere.

Archaeological research and studies of modern hunter-gatherer societies indicate that a varied diet met the basic nutritional needs of most individuals, and as a result, illnesses related to nutritional deficiencies and malnutrition were rare. Famines occurred infrequently, but when they did, they were most likely to develop in areas with especially harsh climates such as the Arctic and Subarctic and in the driest regions of the southwestern United States and northern Mexico. Owing to low population densities, epidemics seldom occurred. While life expectancies at birth were short, they varied significantly from one society to another, from 16 to 22 years for males and 14 to 18 years for females, according to two samples (Jaffee 1992:58; Cassidy 1984:320). This meant that few lived long enough to develop chronic, degenerative diseases associated with aging. Virtually everyone married young and polygamy was common, as was remarriage following the death of a spouse. Infant mortality rates were high--at least 40 percent of all children died by age 5. But because many women conceived soon after the death of an infant, birth rates also tended to be high. Complications due to childbirth were a leading cause of death among women (Dunn 1968:223-4; Buikstra 1993:305; Jaffee 1992:58-60).

Males, on the other hand, were more likely to sustain traumatic injuries either as a result of violence or accident (Jaffee 1992:60). Females also incurred trauma, but less frequently than males. Archaeological evidence reveals wide regional variation in the rate of traumatic injuries, but violent death resulting from "cannibalism, infanticide, sacrifice, geronticide, head-hunting, and other forms of warfare," was common in many hunter-gatherer societies (Dunn 1968:225). Skeletal remains from the south-western United States reveal evidence of cannibalism, but whether it occurred in association with famine or war is unclear (Larsen 1994:118-9). Mortality as a result of hunting accidents, exposure, and drowning occurred in many societies, but was especially significant among inhabitants of the Arctic and Subarctic (Dunn 1968: 224-5).

Among the diseases common to hunter-gatherer populations, some, particularly bacterial and parasitic infections such as shigellosis, salmonellosis, tapeworms, hookworms, whipworms, and pin worms, accompanied human migrants directly from the Old World to the New and spread throughout the hemisphere. Both shigellosis and salmonellosis produce acute gastrointestinal illness, resulting in high morbidity and mortality especially among children. The former was most common in tropical areas, while the latter occurred more often among North American populations. While helminthic infections such as tapeworms, hookworms, whipworms, and pin-worms did not pose a serious threat to public health, lack of energy and chronic malaise were common long-term side effects that reduced productivity and weakened the body's defenses against other infections (Alchon 1991:23).

Because of their long association with the human species, two other groups of bacterial diseases, staphylococcal and streptococcal, also crossed the Bering Strait with immigrants to the Americas (Merbs 1992:15). Both types of bacteria can cause illness ranging from minor skin and respiratory infections to potentially lethal conditions such as pneumonia, meningitis, and endocarditis. In their acute forms, staph and strep infections, especially pneumonia, would also have been leading causes of mortality in hunter-gatherer societies (Allison 1984:520-21).

Amebiasis, giardiasis, and toxoplasmosis, all protozoan infections, also undermined the health of early prehistoric populations. Neither amebiasis nor giardiasis was in itself fatal, but during famines or in conjunction with other diseases, their debilitating effects often contributed to higher mortality rates, especially among children. Toxoplasmosis was most serious when contracted during pregnancy because it could cause blindness, severe brain damage, or death of the fetus.

In addition to diseases arriving in the Americas with migrant populations, humans also encountered new diseases native to the hemisphere. New World leishmaniasis and American trypanosomiasis, or Chagas' disease, both transmitted by insect vectors, were protozoan infections especially prevalent in tropical areas. Another arthropod-transmitted illness was New World spotted fever. While this infection occurred throughout the hemisphere, it was especially common in North America, particularly west of the Rocky Mountains. Bar-tonellosis, or Carrion's disease, transmitted by sandflies, existed only in mountain valleys in northern South America. All of these infections were chronic and seldom fatal, but their presence could elevate mortality rates when other diseases or nutritional deficiencies developed.

Of the several spriochetal infections attacking prehispanic populations, pinta, a nonvenereal treponematosis, was probably the most common in tropical areas. In temperate regions, especially eastern North America, another nonvenereal form of the disease was prevalent. Evidence of venereal treponematosis also exists, but a wide-ranging literature review turned up only two cases, suggesting that this form of the disease was extremely rare (Buikstra 1993:310). In addition, three other spirochetal diseases, leptospirosis and two types of relapsing fever, were also native to the Americas. Leptospirosis, transmitted through contaminated water, soil, and food was rarely fatal, but occasionally complications such as anemia, meningitis, or hemorrhaging developed. Endemic relapsing fever, transmitted by ticks, was less severe than the louse-borne epidemic variety, which could produce mortality rates of up to 50 percent.

Acute respiratory infections, especially pneumonia, a frequent cause of death in the period following the development of sedentary, agricultural societies, were also the major cause of mortality among hunter-gatherer populations throughout the hemisphere (Allison 1984:520-1). Archaeological evidence suggests that tuberculosis has a long history among human inhabitants of the New World; the earliest remains showing clear signs of the disease date back some 2000 years (Buikstra 1993:311). But, according to one author, among small, nomadic populations of the early prehistoric period, the disease would have posed such a serious threat that it must have occurred infrequently (McGrath 1986). Two other respiratory infections, blastomycosis and coccidioidmycosis, both caused by fungi transmitted in soil, were uncommon among non-agricultural peoples.

In large part, demographic factors determined patterns of mortality in hunter-gatherer societies. Small, mobile populations seldom experienced outbreaks of epidemic disease, but because most individuals were under the age of 20, infections of childhood were especially common. Respiratory and gastrointestinal illness, including pneumonia, tuberculosis, shigellosis, salmonellosis, amebiasis, and giardiasis, were the leading causes of mortality among all age groups, but they struck particularly hard at infants and children under the age of 5. Other infections such as leishmaniasis, trypanoso-miasis, bartonellosis, leptospirosis, and relapsing fever had a greater impact on the health of adults whose daily tasks placed them in more frequent contact with the insect vectors that transmitted these diseases (Armelagos 1990:130). Among women, complications arising from childbirth were a leading cause of death throughout the hemisphere. The frequency of death due to traumatic injuries from social violence or accidents varied significantly from one region to another; but in some areas, violent trauma claimed the lives of many, especially post-adolescent males.

Patterns of Mortality among Sedentary, Agricultural Populations

The demographic increase of human populations throughout the Americas following the domestication of food crops and the widespread adoption of agriculture practices altered patterns of mortality in significant ways. While all of the threats to health and life prevalent in hunter-gatherer societies continued to exist, new problems developed as the result of dietary changes and increasingly dense populations. According to archaeologists and paleopathologists, the transition to a sedentary, agricultural way of life had a negative impact on the health of human populations around the world. A largely vegetarian diet, often composed almost entirely of one or two food crops, replaced the varied, more nutritionally balanced diet of hunter-gatherers.

In many regions of the Americas, corn, deficient in several key nutrients, became the dietary staple of agriculturalists and as a result, health problems related to nutritional deficiencies increased significantly in most, but not all, sedentary societies (Larsen 1994:117). One very visible indication of declining dietary standards among Mesoamerican populations is a temporal and regional decline in human stature occurring on a north-south axis; the skeletal remains of Northerners, who adopted agricultural practices later and continued to consume a more varied diet, displayed greater mean heights than those of Southerners who earlier adopted a corn-based diet (Storey 1992:230-1; McCaa 1993:6-7). A similar decline in stature occurred among prehistoric residents of coastal Georgia following their transition to sedentary agricultural settlements (Larsen 1984:374-9).

Shorter stature is only one indicator of declining health among New World agriculturalists. Throughout the Americas, archaeologists and paleopathologists have uncovered a pattern of undernutrition, decreased resistance, and increased frequency of infection. A high incidence of porotic hyperostosis, dental caries, and Harris Lines, especially among young children, ages 2-4, suggests that mothers often weaned their offspring on a corn pap, leading, in many instances, to protein-energy malnutrition. This condition, in combination with parasitic or other infections, often precipitated a crisis, resulting in the death of the child (Kiple 1992:6; Armelagos 1990:137-40; and Goodman et al. 1984:297). Owing to the physiological stress of weaning and the possible impairment of their immunological systems, many who survived continued to experience high rates of infection throughout their often short lives (Armelagos 1990:138-9). Because corn is deficient in iron and niacin, the incidence of anemia and pellagra increased. In many societies, anemia was common in individuals of both sexes and all age groups, but especially so among pregnant women and children, both of whom required larger amounts of iron than other segments of the population. In populations heavily dependent upon corn, iron-deficiency anemia became a serious problem throughout the Americas, particularly in tropical areas where chronic parasitic infections further increased iron losses (Bollet and Brown 1993:572-3).

In spite of poor nutrition and rising rates of infection, sedentary populations throughout the Americas expanded over time. This increase, in the face of declining health, was due to several factors. First, the availability of corn pap allowed mothers to wean their children at an earlier age, thus decreasing the time between birth intervals. This allowed women to bear more children over the course of their reproductive lives. McCaa has calculated that in prehistoric Mexico, females who survived to puberty could expect to bear a child every 3-4 years. Thus, a woman who lived to menopause, though few did, might produce 8 or more offspring (McCaa 1993:8). So while mortality rates increased in agricultural societies, so did fertility rates. In addition, while several studies suggest that agriculturalists lived slightly longer lives, approximately 2-4 years, than did hunter-gatherers, others indicate a decline (Jaffee 1992:58; Cook 1984:261; and Cohen and Armelagos 1984:592). Human remains from sites in northern Chile and northern Peru also indicate that, at least in some societies, members of the elite enjoyed better health, though not necessarily longer lives, than the rest of the population (Allison 1984:525-6 and Verano 1992:21). But data from Teotihuacan reveals that during periods of stress associated with population pressure, shrinking food supplies, and social strife, life expectancies at birth actually declined significantly, from 24 years during the early classic to 16 years during the late classic period (Storey 1992:184-5). In sharp contrast to the short life expectancies posited by these studies, Gerszten and Allison claim that, "In many of the 23 pre-Columbian cultures we have studied, at least 40% of the population lived past the age of 40 years, including them in a geriatric population. Many of these cultures had a geriatric survival rate of greater than 25%" (Gerszten and Allison 1991:259). Unfortunately, the authors do not give citations for their findings, nor offer further explanations.

Thus, while it remains unclear whether or not agricultural peoples lived slightly longer or shorter lives than did hunter-gatherers, life expectancies in the precolumbian Americas remained low, even in comparison to those of western Europe. Certainly no evidence exists to support Guaman Poma's claim that before the arrival of Europeans, native peoples lived long and healthy lives.

With the transition to sedentary agricultural communities and the accompanying demographic expansion came increased social contact and increased frequency of infection. Diseases associated with crowding and poor sanitation became common, and when they developed in individuals already weakened by undernutrition and parasitic infections, they often proved fatal. Gastrointestinal infections such as amebiasis, giardiasis, and salmonellosis, long prevalent among hunter-gatherer populations, flourished in the often contaminated water and food supplies of village dwellers and continued to claim many lives, especially among the young. While the prevalence of treponematoses, especially pinta and yaws, increased as a result of expanded social contacts, these infections remained chronic and seldom fatal.

But agriculturalists also contended with diseases seldom experienced by hunter-gatherers and even some illness previously unknown. Acute respiratory infections continued to pose the greatest threat to the lives of native Americans, and within densely settled regions, tuberculosis appeared with increasing frequency. The tuberculosis bacilli, inhaled or ingested in contaminated food, could affect any organ of the body; but in the Americas, the pulmonary and spinal forms of the disease were most common. In its chronic, pulmonary form, individuals experienced fatigue, fever, weight loss, and coughing. Skeletal remains from North America indicate that the disease was so common that "virtually every member of these late prehistoric communities had primary exposure to tuberculosis" (Buikstra 1991:165). A similar situation probably prevailed in highland areas of Mesoamerica and the Andes. This infection was especially lethal in children and young adults; but in conjunction with other illness, malnutrition, and crowded, unsanitary conditions, mortality increased among all segments of the population.

Tissue samples also indicate that bacterial pneumonia was common and that many individuals contracted the disease more than once (Allison 1984:521). When pneumonia appeared in association with tuberculosis and other diseases, death often followed. Yet another serious, though much less common, respiratory infection was blastomycosis. While the fungus responsible for producing the disease lived in soils throughout the hemisphere, it occurred more often in tropical and subtropical regions of South America, where those engaged in agricultural activities were most susceptible. The fungus produced lesions on the lungs, mucous membranes, and skin, and frequently resulted in death.

One can also build a strong case for the existence of both endemic (flea-borne) and epidemic (louse-borne) typhus in the New World before 1492. In both tropical and temperate zones, rodents and other small mammals often living in close proximity to humans, served as reservoirs for the endemic form of the disease. Zinsser speculates that isolated cases of endemic typhus probably occurred long before the illness developed into its epidemic form (Zinsser 1941:236). Thus, while some hunter-gatherer populations probably experienced the endemic illness, epidemic typhus was a new disease that appeared in association with crowded, unsanitary conditions. Human remains reveal that head and body lice commonly infested sedentary populations. Lice prefer cool climates, and the heavy cotton and woolen clothing worn by residents of temperate regions of North America, Mesoamerica, and the Andes, provided safe habitats for these parasites. Epidemic typhus was transmitted directly from one human to another by the bite of an infected body louse. Both forms of the disease began suddenly with fever, chills, severe headaches, exhaustion, and general pain. A skin eruption appeared by the fifth or sixth day, often accompanied by delirium and deafness. Death resulted from a collapse of the cardiovascular system. During the twentieth century, mortality rates for endemic typhus averaged 2 percent, climbing to 10-40 percent for the epidemic variety.

Preconquest traditions of epidemics occurring during periods of social turmoil--wars, famines, and natural disasters--support the assertion that typhus may have existed in the Americas before the sixteenth century. In his history of the Incas, Guaman Poma described two epidemics that occurred before the Spanish conquest. In recounting the military achievements of Pachacuti Inca Yupanqui (1438-71), Guaman Poma wrote (1978:42):

The defeat of Chile was made possible by the ravages of plague, which lasted for ten years. Disease and famine, even more than force of arms, brought about the downfall of the Chileans, just as civil war between Huascar and Atahualpa was later to facilitate the Spanish conquest. Peru itself suffered terribly from plague, famine, and drought. For a decade no rain fell and the grass withered and died. People were reduced to devouring their own children and when the stomachs of the poor were opened it was sometimes found that they had managed to survive by eating grasses.

Furthermore, Guaman Poma wrote that the Incas associated "a plague of fleas" with death, suggesting that they may have connected these ectoparasites with the appearance of typhus (Guaman Poma 1978:77).

In precolumbian Mesoamerica, a similar association developed between famines and outbreaks of epidemic disease. Both Aztec and Maya historical accounts contain references to periods of disease related to natural disasters and famines (Cook 1946:330-5; Roys 1967:133 and 142). Although some historians argue that typhus was not present in Mexico before contact (Merbs 1992:27; Ortiz de Montellano 1990:121; Cook 1946:321-2), others claim that it was (Zinsser 1941:253-64; Hernández 1962:33; Fernández 1982:1:127; León 1982:1:385). Certainly the dense populations of highland Mesoamerica would have provided an attractive habitat for typhus rickettsiae. In 1576, an epidemic often diagnosed as typhus broke out in central Mexico (MacLeod 1973:19; Cook 1946:321; Veblen 1977:496; Gerhard 1972:23). The Aztecs called the disease, matlazahuatl, meaning eruptions that appeared on the skin in a regular net-like pattern, suggesting that they were already familiar with the illness. One historian claims that the representation of an individual covered with the skin eruptions characteristic of typhus is depicted in a precolumbian codex (Flores 1886:1:150 as cited in Cook 1946:321).

According to Cook, the Aztecs recounted five periods of epidemic disease in their preconquest history. All of the descriptions are vague, but one outbreak that occurred at the end of late thirteenth century involved an inflammation of the skin, which Cook translated as "splitting or cracking of all the flesh" (Cook 1946:330). While this pathology could have been caused by any number of diseases, epidemic typhus is a possibility. Aztec history also recorded a period of significant mortality that occurred during the 1450s. Precolumbian traditions recount a cycle of natural disaster, famine, disease, and death beginning with a freezing winter that occurred either in 1450-51 or 1453-54. A three-year drought followed, resulting in mass famine and the appearance of disease. Descriptions differ, but one source noted the presence of "pestilential catarrh," another "fuego," a possible reference to fever, skin eruptions, or rash. Cook argues that no evidence indicates any diseases other than those resulting directly from malnutrition and starvation were present; on the other hand, it is possible that typhus, or some other serious epidemic disease was circulating among the already weakened population (Cook 1946:333-5; and Hernández 1962:129).

It also seems likely that typhus may have existed in temperate regions of North America during the late prehistoric period. Saunders argues that among the precontact Ontario Iroquoians the presence of refuse dumps, scavenging animals, crowded, longhouse living conditions, and migrants from other societies provided an environment conducive to the spread of epidemic diseases including fevers, encephalitides, rabies, typhus, dysentery, pneumonia, and tuberculosis (Saunders 1992:121). If that was indeed the case, then typhus probably ravaged other agricultural societies in temperate regions of North America; and, in fact, increased contact between various native societies during the late prehistoric period could easily have facilitated the spread of the disease from one settlement to another. But because typhus does not leave physical markers, we may never know for certain whether or not it existed in the New World before 1492. If it did, typhus would have been one of the most lethal of all diseases and a significant cause of mortality.

Similarly, scholars have uncovered no data regarding the existence of influenza in precolumbian America, but circumstantial evidence suggests that this disease also may have appeared by the late prehistoric period, if not earlier in some areas. Viral influenza infects many animals including humans, pigs, and fowl. Recent studies indicate that influenza viruses originating among populations of domesticated ducks are responsible for the most lethal outbreaks; and, as already stated, ducks were among the species domesticated by prehistoric Americans (Smith 1995:1 and 12). Crosby speculates that influenza probably appeared in many regions of the world with the development of agriculture and the domestication of animals (Crosby 1993:808). Others have also suggested that influenza may have been present in densely-populated regions of the Americas long before the arrival of Europeans (Merbs 1992:35; Newman 1976:669). In his study of pandemic influenza, Patterson posits that wild ducks or other migratory birds could have introduced the virus to New World duck populations, leading to its eventual transfer to humans. He also explains that because of the viruses' ability to mutate rapidly and its antigenic variability, "the disease can maintain itself in much smaller populations than, for example, measles or smallpox" (Patterson 1986:5-6). Influenza was characterized by its abrupt onset signalled by fever, chills, headache, sore throat, and cough. Epidemics developed and spread rapidly, often appearing in temperate zones during the winter. In tropical regions, timing was not related to seasons. Complications, including pneumonia, often developed, escalating mortality rates, especially among the elderly and young adults. Influenza could have been responsible for the "pestilential catarrh" and "fuego" (in this case "fuego" would be translated as fever) that the Aztecs described in association with the famine and epidemic of 1454-57.

It should come as no surprise to note that among sedentary populations, depending as they did on agricultural production for their continued survival, malnutrition and famines occurred with greater regularity than they did among hunter-gatherers. As previously mentioned, the histories of the Incas, Aztecs, and Mayas all contain accounts of prolonged droughts followed by periods of famine and disease. The Maya Book of Chilam Balam includes several references to drought and famine during the prehistoric period (Roys 1967:103,115,133-4). One of these occurred during Katun 4 Ahua (1480-85):

The face of [the lord of the katun] is covered; his face is dead. There is mourning for water; there is mourning for bread. His mat and his throne shall face the west. Blood-vomit is the charge [of the katun] (Roys 1976:133).

Insufficient information prevents a reliable diagnosis, but Roys speculates that this may be the same outbreak described years later by Bishop Landa. In that case, the symptoms included fever, body swelling, and infestations of "worms" (Roys 1976:133). Bloody vomit could have resulted from acute gastroenteritis; "worms" could be a reference to intestinal parasites or to the larvae of flies or other insects that laid their eggs in festering sores.

Inca history recounts the harrowing episode of the ten-year-long drought and famine that reduced some people to eating their own children. The Huarochiri Manuscript, a compilation of Andean traditions recorded during the early seventeenth century, also includes references to famine and periods of overpopulation (Salomon 1991:5, 361, 377, 468). Among the Aztecs, memories of hunger and death lingered long; traditions recall famines that occurred around 1330, between 1454-57, and again between 1504-06 (Duran 1994:238-41; Sahagun 1954:9:2; Cook 1946:330-35). Both gastrointestinal and respiratory infections accompanied the famine of 1330, resulting in many deaths (Cook 1946:331). Famines could also be exacerbated or manipulated for political and economic purposes. For example, during the drought and famine in parts of central Mexico between 1454-57, the coastal-dwelling Totonacs of Vera Cruz, long-time enemies of the Aztecs, exploited the situation by trading food for slaves. According to one account,

They [the Totonacs] came to Tenochtitlan carrying great loads of maize in order to buy slaves. They also went to other cities--Tezcoco, Chalco, Xochimilco, and the Tepanec center, Tacuba--where they purchased large numbers of slaves with their corn. They placed yokes around the necks of adults and children. Then the slaves, lined up one behind another, were led out of the cities in a pitiful manner, the husband leaving his wife, the father his son, the grandmother her grandchild. They went along weeping and their wails reached the heavens. In this way a great number of people from all these nations became slaves. Others without having been sold went freely to the land of the Totonacs with their wives and children, where they settled permanently and where they remain to this day. Others, in their desire to escape the province, fell dead along the way, together with the loads they carried (Duran 1994:240).

Undoubtedly, these fragments describe only a few of the famines that occurred in the precolumbian Americas. Owing to the destruction of preconquest records, the disruption and loss of many oral traditions, and the fallibility of human memory, evidence regarding other natural disasters, famines, and epidemics have been lost forever.

Archaeological evidence also indicates that levels of violence increased among agricultural populations (Larsen 1994:117-19). Competition for resources in densely populated areas often resulted in violence between individuals and entire societies. The Aztecs, Incas, Mayas, and their predecessors, all waged massive military campaigns against neighboring populations in order to expand territorial control over human labor and natural resources. At various times during the prehistoric period, mortality as a result of inter-personal or inter-societal violence was significant. For example, the Incas were forced to mount four costly campaigns in order to conquer the rebellious Carangues and Cayambes of northern Ecuador. Following the final battle, around 1500, Inca soldiers carried out a massacre on the shores of Lake Yaguarcocha. According to the Spanish chronicler, Pedro Cieza de León, more than 20,000 adult males from the Otavalo area died in this battle (Cieza de León 1984:1:53). The Inca army staged another massacre in southern Ecuador shortly before the arrival of Francisco Pizarro; in this case, the army of Atahualpa Inca slew "more than 35,000 Canari males and left many wounded" (Cieza de León 1984:1:224). Another Spaniard describing the same incident wrote, "of 50,000, not more than 3,000 remained" (Jimenez de la Espada 1965:2:267). Aztec and Maya armies also engaged in major military confrontations, often claiming thousands of lives.

While the native populations of North America may not have been as large as those of Mesoamerica and the Andes, by the late prehistoric period, skeletal evidence indicates high rates of mortality related to violence in many areas. At one site in the central Illinois River Valley, one-third of all adults died as a result of violent injuries. Similar patterns of violence appear at sites in northwestern Alabama, the northern Great Plains, northern California, and Michigan. Evidence of scalping is especially common; at the Crow Creek site in the Missouri River valley, 90 percent of all crania showed signs of scalping. Decapitation as well as nose and tongue removal also occurred. Human remains indicate that adult males died as a result of violence more often than females; but at one site in Michigan, archaeologists have found a significantly higher rate of fatal injuries in adult women between the ages of 21-25 than in males. Spousal abuse or bride-raiding have been suggested as possible explanations for this anomaly (Larsen 1994:117-19).


The preceding analysis of mortality among ancient Americans dispels the long-cherished myth of a precolumbian paradise. Like their Old World counterparts, before 1492, residents of the New World died as a result of disease, famine, and violence. While the disease environment of the Americas may have differed from that of the Old World in terms of particular diseases, the leading causes of mortality among humans in all parts of the world were basically the same--acute respiratory and gastrointestinal infections. Residents of the Old World were exposed to a wider variety of epidemic diseases, but typhus and influenza may have been universal among agricultural populations. Similarly, periodic famines, attended by high rates of mortality, were a regular occurrence for agricultural populations around the world. And certainly there is ample evidence to suggest that native Americans were just as violent as their counterparts in other regions of the globe.

While the idea of a New World paradise, free of disease, hunger, and violence, has provided comfort to many over the centuries, the evidence does not support this fantasy. And perhaps it has been a disservice to native Americans to set them and their world apart from and above the rest of humanity.


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