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Introduction: It is well known that people fall ill even in conditions of plenty, and even with high standards of living. Although it cannot be denied that dietary practices play a major role in individual and group health, it would be a mistake to think that simple correlations with subsistence practices are valid. When we look at past human cultures we often generalize or simplify the picture. These simplifications are not solely based on the limitations of our evidence for ancient health (usually only skeletal non-specific indicators), but are also built into our models of how subsistence, nutrition and health interacted in past societies. Until the 1970s for example, it was very much accepted that human societies progressed in a single direction towards modernity, starting from hunter-gatherers towards agriculturalists (e.g. Childe 1956
Braidwood 1960
for a review see Barker and Janowski 2011), and using such a framework it was not problematic to interpret direct correlations between subsistence strategy and human health, progressing over time towards better health and medical care. After years of independent studies on existing hunting and gathering societies, and the publication of the seminal volume <i>Man the Hunter</i> (Lee and de Vore 1968), a directed drive began to improve palaeopathological approaches using archaeological human skeletal assemblages that addressed human health issues during the transition from foraging to cereal agriculture. Anthropologists such as Cohen (1977) and his collaborators were at the forefront of questioning the ostensible correlation between the adoption of agriculture and health improvement in ancient societies. These efforts led to an edited volume focused on archaeological bone assemblages from around the world, reinforcing the criticism of the previously held view on the so-called health benefits to human populations engaging in agricultural intensification in its early periods (Cohen and Armelagos 1984). Research suggests that both ancient hunter-gatherers and ancient sedentary agriculturalists were not as healthy as people in later cultures. However, there is also a view, held by some, that gatherers and hunters are generally healthier than individuals from early sedentary agriculture communities (e.g., Diamond 1987
Ponting 1991). Though this view is less well documented and largely unsupported by palaeopathological studies (see Larsen 1995), it still captures the imagination of many in the contemporary world. Although palaeopathological studies are mostly cautious, we can follow a chain of reasoning by using possible pathologies seen in archaeological human remains to infer health conditions, and thereby infer the general nature of the subsistence strategy of a population (e.g., Eshed et al. 2010
Lukacs 1992). Interpreting bone pathologies in this way is most useful in combination with other proxy evidence of health, diet and nutrition, such as isotope and trace element studies of bone (e.g., Sealy et al. 1991
Schoeninger and Moore 1992
Pollard and Heron 2008, Chapter 10) along with environmental, archaeological, and palaeoenvironmental studies of subsistence practices with evidence of subsistence-related technologies (e.g., Richter Jr. 1982
Collard et al. 2011). All of these approaches are based on the direct study of archaeological remains, with interpretative strength increased by using analogies to pathways and processes in modern environments and human health, ethnographic investigations, and experimental archaeological modeling with sufficient individual and population-level archaeological data to interpret broad patterns over time. Correlating health and a societys mode of subsistence still remains a central problem, as represented in key edited volumes (e.g., Cohen and Armelagos 1984
Oxenham and Tayles 2006) and syntheses (e.g., Larsen 1991). Ethnographic insights referred to in many studies also carry a similar kind of reasoning, for example studies on the Baka foragers from south Cameroon (Dounias 2001
Sato 2001), the Yanomami from the Amazon (Good 1995), and foraging groups in the Malay Peninsula (Endicott and Bellwood 1991
Rambo 1984). Island Southeast Asia (ISEA) is a significant region in this discourse of health and subsistence change. As Hutterer (1990) pointed out, the anthropological study of gatherer-hunters became popular in Southeast Asia and other tropical regions of the world as a second wave of studies after the Bushman model from the arid regions of southern Africa (for a summary of the history of the importance of anthropological Bushman studies to archaeological social interpretation see Barnard 2007). Some examples of this second-wave from ISEA include studies on foragers such as the Penan of Sarawak (Brosius 1991), the Batak of Palawan (Eder 1987), and several Agta groups from the Sierra Madre, Luzon (Rai 1990
Griffin 1986). It has already been argued by specialist practitioners that there should be multiple data sets for a more robust approach to the study of human remains when correlated with health conditions and subsistence. A triangulation of independent lines of evidence is needed: uniformitarian principles for parasite life cycles and nutrient distributions, studies of health among ethnographic populations actually partaking in different lifestyles, and evidence from palaeopathology (Armelagos and Cohen 1984, 2013
Cohen 1977). Addressing these issues entails much focused study. Unfortunately, due to relatively limited health-focused bioarchaeological research, ISEA is at present far from providing robust multiple sets of data. For example, while there is good work published on contemporary foraging cultures and their different lifestyles, including on the Negrito groups of Luzon (Fox 1953
Estioko-Griffin 1985
Rai 1990
Headland 1987), comparative archaeological work on skeletal collections has been limited. Furthermore, despite many ethnoarchaeological studies of material culture (e.g., Griffin 1978
Griffin and Estioko-Griffin 1978
Davenport and Kamminga 2002), there are no studies on the pathology of archaeological human remains in the same areas. A survey of bioarchaeological work done in ISEA reveals that palaeopathological work is limited, and clustered on assemblages from the Malay Peninsula (Bulbeck 2005a, 2005b
Matsumura and Majid 2005) and Sarawak (Krigbaum and Manser 2005
Barker et al. 2013). In regard to the aims of this chapter, there are no studies on cremated bones from the early Holocene in ISEA exploring an assemblage from the basis of pathology. This is partly due to the rarity of such assemblages, and perhaps also due to the lack of dating of cremation burials in the region (e.g., Lewis et al. 2008). This contribution presents the macroscopic evidence of pathological lesions in a population living in ISEA <i>c</i>.9,000 years ago (Lara et al. 2013
Lewis et al. 2008). During this period, ISEA may have been populated by many small groups of gatherers and hunters (Bellwood 1997, 2005), communities of semi-nomadic maritime cultures (Solheim 2006), and groups capable of managing their resources to the point of domesticating plant and animal species (Denham 2013
Barton and Denham 2011). Based on present evidence in this region, there is a backdrop of ambiguity as to what kind of subsistence strategy may have been practiced during this period, which makes any study of diet and health from human skeletal remains extremely important, especially in comparison to the results of environmental archaeological studies. The human remains from the cremation burial cemetery discussed in this chapter are being studied within the larger context of the Palawan Island Palaeohistoric/Prehistoric Research Project (PIRP) which is an ongoing long-term collaborative and multidisciplinary archaeological research project (Lewis et al. 2006
Paz et al. 2009, 2011, 2012, 2013). Since the PIPRPs beginnings in 2002, the goal has been to contribute to a high-resolution understanding of the rich human past in the Philippines and wider ISEA and to make heritage education relevant in local communities in Palawan (Paz et al. 2013). The focus on Palawan gives the project a strong local profile while also addressing larger global research concerns.
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