Based on the presence of palisades and an iconography suggesting a warrior elite, warfare is presumed to be endemic in the Late Mississippian period (AD 1200-1600) of the southeastern United States. Warfare is theorized to play a vital role in the cycling of chiefdoms. However, apart from a few exemplary cases that display double-digit frequencies, very little direct (i.e., skeletal) evidence of violent trauma has dovetailed with the archaeological presumptions of warfare. Eight sites from the Chickamauga Reservoir of east Tennessee were examined for skeletal evidence of deliberate violent trauma. Violent trauma was anticipated because these sites are in close proximity and consist of two adjacent, sociopolitically distinct, and temporally overlapping phases: Dallas (AD 1300-1600) and Mouse Creek (AD 1400-1600). In addition to small, round, nonlethal ectocranial blunt-force trauma (BFT) on the frontal and upper parietal bones, inflicted projectile points and scalping were identified. The low total trauma frequency in the Dallas sample (3.86%, n = 259) is consistent with emerging evidence from east and west Tennessee Late Mississippian data, but significantly different from Mouse Creek (8.06%, n = 273). The proportion of nonlethal cranial BFT in the collective Chickamauga sample is large and at odds with the Tennessee River Valley comparative literature. Based on other bioarchaeological literature, this pattern suggests intragroup violence, but not face-to-face ritual contests. It is better explained as interpersonal conflict resolution along codified lines. This is consistent with southeastern ethnohistoric data and may explain the more frequent cranial BFT in the less stratified Mouse Creek phase, which likely would not have had an overarching civil authority.

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The high frequency of late prehistoric New World treponemal disease is attributable to the demographic changes concomitant with the adoption of agriculture. However, these demographic changes in group mobility and site density episodically preceded intensive plant domestication, suggesting possible staggered temporal change in observed treponemal disease case frequency. Thirteen convincing and an additional two probable (N = 581) cases of treponemal disease were identified in an eight-site skeletal sample spanning the Middle (6,000-3,000 BCE) to Late (2,500-ca. 1,000 to 500 BCE) Archaic and Early Woodland (500 BCE-0 CE) periods from the western Tennessee River Valley. Treponemal disease cases are infrequent in both the Middle (3/115, 2.6%) and Late (2 to 4 cases,

Treponemal disease is known to be associated with the compromised community health of permanent village settlement. This association explains its high visibility in the village-based, arguably chiefdom level, agriculturalist societies of late prehistoric (AD 1300-1600) North America. Within chiefdom-level societies, health differences have often been demonstrated between mortuary-defined "elite" and "nonelite" individuals. This theoretically should predict status-based differences in treponemal disease visibility. The prediction is tested in a five-site osteological sample (N = 650) from the Dallas phase (AD 1300-1550), a simple mortuary-defined two-tiered presumptive chiefdom level maize agriculturalist socioeconomic context from lower east Tennessee. The Dallas phase results affirm a general pre-Colombian North American pattern of no sex differences and display comparable adult to subadult frequencies. The study also reveals that given a sufficient sample size, "elites" do indeed exhibit a significantly lower frequency of tertiary stage treponemal disease. This can be attributed to better baseline health, which has been previously demonstrated in this sample. It may also be affected by the mortuary inclusion of achieved status individuals whose good health may have facilitated sociopolitical advancement. Another pattern that emerged is an apparent young adult age bias in disease visibility. This suggests that tertiary treponemal disease morbidity may either directly or synergistically factor in early adult age at death. Future research will address the veracity of this association.

There are few described cases of metastatic carcinoma from the prehistoric eastern UnitedStates and none primarily differentially diagnosed from the southeast. A mature adult female exhibiting several large lytic cranial lesions suggestive of neoplastic disease was identified in a late prehistoric Mississippian Period (AD 1200-1600) context. Burial 371 is from Ledford Island, a Mouse Creek phase (AD 1400-1500) site from the Chickamauga Reservoir of southeastern Tennessee. It is the only case in this reservoir (total adult n = 843). The radiographs of the otherwise asymptomatic postcranium yielded radiolucencies in both proximal femora, both medial clavicles, the sternum, the surviving humeral metaphysis and fragmentary innominate. The locations are all consistent with metastasized carcinoma. The identity of the possible primary lesion is argumentative. Age, sex and the mixed nature of the osseous response are consistent with carcinoma of the breast but not to the exclusion of bronchogenic, thyroid, or kidney cancers.

After ca 1000 BC, coinciding with the transition to sedentism, tertiary stage treponemal disease apparently becomes osteologically pervasive in pre‐Columbian North America. However, varying interobserver treponemal disease diagnostic thresholds, sampling error and the possibly ecosensitive nature of the pre‐Columbian nonvenereal treponemal disease variants (i.e. yaws and treponarid) prevents subsistence‐settlement pattern from becoming a reliable predictor of treponemal disease prevalence. This is particularly true of later prehistory with the transition from horticulture to intensive, maize‐based agriculture. To address whether treponemal disease visibility does vary across this specific subsistence‐settlement threshold, subadults (4+ years of age) and adults from 11 late prehistoric sites (N = 997) from the same geographic area of East Tennessee were sampled for the presence of treponemal disease. Six sites (N = 279) primarily date to the Late Woodland period (AD 700–900) and culturally belong to what is referred to as the Hamilton mortuary complex. The sample is archaeologically characterised as horticulturalist with presumably a dispersed farmstead or hamlet settlement pattern. Six sites (N = 718) date to the Late Mississippian (AD 1300–1550, Dallas phase) and are maize‐intensive agriculturalists with a large, aggregate village settlement pattern. The sites were examined using three different levels of treponemal disease diagnostic confidence. Treponemal disease raw frequency does indeed differ across the levels of diagnostic confidence between the total Late Woodland horticulturalist sample (4.3–5.5%) and total Late Mississippian maize agriculturalist sample (5.4–6.5%). The meaning is complex as the Dallas phase sample may have a socially segregated elite; the mound‐interred (1.8%) relative to the village‐interred (6.1–7.4%) exhibited significantly fewer cases of treponemal disease. Tentatively, treponemal disease visibility does appear to co‐associate with sedentism and perhaps (if the mound‐interred Dallas individuals are elites) also aggregated settlement. Copyright © 2013 John Wiley & Sons, Ltd.

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