Conclusions

As demonstrated by this synthesis, simple questions are frequently the most difficult to answer. Determining which diseases were allochthonous in the Americas before A.D. 1700 requires the expertise of numerous disciplines, including the study of evolution, ecology, microbiology, history, archeology, and geography. The integration of diverse and sometimes contradictory sets of information provides a means of evaluating past and present assumptions and of suggesting future directions. Although skeptical of the possibility of reconstructing the exact number of introductions, or dates and places of entry during the Columbian period, I support serious interdisciplinary efforts aimed at establishing the nature of the parasitic environment that confronted native populations during the sixteenth and seventeenth centuries. I hope that this preliminary synthesis will promote such efforts.

Ann Ramenofsky

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