Hypertrophic pulmonary osteoarthropathy (or Bamberger-Marie disease) is a medical condition combining clubbing and periostitis of the long bones of the upper and lower extremities. Distal expansion of the long bones as well as painful, swollen joints and synovial villous proliferation are often seen. The condition may be primary or secondary to diseases like lung cancer.

Hypertrophic Pulmonary Osteoarthropathy in Supervolcano[]

After being marooned in Lincoln, Nebraska when the Yellowstone Supervolcano erupted, Bryce Miller visited a museum at the University associated with the Ashfall State Historical Park. There he found fossil remains from a previous supervolcano eruption and a plaque indicating that many of the specimens showed signs of Hypertrophic Pulmonary Osteoarthropathy or HPO. Being a classics major, Miller translated this to "bad bone overgrowth that had to do with the lungs". The plaque confirmed this, indicating that the disease is caused by slow suffocation and that in the case of the fossils it was due to inhaling volcanic ash. Miller immediately associated this with the ash in the air from the Yellowstone eruption and its possible effect on current survivors. Marcus Wilson agreed and also pointed out that it would affect livestock too, leading to further food shortages.[1]

Several months after the eruption, HPO had already sickened and killed thousands of people in Denver, Salt Lake City, Topeka, Pocatello, and Saskatoon and all places in between. However, due to the huge economic impact on the US economy, both in physical destruction and displaced population, little money was available to do research for a cure.[2]

When Vanessa Ferguson joined a savage crew working in Kansas, the second spring after the eruption, she wore a gas masks to help keep the dust that blew in from further west out of her eyes and lungs. The countryside was either empty or containing corpses since hundreds of thousands who had not fled had already died.[3]

Some three years after the eruption, Miller was back in Nebraska, teaching at Wayne State College. He reflected on how many people had died from HPO which had also killed most of the livestock in the mid-west.[4]


  1. Eruption, pg. 256, HC.
  2. Ibid, pg. 328.
  3. All Fall Down, pgs. 124-126, HC.
  4. Ibid, pg. 298.