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Nutrition and Physical Degeneration

A Comparison of Primitive and Modern Diets and Their Effects


BY Weston A Price! M" ! D D " ! # A $ D Mem%er &esearch Commission! American Dental Association Mem%er American Association of Physical Anthropologists Author! 'Dental (nfections! )ral and "ystemic' #ore*ord %y Earnest Al%ert +ooton Professor of Anthropology, Harvard University With ,-. figures

Paul B +oe%er! (nc Medical Boo/ Department of +arper 0 Brothers Ne* Yor/ 1ondon Copyright! ,2-2! %y Paul B +oe%er! (nc All rights reserved This %oo/ or any part thereof must not %e reproduced in any form *ithout permission of the pu%lishers Printed in the 3nited "tates of America

To that /indred soul My Wife *ho has assisted me so greatly on these difficult e4peditions! this %oo/ is lovingly dedicated

Contents
1ist of (llustrations Preface #ore*ord %y Earnest A +ooton (ntroduction , 5 . 7 8 9 : 2 ,; ,, ,5 ,,. ,7 ,8 ,9 ,: ,2 5; Why "ee/ Wisdom from Primitive &aces The Progressive Decline of Modern Civili6ation (solated and Moderni6ed "*iss (solated and Moderni6ed $aelics (solated and Moderni6ed Es/imos Primitive and Moderni6ed North American (ndians (solated and Moderni6ed Melanesians (solated and Moderni6ed Polynesians (solated and Moderni6ed African Tri%es (solated and Moderni6ed Australian A%origines (solated and Moderni6ed Torres "trait (slanders (solated and Moderni6ed Ne* <ealand Maori Ancient Civili6ations of Peru (solated and Moderni6ed Peruvian (ndians Characteristics of Primitive and Moderni6ed Dietaries Primitive Control of Dental Caries )ne )rigin of Physical Deformities Prenatal Nutritional Deformities and Disease Types Physical! Mental and Moral Deterioration "oil Depletion and Plant and Animal Deterioration 5, Practical Applications of Primitive Wisdom

1ist of illustrations , 1oetschental =alley in "*it6erland 5 +and>mill used %y natives in 1oetschental =alley - Natives of modern "*iss valley sho*ing normal design of face and dental arches *hen ade?uate nutrition is provided . Natives of 1oetschental =alley sho*ing tooth decay and deformed dental arches typical of those living on modern foods 7 A typical '%lac/>house' on the (sle of 1e*is Natives of the (sle of 1e*is 8 Tooth decay in native of (sle of +arris living on modern foods and e4cellent teeth of natives living on primitive foods 9 $aelic children living on native foods : =ariations in gro*th of oats fertili6ed *ith varying ?uantities of smo/e> thatch 2 Primitive Alas/an Es/imos sho*ing e4cellent facial and dental arch formation ,; Primitive Alas/an mothers ,, Alas/an Es/imos sho*ing effect on teeth of modern foods ,5 Defective teeth and dental arches in Es/imo children living on modern foods ,- Dried eggs of salmon are an important item of nutrition ,. #acial and dental arch deformity in *hite %oy %orn in Alas/a and living on modern foods ,7 #amily of forest (ndians of northern Canada ,8 Moderni6ed (ndian children *ith tu%erculosis ,9 (ndian *omen and girls typical of those living on primitive foods ,: (ndian *omen typical of those living on modern foods ,2 Deformed facial formation in children of first generation after adoption of modern foods %y parents 5; Primitive (ndians of central Canada@ parents developed on native foods! children on modern foods 5, Typical crippled children found among (ndians living on modern foods 55 "/ulls of primitive (ndians sho*ing super% dental arches 5- "/ulls of primitive (ndians sho*ing e4cellent %one formation 5. "eminole (ndians! typical of those living on native foods 57 Dental caries in "eminole (ndians living on modern foods 58 "eminole (ndian children sho*ing changes in facial and dental arch form *hich result from modern foods 59 "/ulls of pre>Colum%ian (ndians of #lorida

5: 52 -; -, -5 --. -7 -8 -9 -: -2 .; ., .5 ... .7 .8 .9 .: .2 7; 7, 75 77. 77

Melanesians typical of those living under native conditions #acial %one formation in Melanesians living on native foods #iAi council house and hereditary #iAi monarch Tooth decay in natives of #iAi (slands living on imported food Tooth decay and changes in arch formation in first generation after adoption of modern foods Perfect dental arches of Polynesians living under native conditions Tahitians sho*ing dental caries due to imported foods Changes in teeth and in dental arch formation of Polynesians living on modern foods "amoans typical of e4cellent facial and dental arch formation *hen living on native foods Children *ith formation typical of those %orn of under>nourished parents +a*aiian family sho*ing changes in facial form in younger children of same family Tooth decay and tu%erculosis as a result of under>nutrition in a Polynesian girl Mem%ers of Masai tri%e illustrating e4cellent results of diet of meat! mil/ and %lood Method %y *hich %lood is dra*n from steer #acial and dental arch development in African tri%es living on native foods #acial and dental arch development in mem%ers of Belgian Congo tri%e living on native foods Pygmies of Belgian Congo Dental caries in Africans *ho have adopted modern foods Changes in facial and dental arch development in children of first generation after adoption %y parents of modern foods Africans sho*ing facial deformities due to diet of modern foods Africans sho*ing facial deformities in first generation after adoption %y parents of modern foods African children sho*ing a mar/ed depression of middle third of face due to malnutrition of parents CamelsB mil/ is an important item of nutrition in Asia and Africa #acial deformities found in %oys and girls living in Cairo under modern conditions African children *al/ing on 'all fours' Typical A%origines of Australia Magnificent dental arches and teeth found in A%origines Dental caries in A%origines living on modern foods Changes in teeth and arch formation in moderni6ed A%origines

78 79 7: 72 8; 8, 85 88. 87 88 89 8: 82 9; 9, 95 99. 97 98 99 9: 92 :; :, :5 ::. :7 :8 :9

Distur%ance in facial gro*th in moderni6ed A%origines Deformity patterns produced in A%origines %y modern food Effects of malnutrition in Australian A%origines living on a reservation Typical A%origine mothers *ith their children Comparison of s/ull of typical A%origine *ith that of Pe/ing Man (nha%itants of islands north of Australia have splendidly %uilt %odies *ith fine facial and dental arch form Comparison of facial and dental arch formation in native and in *hite children on Thursday (sland $ood physical development of natives of +ammond (sland Dental arches in natives on the islands of the $reat Barrier &eef Contrast in facial and dental arch form %et*een primitive and moderni6ed natives Deformed dental arches in *hite children on Thursday (sland Tooth decay in *hite children in Torres "trait islands Dental clinic maintained %y Ne* <ealand $overnment The Maori had the reputation of having the finest teeth and %odies of any race in the *orld Tooth decay is found in moderni6ed Maori The *hites living in Ne* <ealand have poor teeth #acial deformities in Maori %orn after adoption of modern foods Maori s/ulls sho*ing fine physical development Maori demonstrating some of the accessory essentials o%tained from the sea Trephined s/ulls of ancient peoples of Peru Trephined s/ulls *ith gold plates in position Pottery Aar depicting ancient Peruvian surgery Bone sho*ing healing of fracture "/ulls of fishermen of Chimu culture Ancient a?ueduct of Peru Descendants of ancient Chimus sho*ing flattening of %ac/ of head "ome descendants of the ancient Chimus are still living in a fe* fishing villages in the north of Peru "tone fortress %uilt %y primitive people of Andean "ierra Typical s/ulls of +igh "ierra (ndians Descendants of the Tauhuanocan (ndians of Peru The Cuichua (ndians living in the +igh Andes are descendants of the (ncas (ndians of the +igh Andes have magnificent physi?ues (ndians of the +igh Andes have super% facial and dental arch development

:: (ntroduction of modern foods to "ierra (ndians produced *rec/age of physi?ues :2 Dungle (ndians of the Ama6on Basin 2; #acial and dental arch development of the Aungle (ndians is super% 2, E4cellence of s/eletal development of Aungle (ndians as e4pressed in faces and dental arches 25 A mar/ed change in facial form *ith cro*ding of teeth occurs in Aungle (ndians %orn after adoption of modern foods 2- &apid healing of fractured femur in %oy suffering from malnutrition! after institution of proper nutrition 2. (mprovement accomplished %y proper nutrition in %oy suffering from inflammatory rheumatism 27 Effect of different *heat products on rats 28 Teeth sho*ing permea%ility of decayed dentin to silver nitrate 29 Three cases illustrating ho* nature can close an e4posure of pulp due to dental caries 2: #our Melanesians %orn on four different islands loo/ li/e %rothers %ut are not %lood relations 22 #our Polynesian girls living on different islands are not related though they loo/ li/e sisters ,;; Distur%ed heredity@ t*o Peruvian (ndian fathers *ith good physical development and their sons *ho sho* defects ,;, Distur%ed heredity illustrated %y father and son of Wa/am%a tri%e of Central Africa ,;5 Distur%ed heredity in Cuicha (ndians ,;Distur%ed heredity in Australian A%origines ,;. T*o Maori sisters! and t*o *hite sisters in Peru! sho*ing facial changes that may occur in same generation *ith change from primitive to modern diet %y parents ,;7 "i4 %rothers sho*ing facial changes in same generation due to change from primitive to modern foods %y parents ,;8 Change in facial form in t*o younger %rothers! corresponding to change in diet %y parents ,;9 Natives from islands north of Australia sho*ing progressive facial change in same family due to change in foods ,;: White girls in Ne* <ealand illustrate progressive lengthening and narro*ing of face and hips ,;2 Ne* <ealand Maori illustrating progressive change in facial form of t*o younger %oys ,,; Ne* <ealand Maori illustrating mar/ed undersi6e and deformity of feet in second child in family

,,, Moderni6ed Peruvian (ndian %oy sho*ing distur%ed development of face and foot ,,5 Moderni6ed coastal (ndian of Ecuador sho*ing serious physical deformities ,,Es/imo children ill in tu%erculosis *ard of the government hospital at Duneau ,,. Patients in the Maori hospital in Ne* <ealand sho*ing mar/ed facial under>development ,,7 $irls in tu%erculosis *ard of Ne* <ealand hospital for Maori sho* mar/ed facial and dental arch distur%ances ,,8 Native +a*aiian children *ith tu%erculosis! sho*ing mar/ed distur%ances of facial form and dental arch development ,,9 Deformities of pig due to lac/ of =itamin A in mothers diet ,,: Deformities due to lac/ of ade?uate =itamin A in mothers diet ,,2 Many young of modern domestic animals are %orn *ith deformities ,5; Puppies %orn *ith physical defects due to deficiency of =itamin A in father ,5, Typical deformities in domestic animals ,55 Criminals Were their unsocial traits related to incomplete %rain organi6ation associated *ith prenatal inAury ,5Mar/ed lac/ of normal facial development in notorious young criminals ,5. Typical Mongoloid defective ,57 Physical changes in Mongoloid type due to movement of ma4illary %ones to stimulate pituitary gland in %ase of %rain ,58 E>ray pictures sho*ing position of teeth %efore and during operation to move ma4illary %ones ,59 T*in %oys *ith same deformity of dental arch ,5: Boys typical of group in special school for %ac/*ard children ,52 #iAi *oman *ho has gone long distance to gather special food needed for production of healthy children ,-; African *oman *ho has come do*n the mountains to gather special plants of *hich the ashes prevent goiter ,-, E>rays of teeth of three children in one family sho* progressive inAury in younger children ,-5 E>rays illustrating progressive inAury in t*o younger children in family ,-E>rays comparing deformities of facial form in child %orn after long la%or *ith %etter facial form in sister %orn after short la%or

,-. $irl sho*ing relationship %et*een lac/ of pelvic development and deformity of face Preface

T+E gracious reception given to my several reports of field studies among


primitive racial groups and the many re?uests for copies of those %rief reports and for further data! together *ith the need for providing interpretations and applications of the data! have induced me to consolidate my investigations There have also %een many re?uests from my patients and from mem%ers of the medical and dental professions for concise statements as to *hat ( have found that *ould %e useful as preventive procedures (n addition ( have %een conscious of an opportunity for helpfulness to the mem%ers of the various primitive races that ( have studied and *ho are so rapidly declining in health and num%ers at their point of contact *ith our modern civili6ation "ince they have so much accumulated *isdom that is passing *ith them! it has seemed important that the elements in the modern contacts that are so destructive to them should %e discovered and removed There has %een a deep sense of o%ligation to the officials of many countries for the great /indness and assistance that they have so cheerfully given %y providing the opportunity for these investigations The list of these individuals is much too long to mention them all %y name )ne of the Aoys of my *or/ has %een the privilege of /no*ing the magnificent characters that are at the outposts earnestly striving to %etter the *elfare of the natives *hom they are ministering to! %ut *ho are distraught *ith the recognition that under the moderni6ation program the natives decline in health and %ecome afflicted %y our modern types of degenerative diseases (t *ould %e fortunate if each of these field *or/ers could %e provided *ith a copy of this report *hich they have helped to ma/e possi%le (n order to ma/e this information availa%le to as *ide a group as possi%le! ( have avoided technical language and *ill as/ the indulgence of professional readers There are some individuals *hose assistance ( must ac/no*ledge specifically@ &everend #ather Dohn "iegen and Doctor Alfred $ysi of "*it6erlandF Mrs 1ulu +erron and Doctor D &omig of Alas/aF the (ndian Department at )tta*aF the Department of (ndian Affairs at Washington! D C F the officials of the eight archipelagos studied in the PacificF Colonel D 1 "aunders of Ne* <ealandF the Minister of +ealth! Ne* <ealandF Dr W

"te*art <iele of "ydney! AustraliaF "ir +er%ert $epp of Mel%ourne! AustraliaF Doctor William M +ughes! Minister of +ealth! Can%erraF Dr Cummiston! Director>$eneral of +ealth! Australian Common*ealth! Can%erraF Doctor &apael Cilento of Cueensland! AustraliaF Mr E W "aranealis! Thursday (slandF the Department of +ealth of Genya! AfricaF the Department of +ealth for Belgian Congo! BrussellsF the Department of National Par/s! Belgian CongoF Minister of the (nterior! PeruF Doctor Al%ert $iesec/e and Esther $iesec/e of PeruF the Directors of Museums in "ydney and Can%erra! AustraliaF Auc/land! Ne* <ealandF =ancouver! and Toronto! CanadaF Washington! Ne* Yor/ and Chicago! the 3nited "tatesF Duneau! Alas/aF &ome! (talyF and Cairo! EgyptF the pu%lishers of the )hio "tate Medical Dournal! the Dournal of the American Dental Association! the Dental Digest and the Dental (tems of (nterestF my faithful secretary! Mrs &uth MacMasterF Professor W $ $arnett *ho so /indly provided the critical reading of the manuscript! and the pu%lishers *ho furnished constructive suggestions and cooperation To these and a host of others ( am deeply inde%ted and profoundly grateful WE"T)N A P&(CE :258 Euclid Avenue Cleveland! )hio! ,2-: Introduction T+(" te4t provides a ne* approach to some pro%lems of modern degeneration (nstead of the customary procedure of analy6ing the e4pressions of degeneration! a search has %een made for groups to %e used as controls *ho are largely free from these affections After spending several years approaching this pro%lem %y %oth clinical and la%oratory research methods! ( interpreted the accumulating evidence as strongly indicating the a%sence of some essential factors from our modern program! rather than the presence of inAurious factors This immediately indicated the need for o%taining controls To accomplish this it %ecame necessary to locate immune groups *hich *ere found readily as isolated remnants of primitive racial stoc/s in different parts of the *orld A critical e4amination of these groups revealed a high immunity to many of our serious affections so long as they *ere sufficiently isolated from our modern civili6ation and living in accordance *ith the nutritional programs *hich *ere directed %y the accumulated *isdom of the group (n every instance *here individuals of the same racial stoc/s *ho had lost this isolation and *ho had adopted the foods and food ha%its of our modern civili6ation *ere e4amined! there *as an early loss of the high immunity characteristics of the isolated

group These studies have included a chemical analysis of foods of the isolated groups and also of the displacing foods of our modern civili6ation These investigations have %een made among the follo*ing primitive racial stoc/s including %oth isolated and moderni6ed groups@ the "*iss of "*it6erland! the $aelics in the )uter and (nner +e%rides! the Es/imos of Alas/a! the (ndians in the far North! West and Central Canada! Western 3nited "tates and #lorida! the Melanesians and Polynesians on eight archipelagos of the "outhern Pacific! tri%es in eastern and central Africa! the A%origines of Australia! Malay tri%es on islands north of Australia! the Maori of Ne* <ealand and the ancient civili6ations and their descendants in Peru %oth along the coast and in the "ierras! also in the Ama6on Basin Where availa%le the moderni6ed *hites in these communities also *ere studied There have %een many important une4pected developments in these investigations While a primary ?uest *as to find the cause of tooth decay *hich *as esta%lished ?uite readily as %eing controlled directly %y nutrition! it rapidly %ecame apparent that a chain of distur%ances developed in these various primitive racial stoc/s starting even in the first generation after the adoption of the moderni6ed diet and rapidly increased in severity *ith e4pressions ?uite constantly li/e the characteristic degenerative processes of our modern civili6ation of America and Europe While tooth decay has proved to %e almost entirely a matter of the nutrition of the individual at the time and prior to the activity of that disease! a group of affections have e4pressed themselves in physical form These have included facial and dental arch changes *hich! heretofore! have %een accounted for as results of admi4tures of different racial stoc/s My investigations have revealed that these same divergencies from normal are reproduced in all these various racial stoc/s *hile the %lood is still pure (ndeed! these even develop in those children of the family that are %orn after the parents adopted the modern nutrition Applying these methods of study to our American families! *e find readily that a considera%le percentage of our families sho* this same deterioration in the younger mem%ers The percentage of individuals so affected in our American communities in *hich ( have made studies varies through a *ide range! usually %et*een 57 per cent to 97 per cent A certain percentage of this affected group has not only these evidences of physical inAury! %ut also personality distur%ances! the most common of *hich is a lo*er than normal mental efficiency and acuteness! chiefly o%served as so>called mental %ac/*ardness *hich includes the group of children in the schools *ho are una%le to /eep up *ith their classmates Their ( C Bs are generally lo*er than normal and they readily develop inferiority comple4es gro*ing out of their

handicap #rom this group or parallel *ith it a certain percentage develop personality distur%ances *hich have their e4pression largely in unsocial traits They include the delin?uents *ho at this time are causing so much trou%le and concern %ecause of evidence of increase in their num%ers This latter group has %een accounted for largely on the %asis of some conditioning e4perience that developed after the child had reached an impressiona%le age My investigations are revealing a physical structural change and therefore! an organic factor *hich precedes and underlies these conditioning influences of the environment The fact that a government survey has sho*n that 88 per cent of the delin?uents *ho have %een treated in the %est institutions and released as cured! later have developed their unsocial or criminal tendencies! strongly emphasi6es the urgent necessity that if preventive methods are to %e applied these must precede and forestall the primary inAuries themselves While it has %een /no*n that certain inAuries *ere directly related to an inade?uate nutrition of the mother during the formative period of the child! my investigations are revealing evidence that the pro%lem goes %ac/ still further to defects in the germ plasms as contri%uted %y the t*o parents These inAuries! therefore! are related directly to the physical condition of one or of %oth of these individuals prior to the time that conception too/ place A very important phase of my investigations has %een the o%taining of information from these various primitive racial groups indicating that they *ere conscious that such inAuries *ould occur if the parents *ere not in e4cellent physical condition and nourishment (ndeed! in many groups ( found that the girls *ere not allo*ed to %e married until after they had had a period of special feeding (n some tri%es a si4 months period of special nutrition *as re?uired %efore marriage An e4amination of their foods has disclosed special nutritional factors *hich are utili6ed for this purpose The scope of this *or/! accordingly! %ecomes of direct interest in many fields including the various %ranches of the healing arts! particularly medicine and dentistry! and the social organi6ations that are concerned *ith %etterment of the racial stoc/ "imilarly! the educational groups are concerned directly since! if *e are to stem the tide %y passing ne* information on to the parents of the ne* generation! it must %e done prior to the time the emergency shall arise This involves a system of education directed particularly to the high school age pupils The data that are %eing presented in the follo*ing chapters suggest the need for reorientation in many pro%lems of our modern social organi6ation The forces involved in heredity have in general %een deemed to %e so po*erful as to

%e a%le to resist all impacts and changes in the environment These data *ill indicate that much that *e have interpreted as %eing due to heredity is really the result of intercepted heredity While great emphasis has %een placed on the influence of the environment on the character of the individual! the %ody pattern has generally %een supposed to re?uire a great num%er of impacts of a similar nature to alter the design The %rain has %een assumed to %e similarly *ell organi6ed in most individuals e4cept that incidents in the life of the individual such as disappointments! fright! etc ! are largely responsi%le for distur%ed %ehavior Normal %rain functioning has not %een thought of as %eing as %iologic as digestion The data provided in the succeeding chapters indicate that associated *ith distur%ances in the development of the %ones of the head! distur%ances may at the same time occur in the development of the %rain "uch structural defects usually are not hereditary factors even though they appear in other mem%ers of the family or parents They are products of the environment rather than hereditary units transmitted from the ancestry (n the light of these data important ne* emphasis is placed on the ?uality of the germ cells of the t*o parents as *ell as on the environment provided %y the mother The ne* evidence indicates that the paternal contri%ution may %e an inAured product and that the responsi%ility for defective germ cells may have to %e a%out e?ually divided %et*een the father and mother The %lending of races has %een %lamed for much of the distortion and defects in %ody form in our modern generation (t *ill %e seen that these face changes occur in all the pure %lood races studied in even the first generation! after the nutrition of the parents has %een changed The origin of personality and character appear in the light of the ne*er data to %e %iologic products and to a much less degree than usually considered pure hereditary traits "ince these various factors are %iologic! %eing directly related to %oth the nutrition of the parents and to the nutritional environment of the individuals in the formative and gro*th period any common contri%uting factor such as food deficiencies due to soil depletion *ill %e seen to produce degeneration of the masses of people due to a common cause Mass %ehavior therefore! in this ne* light %ecomes the result of natural forces! the e4pression of *hich may not %e modified %y propaganda %ut *ill re?uire correction at the source Nature has %een at this process of %uilding human cultures through many millenniums and our culture has not only its o*n e4perience to dra* from %ut that of parallel races living today as *ell as those *ho lived in the past This *or/! accordingly! includes data that have %een o%tained from several of NatureBs other %iologic e4periments to thro* light on the pro%lems of our modern *hite civili6ation

(n presenting the evidence ( am utili6ing photographs very li%erally A good illustration is said to %e e?uivalent to a thousand *ords of te4t This is in /eeping too *ith the recent trend in Aournalism The pictures are much more convincing than *ords can %e! and since the te4t challenges many of the current theories! the most conclusive evidence availa%le is essential )*ing to the many re?uests received for slides or the loan of my negatives! provision is %eing made for supplying a limited num%er of slides of the illustrations in either %lac/ and *hite or in color "lides of other su%Aects are availa%le Chapter 1 Why seek wisdom from primitive peoples ")ME of the primitive races have avoided certain of the life pro%lems faced %y moderni6ed groups and the methods and /no*ledge used %y the primitive peoples are availa%le to assist moderni6ed individuals in solving their pro%lems Many primitive races have made ha%itual use of certain preventive measures in meeting crucial life pro%lems "earch for controls among remnants of primitive racial stoc/s has %een resorted to as a result of failure to find them in our moderni6ed groups or to find the controlling factors %y applying la%oratory methods to the affected clinical material )nly the primitive groups have %een a%le to provide ade?uate normal controls (n the follo*ing chapters! ( have presented descriptions of certain peoples and their environments in primitive state! and! for comparative study! descriptions of mem%ers of the primitive tri%es *ho have %een in contact *ith moderni6ed *hite races ( have recorded the effects of that contact as e4pressed in physical and character changes! and have given a survey of the factors in the environment *hich have changed (t has %een necessary to study in this *ay a *ide variety of primitive groups and physical environments (t *ill! accordingly! %e advisa%le for the reader to /eep in mind the comparative effects of different altitudes! latitudes! temperatures and races! and to note the similarity of the reactions of these primitive groups *hen contact is made *ith our modern civili6ation The purpose is to glean data that *ill %e applica%le for use in correcting certain tragic e4pressions of our modern degeneration! including tooth decay! general physical degeneration! and facial and dental>arch deformities! and character changes These data *ill %e useful in preventing race decay and deformities! in esta%lishing a higher resistance to infective diseases!

and in reducing the num%er of prenatal deficiency inAuries These latter include such e4pressions as mental deficiencies caused %y %rain defects in the formative period! *hich result in mental distur%ances ranging from moderate %ac/*ardness to character a%normalities The data presented sho* the level of suscepti%ility to dental caries Htooth decayI in each isolated primitive group and! contrasted *ith that! the level of suscepti%ility in the moderni6ed natives of the same stoc/ A rJsumJ of the changes in the environment that are associated *ith the changes in immunity and suscepti%ility *ill %e presented These data reveal an average increase in suscepti%ility of thirty>five fold "imilar contrasts are sho*n in relation to the relative incidence of facial and dental arch deformities among primitive natives and moderni6ed natives (t *ill %e easy for the reader to %e preAudiced since many of the applications suggested are not orthodo4 ( suggest that conclusions %e deferred until the ne* approach has %een used to survey the physical and mental status of the readerBs o*n family! of his %rothers and sisters! of associated families! and finally! of the mass of people met in %usiness and on the street Almost everyone *ho studies the matter *ill %e surprised that such clear>cut evidence of a decline in modern reproductive efficiency could %e all a%out us and not have %een previously noted and revie*ed (t is important to preface the o%servations %y constructing a mental pattern of physical e4cellence from the pictures of the various primitive groups and! *ith this yardstic/ or standard of normalcy! o%serve our modern patterns Certain preconceived ideas may have to %e modified! as for e4ample! that %ased on the %elief that *hat *e see is due to heredity or that deformity is due to mi4ing of races (f so! *hy should the last child in a large family generally suffer most! and often %e different in facial formF or *hy should there %e these changes in the later children! even in pure racial stoc/s! after the parents have adopted our modern types of nutritionK Although the causes of physical degeneration that can %e seen easily have %een hard to trace! the defects in the development of the %rain! *hich affect the mind and character! are much more o%scure! and the causes of mental degeneration are e4ceedingly difficult to trace Much that formerly has %een left to the psychiatrist to e4plain is no* rapidly shifting to the realm of the anatomist and physiologist Those contri%utions of the past cultures *hich have %lended agreea%ly into our modern e4perience have %een accepted *ith too little ?uestioning Much ancient *isdom! ho*ever! has %een reAected %ecause of preAudice against the

*isdom of so>called savages "ome readers may e4perience this reaction to the primitive *isdom recorded in these chapters The *riter is fully a*are that his message is not orthodo4F %ut since our orthodo4 theories have not saved us *e may have to readAust them to %ring them into harmony *ith NatureBs la*s Nature must %e o%eyed! not orthodo4y Apparently many primitive races have understood her language %etter than have our moderni6ed groups Even the primitive races share our %lights *hen they adopt our conception of nutrition The supporting evidence for this statement is voluminous and as much of it as space permits is included in this volume The illustrative material used is ta/en from the many thousands of my negatives *hich are availa%le Photographs alone can tell much of the story! and one illustration is said to %e *orth as much as one thousand *ords "ince the pro%lem of applying the *isdom of the primitives to our modern needs concerns not only health *or/ers and nutritionists! %ut also educators and social *or/ers! the data are presented *ithout technical details While many of the primitive races studied have continued to thrive on the same soil through thousands of years! our American human stoc/ has declined rapidly *ithin a fe* centuries! and in some localities *ithin a fe* decades (n the regions in *hich degeneration has ta/en place the animal stoc/ has also declined A decadent individual cannot regenerate himself! although he can reduce the progressive decadence in the ne4t generation! or can vastly improve that generation! %y using the demonstrated *isdom of the primitive races No era in the long Aourney of man/ind reveals in the s/eletal remains such a terri%le degeneration of teeth and %ones as this %rief modern period records Must Nature reAect our vaunted culture and call %ac/ the more o%edient primitivesK The alternative seems to %e a complete readAustment in accordance *ith the controlling forces of Nature Thin/ing is as %iologic as is digestion! and %rain em%ryonic defects are as %iologic as are clu% feet "ince %oth are readily produced %y lo*ered parental reproductive capacity! and since Nature in her large>scale human demonstration reveals that this is chiefly the result of inade?uate nutrition of the parents and too fre?uent or too prolonged child %earing! the *ay %ac/ is indicated 1i/e the successful primitive racial stoc/s! *e! too! can ma/e! as a first re?uisite! provision for ade?uate nutrition %oth for generation and gro*th! and can ma/e provision for the regulation of the overloads We! li/e the successful primitives! can esta%lish programs of instruction for gro*ing youth and ac?uaint it *ith Nature s re?uirements long %efore the emergencies and stresses arise This may re?uire a large>scale program of home and classroom instruction! particularly

for the high school girls and %oys This *ould %e in accordance *ith the practice of many of the primitive races reported upon in the follo*ing chapters (f the individuals in our modern society *ho are sufficiently defective to re?uire some supervision are in part or largely the product of an inAured parentage! *ho should %e held responsi%leK (s it Aust for society to consign these unsocial individuals *hich it has made to a life of hard la%or or confinement in depressing environmentsK (s it Aust for society to permit production of physical and mental cripplesK Many primitive races apparently have prevented the distortions *hich find e4pressions in unsocial acts (f so! cannot modern society do this %y studying and adopting the programs developed through centuries of e4perience %y the primitivesK Nature uses a *ritten language *hich! *ithout the /eys! is made up of meaningless hieroglyphics! %ut *hich! *ith the proper /eys! %ecomes a clear story of racial and individual history The hieroglyphics indicate racial and individual disaster for moderni6ed groups *ho heed not the *arning story The primitive races have some of these /eys and have used them successfully in avoiding many of the disasters of our modern society The follo*ing chapters record many of the e4cellent practices of the primitives and they are presented here *ith the hope that they *ill %e helpful in a program designed to relieve man/ind of some of the misfortunes common in the present social order and to prevent disorders for future generations of civili6ed peoples Chapter 2 The progressive decline of modern civilization T+AT modern man is declining in physical fitness has %een emphasi6ed %y many eminent sociologists and other scientists That the rate of degeneration is progressively accelerating constitutes a cause for great alarm! particularly since this is ta/ing place in spite of the advance that is %eing made in modern science along many lines of investigation Dr Ale4is Carrel in his treatise 'Man! the 3n/no*n' states@ Medicine is far from having decreased human sufferings as much as it endeavors to ma/e us %elieve (ndeed! the num%er of deaths from infectious diseases has greatly diminished But *e still must die in a much larger proportion from degenerative diseases After revie*ing the reduction in the epidemic infectious diseases he continues as follo*s@

All diseases of %acterial origin have decreased in a stri/ing manner Nevertheless! in spite of the triumphs of medical science! the pro%lem of disease is far from solved Modern man is delicate Eleven hundred thousand persons have to attend the medical needs of ,5;!;;;!;;; other persons Every year! among this population of the 3nited "tates! there are a%out ,;;!;;;!;;; illnesses! serious or slight (n the hospitals! 9;;!;;; %eds are occupied every day of the year Medical care! under all its forms! costs a%out L-!7;;!;;;!;;; yearly The organism seems to have %ecome more suscepti%le to degenerative diseases The present health condition in the 3nited "tates is reported from time to time %y several agencies representing special phases of the health program The general health pro%lem has %een thoroughly surveyed and interpreted %y the "urgeon $eneral of the 3nited "tates Pu%lic +ealth "ervice! Dr Parran Pro%a%ly no one is so *ell informed in all of the phases of health as is the head of this important department of the government (n his recent preliminary report H,I to state and local officers for their information and guidance! he presented data that have %een gathered %y a large group of government *or/ers The report includes a census of the health conditions of all the groups constituting the population of the 3nited "tates>>records of the health status and of the economic status of 5!88;!;;; individuals living in various sections! in various types of communities! on various economic levels The data include records on every age>group +e ma/es the follo*ing interpretations %ased upon the assumption that the 5!88;!;;; offer a fair sampling of the population! and he indicates the conclusions *hich may %e dra*n regarding conditions of status for the total population of some ,-;!;;;!;;; people Every day one out of t*enty people is too sic/ to go to school or *or/! or attend his customary activities Every man! *oman and child Hon the averageI in the nation suffers ten days of incapacity annually The average youngster is sic/ in %ed seven days of the year! the average oldster -7 days T*o million five hundred thousand people H.5 per cent of the 8!;;;!;;; sic/ every dayI suffer from chronic diseases>heart disease! hardening of the arteries! rheumatism! and nervous diseases

"i4ty>five thousand people are totally deafF 97!;;; more are deaf and dum%F 5;;!;;; lac/ a hand! arm! foot or legF -;;!;;; have permanent spinal inAuriesF 7;;!;;; are %lindF ,!;;;!;;; more are permanent cripples T*o persons on the &elief income level Hless than L,!;;; yearly income for the entire familyI are disa%led for one *ee/ or longer for every one person %etter off economically )nly one in 57; family heads in the income group of more than L5!;;; yearly cannot see/ *or/ %ecause of chronic disa%ility (n &elief families one in every 5; family heads is disa%led &elief and lo*>income families are sic/ longer as *ell as more often than %etter>financed families They call doctors less often But the poor! especially in %ig cities! get to stay in hospitals longer than their %etter>off neigh%ors Concluded Dr Parran@ (t is apparent that inade?uate diet! poor housing! the ha6ards of occupation and the insta%ility of the la%or mar/et definitely create immediate health pro%lems (t *ill %e seen from this report that the group e4pressed as oldsters! *ho spend on an average thirty>five days per year in %ed! are sic/ in %ed one>tenth of the time Those of us *ho are *ell! *ho may have %een so fortunate as to spend very little time in %ed! *ill contemplate this fact *ith considera%le concern since it e4presses a vast amount of suffering and enforced idleness (t is clear that so great an incidence of mor%idity must place a heavy load upon those *ho at the time are *ell The pro%lem of the progressive increase in percentage of individuals affected *ith heart disease and cancer is ade?uate cause for alarm "tatistics have %een pu%lished %y the Department of Pu%lic +ealth in Ne* Yor/ City *hich sho* the increase in the incidence of heart disease to have progressed steadily during the years from ,2;9 to ,2-8 The figures provided in their report reveal an increase from 5;- 9 deaths per ,;;!;;; in ,2;9 to -59 5 per ,;;!;;; in ,2-8 This constitutes an increase of 8; per cent Cancer increased 2; per cent from ,2;9 to ,2-8 That this pro%lem of serious degeneration of our modern civili6ation is not limited to the people of the 3nited "tates has %een commented on at length %y *or/ers in many countries "ir Ar%uthnot 1ane! one of EnglandBs distinguished surgeons! and a student of pu%lic *elfare! has made this comment@ H5I

1ong surgical e4perience has proved to me conclusively that there is something radically and fundamentally *rong *ith the civili6ed mode of life! and ( %elieve that unless the present dietetic and health customs of the White Nations are reorgani6ed! social decay and race deterioration are inevita%le The decline in *hite population that is ta/ing place in many communities throughout several countries illustrates the *idespread *or/ing of the forces that are responsi%le for this degeneration (n discussing this matter in its relation to Australia! " & Wolstenhole! H-I lecturer in economics at "ydney 3niversity! predicts that@ A decline in AustraliaBs population is inevita%le *ithin .; years %ecause of the a%sence of a vigorous population policy "tudents of our modern social pro%lems are recogni6ing that these pro%lems are not limited to health conditions *hich *e have %een accustomed to thin/ of as %odily diseases This is illustrated in a recent discussion %y Will Durant@ H.I The American people are face to face *ith at least . maAor and militant pro%lems that have to do *ith the continuity and *orth*hile progress of modern civili6ation@ , The threatened deterioration of our stoc/ 5 The purchasing po*er of our people must rise as fast as the po*er to procure - The third pro%lem is moral A civili6ation depends upon morals for a social and governmental order . The sources of statesmanship are drying up Dental caries or tooth decay is recogni6ed as affecting more individuals throughout the so>called civili6ed *orld today than any other affection (n the 3nited "tates! England and Europe e4aminations of highly moderni6ed groups! consisting of several million individuals! reveal the fact that from :7 to ,;; per cent of the individuals in various communities are suffering from this affection As a contri%uting factor to a%sence from school among children it leads all other affections #rom the standpoint of inAury to health! it has %een estimated %y many to %e the most serious contri%uting factor through its involvement of other organs of the %ody The +onora%le D A Young! Minister of +ealth of Ne* <ealand! strongly emphasi6ed that the insidiousness of the effect of dental disease lies in the fact that it is the forerunner of other far>reaching distur%ances and he has referred to the seriousness *ith *hich it is vie*ed in England as follo*s@ '"ir $eorge Ne*man! Principal Medical )fficer of the Ministry of

+ealth in $reat Britain! has said that Bdental disease is one of the chief! if not the chief! cause of the ill health of the people B' Dr Earnest A +ooton! of +arvard 3niversity! has emphasi6ed the importance of oral sepsis and the tas/ of stopping tooth decay (n closing Chapter =(( of his recent %oo/ 'Apes! Men and Morons!' H7I he states the case as follo*s@ ( firmly %elieve that the health of humanity is at sta/e! and that! unless steps are ta/en to discover preventives of tooth infection and correctives of dental deformation! the course of human evolution *ill lead do*n*ard to e4tinction The facts that *e must face are! in %rief! that human teeth and the human mouth have %ecome! possi%ly under the influence of civili6ation! the foci of infections that undermine the entire %odily health of the species and that degenerative tendencies in evolution have manifested themselves in modern man to such an e4tent that our Aa*s are too small for the teeth *hich they are supposed to accommodate! and that! as a conse?uence! these teeth erupt so irregularly that their fundamental efficiency is often entirely or nearly destroyed (n discussing the strategic situation of dental science! Dr +ooton states (n my opinion there is one and only one course of action *hich *ill chec/ the increase of dental disease and degeneration *hich may ultimately cause the e4tinction of the human species This is to elevate the dental profession to a plane on *hich it can command the services of our %est research minds to study the causes and see/ for the cures of these dental evils The dental practitioner should e?uip himself to %ecome the agent of an intelligent control of human evolution! insofar as it is affected %y diet 1et us go to the ignorant savage! consider his *ay of eating! and %e *ise 1et us cease pretending that tooth>%rushes and tooth>paste are any more important than shoe>%rushes and shoe>polish (t is store food *hich has given us store teeth "tudents of history have continually commented upon the superior teeth of the so>called savages including the human types that have preceded our moderni6ed groups While dental caries has %een found occasionally in several animal species through the recent geologic ages! the teeth of the human species have %een comparatively free from dental caries Primitive human %eings have %een freer from the disease than has contemporary animal life This a%sence of tooth decay among primitive races has %een so stri/ing a characteristic of human /ind that many commentators have referred to it as a stri/ingly modern disease

Dryer! H8I in discussing dental caries in the pre>historic "outh Africans! ma/es this comment@ (n not one of a very large collection of teeth from s/ulls o%tained in the MatAes &iver "helter H+oloceneI *as there the slightest sign of dental caries The indication from this area! therefore! %ears out the e4perience of European anthropologists that caries is a comparatively modern disease and that no s/ull sho*ing this condition can %e regarded as ancient (n connection *ith the studies reported in this volume! it is of particular importance that a desire to find the cause of dental caries *as the primary reason for underta/ing these investigations "ince it *as e4ceedingly difficult to find in our modern social organi6ation any large group *ith relatively high immunity to dental caries! a search *as made for such control groups among remnants of primitive racial stoc/s that could also %e e4amined at the point of contact *ith modern civili6ation in order that the changes associated *ith their racial loss of immunity might %e noted Pro%a%ly fe* pro%lems *ith *hich our modern social groups are concerned have %een so inade?uately understood not only %y the laity! %ut %y the mem%ers of the medical and dental professions as has this pro%lem of the cause of dental caries The pro%lem of correcting dental arch deformities and there%y improving facial form has developed a specialty in dentistry /no*n as 'orthodontia ' The literature dealing *ith the cause of facial deformities is no* voluminous The %lending of racial stoc/s that differ radically in facial form has %een said %y many to %e the chief factor contri%uting to the creation of deformities of the face Cro*ded teeth have %een said to %e due to the inheritance of the large teeth of one parent and the small %one formation of the other and that such inheritances *ould provide dental arches that are too small for the teeth that have %een made for them A more general e4planation for certain types of deformity! particularly for the protruding of the upper teeth over the lo*er! is that they result from thum% suc/ing! *hich tends to %ring the upper arch for*ard and to depress the lo*er Among the other contri%uting factors named have %een faulty sleeping and %reathing ha%its To these has %een assigned much of the %lame This pro%lem of facial form! as *ell as that of %odily design! including dental arch design! is so directly a pro%lem of gro*th! not only of individuals! %ut of races themselves! that certain la*s have %een very definitely *or/ed out %y physical anthropologists as la*s of development They have assumed that changes in physical type can occur only through the impact of changes in the environment *hich have affected a great num%er of generations (t is important to /eep this vie*point in mind as the succeeding

chapters are read! for they contain descriptions of many changes in physical form that have occurred routinely in the various racial groups! even during the first generation after the parents have adopted the foods of modern civili6ation Many of our modern *riters have recogni6ed and have emphasi6ed the seriousness of mental and moral degeneration 1aird has made a splendid contri%ution under the title 'The Tail That Wags the Nation!' H9I in *hich he states@ The countryBs average level of general a%ility sin/s lo*er *ith each generation "hould the %allot %e restricted to citi6ens a%le to ta/e care of themselvesK )ne out of four cannot The tail is no* *agging Washington! and Wall "t and 1a"alle "treet Each generation has seen some lo*ering of the American average level of general a%ility (n 1airdBs analysis of our present situation he has stressed a very important phase While emphasi6ing that the degeneration is not limited to restricted areas! he raises the ?uestion as to *hether local conditions in certain areas play important roles in the rate and e4tent to *hich degeneration has ta/en place +e says further! H9I Although *e might cite any one of nearly t*o do6en states! *e *ill first mention =ermont %y name %ecause that is the place studied %y the late Dr Pearce Bailey '(t *ould %e!' he *rote! 'safe to assume that there are at least -; defectives per ,;;; in =ermont of the eight>year>old mentality type! and -;; per ,;;; of %ac/*ard or retarded persons! persons of distinctly inferior intelligence (n other *ords! nearly one>third of the *hole population of that state is of a type to re?uire some supervision ' The pro%lem of lo*ered mentality and its place in our modern conception of %odily diseases has not %een placed on a physical %asis as have the %etter understood degenerative processes! *ith their direct relationship to a diseased organ! %ut has generally %een assigned to a realm entirely outside the domain of disease or inAury of a special organ or tissue Ed*ard 1ee Thorndi/e! H:I of Colum%ia 3niversity! says that 'thin/ing is as %iological as digestion ' This implies that a distur%ance in the capacity to thin/ is directly related to a defect in the %rain Another of the distinguished students of mental capacity! D B Miner! H2I states@

(f morality and intellect are finally demonstrated to %e correlated throughout the *hole range of individual differences! it is pro%a%ly the most profoundly significant fact *ith *hich society has to deal The origin of %ac/*ardness in a child seems to have %een assigned very largely to some e4perience in that childBs life *hich %ecomes a conditioning factor and *hich thereafter strongly influences his %ehavior The pro%lem of the relation of physical defects to delin?uency in its various phases! including maAor crime! constitutes one of the most alarming aspects of our modern pro%lems in social degeneration Chassell H,;I has made an e4haustive study of the reports from *or/ers in different fields in several countries and summari6es her finding as follo*s@ 'The correlation %et*een delin?uency and mental inferiority as found in the case of fee%le>minded groups is clearly positive! and tends to %e mar/ed in degree ' Burt! H,,I *ho had made an e4tensive study! over an e4tended period! of the pro%lems of the %ac/*ard child and the delin?uent child in 1ondon! states in his summary and conclusion *ith regard to the origin of %ac/*ardness in the child@ Both at 1ondon and at Birmingham %et*een 8; and 9; per cent %elong to the HinnatelyI 'dull' category (n the maAority the outstanding cause is a general inferiority of intellectual capacity! presuma%ly in%orn and fre?uently hereditary (n discussing the relationship %et*een general physical *ea/ness and the mentally %ac/*ard! he *rites@ )ld and time>honoured as it must seem to the schoolmaster! the pro%lem of the %ac/*ard child has never %een attac/ed %y systematic research until ?uite recently We /no* little a%out causes! and still less a%out treatment Thirdly! though the vast maAority of %ac/*ard children>>:; per cent in an area li/e 1ondon>>prove to %e suffering from minor %odily ailments or from continued ill>health! nevertheless general physical *ea/ness is rarely the main factor Among the many surveys made in the study of the forces that are responsi%le for producing delin?uency and criminality! practically all the *or/ers in this field have testified to the o%scure nature of those forces Burt H,5I says that! 'it is almost as though crime *ere some contagious disease! to *hich the constitutionally suscepti%le *ere suddenly e4posed at pu%erty! or to *hich

pu%erty left them peculiarly prone ' +e emphasi6es a relationship %et*een delin?uency and physical deficiency@ Most repeated offenders are far from ro%ustF they are frail! sic/ly! and infirm (ndeed! so regularly is chronic moral disorder associated *ith chronic physical disorder that many have contended that crime is a disease! or at least a symptom of disease! needing the doctor more than the magistrate! physic rather than the *hip . . . . . . .

The fre?uency among Auvenile delin?uents of %odily *ea/ness and ill health has %een remar/ed %y almost every recent *riter (n my o*n series of cases nearly 9; per cent *ere suffering from such defectsF and nearly 7; per cent *ere in urgent need of medical treatment )f all the psychological causes of crime! the commonest and the gravest is usually alleged to %e defective mind The most eminent authorities! employing the most ela%orate methods of scientific analysis! have %een led to enunciate some such %elief (n England! for e4ample! Dr $oring has affirmed that 'the one vital mental constitutional factor in the etiology of crime is defective intelligence ' (n Chicago! Dr +ealy has li/e*ise maintained that among the personal characteristics of the offender 'mental deficiency forms the largest single cause of delin?uency ' And most American investigators *ould agree The assertion of the o%scurity of the fundamental causative factors of delin?uency constitutes one of the most stri/ing aspects of the e4tensive literature that has %een accumulated through the reporting of intensive studies made %y *or/ers in many countries Thrasher! H,-I in discussing the nature and origin of gangs! e4presses this very clearly@ $angs are gangs! *herever they are found They represent a specific type or variety of society! and one thing that is particularly interesting a%out them is the fact that they are! in respect to their organi6ation! so elementary! and in respect to their origin! so spontaneous #ormal society is al*ays more or less conscious of the end for *hich it e4ists! and the organi6ation through *hich this end is achieved is al*ays more or less a product of design But gangs gro* li/e *eeds! *ithout consciousness of their aims! and *ithout administrative machinery to achieve them They are! in fact! so spontaneous in their origin! and so little conscious of the purposes for

*hich they e4ist! that one is tempted to thin/ of them as predetermined! foreordained! and 'instinctive!' and so! ?uite independent of the environment in *hich they ordinarily are found No dou%t! many cities have %een provided! as has Cleveland! *ith a special school for delin?uent %oys The institution there has %een given the appropriate title! the 'Thomas A Edison "chool ' (t usually has an enrollment of :;; to 2;; %oys Dr Watson! H,.I *ho has %een of outstanding service in the organi6ation of this *or/! ma/es an important comment on the origin of the student population there@ The Thomas A Edison student population consists of a group of truant and %ehavior %oys! most of them in those earlier stages of mal>adAustment *hich *e have termed predelin?uency (n general! they are the products of unhappy e4periences in school! home and community They are sensitive recorders of the total comple4 of social forces *hich operate in and com%ine to constitute *hat *e term their community environment (t *ill %e seen from these ?uotations that great emphasis has %een placed upon the influence of the environment in determining factors of delin?uency +ooton! the distinguished physical anthropologist of +arvard! has made important o%servations regarding our modern physical degeneration As an approach to this larger pro%lem of manBs progressive degeneration! he has proposed the organi6ation and esta%lishment of an (nstitute of Clinical Anthropology! H,7I the purpose of *hich he has indicated@ for finding out *hat man is li/e %iologically *hen he does not need a doctor! in order to further ascertain *hat he should %e li/e after the doctor has finished *ith him ( am entirely serious *hen ( suggest that it is a very myopic medical science *hich *or/s %ac/*ard from the morgue rather than for*ard from the cradle =ery important contri%utions have %een made to the forces that are at *or/ in the development of delin?uents through an e4amination of the families in *hich affected individuals have appeared "ullenger! H,8I in discussing this phase! states@ A%%ott and Brec/inridge found in their Chicago studies that a much higher percentage of delin?uent %oys than girls *ere from large families +o*ever! +ealy and Bronner found in their studies in Chicago and Boston that the large family is conducive to delin?uency among children in that the larger the family

the greater percentage of cases *ith more than one delin?uent They *ere una%le to detect *hether or not this fact *as due to parental neglect! poverty! %ad environmental conditions! or the influence of one child on another (n each of the series in %oth cities the num%er of delin?uents in families of different si6es sho*ed general similarity As the investigations outlined in this study are revie*ed! many pro%lems not anticipated %y the *riter *hen these investigations *ere underta/en *ill %e presented These ne* pro%lems *ere not! at first! generally thought of as related directly or indirectly to our modern racial degeneration! %ut have %een found recently to %e so related "ince it *ill %e seen that the si6e and shape of the head and sinuses! including the oral cavity and throat! are directly influenced %y forces that are at *or/ in our modern civili6ation! *e shall consider the spea/ing and singing voice (n traveling among several of the primitive races! one is fre?uently impressed *ith the range and resonance of many of the voices>>in fact! %y almost every voice We are ?uite familiar *ith the high premium that is placed on singing voices of e4ceptional ?uality in our modern social order This is illustrated %y the follo*ing comment@ H,9I Tip>top (talian>style tenors have al*ays %een a scarce commodity! and for the past t*o decades they have %een gro*ing scarcer and scarcer )pera impresarios count on the fingers of one hand the lust>high>voice 1atins "ince the death of Enrico Caruso H,25,I opera houses have sho*n a steady decline (mportant light *ill %e thro*n on this phase of the pro%lem>>the cause of fe*er good voices in (taly today than of old>>as *e note the narro*ing of the face and of the dental arches and as *e see the change in the form of the palate of the various primitive races These changes occur even in the first generation after the parents have adopted the foods of modern *hite civili6ations As *e study the primitives *e *ill find that they have had an entirely different conception of the nature and origin of the controlling forces *hich have molded individuals and races Buc/le! H,:I in *riting his epoch>ma/ing '+istory of Civili6ation' a%out the middle of the last century! summed up his years of historical studies *ith some very important conclusions! some of *hich are as follo*s@

5 (t is proved %y history! and especially %y statistics! that human actions are governed %y la*s as fi4ed and regular as those *hich rule in the physical *orld - Climate! soil! food! and the aspects of Nature are the principal causes of intellectual progress 8 &eligion! literature! and government are! at %est! %ut the products! and not the cause of civili6ation This important vie* *as not orthodo4 and *as met %y very severe criticism The ne*er /no*ledge strongly corro%orates his vie* My early studies of the relation of nutrition to dental pro%lems *ere related chiefly to gro*th defects in the teeth produced long %efore the eruption of the permanent teeth! chiefly from one year of age to the time of eruption These often appeared as lines across the teeth ( *as a%le to trace these lines directly to the use of a fe* highly processed %a%y foods ( pu%lished an e4tensive report on this phase of the pro%lem! together *ith illustrations! in ,2,- H,2I These inAuries are disclosed *ith the 4>ray long %efore the teeth erupt These distur%ances occur much less fre?uently in connection *ith the %a%y foods used today The pro%lems of modern degeneration can in general %e divided into t*o main groups! those *hich relate to the perfection of the physical %ody and those *hich relate to its function The latter include character as e4pressed in %ehavior of individuals and of groups of individuals *hich thus relate to national character and to an entire culture (n an enumeration of the phases in *hich there is a progressive decline of modern civili6ation! it is essential that *e /eep in mind that in addition to an analysis of the forces responsi%le for individual degeneration! the ethical standards of the *hole group cannot %e higher than those of the individuals that compose it That recent mass degeneration is in progress is attested %y daily events throughout the *orld The current interpretation for individual character degeneration largely places the responsi%ility on a conditioning factor *hich e4erts an influence during early childhood and therefore is directly related to the environment of the child These! therefore! are postnatal conditioning factors An important contri%ution to this phase comes directly from the e4perience of primitive races and indicates that a more fundamental conditioning factor had developed in the prenatal period (f! therefore! large groups of individuals suffer from such a prenatal conditioning influence! ne*

light *ill %e thro*n upon the larger pro%lems of group deterioration +istory seems to provide records of such mass degeneration as! for e4ample! those *hich culminated in the so>called 'dar/ ages ' That some such mass degeneration is no* in progress is suggested %y leading students of human *elfare The regius professor of $ree/ at )4ford in his inaugural lecture in ,2-9 made the follo*ing o%servation@ H5;I (n the revolution of thought through *hich *e are living! the profoundest and most distur%ing element is the %rea/do*n of that ethical system *hich! since the days of Constantine! has imposed upon European culture at least the sem%lance of moral unity (n commenting on this important statement "ir Alfred <immern in his address on the decline of international standards said that '&ecent events should convince the dullest mind of the e4tent to *hich international standards have deteriorated and the anarchy *hich threatens the repudiation of la* and order in favour of %rute force ' The pro%lem of progressive decline in individual and group ethical standards is commanding the attention of great international organi6ations (n discussing this pro%lem %efore the (nternational &otary at its meeting in "an #rancisco in Dune! ,2-:! one of the leaders in mass reform! Mayor +arold Burton of Cleveland! stressed very important phases +e stated that the American %oys 'are ma/ing irrevoca%le choices' %et*een good and %ad citi6enship *hich 'may ma/e or *rec/ the nation (t may %e on the %attlefield of crime prevention that the life of democracy *ill %e saved ' +e descri%ed great industrial cities as %attlefields *here 'the tests of democracy are the ne*est and sharpest ' H5,I '#or centuries!' he said@ *e have fought crime primarily %y see/ing to catch the criminal after the crime has %een committed and then through his punishment to lead or drive him and others to good citi6enship Today the greater range of operation and greater num%er of criminals argue that *e must deal *ith the flood *aters of crime We must prevent the flood %y study! control and diversion of the *aters at their respective sources To do this *e must direct the streams of gro*ing %oys in each community a*ay from fields of crime to those of good citi6enship (f the 'flood *aters' that must %e controlled lie farther %ac/ than the cradle! in order to safeguard individual character and individual citi6enship from prenatal conditioning factors *hich have profound influence in determining the reaction of the individuals to the environment! it is essential that programs that are to %e efficient in maintaining national character reach %ac/ to those forces

*hich are causing the degeneration of increasing num%ers of the population in succeeding generations of our modern cultures That the pro%lem of mass degeneration constitutes one of the most alarming pro%lems of our moderni6ed cultures is demonstrated %y the urgency of appeals that are %eing made %y students in national and international affairs The discussion of 'An Ethical Declaration for the Times!' H55I a declaration of faith! is accompanied %y a pledge This pledge reads@ ( pledge myself to use every opportunity for action to uphold the great tradition of civili6ation to protect all those *ho may suffer for its sa/e! and to pass it on to the coming generations ( recogni6ed no loyalty greater than that to the tas/ of preserving truth! toleration! and Austice in the coming *orld order The author emphasi6es the great danger of ta/ing for granted that the cultural progress that has %een attained *ill continue There is pro%a%ly no phase of this *hole pro%lem of modern degeneration that is so %rilliantly illuminated %y the accumulated *isdom of primitive races as group degeneration They have so organi6ed the life of the family and the individual that the nature of the forces *hich esta%lished individual %ehavior and character are controlled )ur pro%lem of modern degeneration involves %oth individual and group destiny )ur approach to this study *ill! accordingly! involve first a critical e4amination of the forces that are responsi%le for individual degeneration (n my search for the cause of degeneration of the human face and the dental organs ( have %een una%le to find an approach to the pro%lem through the study of affected individuals and diseased tissues (n my t*o volume *or/ on 'Dental (nfections!' =olume (! entitled 'Dental (nfections! )ral and "ystemic!' and =olume ((! entitled 'Dental (nfections and the Degenerative Diseases!' H5-I ( revie*ed at length the researches that ( had conducted to thro* light on this pro%lem The evidence seemed to indicate clearly that the forces that *ere at *or/ *ere not to %e found in the diseased tissues! %ut that the undesira%le conditions *ere the result of the a%sence of something! rather than of the presence of something This strongly indicated the need for finding groups of individuals so physically perfect that they could %e used as controls (n order to discover them! ( determined to search out primitive racial stoc/s that *ere free from the degenerative processes *ith *hich *e are concerned in order to note *hat they have that *e do not have These field investigations have ta/en me to many parts of the *orld through a series of years The follo*ing chapters revie* the studies made of primitive groups! first! *hen still protected %y their isolation! and! second! *hen in contact *ith modern civili6ation

&eferences
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PA&&AN! T "ic/ness survey Time, -,@55! ,2-: 1ANE! A Preface to Maori "ym%olism %y Ettie A &out 1ondon! Paul Trench Tru%ner! ,258 W)1"TEN+)1E! " & Proposes "tor/ Der%y Cleveland Press, March ,5! ,2-9 D3&ANT! W A crisis in civili6ation Speakers Library Magazine, p 5! Dan ,7! ,2-: +))T)N! E A Apes! Men and Morons Ne* Yor/! Putnam! ,2-9 D&YE&! T # Dental caries in prehistoric "outh Africans at!re, ,-8@-;5! ,2-7 1A(&D! D The tail that *ags the nation "ev, of "evs#, 25@..! ,2-7 T+)&ND(GE! E 1 Big ChiefBs $ $ Time, -;@57! ,2-9 M(NE&! D B Pro$# Am# Ass# for %eeble&Minded, p 7.! ,2,2 C+A""E11! C # &elation %et*een morality and intellect N Y ! Colum%ia! ,2-7 B3&T! C 1 Bac/*ard Child Ne* Yor/! Appleton! ,2-9 B3&T! C 1 The Young Delin?uent 1ondon! 3niversity of 1ondon Press! ,257 T+&A"+E&! # M The $ang Chicago! 3niversity of Chicago Press! ,2-8 WAT")N! M P )rgani6ation and administration of a pu%lic school for pre>delin?uent %oys in a large city Thesis! Cleveland! Western &eserve 3niversity +))T)N! E A An Anthropologist 1oo/s at Medicine &evie*ed in Time, 59@9-! ,2-8 "311EN$E&! T E "ocial Determinants in Duvenile Delin?uency 1ondon! Chapman and +all! ,2-8 TEN)&" Time, -;@7;! ,2-9 B3CG1E! + T +istory of Civili6ation Ne* Yor/! Appleton! ,2,; P&(CE! W A "ome contri%utions to dental and medical science 'ental S!mmary, -.@57-! ,2,. <(MME&N! A "cientific research in international affairs at!re, ,.,@2.9! ,2-: Burton Tells of Crime Drive Cleveland Press, Dune 55! ,2-: W+YTE! 1 1 An ethical declaration for the times at!re, ,.,@:59! ,2-: P&(CE! W A Dental (nfections! )ral and "ystemic Cleveland! Penton! ,25-

Chapter Isolated and modernized !wiss (N )&DE& to study the possi%ility of greater nutritive value in foods produced at a high elevation! as indicated %y a lo*ered incidence of mor%idity! including tooth decay! ( *ent to "*it6erland and made studies in t*o successive years! ,2-, and ,2-5 (t *as my desire to find! if possi%le! groups of "*iss living in a physical environment such that their isolation *ould compel them to live largely on locally produced foods )fficials of the "*iss $overnment *ere consulted as to the possi%ility of finding people in "*it6erland *hose physical isolation provided an ade?uate protection We *ere told that the physical conditions that *ould not permit people to o%tain modern foods *ould prevent us from reaching them *ithout hardship +o*ever! o*ing to the completion of the 1oetsch%erg Tunnel! eleven miles long! and the %uilding of a railroad that crosses the 1oetschental =alley! at a little less than a mile a%ove sea level! a group of a%out 5!;;; people had %een made easily accessi%le for study! shortly prior to ,2-, Practically all the human re?uirements of the people in that valley! e4cept a fe* items li/e sea salt! have %een produced in the valley for centuries A %irdBs eye vie* of the 1oetschental =alley! loo/ing to*ard the entrance! is sho*n in #ig , The people of this valley have a history covering more than a do6en centuries The architecture of their *ooden %uildings! some of them several centuries old! indicates a love for simple sta%ility! adapted to e4pediency and efficiency Artistically designed mottoes! many of them centuries old! are carved deep in the heavy supporting tim%ers! %oth *ithin and *ithout the %uildings They are al*ays e4pressive of devotion to cultural and spiritual values rather than to material values These people have never %een con?uered! although many efforts have %een made to invade their valley E4cept for the rugged cleft through *hich the river descends to the &hone =alley! the 1oetschental =alley is almost completely enclosed %y three high mountain ranges *hich are usually sno*>capped This pass could %e guarded %y a small %and against any attac/ing forces since artificial landslides could easily %e released The natural occurrence of these landslides has made passage through the gorge ha6ardous! if not impossi%le! for months of the year According to early legends of the valley these mountains *ere the parapets of the universe! and the great glacier of the valley! the end of the universe The glacier is a %ranch of the great ice field that stretches a*ay to the *est and south from the ice>cap of the Dungfrau and Monch The mountains! ho*ever! are seldom approached from this direction %ecause of the ha6ardous ice fields

The gate*ay to them *ith *hich the traveling *orld is familiar is from (nterla/en %y *ay of the 1auter%runnen or $rindel*ald valleys

Fig. 1. Beautiful Loetschental Valley about a mile above sea level. About two thousand Swiss live here. In 19 ! no deaths had occurred from tuberculosis in the history of the valley.

At the altitude of the 1oetschental =alley the *inters are long! and the summers short %ut %eautiful! and accompanied %y e4traordinarily rapid and lu4uriant gro*th The meado*s are fragrant *ith Alpine flo*ers! *ith violets li/e pansies! *hich %loom all summer in deepest hues The people of the 1oetschental =alley ma/e up a community of t*o thousand *ho have %een a *orld unto themselves They have neither physician nor dentist %ecause they have so little need for themF they have neither policeman nor Aail! %ecause they have no need for them The clothing has %een the su%stantial homespuns made from the *ool of their sheep The valley has produced not only everything that is needed for clothing! %ut practically everything that is needed for food (t has %een the achievement of the valley to %uild some of the finest physi?ues in all Europe This is attested to %y the fact that many of the famous "*iss guards of the =atican at &ome! *ho are the admiration of the *orld and are the pride of "*it6erland! have %een selected from this and other Alpine valleys (t is every 1oetschental %oyBs am%ition to %e a =atican guard Not*ithstanding the fact that tu%erculosis is the most serious disease of "*it6erland! according to a statement given me %y a government official! a recent report of inspection of this valley did not reveal a single case ( *as aided in my studies in "*it6erland %y the e4cellent cooperation of the &everend Dohn "iegen! the pastor of the one church of this %eautiful valley The people live largely in a series of villages dotting the valley floor along the river %an/ The land that is tilled! chiefly for producing hay for feeding the cattle in the *inter and rye for feeding the people! e4tends from the river and

often rises steeply to*ard the mountains *hich are *ooded *ith tim%er so precious for protection that little of it has %een distur%ed #ortunately! there is much more on the vast area of the mountain sides than is needed for the relatively small population The forests have %een Aealously guarded %ecause they are so greatly needed to prevent slides of sno* and roc/s *hich might engulf and destroy the villages The valley has a fine educational system of alternate didactic and practical *or/ All children are re?uired to attend school si4 months of the year and to spend the other si4 months helping *ith the farming and dairying industry in *hich young and old of %oth se4es must *or/ The school system is under the direct supervision of the Catholic Church! and the *or/ is *ell done The girls are also taught *eaving! dyeing and garment ma/ing The manufacture of *ool and clothing is the chief home*or/ for the *omen in the *inter No truc/s nor even horses and *agons! let alone tractors! are availa%le to %ear the %urdens up and do*n the mountain sides This is all done on human %ac/s for *hich the hearts of the people have %een made especially strong We are primarily concerned here *ith the ?uality of the teeth and the development of the faces that are associated *ith such splendid hearts and unusual physi?ues ( made studies of %oth adults and gro*ing %oys and girls! during the summer of ,2-,! and arranged to have samples of food! particularly dairy products! sent to me a%out t*ice a month! summer and *inter These products have %een tested for their mineral and vitamin contents! particularly the fat>solu%le activators The samples *ere found to %e high in vitamins and much higher than the average samples of commercial dairy products in America and Europe! and in the lo*er areas of "*it6erland +ay is cut for *inter feeding of the cattle! and this hay gro*s rapidly The hay proved! on chemical analysis made at my la%oratory! to %e far a%ove the average in ?uality for pasturage and storage grasses Almost every household has goats or co*s or %oth (n the summer the cattle see/ the higher pasturage lands and follo* the retreating sno* *hich leaves the lo*er valley free for the harvesting of the hay and rye The turning of the soil is done %y hand! since there are neither plo*s nor draft animals to drag the plo*s! in preparation for the ne4t yearBs rye crop A limited amount of garden stuff is gro*n! chiefly green foods for summer use While the co*s spend the *arm summer on the verdant /nolls and *ooded slopes near the glaciers and fields of perpetual sno*! they have a period of high and rich productivity of mil/ The mil/ constitutes an important part of the summerBs harvesting While the men and %oys gather in the hay and rye! the *omen and children go in large num%ers

*ith the cattle to collect the mil/ and ma/e and store cheese for the follo*ing *interBs use This cheese contains the natural %utter fat and minerals of the splendid mil/ and is a virtual storehouse of life for the coming *inter #rom Dr "iegen! ( learned much a%out the life and customs of these people +e told me that they recogni6e the presence of Divinity in the life>giving ?ualities of the %utter made in Dune *hen the co*s have arrived for pasturage near the glaciers +e gathers the people together to than/ the /ind #ather for the evidence of his Being in the life>giving ?ualities of %utter and cheese made *hen the co*s eat the grass near the sno* line This *orshipful program includes the lighting of a *ic/ in a %o*l of the first %utter made after the co*s have reached the luscious summer pasturage This *ic/ is permitted to %urn in a special sanctuary %uilt for the purpose The natives of the valley are a%le to recogni6e the superior ?uality of their Dune %utter! and! *ithout /no*ing e4actly *hy! pay it due homage The nutrition of the people of the 1oetschental =alley! particularly that of the gro*ing %oys and girls! consists largely of a slice of *hole rye %read and a piece of the summer>made cheese Ha%out as large as the slice of %readI! *hich are eaten *ith fresh mil/ of goats or co*s Meat is eaten a%out once a *ee/ (n the light of our ne*er /no*ledge of activating su%stances! including vitamins! and the relative values of food for supplying minerals for %ody %uilding! it is clear *hy they have healthy %odies and sound teeth The average total fat> solu%le activator and mineral inta/e of calcium and phosphorus of these children *ould far e4ceed that of the daily inta/e of the average American child The sturdiness of the child life permits children to play and frolic %areheaded and %arefooted even in *ater running do*n from the glacier in the late eveningBs chilly %ree6es! in *eather that made us *ear our overcoats and gloves and %utton our collars )f all the children in the valley still using the primitive diet of *hole rye %read and dairy products the average num%er of cavities per person *as ; - )n an average it *as necessary to e4amine three persons to find one defective deciduous or permanent tooth The children e4amined *ere %et*een seven and si4teen years of age (f one is fortunate enough to %e in the valley in early August and *itness the earnestness *ith *hich the people cele%rate their national holiday! he *ill %e privileged to see a sight long to %e remem%ered These cele%rations close *ith the gathering together of the mountaineers on various crags and prominences *here great %onfires are lighted from fuel that has %een accumulated and %uilt into an enormous mound to ma/e a huge torchlight These %onfires are lighted at a given hour from end to end of the valley throughout its e4panse Every

mountaineer on a distant crag seeing the lights /no*s that the others are signalling to him that they! too! are ma/ing their sacred consecration in song *hich says one for all and all for one ' This motive has %een crystalli6ed into action and has %ecome a part of the very souls of the people )ne understands *hy doors do not need to %e %olted in the 1oetschental =alley +o* different the level of life and hori6on of such souls from those in many places in the so>called civili6ed *orld in *hich people have degraded themselves until life has no interest in values that cannot %e e4pressed in gold or pelf! *hich they *ould o%tain even though the life of the person %eing cheated or ro%%ed *ould there%y %e crippled or %lotted out )ne immediately *onders if there is not something in the life>giving vitamins and minerals of the food that %uilds not only great physical structures *ithin *hich their souls reside! %ut %uilds minds and hearts capa%le of a higher type of manhood in *hich the material values of life are made secondary to individual character (n succeeding chapters *e *ill see evidence that this is the case )ur ?uest has %een for information relative to the health of the %ody! the perfection of the teeth! and the normality of development of faces and dental arches! in order that *e might through an analysis of the foods learn the secret of such splendid %ody %uilding and learn from the people of the valley ho* the nutrition of all groups of people may %e reinforced! so that they! too! may %e free from man/indBs most universal disease! tooth decay and its se?uelae These studies included not only the ma/ing of a physical e4amination of the teeth! the photographing of su%Aects! the recording of voluminous data! the o%taining of samples of food for chemical analysis! the collecting of detailed information regarding daily menusF %ut also the collecting of samples of saliva for chemical analysis The chemical analysis of saliva *as used to test out my ne*ly developed procedure for estimating the level of immunity to dental caries for a given person at a given time This procedure is outlined in follo*ing chapters The samples of saliva *ere preserved %y an addition of formalin e?uivalent in amount to one per cent of the sample of saliva These children *ill! it is hoped! %e ree4amined in succeeding years in order to ma/e comparative studies of the effect of the changes in the local nutritional programs "ome of these changes are already in progress There is no* a modern %a/ery dispensing *hite %read and many *hite>flour products *hich *as in full operation in ,2-5

( in?uired of many persons regarding the most favora%le districts in *hich to ma/e further studies of groups of people living in protected isolation %ecause of their physical environment! and decided to study some special high Alpine valleys %et*een the &hone =alley and (taly! *hich ( included in ,2-5 The Canton of Wallis is %ordered %y #rench>spea/ing people on the *est! %y (talian>spea/ing people on the south! and %y $erman>spea/ing people on the east and north ( had as guides and interpreters in Wallis! Dr Alfred $ysi and also Dr Adolf &oos through part of the territory )ur first e4pedition *as into the valley of the =isp *hich is a great gorge e4tending south*ard from the &hone &iver! dividing into t*o gorges! one going to the "aas #ee country! and the other to the vicinity of the Matterhorn *ith its almost spireli/e pinnacle lifting itself a%ove the surrounding sno*> capped mountains and visi%le from eminences in all directions as one of the mightiest and most su%lime spectacles in the *orld (t *as one of the last mountains of Europe to %e scaled %y man )ne has not seen the full maAesty of the Alps if he has not seen the Matterhorn We left the mountain railroad! *hich ma/es many of the grades *ith the cog system! at the to*n of "t Nicholas! and clim%ed the mountain trail to an isolated settlement on the east %an/ of the Mattervisp &iver! called $rachen! a five>hour Aourney The settlement is on a shelf high a%ove the east side of the river *here it is e4posed to southern sunshine and enAoys a uni?ue isolation %ecause of its physical inaccessi%ility An e4amination made of the children in this community sho*ed that only 5 - teeth out of every hundred had %een attac/ed %y tooth decay The hardihood of the people *as splendidly illustrated %y a *oman of 85 years *ho carried an enormous load of rye on her %ac/ at an altitude of a%out 7!;;; feet We met her later and tal/ed to her! and found that she *as e4traordinarily *ell developed and *ell preserved "he sho*ed us her grandchildren *ho had fine physi?ues and facial developments The rye is so precious that *hile %eing carried the heads are protected %y *rapping them in canvas so that not a /ernel *ill %e lost The rye is thrashed %y hand and ground in stone mills *hich *ere formerly hand>turned li/e the one sho*n in #ig 5 &ecently *ater tur%ines have %een installed Water po*er is a%undant and the grinding is done for the people of the mountain side in these *ater>driven mills )nly *holerye flour is availa%le Each household ta/es turns in using the community %a/e>oven! *hich is sho*n in #ig 5 A monthBs supply of *hole>rye %read is %a/ed at one time for a given family

FI". !. For centuries the natives ground their rye in this ty#e of hand mill. $his community ba%e&oven for whole rye bread is #assing.

+ere again the co*s *ere a*ay in the midsummer! pasturing up near the glaciers $rachen has an altitude of a%out 7!;;; feet The church at $rachen *as %uilt several hundred years ago We *ere sho*n an em%ossed certificate of honor and privilege e4tended to a group of a%out ,5; people *ho had originally %uilt the edifice We *ere given valued assistance %y the local priest! and *ere provided *ith facilities in his spacious and *ell>/ept rooms for ma/ing our studies of the children #rom $rachen *e returned to "t Nicholas and proceeded from there %y train do*n the valley and up another steep ascent! re?uiring several hours! to the hamlet of =isperterminen! on the east side of the mountain a%ove the =isp &iver! and %elo* the Aunction of the Mattervisp and "aaservisp This community is made up of a%out ,!8;; people living on a sheltered shelf high a%ove the river valley The vie* from this position is indescri%a%ly %eautiful (t is a little %elo* the tim%er line of this and the surrounding mountains MaAestic sno*>clad pea/s and precipitous mountains dot the hori6on and shade off into *inding gorges *hich mar/ the course of *andering streams several thousand feet %elo* our vantage point (t is a place to stop and ponder The gradations in climate range in the summer from a tropical temperature in protected noo/s during the daytime to su%>6ero *eather *ith raging %li66ards at night on the high mountains (t is a place *here human stamina can %e tempered to meet all the vicissitudes of life

The village consists of a group of characteristically designed "*iss chalets clustered on the mountain side The church stands out as a %eacon visi%le from mountains in all directions =isperterminen is uni?ue in many respects Not*ithstanding its relative pro4imity to civili6ation>>it is only a fe* hoursB Aourney to the thoroughfare of the &hone =alley>>it has enAoyed isolation and opportunity for maintaining its characteristic primitive social and civil life We *ere greeted here %y the president of the village *ho graciously opened the school house and sent messengers to have the children of the community promptly come to the school %uilding in order that *e might ma/e such studies as *e desired This study included a physical e4amination of the teeth and of the general development of the children! particularly of the faces and dental arches! the ma/ing of photographic records! the o%taining of samples of saliva! as in other places! and also the ma/ing of a detailed study of the nutrition (n addition! *e o%tained samples of foods for chemical analysis The people of =isperterminen have the uni?ue distinction of o*ning land in the lo*er part of the mountain on *hich they maintain vineyards to supply *ine for this country They have the highest vineyards of Europe They are gro*n on %an/s that are often so steep that one *onders ho* the tillers of the soil or the gatherers of the fruit can maintain their hold on the precarious and shifting footing Each terrace has a trench near its lo*er retaining *all to catch the soil that is *ashed do*n! and this soil must %e carried %ac/ in %as/ets to the upper %oundary of the plot This is all done %y human la%or The vineyards afforded them the additional nutrition of *ine and of fruit minerals and vitamins *hich the t*o groups *e studied at 1oetschental and $rachen did not have This additional nutrition *as of importance %ecause of the opportunity for o%taining through it vitamin C (t is of particular interest in the study of the incidence of tooth decay in =isperterminen that these additional factors had not created a higher immunity to tooth decay! nor a %etter condition of health in gingival tissues than previously found (n each one hundred teeth e4amined 7 5 *ere found to have %een attac/ed at some time %y tooth decay +ere again the nutrition consisted of rye! used almost e4clusively as the cerealF of dairy productsF of meat a%out once a *ee/F and also some potatoes 1imited green foods *ere eaten during the summer The general custom is to have a sheep dressed and distri%uted to a group of families! thus providing each family *ith a ration of meat for one day a *ee/! usually "unday The %ones and scraps are utili6ed for ma/ing soups to %e served during the *ee/ The children have goatBs mil/ in the summer *hen the co*s are a*ay in the higher pastures near

the sno* line Certain mem%ers of the families go to the higher pastures *ith the co*s to ma/e cheese for the coming *interBs use The pro%lem of identifying goats or cattle for esta%lishing individual o*nership is a considera%le one *here the stoc/ of all are pastured in common herds (t *as interesting to us to o%serve ho* this pro%lem *as met The president of the village has *hat is called a 'tessel' *hich is a string of mani/ins in imitation of goats or cattle made of *ood and leather Every stoc/ o*ner must provide a mani/in to %e left in the safe/eeping of the president of the village *ith *hom it is registered (t carries on it the individual mar/ings that this mem%er of the colony agrees to put on every mem%er of his animal stoc/ The mar/ing may %e a hole punched in the left ear or a slit in the right ear! or any com%ination of such mar/ings as is desired Thereafter all animals carrying that mar/ are the property of the person *ho registered itF similarly! any animals that have not this individual sym%ol of identification cannot %e claimed %y him As one stands in profound admiration %efore the stal*art physical development and high moral character of these sturdy mountaineers! he is impressed %y the superior types of manhood! *omanhood! and childhood that Nature has %een a%le to produce from a suita%le diet and a suita%le environment "urely! here is evidence enough to ans*er the ?uestion *hether cereals should %e avoided %ecause they produce acids in the system *hich if formed *ill %e the cause of tooth decay and many other ills including the acidity of the %lood or saliva "urely! the ultimate control *ill %e found in NatureBs la%oratory *here man has not yet %een a%le to meddle sufficiently *ith NatureBs nutritional program to %light humanity *ith a%normal and synthetic nutrition When one has *atched for days the childlife in those high Alpine preserves of superior manhoodF *hen one has contrasted these people *ith the pinched and sallo*! and even deformed! faces and distorted %odies that are produced %y our modern civili6ation and its dietsF and *hen one has contrasted the unsurpassed %eauty of the faces of these children developed on NatureBs primitive foods *ith the varied assortment of modern civili6ationBs children *ith their defective facial development! he finds himself filled *ith an earnest desire to see that this %etterment is made availa%le for modern civili6ation Again and again *e had the e4perience of e4amining a young man or young *oman and finding that at some period of his life tooth decay had %een rampant and had suddenly ceasedF %ut! during the stress! some teeth had %een lost When *e as/ed such people *hether they had gone out of the mountain and at *hat age! they generally replied that at eighteen or t*enty years of age they had gone

to this or that city and had stayed a year or t*o They stated that they had never had a decayed tooth %efore they *ent or after they returned! %ut that they had lost some teeth in the short period a*ay from home At this point of our studies Dr &oos found it necessary to leave! %ut Dr $ysi accompanied us to the Anniviers =alley! *hich is also on the south side of the &hone The river of the valley! the Navi6en6e! drains from the high "*iss and (talian %oundary north to the &hone &iver +ere again *e had the remar/a%le e4perience of finding communities near to each other! one %lessed *ith high immunity to tooth decay! and the other afflicted *ith rampant tooth decay The village of Ayer lies in a %eautiful valley *ell up to*ard the glaciers (t is still largely primitive! although a government road has recently %een developed! *hich! li/e many of the ne* arteries! has made it possi%le to dispatch military protection *hen and if necessary to any community (n this %eautiful hamlet! until recently isolated! *e found a high immunity to dental caries )nly 5 teeth out of each hundred e4amined *ere found to have %een attac/ed %y tooth decay +ere again the people *ere living on rye and dairy products We *onder if history *ill repeat itself in the ne4t fe* years and if there! too! this envia%le immunity *ill %e lost *ith the advent of the high*ay 3sually it is not long after tunnels and roads are %uilt that automo%iles and *agons enter *ith modern foods! *hich %egin their destructive *or/ This fact has %een tragically demonstrated in this valley since a road*ay *as e4tended as far as =issoie several years ago (n this village modern foods have %een availa%le for some time )ne could pro%a%ly *al/ the distance from Ayer to =issoie in an hour The num%er of teeth found to %e attac/ed *ith caries for each one hundred childrenBs teeth e4amined at =issoie *as 5; 5 as compared *ith 5 - at Ayer We had here a splendid opportunity to study the changes that had occurred in the nutritional programs With the coming of transportation and ne* mar/ets there had %een shipped in modern *hite flourF e?uipment for a %a/ery to ma/e *hite>flour goodsF highly s*eetened fruit! such as Aams! marmalades! Aellies! sugar and syrups>>all to %e traded for the locally produced high>vitamin dairy products and high>mineral cheese and ryeF and *ith the e4change there *as enough money as premium to permit %uying machine>made clothing and various novelties that *ould soon %e translated into necessities Each valley or village has its o*n special feast days of *hich athletic contests are the principal events The feasting in the past has %een largely on dairy products The athletes *ere provided *ith large %o*ls of cream as constituting one of the most popular and healthful %everages! and special cheese *as al*ays availa%le Practically no *ine *as used %ecause no grapes

gre* in that valley! and for centuries the isolation of the people prevented access to much material that *ould provide *ine (n the =isperterminen community! ho*ever! the special vineyards o*ned %y these people on the lo*er level of the mountain side provided grape Auice in various stages of fermentation! and their feasts in the past have %een cele%rated %y the use of *ines of rare vintage as *ell as %y the use of cream and other dairy products Their cream products too/ the place of our modern ice cream (t *as a matter of deep interest to have the President of =isperterminen sho* us the tan/ards that had %een in use in that community for nine or ten centuries The care of these *as one of the many responsi%ilities of the chief e4ecutive of the hamlet (t is reported that practically all s/ulls that are e4humed in the &hone valley! and! indeed! practically throughout all of "*it6erland *here graves have e4isted for more than a hundred years! sho* relatively perfect teethF *hereas the teeth of people recently %uried have %een riddled *ith caries or lost through this disease (t is of interest that each church usually has associated *ith it a cemetery in *hich the graves are /ept decorated! often *ith %eautiful designs of fresh or artificial flo*ers Mem%ers of succeeding generations of families are said to %e %uried one a%ove the other to a depth of many feet Then! after a sufficient num%er of generations have %een so honored! their %odies are e4humed to ma/e a place for present and coming generations These s/eletons are usually preserved *ith honor and deference The %ones are stac/ed in %asements of certain %uildings of the church edifice *ith the s/ulls facing out*ard These often constitute a solid *all of considera%le e4tent (n Naters there is such a group said to contain 5;!;;; s/eletons and s/ulls These *ere studied *ith great interest as *as also a smaller collection in connection *ith the cathedral at =isp While many of the single straight>rooted teeth had %een lost in the handling! many *ere present (t *as a matter of importance to find that only a small percentage of teeth had had caries Teeth that had %een attac/ed *ith deep caries had developed apical a%scesses *ith conse?uent destruction of the alveolar processes Evidence of this %one change *as readily visi%le "oc/ets of missing teeth still had continuous *alls! indicating that the teeth had %een vital at death The reader *ill scarcely %elieve it possi%le that such mar/ed differences in facial form! in the shape of the dental arches! and in the health condition of the teeth as are to %e noted *hen passing from the highly moderni6ed lo*er valleys and plains country in "*it6erland to the isolated high valleys can e4ist #ig sho*s four girls *ith typically %road dental arches and regular arrangement of the teeth They have %een %orn and raised in the 1oetschental =alley or other isolated valleys of "*it6erland *hich provide the e4cellent nutrition that *e

have %een revie*ing They have %een taught little regarding the use of tooth %rushes Their teeth have typical deposits of unscru%%ed mouthsF yet they are almost completely free from dental caries! as are the other individuals of the group they represent (n a study of .!5:; teeth of the children of these high valleys! only - . per cent *ere found to have %een attac/ed %y tooth decay This is in stri/ing contrast to conditions found in the moderni6ed sections using the modern foods

FI". . 'ormal design of face and dental arches when ade(uate nutrition is #rovided for both the #arents and the children. 'ote the well develo#ed nostrils.

(n 1oetschental! $rachen! =isperterminen and Ayer! *e have found communities of native "*iss living almost e4clusively on locally produced foods consisting of the cereal! rye! and the animal product! mil/! in its various forms At =issoie! *ith its availa%le modern nutrition! there has %een a complete change in the level of immunity to dental caries (t is important that studies %e made in other communities *hich correspond in altitude *ith the

first four places studied in *hich there *as a high immunity to dental caries Modern foods should %e availa%le in the ne* communities selected for comparative study To find such places one *ould naturally thin/ of those that are *orld>famed as health resorts providing the %est things that modern science and industry can assem%le "urely "t Morit6 *ould %e such a place (t is situated in the southeastern part of the &epu%lic of "*it6erland near the head*aters of the Danu%e in the upper Engadin This *orld>famous *atering place attracts people of all continents for %oth summer and *inter health %uilding and for the enAoyment of the mountain la/es! sno*>capped pea/s! forested mountain sides! and crystal clear atmosphere *ith a%undance of sunshine The Aourney from the Canton of Wallis H=alaisI to the upper Engadin ta/es one up the &hone valley! clim%ing continually to get a%ove cascades and %eautiful *aterfalls until one comes to the great &hone glacier *hich %loc/s the end of the valley The *ater gushes from %eneath the mountain of ice to %ecome the parent stream of the &hone river *hich passes *est*ard through the &hone valley receiving tri%utaries from sno*>fed streams from %oth north and south *atersheds! as it rolls *est*ard to the %eautiful 1a/e $eneva and then on*ard *est and south to the Mediterranean (t is of significance that a study of the child life in the &hone valley! as made %y "*iss officials and reported %y Dr Adolf &oos and his associates! sho*s that practically every child had tooth decay and the maAority of the children had decay in an aggravated form People of this valley are provided *ith ade?uate railroad transportation for %ringing them the lu4uries of the *orld As *e pass east*ard over the pass through Andermatt! *e are reminded that the trains of the "t $otthard tunnel go thundering through the mountain a mile %elo* our feet en route to (taly To reach our goal! the %eautiful modern city and summer resort of "t Morit6! *e enter the Engadin country famed for its %eauty and crystal>clear atmosphere We already /no* something of the %eauty that a*aits us *hich has attracted pleasure see/ers and %eauty lovers of the *orld to "t Morit6 )ne *ould scarcely e4pect to see so modern a city as "t Morti6 at an altitude of a little over a mile! *ith little else to attract people than its climate in *inter and summer! the magnificent scenery! and the clear atmosphere We have passed from the communities *here almost everyone *ears homespuns to one of English *al/ing coats and the most elegant of feminine attire Everyone sho*s the effect of contact *ith culture The hotels in their appointments and design are reminiscent of Atlantic City (mmediately one sees something is different here than in the primitive localities@ the children have not the

splendidly developed features! and the people give no evidence of the great physical reserve that is present in the smaller communities Through the /indness of Dr William Barry! a local dentist! and through that of the superintendent of the pu%lic schools! *e *ere invited to use one of the school %uildings for our studies of the children The summer classes *ere dismissed *ith instructions that the children %e retained so that *e could have them for study "everal factors *ere immediately apparent The teeth *ere shining and clean! giving elo?uent testimony of the thoroughness of the instructions in the use of the modern dentifrices for efficient oral prophyla4is The gums loo/ed %etter and the teeth more %eautiful for having the de%ris and deposits removed "urely this super% climate! this magnificent setting! com%ined *ith the %est of the findings of modern prophylactic science! should provide a ,;;>per>cent immunity to tooth decay But in a study of the children from eight to fifteen years of age! 52 : per cent of the teeth had already %een attac/ed %y dental caries )ur study of each case included careful e4amining of the mouthF photographing of the face and teethF o%taining of samples of saliva for chemical analysisF and a study of the program of nutrition follo*ed %y the given case (n most cases! the diet *as stri/ingly modern! and the only children found *ho did not have tooth decay proved to %e children *ho *ere eating the natural foods! *hole rye %read and plenty of mil/ (n Chapter ,7! a detailed discussion of the chemical differences in the food constituents is presented for %oth the districts su%Aect to immunity! and for those su%Aect to suscepti%ility ( *as told %y a former resident of this upper Engadin country that in one of the isolated valleys only a fe* decades ago the children *ere still carrying their luncheons to school in the form of roasted rye carried dry in their poc/ets Their ancestors had eaten cereal in this dry form for centuries "t Morit6 is a typical Alpine community *ith a physical setting lar to that in the Cantons of Bern and Wallis H=alaisI (t is! ho*ever! provided *ith modern nutrition consisting of an a%undance of *hite>flour products! marmalades! Aams! canned vegeta%les! confections! and fruits>>all of *hich are transported to the district )nly a limited supply of vegeta%les is gro*n locally We studied some children here *hose parents retained their primitive methods of food selection! and *ithout e4ception those *ho *ere immune to dental caries *ere eating a distinctly different food from those *ith high suscepti%ility to dental caries

#e* countries of the *orld have had officials so untiring in their efforts to study and ta%ulate the incidence of dental caries in various geographic localities as has "*it6erland (n the section lying to the north and east! and near 1a/e Constance! there is a considera%le district *here it is reported that ,;; per cent of the people are suffering from dental caries (n almost all the other parts of "*it6erland in *hich the population is large 27 to 2: per cent of the people suffer from dental caries )f the t*o remaining districts! in one there is from 2; to 27 per cent and in the other from :7 to 2; per cent individual suscepti%ility to dental caries "ince in the district in the vicinity of 1a/e Constance the incidence of dental caries is so high that it is recorded as ,;; per cent! it seemed especially desira%le to ma/e a similar critical study there and to o%tain samples of saliva and detailed information regarding the food! and to ma/e detailed physical e4aminations of gro*ing children in this community! and through the great /indness of Dr +ans Eggen%erger! Director of Pu%lic +ealth for this general district! *e *ere given an opportunity to do so Arrangements *ere made %y Dr Eggen%erger so that typical groups of children! some in institutions! could %e studied +e is located at +erisau in the Canton of "t $all We found *or/ *ell organi6ed for %uilding up the health of these children in so far as outdoor treatment! fresh air! and sunshine *ere concerned As dental caries is a maAor pro%lem! and pro%a%ly nutritional! it is treated %y sunshine The %oysB group and girlsB group are %oth given suita%le athletic sports under s/illfully trained directors These groups are located in different parts of the city Their recreation grounds are open la*ns adAoining *ooded /nolls *hich give the children protection and isolation in *hich to play in their sunsuits and %uild vigorous appetites! and thus to prepare for their institutional foods *hich *ere largely from a modern menu Critical dental e4aminations *ere made and an analysis of the data o%tained revealed that one> fourth of all teeth of these gro*ing %oys and girls had already %een attac/ed %y dental caries! and that only . per cent of the children had escaped from the ravages of tooth decay! *hich disease many of them had in an aggravated form (n the +erisau group 57 7 per cent of the 5!;87 teeth e4amined had %een attac/ed %y dental caries and many teeth *ere a%scessed The upper photographs in #ig . are of t*o girls *ith typically rampant tooth decay The one to the left is si4teen years of age and several of her permanent teeth are decayed to the gum line +er appearance is seriously marred! as is also that of the girl to the right Another change that is seen in passing from the isolated groups *ith their more nearly normal facial developments! to the groups of the lo*er valleys! is

the mar/ed irregularity of the teeth *ith narro*ing of the arches and other facial features (n the lo*er half of #ig . may %e seen t*o such cases While in the isolated groups not a single case of a typical mouth %reather *as found! many *ere seen among the children of the lo*er>plains group The children studied *ere from ten to si4teen years of age

Fig. ). In the moderni*ed districts of Swit*erland tooth decay is ram#ant. $he girl+ u##er left+ is si,teen and the one to the right is younger. $hey use white bread and sweets liberally. $he two children below have very badly formed dental arches with crowding of the teeth. this deformity is not due to heredity.

Many individuals in the moderni6ed districts %ore on their faces scars *hich indicated that the a%scess of an infected tooth had %ro/en through to the e4ternal surface *here it had developed a fistula *ith resultant scar tissue! thus producing permanent deformity Bad as these conditions *ere! *e *ere told that they *ere %etter than the average for the community The ravages of dental caries had %een stri/ingly evident as *e came in contact *ith the local and traveling pu%lic As *e had at "t Morit6! *e found an occasional child *ith much %etter teeth than the

average 3sually the ans*er *as not far to see/ #or e4ample! in one of the "t Morit6 groups! in a class of si4teen %oys! there *ere ,7: cavities! or an average of 2 : cavities per person Hfillings are counted as cavitiesI (n the cases of three other children in the same group! there *ere only three cavities! and one case *as *ithout dental caries T*o of these three had %een eating dar/ %read or entire>grain %read! and one *as eating dar/ %read and oatmeal porridge All three dran/ mil/ li%erally When loo/ing here for the source of dairy products one is impressed %y the a%sence of co*s at pasture in the plains of "*it6erland! areas in *hich a large percentage of the entire population resides True! one fre?uently sees large laiteries or creameries! %ut the co*s are not in sight )n as/ing the e4planation for this! ( found that a larger ?uantity of mil/ could %e o%tained from the co*s if they *ere /ept in the sta%les during the period of high production (ndeed! this *as a necessity in most of these communities since there *ere so fe* fences! and during the time of the gro*th of the crops! including the stoc/ feed for the *interBs use! it *as necessary that the co*s %e /ept enclosed A%out the only time that co*s *ere allo*ed out on pasture *as in the fall after the crops had %een harvested and *hile the stu%%le *as %eing plo*ed Among the children in "t Morit6 and +erisau! those groups *ith the lo*er num%er of cavities per person *ere using mil/ more or less li%erally )f the total num%er of children e4amined in %oth places only ,, per cent *ere using mil/ in their diets! *hereas ,;; per cent of the children in the other districts that provided immunity *ere using mil/ Nearly every child in "t Morit6 *as eating *hite %read (n +erisau! all %ut one of the children e4amined *ere eating *hite %read in *hole or in principal part "ince so many cattle *ere stall>fed in the thic/ly populated part of "*it6erland! and since so lo* a proportion of the children used mil/ even sparingly! ( *as concerned to /no* *hat use *as made of the mil/ Numerous road signs announcing the %rand of s*eetened mil/ chocolate made in the several districts suggested one use This chocolate is one of the important products for e4port and as a %everage constitutes a considera%le item in the nutrition of large num%ers living in this and in other countries (t is recogni6ed as a high source of energy! primarily %ecause of the sugar and chocolate *hich *hen com%ined *ith the mil/ greatly reduces the ratio of the minerals to the energy factors as e4pressed in calories (t *as formerly thought that dental caries *hich *as so rampant in the greater portion of "*it6erland *as due in part to lo* iodine content in the cattle feed and in other food %ecause of iodine deficiency in the soil 1arge num%ers

of former generations suffered from clinical goiter and various forms of thyroid distur%ances That this is not the cause seems clearly demonstrated %y the fact that dental caries is apparently as e4tensive today as ever %efore! if not more so! *hile the iodine pro%lem has %een met through a reinforcement of the diet of gro*ing children and others in stress periods *ith iodine in suita%le form (ndeed the early *or/ done in Cleveland %y Crile! Marine! and Gim%all *as referred to %y the medical authorities there as %eing the forerunner of the control of the thyroid disorder in these communities The officials of the +erisau community *ere so deeply concerned regarding the prevalence of dental caries that they *ere carrying for*ard institutional and community programs *ith the hope of chec/ing this affliction (f dental caries *ere primarily the result of an inade?uate amount of vitamin D! then sunning the patients should provide an ade?uate reinforcement This is one of the principal purposes for getting the gro*ing %oys and girls of the community into sunsuits for tanning their %odies Another procedure to *hich my attention *as called consisted of adding to the %read a product high in lime! *hich *as %eing o%tained in the foothills of the district This and other types of %read *ere studied %y chemical analyses Clinically! tooth decay *as not reduced ( made an effort to esta%lish a clinic in a neigh%oring to*n for the purpose of demonstrating *ith a group of children that dental caries can %e controlled %y a simple nutritional program An interesting incident developed in connection *ith the selection of the children for this e4perimental group When parents *ere as/ed to permit their children to have one meal a day reinforced! according to a program that has proved ade?uate *ith my clinical groups in Cleveland! the o%Aection *as made that there *as no use trying to save the teeth of the girls The girls should have all their teeth e4tracted and artificial teeth provided %efore they *ere married! %ecause if they did not they *ould lose them then (t is of interest that the southern part of "*it6erland including the high Alpine country is largely granite The hills in the northern part of "*it6erland are largely limestone in origin A great num%er of people live in the plain %et*een these t*o geologic formations! a plain *hich is largely made of alluvial deposits *hich have %een *ashed do*n from the upper formations The soil is e4traordinarily fertile soil and has supported a thrifty and healthy population in the past

When ( as/ed a government official *hat the principal diseases of the community *ere! he said that the most serious and most universal *as dental caries! and the ne4t most important! tu%erculosisF and that %oth *ere largely modern diseases in that country When ( visited the famous advocate of heliotherapy! Dr &ollier! in his clinic in 1eysin! "*it6erland! ( *ondered at the remar/a%le results he *as o%taining *ith heliotherapy in nonpulmonary tu%erculosis ( as/ed him ho* many patients he had under his general supervision and he said a%out thirty>five hundred ( then as/ed him ho* many of them come from the isolated Alpine valleys and he said that there *as not oneF %ut that they *ere practically all from the "*iss plains! *ith some from other countries ( in?uired of several clinicians in "*it6erland *hat their o%servations *ere *ith regard to the association of dental caries and tu%erculosis among the people of "*it6erland ( noted that the reports indicated that the t*o diseases *ere generally associated We *ill find a corollary to this in many studies in other parts of the *orld These studies in "*it6erland! as %riefly presented here! seem to demonstrate that the isolated groups dependent on locally produced natural foods have nearly complete natural immunity to dental caries! and that the su%stitution of modern dietaries for these primitive natural foods destroys this immunity *hether in ideally located elevated districts li/e "t Morit6 or in the %eautiful and fertile plains of lo*er "*it6erland The ?uestion seems to ans*er itself in a general *ay! *ithout much la%oratory data! from the results of a critical e4amination of the foods The la%oratory analyses! ho*ever! identify the particular factors in the foods *hich are primarily responsi%le %y their presence for esta%lishing immunity! and %y their a%sence in inducing suscepti%ility to dental caries These chemical data are discussed in Chapter ,7 +igh immunity to dental caries! freedom from deformity of the dental arches and face! and sturdy physi?ues *ith high immunity to disease *ere all found associated *ith physical isolation! and *ith forced limitation in selection of foods This resulted in a very li%eral use of dairy products and *hole>rye %read! in connection *ith plant foods! and *ith meat served a%out once a *ee/ The individuals in the moderni6ed districts *ere found to have *idespread tooth decay Many had facial and dental arch deformities and much suscepti%ility to diseases These conditions *ere associated *ith the use of refined cereal flours! a high inta/e of s*eets! canned goods! s*eetened fruits! chocolateF and a greatly reduced use of dairy products

Chapter " Isolated and modernized #aelics "T)&(E" have long %een told of the super% health of the people living in the (slands of the )uter +e%rides The smo/e oo6ing through the thatched roofs of their '%lac/ houses' has added *eirdness to the description of their home life and strange environment These stories have included a description of their *onderfully fine teeth and their stal*art physi?ues and strong characters They! accordingly! provide an e4cellent setting for a study to thro* light on the pro%lem of the cause of dental caries and modern physical degeneration These (slands lie off the north*est coast of "cotland! e4tending to a latitude nearly as far north as the southern part of $reenland A typical vie* of their thatched> roof cottages may %e seen in #ig 7

FI". -. A ty#ical .blac% house. of the Isle of Lewis derives its name from the smo%e of the #eat burned for heat. $he s#lendid #hysical develo#ment of the native "aelic fisherfol% is characteri*ed by e,cellent teeth and well formed faces and dental arches.

The (sle of 1e*is has a population of a%out t*enty thousand! made up almost entirely of fisher fol/ and crofters or sheep raisers This island has so little lime in its soil that it is said that there are no trees in the entire island e4cept a fe* *hich have %een planted The surface of the island is largely covered *ith peat! varying in thic/ness from a fe* inches to t*enty feet This is the fuel Peat contains the rootlets of the plant life *hich gre* many centuries ago There is so little %acterial gro*th that vegeta%le products undergo very slo* decay The pasturage of the island is so poor that e4ceedingly fe* cattle are to %e found! largely %ecause they do not properly mature and reproduce (n a fe* districts some highland cattle *ith long shaggy hair and *ide spread horns are found Almost all of these are imported The principal herd of cattle on the island consists of a fe* do6en head on the government e4perimental farm The %asic foods of these islanders are fish and oat products *ith a little %arley )at grain is the one cereal *hich develops fairly readily! and it provides the porridge and oat ca/es *hich in many homes are eaten in some form regularly *ith each meal The fishing a%out the )uter +e%rides is specially favora%le! and small sea foods! including lo%sters! cra%s! oysters and clams! are a%undant An important and highly relished article of diet has %een %a/ed codBs head stuffed *ith chopped codBs liver and oatmeal The principal port of the (sle of 1e*is is "torno*ay *ith a fi4ed population of a%out four thousand and a floating population of seamen over *ee/>ends! of an e?ual or greater num%er The "unday *e spent there! .7; large fishing %oats *ere said to %e in the port for the *ee/>end 1arge ?uantities of fish are pac/ed here for foreign mar/ets These hardy fisher*omen often toil from si4 in the morning to ten at night The a%undance of fish ma/es the cost of living very lo* (n #ig 7 may %e seen three of these fisher>people *ith teeth of unusual perfection We sa* them at the fish>cleaning %enches from early morning till late at night dressed! as you see them pictured! in their oils/in suits and ru%%er %oots We met them again in their "unday attire ta/ing important parts in the leading church (t *ould %e difficult to find e4amples of *omanhood com%ining a higher degree of physical perfection and more e4alted ideals than these *eather>hardened toilers Theirs is a land of fre?uent gales! often sleet> ridden or enshrouded in penetrating cold fogs 1ife is full of meaning for characters that are developed to accept as everyday routine raging seas and piercing %li66ards representing the accumulated fury of the treacherous north Atlantic )ne marvels at their gentleness! refinement and s*eetness of character

The people live in these so>called %lac/ houses These are thatched>roof d*ellings containing usually t*o or three rooms The *alls are %uilt of stone and dirt! ordinarily a%out five feet in thic/ness There is usually a fireplace and chimney! one or t*o outside doors! and very fe* *indo*s in the house The thatch of the roofs plays a very important rMle (t is replaced each )cto%er and the old thatch is %elieved %y the natives to have great value as a special fertili6er for their soil %ecause of its impregnation *ith chemicals that have %een o%tained from the peat smo/e *hich may %e seen seeping through all parts of the roof at all seasons of the year Peat fires are /ept %urning for this e4plicit purpose even *hen the heat is not needed This means that enormous ?uantities of peat are re?uired to maintain a continuous smudge "ome of the houses have no chimney %ecause it is desira%le that the smo/e leave the %uilding through the thatched roof Not infre?uently smo/e is seen rolling out of an open door or open *indo* #ortunately the peat is so a%undant that it can %e o%tained easily from the almost limitless ?uantities near%y The sheep that roam the heather>covered plains are of a small %lac/>faced %reed! e4hi%iting great hardihood They provide *ool of specially high ?uality! *hich! incidentally! is the source of the famous +arris T*eeds *hich are *oven in these small %lac/ houses chiefly on the (sle of +arris We are particularly concerned *ith the people of early "cotch descent *ho possess a physi?ue that rivals that found in almost any place in the *orld They are descendants of the original $aelic stoc/ *hich is their language today! and the only one *hich a large percentage of them can spea/ This island has only one port *hich means that most of the shore line still provides primitive living conditions as does the central part of the island (t *as a great surprise! and indeed a very happy one! to find such high types of manhood and *omanhood as e4ist among the occupants of these rustic thatched>roof homes! usually located in an e4panse of heather>covered treeless plains (t *ould %e hard to visuali6e a more complete isolation for child life than many of these homes provide! and one marvels at the refinement! intelligence! and strength of character of these rugged people They resent! and ( thin/ Austly so! the critical and uncomplimentary references made to their homes in attaching to them the name '%lac/>houses ' "everal that *e visited *ere artistically decorated *ith clean *allpaper and improvised hangings )ne *ould e4pect that in their one seaport to*n of "torno*ay things *ould %e gay over the *ee/>end! if not %oisterous! *ith %et*een four and five thousand fishermen and seamen on shore>leave from "aturday until midnight "unday )n "aturday evening the side*al/s *ere cro*ded *ith happy carefree people! %ut no %oisterousness and no drin/ing *ere to %e seen "unday the

people *ent in throngs to their various churches Before the sailors *ent a%oard their crafts on "unday evening they met in %ands on the street and on the piers for religious singing and prayers for safety on their ne4t fishing e4pedition )ne could not %uy a postage stamp! a picture card! or a ne*spaper! could not hire a ta4i! and could not find a place of amusement open on "unday Every%ody has reverence for the "a%%ath day on the (sle of 1e*is Every activity is made su%servient to their o%servance of the "a%%ath day (n fe* places in the *orld are moral standards so high )ne *onders if the %lea/ *inds *hich thrash the north Atlantic from our 1a%rador and $reenland coasts have not tempered the souls of these people and created in them higher levels of no%ility and e4alted human e4pression These people are the outposts of the *estern fringe of the European continent Dust as one sees in Brittany! on the *est coast of #rance! the prehistoric druidical stone forest mar/ing a civili6ation *hich e4isted so far in the past as to %e *ithout historic records e4cept in its monumentsF so! too! *e find here the forest of granite sla%s in *hich these sturdy prehistoric souls *orshipped their divinities %efore they *ere cro*ded into the sea %y the *est*ard moving hordes When one reali6es the distance that these heavy stones had to %e transported! a distance of pro%a%ly t*enty miles over difficult terrain! *e can appreciate the tas/ Their si6e can %e calculated from the depth to *hich they must %e %uried in order to stand erect even to this day We are concerned primarily *ith the physical development of the people! and particularly *ith their freedom from dental caries or tooth decay )ne has only to see them carrying their %urdens of peat or to o%serve the ease *ith *hich the fisher*omen on the doc/s carry their tu%s of fish %ac/ from the cleaning ta%le to the tiers of pac/ing %arrels to %e convinced that these people have not only %een trained to *or/! %ut have physi?ues e?ual to the tas/ These studies included the ma/ing of dental e4aminations! the ta/ing of photographs! the o%taining of samples of saliva for chemical analysis! the gathering of detailed clinical records! and the collecting of samples of food for chemical analysis and detailed nutritional data Communication is very difficult among many of these islands (t *ould %e difficult to find more complete isolation than some of them afford We tried to get to the islands of Taransay and "carpa on the *est coast of the (sle of +arris! %ut *ere una%le to o%tain transportation since the trip can %e made only in special! sea*orthy crafts! *hich *ill underta/e the passage only at certain phases of the tide and at certain directions of the *inds )n one of these islands! *e *ere told! the gro*ing %oys and girls had e4ceedingly high

immunity to tooth decay Their isolation *as so great that a young *oman of a%out t*enty years of age *ho came to the (sle of +arris from Taransay (sland had never seen mil/ in any larger ?uantity than drops There are no dairy animals on that island Their nutrition is provided %y their oat products and fish! and %y a very limited amount of vegeta%le foods 1o%sters and flat fish are a very important part of their foods #ruits are practically un/no*n Yet the physi?ues of these people are remar/a%ly fine (t *as necessary sometimes for us to engage s/illed seamen and their crafts to ma/e a special trip to some of these isolated islands These seamen *atch critically the tide! *ind and s/y! and determine the length of time it *ill %e safe to travel in a certain direction under conditions e4isting in the speed of the running tide and the periodic change of the *ind "ome of the islands are isolated %y severe *eather conditions for many months of the year These islands have %een important in the *haling industry! even up to recent years We visited a *haling station on the (sle of +arris! not active at this time! *here monsters of the sea *ere to*ed into a deep %ay (n the interior of the (sle of 1e*is the teeth of the gro*ing %oys and girls had a very high degree of perfection! *ith only , - teeth out of every hundred e4amined that had even %een attac/ed %y dental caries An important part of the study of these islands *as the o%servations made on conditions at the fringe of civili6ation A typical cross>section of the residents of the seaport to*n of "torno*ay can %e seen assem%led on the doc/s to greet the arrival of the evening %oat! the principal event of the community The group consists largely of adult young people (n a count of one hundred individuals appearing to %e %et*een the ages of t*enty and forty! t*enty>five *ere already *earing artificial teeth! and as many more *ould have %een more presenta%le had they too %een so e?uipped Dental caries *as very e4tensive in the moderni6ed section of "torno*ay "ince an important part of these studies involved a determination of the /inds and ?uantities of foods eaten! it *as necessary to visit the sources availa%le for purchasing foods in each to*n studied (n "torno*ay! one could purchase angel food ca/e! *hite %read! as sno* *hite as that to %e found in any community in the *orld! many other *hite>flour productsF also! canned marmalades! canned vegeta%les! s*eetened fruit Auices! Aams! confections of every type filled the store *indo*s and counters These foods pro%a%ly made a great appeal %oth %ecause of their variety and their high sugar content to the pallets of these primitive people The difference in physical appearance of the child life of "torno*ay from that of the interior of the (sle of 1e*is *as stri/ing We found a family on the opposite

coast of the island *here the t*o %oys sho*n in the upper half of #ig 8 resided )ne had e4cellent teeth and the other had rampant caries These %oys *ere %rothers eating at the same ta%le The older %oy! *ith e4cellent teeth! *as still enAoying primitive food of oatmeal and oatca/e and sea foods *ith some limited dairy products The younger %oy! seen to the left! had e4tensive tooth decay Many teeth *ere missing including t*o in the front +e insisted on having *hite %read! Aam! highly s*eetened coffee and also s*eet chocolates +is father told me *ith deep concern ho* difficult it *as for this %oy to get up in the morning and go to *or/

FI". /. Above0 brothers+ Isle of 1arris. $he younger at left uses modern food and has ram#ant tooth decay. Brother at right uses native food and has e,cellent teeth. 'ote narrowed face and arch of younger brother. Below0 ty#ical ram#ant tooth decay+ moderni*ed "aelic. 2ight0 ty#ical e,cellent teeth of #rimitive "aelic.

)ne of the sad stories of the (sle of 1e*is has to do *ith the recent rapid progress of the *hite plague The younger generation of the moderni6ed part of the (sle of 1e*is is not sho*ing the same resistance to tu%erculosis as their ancestors (ndeed a special hospital has %een %uilt at "torno*ay for the rapidly

increasing num%er of tu%ercular patients! particularly for girls %et*een t*enty and thirty years of age The superintendent told me *ith deep concern of the rapidity *ith *hich this menace is gro*ing Apparently very little consideration *as %eing given to the change in nutrition as a possi%le e4planation for the failure of this generation to sho* the defense of previous generations against pulmonary tu%erculosis (n this connection much %lame had %een placed upon the housing conditions! it %eing thought that the thatched>roof house *ith its smo/e>laden air *as an important contri%uting factor! not*ithstanding the fact that former generations had %een free from the disease ( *as told that the incidence of tu%erculosis *as fre?uently the same in the modern homes as it *as in the thatched>roof homes (t *as of special interest to o%serve the mental attitude of the native *ith regard to the thatched>roof house Again and again! *e sa* the ne* house %uilt %eside the old one! and the people apparently living in the ne* one! %ut still /eeping the smo/e smudging through the thatch of the old thatched>roof house When ( in?uired regarding this ( *as told %y one of the clearthin/ing residents that this thatch collected something from the smo/e *hich *hen put in the soil dou%led the gro*th of plants and yield of grain +e sho*ed me *ith /een interest t*o patches of grain *hich seemed to demonstrate the soundness of his contention ( *as particularly interested in studying the gro*ing %oys and girls at a place called "calpay in the (sle of +arris This (sland is very roc/y and has only small patches of soil for availa%le pasturage #or nutrition! the children of this community *ere dependent very largely on oatmeal porridge! oatca/e and sea foods An e4amination of the gro*ing %oys and girls disclosed the fact that only one tooth out of every hundred e4amined had ever %een attac/ed %y tooth decay The general physical development of these children *as e4cellent! as may %e seen in the upper half of #ig 9 Note their %road faces

FI". 3. Above0 ty#ical rugged "aelic children+ Isle of 1arris+ living on oats and sea food. 'ote the breadth of the faces and nostrils. Below0 ty#ical moderni*ed "aelics+ Isle of Bardsey. 'ote narrowed faces and nostrils.

This is in stri/ing contrast *ith the children of the hamlet of Tar%ert *hich is the only shipping port on the (sle of +arris! and the place of e4port of most of the famous +arris t*eeds *hich are manufactured on looms in the various croftersB homes These Tar%ert children had an incidence of -5 . carious teeth out of every hundred teeth e4amined The distance %et*een these t*o points is not over ten miles and %oth have e?ual facilities for o%taining sea foods! %eing on the coast )nly the latter! ho*ever! has access to modern foods! since it supports a *hite %read %a/ery store *ith modern Aams! marmalades! and other /inds of canned foods (n studying the tragedy of the rampant tooth decay in the mouth of a young man! ( as/ed him regarding his plans and he stated that he *as e4pecting to go to "torno*ay a%out si4ty miles a*ay in the near future! *here there *as a dentist! and have all his teeth e4tracted and plates made +e said that it *as no use to have any teeth filled! that he *ould have to lose them any*ay since that *as every%odyBs e4perience in Tar%ert The young *omen *ere in Aust as poor a condition

Through the department of dental inspection for north "cotland! ( learned of a place on the (sle of "/ye! Airth of "leat! in *hich only a fe* years ago there *ere thirty>si4 children in the school! and not one case of dental caries in the group My e4amination of the children in this community disclosed t*o groups! one living e4clusively on modern foods! and the other on primitive foods Those living on primitive foods had only ; 9 carious teeth per hundred! *hile those in the group living on modern foods had ,8 -! or t*enty>three times as many This community living near the sea had recently %een connected *ith the outside *orld %y daily steam%oat service *hich delivered to the people modern foods of various /inds! and *ithin this community a modern %a/ery! and a supply house for purchasing the canned vegeta%les! Aams and marmalades had %een esta%lished This district *as Aust in the process of %eing moderni6ed ( e4amined teeth of several people in the seventies and eighties! and e4cept for gingival infections *ith some loosening of the teeth! nearly all of the teeth *ere present and there *as very little evidence that dental caries had ever e4isted The elderly people *ere %emoaning the fact that the generation that *as gro*ing up had not the health of former generations ( as/ed *hat their e4planation *as and they pointed to t*o stone grinding mills *hich they said had ground the oats for oatca/e and porridge for their families and preceding families for hundreds of years Though they pri6ed them highly! the plea that they *ould %e helpful in educational *or/ in America induced them to sell the mills to me They told us *ith great concern of the recent rapid decline in health of the young people of this district This one>time *ell>populated (sland! the misty (sle of "/ye! still has one of the finest of the famous old castles! that %elonging to the Dunvegan clan (t participated in the romantic life of Prince Charlie The castle e?uipment still %oasts the grandeur of a past glory Among the relics is a horn *hich measured the draft to %e drun/ %y a prospective chieftain %efore he could aspire to the leadership of the clan +e must drin/ its contents of t*o ?uarts *ithout stopping Again the character of that manhood is reflected in the fact that although a %ounty of thirty thousand pounds *as placed upon the head of Prince Charlie! none of the many *ho /ne* his place of hiding %etrayed it )n my return from the )uter +e%rides to "cotland! ( *as concerned to o%tain information from government officials relative to the incidence of tooth decay and the degenerative diseases in various parts of north "cotland ( *as advised that in the last fifty years the average height of "cotch men in some parts decreased four inches! and that this had %een coincident *ith the general

change from high immunity to dental caries to a loss of immunity in a great part of this general district A study of the mar/et places revealed that a large part of the nutrition *as shipped into the district in the form of refined flours and canned goods and sugar There *ere very fe* herds of dairy cattle to %e seen (t *as e4plained that even the highland cattle did not do as *ell as formerly on the same ranges As one proceeds from the north of "cotland south*ard to England and Wales! there is a mar/ed increase in the percentage of individuals *earing artificial restorations or in need of them (n several communities this reached fifty per cent of adults over thirty years of age An effort *as made to find primitive people in the high country of Wales! %ut *ithout success We *ere advised that a%out the only place that *e *ould %e li/ely to find people living under primitive conditions *ould %e on the (sland of Bardsey off the north*est coast of Wales This is a roc/ and storm>%ound island *ith the decadent *alls of an old castle and a community made up largely of recently imported colonists *hom *e *ere advised had %een ta/en to the (sland to re>populate it There is considera%le good farm land! %ut very limited gra6ing stoc/ #ormerly the (sland had produced the foods for its inha%itants *ith the assistance of the sea These sources of natural foods have %een largely displaced *ith imported *hite flour! marmalades! sugar! Aams and canned goods We found the physical condition of the people very poor! particularly that of the gro*ing %oys and girls Tooth decay *as so *ide>spread that 59 8 out of every hundred teeth e4amined in the gro*ing %oys and girls had already %een attac/ed %y dental caries (t *as even active in three year olds #rom a conference *ith the director of pu%lic health of this district ( learned that tu%erculosis constituted a very great pro%lem! not only for the people on this island! %ut for those of many districts of northern Wales This *as ascri%ed to the lo*ered defense of the people due to causes un/no*n (t had %een noted that individuals *ith rampant tooth decay *ere more suscepti%le to pulmonary tu%erculosis While on the (sland of Bardsey! ( in?uired as to *hat they thought *as the cause of such e4tensive tooth decay as *e found! and *as told that they *ere familiar *ith the cause and that it *as due to close contact *ith the salt *ater and salt air When ( as/ed *hy many of the old people *ho had lived %y the sea all their lives in some districts still had practically all their teeth and had never had tooth decay! no e4planation *as availa%le This they said *as the reason that had %een given in ans*er to their in?uiries There is a very remar/a%le history *ritten in the ruins of the island! and in the faces of the people *ho live on the (sland of Bardsey The rugged *alls of

ancient castles %espea/ the glory and po*er of the people *ho lived proudly in past centuries They are testified to also %y the monuments in the cemeteriesF %ut a ne* era has come to this island The director of pu%lic health! of this district of Wales! including Bardsey (sland! told me the story of the decline and almost complete e4tinction of the population due to tu%erculosis +e also told ho* the government had re>populated the (sland *ith fifty healthy young families! and then the sad story of ho* these ne* settlers *ere %rea/ing do*n as rapidly as the former occupants The lo*er photograph in #ig 9 is of a family of four children in *hose faces the tragic story is deeply *ritten Everyone is a mouth %reather and everyone has rampant tooth decay These people are products of moderni6ation on this island *hich one time produced vigorous children and stal*art men and *omen (t is important to compare the faces of the children of the (sle of Bardsey sho*n in #ig 9 %elo* *ith those sho*n in #ig 9 a%ove living in an isolated district in the (sle of +arris As *e *ill see later! the facial deformity does not reach its ma4imum severity until the eruption of the second dentition and the development of the adult face! usually at from nine to fourteen years of age (n cases of e4treme inAury! ho*ever! *e find it appearing in the childhood face during the period of temporary or deciduous dentition These children *ill! dou%tless! %e much more seriously deformed *hen their permanent dentitions and adult faces develop (t is important for us to /eep this picture in mind in its relation to the high incidence of tu%erculosis as *e read succeeding chapters and find the part played %y moderni6ation in %rea/ing do*n the defense of individuals to infective processes including tu%erculosis (n #ig 8 Hlo*er leftI is a young girl from the (sle of Bardsey "he is a%out seventeen years of age +er teeth *ere *rec/ed *ith dental caries! the disease involving even the front teeth We ate a meal at the home in *hich she *as living (t consisted of *hite %read! %utter and Aam! all imported to the island This is in stri/ing contrast *ith the picture of the girl sho*n in #ig 8 Hlo*er rightI living in the (sle of 1e*is! in the central area "he has splendidly formed dental arches and a high immunity to tooth decay +er diet and that of her parents *as oatmeal porridge and oatca/e and fish *hich %uilt stal*art people The change in the t*o generations *as illustrated %y a little girl and her grandfather on the (sle of "/ye +e *as the product of the old rJgime! and a%out eighty years of age +e *as carrying the harvest from the fields on his %ac/ *hen ( stopped him to ta/e his picture +e *as typical of the stal*art product raised on the native foods +is granddaughter had pinched nostrils and narro*ed face +er dental arches *ere deformed and her teeth cro*ded "he *as a mouth %reather "he had the typical e4pression of the result of

moderni6ation after the parents had adopted the modern foods of commerce! and a%andoned the oatca/e! oatmeal porridge and sea foods

FI". 4. From left to right. $hese #ots of soil growing oats contained decreasing amounts of smo%e&thatch. 5nly the first #roduced mature grain. $his is in accord with the belief and #ractice of the native "aelics.

"ince a fundamental part of this study involves an e4amination of the accumulated *isdom of the primitive racial stoc/s! it is important that *e loo/ further into the matter of the smo/ed thatch ( *as advised %y the old residents that a serious conflict e4isted %et*een them and the health officials *ho came from outside to their island The latter %lamed the smo/e for the sudden development of tu%erculosis in acute form! and they insisted that the old procedure %e entirely discontinued #or this purpose the government gave very su%stantial assistance in the %uilding of ne* and modern homes The e4perienced natives contended that the oat crop *ould not mature in that severe climate *ithout %eing fertili6ed *ith the smo/ed thatch While they *ere *illing to move into the ne* house! they *ere not *illing to give up the smo/ing of the oat stra* used for the thatch to prepare it for fertili6ing the ground ( %rought some of this smo/ed thatch *ith me %oth for chemical analysis and for testing for the influence on plant gro*th This *as done %y adding different ?uantities of the smo/ed thatch to a series of pots in *hich oat seeds *ere planted (n #ig : *ill %e seen the result The pot to the right sho*s the result of planting the oats in a sandy soil almost li/e that of the (slands of the )uter +e%rides The oats only gre* to the fu66y limited condition sho*n As increasing amounts of this thatch *ere added to the soil! there *as an

increase in the ruggedness of the plants so that in the last pot to the left tall stal/s *ere developed heavily loaded *ith grain *hich ripened %y the time the gro*th sho*n in the other pots had occurred The chemical analysis of the thatch sho*ed that it contained a ?uantity of fi4ed nitrogen and other chemicals resulting from the peat smo/e circulating through the thatch This e4plains the confidence of the hardy old natives *ho insisted on %eing permitted to continue the smo/ing of the thatch even though they did not live in the house A dietary program competent to %uild stal*art men and *omen and rugged %oys and girls is provided the residents of these %arren (slands! *ith their *ind and storm>s*ept coasts! %y a diet of oats used as oatca/e and oatmeal porridgeF together *ith fish products! including some fish organs and eggs A seriously degenerated stoc/ follo*ed the displacement of this diet *ith a typical modern diet consisting of *hite %read! sugar! Aams! syrup! chocolate! coffee! some fish *ithout livers! canned vegeta%les! and eggs

6ey to Location of Indian and 7s%imo "rou#s 7,amined in 8anada

, HCleveland! )hioI 5 "i4 Nation (ndian &eservations! )ntario - Tuscarora (ndian &eservations! Ne* Yor/ . No =ancouver (ndian &eservation! British Colum%ia 7 Craigflo*er (ndian &eservation! =ictoria!

5, Bethel (sland! Alas/a 55 +oly Cross! Alas/a 5- Mc$rath! Alas/a 5. E/lutna! Alas/a 57 Telegraph Cree/! British Colum%ia

British Colum%ia 58 Dease 1a/e (ndian &eservation! British Colum%ia 59 McDames! British 9 Getchi/an! Alas/a Colum%ia 5: 1iard! British Colum%ia! : Wrangell! Alas/a Yu/on Border 2 Duneau! Alas/a 52 Edmonton! Al%erta ,; "it/a! Alas/a -; Winnipeg! Manito%a -, Bro/en +ead (ndian ,, Cordova! Alas/a &eservation! Manito%a -5 "iou4 1oo/out! No ,5 =alde6! Alas/a )ntario ,- "e*ard! Alas/a -- )m%a%i/a! No )ntario ,. Anchorage! Alas/a -. Toronto! )ntario -7 1oretteville &eservation! ,7 "toney &iver! Alas/a Cue%ec -8 Caughna*aga ,8 "leet Mute! Alas/a &eservation! Cue%ec ,9 Croo/ed Cree/! Alas/a -9 =ergennes! =ermont -: "aranac Tu%erculosis ,: Napaimute! Alas/a "anitarium! Ne* Yor/ -2 Moha*/ &eservation! ,2 Bethel! Alas/a )ntario 5; Go/amute! Alas/a 8 "/eena &iver! British Colum%ia

Chapter $ Isolated and modernized %skimos D3&(N$ the rise and fall of historic and prehistoric cultures that have often left their monuments and arts follo*ing each other in succession in the same location! one culture! the Es/imo! living on until today! %rings us a ro%ust sample of the "tone Age people The Maya race is gone! %ut has left its monuments The (ndian race is rapidly changing or disappearing in North America The Es/imo race has remained true to ancestral type to give us a living demonstration of *hat Nature can do in the %uilding of a race competent to *ithstand for thousands of years the rigors of an Arctic climate 1i/e the (ndian! the Es/imo thrived as long as he *as not %lighted %y the touch of modern civili6ation! %ut *ith it! li/e all primitives! he *ithers and dies

(n his primitive state he has provided an e4ample of physical e4cellence and dental perfection such as has seldom %een e4celled %y any race in the past or present We are concerned to /no* the secret of this great achievement since his circumscri%ed life greatly reduces the factors that may enter as controlling units in molding this e4cellence While *e are primarily concerned in this study *ith the characteristics of the Es/imo dentition and facial form and the effect upon it of his contact *ith modern civili6ation! *e are also deeply concerned to /no* the formula of his nutrition in order that *e may learn from it the secrets that *ill not only aid the unfortunate modern or so>called civili6ed races! %ut *ill also! if possi%le! provide means for assisting in their preservation (t is a sad commentary that *ith the coming of the *hite man the Es/imos and (ndians are rapidly reduced %oth in num%ers and physical e4cellence %y the *hite manBs diseases We have fe* pro%lems more urgent or more challenging than that means shall soon %e found for preventing the e4termination of the primitive Americans Many reports have %een made *ith regard to the condition of the teeth of the Es/imos Dou%tless! all have %een relatively authentic for the groups studied! *hich have %een chiefly along the routes of commerce Clearly those people *ould not represent the most primitive groups! *hich could only %e located %eyond the reach of contact *ith modern civili6ation The pro%lems involved strongly suggested the desira%ility of locating and studying Es/imos in isolated districts While dog teams could furnish means of approach in the *inter season! they *ould not %e availa%le for summer travel Through the /indness of Dr Ale4is +rdlic/a! *ho has made anthropological studies of the Es/imos in many of the districts of Alas/a! ( learned that the most primitive groups *ere located south of the Yu/on in the country %et*een it and Bristol Bay including the Delta and mouth of the Gus/o/*im &iver A government station has %een esta%lished on the Gus/o/*im &iver for *hich a government %oat enters the mouth of the Gus/o/*im to deliver supplies (t carries officials! %ut not passengers This contact *ith civili6ation has made availa%le modern foods for a limited district! chiefly at the point at *hich the %oat lands! namely! Bethel A portion of these supplies is transported %y a stern>*heel river %oat to settlements farther up the river A great num%er! ho*ever! of Es/imos live %et*een the mouth of the Gus/o/*im and the mouth of the Yu/on &iver! on the mainland and islands! a distance of several hundred miles! and have little or no contact *ith this food

Accordingly! our program for ma/ing these field studies among the Es/imos in ,2-- re?uired transportation over long distances and into districts *here travelling facilities *ere practically non>e4istent %y other means than %y modern aeroplane Mrs Price accompanies and assists me *ith my records )ur itinerary included steamship service to "e*ard in *estern Alas/a and rail*ay to Anchorage! *here an aeroplane *as chartered *hich carried us to various districts in *estern and central Alas/a This plane carried our field e?uipment! and travelled to the points selected The great Alas/a mountain range! culminating in the magnificent Mt McGinley! stretches across Alas/a from the Aleutian Peninsula at the south*est far into the heart of this vast territory The highest mountain in the 3nited "tates proper is Mt Whitney! ,.!7;5 feet The highest mountain in Canada is Mt 1ogan! ,2!7-2 feet Alas/a! ho*ever! %oasts many mountains that are higher than any of these! many of *hich are in this range Mt McGinley is 5;!-;; feet (t *as necessary for us to surmount this magnificent range to reach the territory in *hich our investigations *ere to %e made The special aeroplane selected *as e?uipped *ith radio for %oth sending and receiving! and *as in touch! or could %e in touch at all times! *ith the "ignal "ervice Corps! as *ell as *ith the head?uarters and %ranches of the Company )*ing to clouds in the selected pass! the pilot found it necessary to go one hundred fifty miles out of his course to find one that *as clear enough to fly through Beyond these mountains *ere vast areas of %are *ilderness *ith no signs of human life Moose *ere fre?uently seen )ur first o%Aective *as to find! if possi%le! a %and of (ndians reported to live on "tony &iver They had %een descri%ed as %eing very primitive )ur pilot! *ho *as *ell informed a%out this region! said this *as the first time he had even landed in this district All the people *ere %usy catching and storing the running salmon After drying the fish they are smo/ed for a fe* hours and then stored for *inter use These thrifty people have physical features ?uite unli/e the (ndians of central! southern and eastern Alas/a )f the t*elve individuals studied here! ten had lived entirely on the native foods or practically so (n their 5:: teeth only one tooth *as found that had ever %een attac/ed %y tooth decay! or ; - per cent T*o had come up from the Gus/o/*im &iver! of *hich the "tony &iver is a %ranch There! they had received a considera%le ?uantity of the 'store gru%' that had %een shipped up the Gus/o/*im from Bethel T*enty> seven per cent of the teeth of these t*o had %een attac/ed %y dental caries We then proceeded to "leet Mute! on the Gus/o/*im &iver! *here three individuals *ere found *ho had lived entirely on native foods None of them had ever had a tooth attac/ed %y tooth decay "even others had lived partly on

native foods and partly on 'store gru%!' and they had dental caries in ,5 5 per cent of their teeth At Croo/ed Cree/! the ne4t settlement! eight individuals *ere e4amined and of their 5,8 teeth forty>one! or ,: 2 per cent! had caries All %ut one of these *ere living in considera%le part on 'store gru%!' and this individual had no dental caries At Napimute! ,8 per cent of the teeth had %een attac/ed %y dental caries! %ut no individuals studied here *ere living entirely on native foods Bethel is the largest settlement on the Gus/o/*im! and contains in addition to the *hite residents many visiting Es/imos from the near%y Tundra country surrounding it Eighty>eight individuals studied here *ere largely Es/imos and mi4ed %loods )f their 5!.2; teeth! ,, 8 per cent! or 5:, teeth! had %een attac/ed %y tooth decay )f these eighty>eight individuals t*enty>seven *ith 928 teeth had lived almost e4clusively on natural foods! and in this group only one tooth *as found *ith dental caries! or ; , per cent #orty individuals *ere living almost e4clusively on modern foods as shipped in %y the government supply %oat )f their ,!;2. teeth! 575! or 5, , per cent! had %een attac/ed %y tooth decay T*enty>one individuals *ere living partly on native foods and partly on 'store gru%!' and of their 8;; teeth thirty>eight! or 8 - per cent! had %een attac/ed %y tooth decay At Go/amute! on the Bering "ea at the mouth of the Gus/o/*im &iver! a large %and of very primitive Es/imos *as studied They had come from the vicinity of Nelson (sland! a district *hich has had e4ceedingly little contact *ith modern civili6ation (n this group t*enty>eight individuals *ith :5; teeth sho*ed only one tooth! or ; , per cent! that had ever %een attac/ed %y dental caries Bethel (sland is situated in the Gus/o/*im &iver (t is visited in the summer %y Es/imos from the Tundra Country for laying in their store of fish for *inter use )f fifteen individuals here! thirteen! *ith .,; teeth! had lived e4clusively on native foods! and not a single tooth had %een attac/ed %y dental caries T*o had come from Bethel! and of their si4ty teeth t*enty>one or -7 per cent had %een attac/ed %y tooth decay (n the various groups in the lo*er Gus/o/*im seventy>t*o individuals *ho *ere living e4clusively on native foods had in their 5!,-: teeth only t*o teeth or ; ;2 per cent that had ever %een attac/ed %y tooth decay (n this district eighty>one individuals *ere studied *ho had %een living in part or in

considera%le part on modern foods! and of their 5!57. teeth -2. or ,- per cent had %een attac/ed %y dental caries This represents an increase in dental caries of ,.. fold (t ne4t %ecame desira%le to study a district that had %een in contact *ith the foods of modern commerce for many years! and for this +oly Cross *as selected This community is located on the Yu/on &iver a%ove the Arctic Circle (t has %een in contact *ith the summer commerce of the Yu/on for several decades (t has one of the oldest and %est organi6ed Catholic Missions of Alas/a The individuals studied *ere all in the school connected *ith the Mission The students had come from as far north as Point Barro* on the Arctic )cean and *est to the Bering "traits All %ut one had %een in contact *ith and had used modern foods %efore coming to the Mission! and *ere using them *hile there This one individual had lived e4clusively on native foods %efore coming to the Mission and he had no carious teeth (n eight individuals *ith 55. teeth! *ho had lived very largely on modern foods! forty>t*o teeth or ,: 9 per cent had %een attac/ed %y tooth decay #our individuals had lived partly on native foods and partly on modern foods! and of their ,,5 teeth four! or - 7 per cent! had %een attac/ed %y tooth decay (t is of interest that *hile the Es/imos and (ndians have lived in accord! they have not intermarried The Es/imos occupy the lo*er section of the Yu/on and Gus/o/*im &ivers! and the Bering "ea frontier The (ndians have occupied the 3pper *ater*ays of %oth these rivers The ne4t place selected for study *as Mc$rath! *hich is on the 3pper Gus/o/*im not far distant from the McGinley Mountain &ange (t is the upper terminus of navigation on the Gus/o/*im &iver for the stern>*heel river %oats (ts chief importance lies in the fact that it is the division point on the Cross Alas/a Aeroplane &outes from Anchorage or #air%an/s to Nome and other *estern points (ts population consists of several *hite prospectors and miners *ho have stayed in the country follo*ing the gold rush "ome of them have married (ndian and Es/imo *omen )f t*enty> one individuals only one had lived almost e4clusively on native foods and she had no dental caries T*enty had lived chiefly on imported foods! and of their 759 teeth ,97! or -- 5 per cent! had %een attac/ed %y tooth decay Among the residents of Mc$rath there is a remar/a%le family The father is an American mining engineer *ho has spent much of his life in that country +is *ife is a charming Es/imo *oman of splendid intelligence and fine personality "he had come originally from the lo*er Gus/o/*im and *as one of the primitive Es/imo stoc/ While mining interests had provided food supplies for the family! shipped from the 3nited "tates! she follo*ed her early

training and insisted on catching and storing salmon in season as an important part of her o*n dietary The salmon *ere dried and smo/ed as *as the custom of her people "he is the mother of at least t*enty children! for she could give the names of that many )nly eleven *ere living! ho*ever! several having died from tu%erculosis Not*ithstanding her many overloads! not a single tooth had ever %een attac/ed %y tooth decay A lo*er anterior tooth had %een %ro/en A picture of this *oman is sho*n in #ig 2 Hupper! leftI There has %een e4tensive *ear of the teeth! as is characteristic of the teeth of many of the Es/imos! a matter *hich *e *ill presently discuss (t is of interest to note the splendid symmetry of her dental arches +er children and hus%and and son>in>la* had lived very largely on modern foods and in these eight individuals *ith 5,5 teeth eighty>seven! or ., per cent! had %een attac/ed %y tooth decay +er oldest living daughter is t*enty>t*o years of age "he has a narro*ing of the upper arch and e4tensive tooth decay Another daughter! si4teen! is a %eautiful girl e4cept for her narro* dental arches "he *as reported %y our pilot to have %ecome so deeply interested in the engines of the aircrafts as they stopped at this point for servicing and fuel that she had %ecome e4pert in tuning up and conditioning aeroplane motors "he! dou%tless! inherited some of the genius of her father! *ho is a mining engineer T*elve of her teeth had %een attac/ed %y dental caries

FI". 9. $y#ical native Alas%an 7s%imos. 'ote the broad faces and broad arches and no dental caries 9tooth decay:. ;##er left+ woman has a bro%en lower tooth.

She has had twenty&si, children with no tooth decay.

)ne does not get a conception of the magnificent dental development of the more primitive Es/imos simply %y learning that they have freedom from dental caries The si6e and strength of the mandi%le! the %readth of the face and the strength of the muscles of mastication all reach a degree of e4cellence that is seldom seen in other races This is typically illustrated in #ig 2 ( *as told that an average adult Es/imo man can carry one hundred pounds in each hand and one hundred pounds in his teeth *ith ease for a considera%le distance This illustrates the physical development of other parts of the %ody as *ell as the Aa*s! and suggests that the e4ercising of the Aa*s is not the sole reason for their very fine teeth! since the super% development of the musculature includes all parts of the %ody (t has also %een suggested that che*ing of tough foods! %y %uilding teeth of e4ceptionally fine ?uality! has %een an important factor in the esta%lishment of immunity to caries As *ill %e sho*n presently! the teeth of these individuals *ith their e4cellent physical development and fine tooth structure develop caries *hen they depart from their native foods and adopt our modern foods Much has %een reported in the literature of the e4cessive *ear of the Es/imosB teeth! *hich in the case of the *omen has %een ascri%ed to the che*ing of the leather in the process of tanning (t is of interest that *hile many of the teeth studied gave evidence of e4cessive *ear involving the cro*ns to a depth that in many individuals *ould have e4posed the pulps! there *as in no case an open pulp cham%er They *ere al*ays filled *ith secondary dentin This is important since our ne*er /no*ledge indicates that *ith the chemical characteristics of their food *e might e4pect that secondary dentin *ould %e readily formed *ithin the pulp cham%ers %y a process similar to that *hich occurs in many individuals under a diet reinforced *ith mineral and activator> providing foods )ne old Es/imo had a scar on his lo*er lip! *hich *as the result of perforations for carrying a decoration as practiced %y his tri%e ( have found primitive tri%es in several parts of the *orld *ith this mar/ing The principal outer garment *orn %y the Es/imo for the more primitive groups consists of a par/a carrying a hood *hich is pulled over the head and closed around the nec/ *ith a shirr string! *hile another shirr string controls the si6e of the face opening in the hood *hen it is up (n the summer this is made of cloth or of s/in *ithout the fur A typical case is sho*n in #ig 2 (t *ill again %e noted that the teeth are e4cessively *orn

FI". 1<. $hese #rimitive Alas%an mothers rear strong+ rugged babies. $he mothers do not suffer from dental caries.

)*ing to the %lea/ness of the *inds off the Bering "ea! even in the summer many of the *omen *ear furs A typical mother and child dressed in their *arm clothing are sho*n in #ig ,; The Es/imo *omen are %oth artistic and s/illful in needle *or/ They use fur of different colors for decorating their garments These *omen ma/e artistic decorations %y carving ivory from *alrus teeth and from the %uried tus/s of the hairy mammoth that *andered over the Tundra tens of thousands of years ago The ear decoration of this Es/imo *oman is a typical design This motherBs teeth are literally 't*o ro*s of pearls ' (t is important to note the *idth of the arches )ne is continually impressed *ith the magnificent health of the child life *hich is illustrated in #ig ,; (n our various contacts *ith them *e never heard an Es/imo child crying e4cept *hen hungry! or frightened %y the presence of strangers The *omen are characteri6ed %y the a%undance of %reastfood *hich almost al*ays develops normally and is maintained *ithout difficulty for a year The mothers *ere completely free of dental caries! and ( *as told that the children of the Es/imos have no difficulties *ith the cutting of their teeth

FI". 11. =hen the #rimitive Alas%an 7s%imos obtain the white man>s foods+ dental caries become active. ?yorrhea also often becomes severe. In many districts dental service cannot be obtained and suffering is acute and #rolonged.

The e4cellence of dentitions among the Es/imos has %een a characteristic also of the s/ulls that have %een e4cavated in various parts of Alas/a (t might %e e4pected that such *onderfully formed teeth *ould maintain so high an immunity to dental caries that their proud possessors *ould never %e trou%led *ith tooth decay This! unfortunately! is not the case! a fact of great significance in evaluating our modern theories of the causes of dental caries When these adult Es/imos e4change their foods for our modern foods! *hich *e *ill discuss in Chapter ,7! they often have very e4tensive tooth decay and suffer severely This is clearly illustrated in #ig ,,! for these Es/imosB teeth had %een seriously *rec/ed %y tooth decay They had %een living on modern foods and *ere typical of a large num%er *ho are in contact *ith the Bering "ea ports Their plight often %ecomes tragic since there are no dentists in these districts A typical effect of moderni6ation on a gro*ing girl *as sho*n in a case in *hich the central incisors and ,8 other teeth *ere attac/ed %y dental caries "i4ty>four per cent of her teeth had tooth decay

There are no dentists in *estern Alas/a! north or *est of Anchorage! *hich is near the southern coast! e4cept at #air%an/s *hich! li/e Anchorage! is many hundreds of miles from these Es/imos (t *ould ta/e months for them to ma/e the Aourney in *inter %y dog team! and it *ould %e practically impossi%le to ma/e it in the summer season %y any means of travel e4cept %y aeroplane! *hich clearly these people could not afford Their dilemma is! accordingly! most tragic *hen they suddenly %ecome victims of diseases *hich re?uire hospitali6ation or s/illed medical or dental service )ne mining engineer in the interior told me that he had spent t*o thousand dollars to have a dentist %rought in %y aeroplane to render dental service )n my e4amination of his mouth ( found t*enty>nine of his thirty>t*o teeth had %een attac/ed %y dental caries )ne important phase of modern degeneration! namely! change in facial and dental arch form and other physical e4pressions! is of interest (t is a matter of great significance that the Es/imos *ho are living in isolated districts and on native foods have produced uniformly %road dental arches and typical Es/imo facial patterns Even the first generation forsa/ing that diet and using the modern diet! presents large num%ers of individuals *ith mar/ed changes in facial and dental arch form (n #ig ,5 *ill %e seen four Es/imo girls *ho are of the first generation follo*ing the adoption of moderni6ed foods %y their parents All have deformed dental arches (t is important to note the pattern of the settling in*ard of the lateral incisors and the cro*ding out*ard of the cuspids This facial design is currently assigned to a mi4ing of racial %loods These girls are pure>%looded Es/imos *hose parents have normally formed dental arches

FI". 1!. =hile dental arch deformities or crowded teeth are #ractically un%nown among many of the #rimitive grou#s of 7s%imos+ they occur fre(uently in the first generation of children born after the #arents have ado#ted the white man>s foods. 'ote the narrow nostrils and changed facial form of these children. $his is not due to thumb suc%ing.

We are particularly concerned *ith the foods used %y these primitive Es/imos They almost al*ays have their homes on or near deep *ater Their s/ill in handling their /aya/s is most remar/a%le During the salmon running season they store large ?uantities of dried salmon They spear many of these fish from their /aya/sF even young %oys are very s/illful They land salmon so large that they can hardly lift them They are e4pert in spearing seals from these light crafts "eal oil provides a very important part of their nutrition As each piece of fish is %ro/en off! it is dipped in seal oil ( o%tained some seal oil from them and %rought it to my la%oratory for analy6ing for its vitamin content (t proved to %e one of the richest foods in vitamin A that ( have found The fish are hung on rac/s in the *ind for drying #ish eggs are also spread out to dry! as sho*n in #ig ,- These foods constitute a very important part of the nutrition of the small children after they are *eaned Naturally! the drifting sands of the %lea/ Bering "traits lodge upon and cling to the moist surfaces of

the fish that are hung up to dry This constitutes the principal cause for the e4cessive *ear of the Es/imosB teeth in %oth men and *omen

FI". 1 . $he eggs of the salmon are dried and stored as an im#ortant item of nutrition for both children and adults. $hey are also used to increase the fertility of the women. From a chemical stand#oint they are one of the most nutritious foods I have found anywhere.

The food of these Es/imos in their native state includes cari%ou! ground nuts *hich are gathered %y mice and stored in caches! /elp *hich is gathered in season and stored for *inter use! %erries including cran%erries *hich are preserved %y free6ing! %lossoms of flo*ers preserved in seal oil! sorrel grass preserved in seal oil! and ?uantities of fro6en fish Another important food factor consists of the organs of the large animals of the sea! including certain layers of the s/in of one of the species of *hale! *hich has %een found to %e very high in vitamin C "ince contact *ith our modern civili6ation! the Es/imo population for Alas/a is very rapidly declining )ne authority has ?uoted the reduction of 7; per cent in population in seventy>five years An important o%servation has %een made relative to the rapid shortening of the average life %y Dr = E 1evine and Professor C W Bauer! of Creighton 3niversity! Ne%ras/a! *ho reported@ Cordova! Alas/a! )ct 58! ,2-.>>Due to suscepti%ility to tu%erculosis and other diseases the average life span of the Es/imo of Alas/a is only 5; years and their race is doomed to e4tinction *ithin a fe* generations unless modern medical science comes to their aid 3nless a very radical change is made in the interference *ith the native supply of game and sea foods! the Es/imo population seems destined to have a rapid decline and an early e4tinction Their primitive fish foods have %een

largely curtailed %y the encroachment on their salmon streams made %y modern canneries (t is of interest to discuss in connection *ith the Alas/an Es/imo t*o *hite %oys Hone is sho*n in #ig ,.I! *ho *ere sons of a mining engineer They had %een %orn and raised in a mining camp in Alas/a! *here their foods had %een almost entirely shipped in ( travelled *ith the mother of these t*o %oys *ho *as %ringing them to the 3nited "tates for operations on their noses! %ecause they *ere mouth>%reathers (t is important to o%serve the mar/ed underdevelopment of %oth the middle third and lo*er third of the face of the %oy sho*n in #ig ,. The nutrition of the family during their development and gro*th had %een largely provided in pac/age form shipped in from the 3nited "tates Their disfiguration is typical of that of large num%ers that are developing in our highly moderni6ed communities! and is similar! in general! to the deformities *hich develop in the primitive races after they adopt the moderni6ed nutrition

FI". 1). $his white boy was born and raised in Alas%a on im#orted foods. 1is facial deformity includes a lac% of develo#ment of the air #assages+ so that he breathes through his mouth. Lac% of bone develo#ment creates the crowded condition of the teeth. 'ote his narrow nostrils.

Not*ithstanding the very inhospita%le part of the *orld in *hich they reside! *ith nine or ten months of *inter and only t*o or three of summer! and in spite of the a%sence for long periods of plant foods and dairy products and eggs! the Es/imos *ere a%le to provide their %odies *ith all the mineral and vitamin re?uirements from sea foods! stored greens and %erries and plants from the sea Chapter & Primitive and modernized 'orth (merican Indians

NAT3&E seems to have made one of her large scale demonstrations in the Americas of the po*er of adaptation of a single racial stoc/ to the scale of climates ranging from torrid Aungles of the tropics to the Arctics The various mem%ers of the American (ndian race seem clearly to have come from a common origin The route %y *hich they reached America from Asia as suggested %y anthropologists *as %y *ay of the Bering "trait Within a decade a &ussian engineer has crossed from Asia to America on the pac/ ice of the Bering sea! a distance of ninety miles (f this is possi%le no*! ho* much more li/ely is it that it has %een possi%le in earlier periods of the *orldBs history! as! for e4ample! during or follo*ing the last ice age! or at the time of an earlier ice age The American (ndian! therefore! provides a very remar/a%le opportunity to study %oth the capacity for adapta%ility to different environments and the variations that different environments can produce in a single racial stoc/ That the (ndian of today is not in general a counterpart of the native resident at the time of the discovery of America %y Colum%us is clearly demonstrated %oth %y the s/eletal material and %y the early records )ur pro%lem involved the location and study of groups of the original stoc/! if such *ere to %e found! *ho *ere living in accordance *ith the tradition of their race and as little affected as might %e possi%le %y the influence of the *hite man At first thought it might seem impossi%le that such groups can e4ist! %ut as a matter of fact there are still great areas of the American continent inha%ited %y the original stoc/ living in areas still une4plored (n order to find (ndians as little changed as possi%le %y reason of their contact *ith the *hite man! particularly *ith the *hite manBs foods! ( *ent to northern Canada to the region inside the &oc/y Mountain range to study the (ndians of Northern British Colum%ia and the Yu/on territory "ince an aeroplane could not %e used! o*ing to the lac/ of a %ase of supplies for fuel for the return tripF and since the MacGen6ie *ater route *as impractica%le Han e4pedition could not go up the *ater*ays through Canada on the MacGen6ie &iver and its %ranches and return the same seasonI! the route selected *as that *hich enters that territory from Alas/a on the large *ater*ay of the "ti/ine &iver This river has cut its channel through the Coast and Cascade &anges of mountains and has its origin in the high *estern *atershed of the &oc/ies (t *as particularly desira%le to reach a group of (ndians *ho could not o%tain the animal life of the sea! not even the running salmon These fish do not enter the *ater*ays draining to the Arctic We used a high>po*ered river transport specially designed for going up rapids on the "ti/ine &iver to the end of navigation at Telegraph Cree/ At this point large ?uantities of modern foods are stored during the short open navigation season of the summer to %e e4changed for furs during the long *inter A +udson Bay Post has %een esta%lished at this point

+ere a truc/ *as chartered *hich too/ us over a trail across the &oc/y Mountain Divide to the head*aters of the rivers flo*ing north to the Arctic At this outpost t*o guides *ere engaged and a high po*ered sco* chartered to ma/e the trip do*n the *ater*ays to*ard the Arctic on the Diese and 1iard &ivers This made it possi%le! in the summer of ,2--! to ma/e contact *ith large %ands of (ndians *ho had come out of the Pelly mountain country to e4change their catch of furs at the last outpost of the +udson Bay Company Most of the (ndians of Canada are under treaty *ith the Canadian $overnment *here%y that government gives them an annual per capita %ounty This arrangement induces the (ndians in the interior to come out to the designated centers to o%tain the %ounty "ince it is %ased on the num%er in the family! all of the children are %rought This treaty! ho*ever! *as never signed %y the (ndians of the British Colum%ia and Yu/on Territory And! accordingly! they have remained as nomadic *andering tri%es follo*ing the moose and cari%ou herds in the necessary search to o%tain their foods The rigorous *inters reach seventy degrees %elo* 6ero This precludes the possi%ility of maintaining dairy animals or gro*ing seed cereals or fruits The diet of these (ndians is almost entirely limited to the *ild animals of the chase This made a study of them e4ceedingly important The *isdom of these people regarding NatureBs la*s! and their s/ill in adapting themselves to the rigorous climate and very limited variety of foods! and these often very hard to o%tain! have developed a s/ill in the art of living comforta%ly *ith rugged Nature that has %een approached %y fe* other tri%es in the *orld The sense of honor among these tri%es is so strong that practically all ca%ins! temporarily unoccupied due to the a%sence of the (ndians on their hunting trip! *ere entirely unprotected %y loc/sF and the valua%les %elonging to the (ndians *ere left in plain sight The people *ere remar/a%ly hospita%le! and *here they had not %een ta/en advantage of *ere very /ind Many of the *omen had never seen a *hite *oman until they sa* Mrs Price Their /no*ledge of *oodcraft as e4pressed in s/ill in %uilding their ca%ins so that they *ould %e /ept comforta%ly *arm and protected from the su%>6ero *eather *as remar/a%le Their planning ahead for storing provisions and fire*ood strongly emphasi6ed their community spirit When an (ndian and his family moved to a camp site on a la/e or river! they al*ays girdled a fe* more trees than they *ould use for fire*ood so that there *ould %e a plentiful supply of dry standing tim%er for future visitors to the camp They lived in a country in *hich gri66ly %ears *ere common Their pelts *ere highly pri6ed and they captured many of them *ith %aited pitfalls Their /no*ledge of the use of different organs and tissues of the animals for

providing a defense against certain of the affections of the %ody *hich *e spea/ of as degenerative diseases *as surprising When ( as/ed an old (ndian! through an interpreter! *hy the (ndians did not get scurvy he replied promptly that that *as a *hite manBs disease ( as/ed *hether it *as possi%le for the (ndians to get scurvy +e replied that it *as! %ut said that the (ndians /no* ho* to prevent it and the *hite man does not When as/ed *hy he did not tell the *hite man ho*! his reply *as that the *hite man /ne* too much to as/ the (ndian anything ( then as/ed him if he *ould tell me +e said he *ould if the chief said he might +e *ent to see the chief and returned in a%out an hour! saying that the chief said he could tell me %ecause ( *as a friend of the (ndians and had come to tell the (ndians not to eat the food in the *hite manBs store +e too/ me %y the hand and led me to a log *here *e %oth sat do*n +e then descri%ed ho* *hen the (ndian /ills a moose he opens it up and at the %ac/ of the moose Aust a%ove the /idney there are *hat he descri%ed as t*o small %alls in the fat These he said the (ndian *ould ta/e and cut up into as many pieces as there *ere little and %ig (ndians in the family and each one *ould eat his piece They *ould eat also the *alls of the second stomach By eating these parts of the animal the (ndians *ould /eep free from scurvy! *hich is due to the lac/ of vitamin C The (ndians *ere getting vitamin C from the adrenal glands and organs Modern science has very recently discovered that the adrenal glands are the richest sources of vitamin C in all animal or plant tissues We found these (ndians most cooperative in aiding us We! of course! had ta/en presents that *e thought *ould %e appreciated %y them! and *e had no difficulty in ma/ing measurements and photographs! nor! indeed! in ma/ing a detailed study of the condition of each tooth in the dental arches ( o%tained samples of saliva! and of their foods for chemical analysis A typical (ndian family in the %ig tim%er forests in sho*n in #ig ,7

FI". 1-. $his ty#ical family of forest Indians of 'orthern 8anada #resents a #icture of su#erb health. $hey live amidst an abundance of food in the form of wild animal life in the

shelter of the big timber.

The condition of the teeth! and the shape of the dental arches and the facial form! *ere super% (ndeed! in several groups e4amined not a single tooth *as found that had ever %een attac/ed %y tooth decay (n an e4amination of eighty> seven individuals having 5!.8. teeth only four teeth *ere found that had ever %een attac/ed %y dental caries This is e?uivalent to ; ,8 per cent As *e came %ac/ to civili6ation and studied! successively! different groups *ith increasing amounts of contact *ith modern civili6ation! *e found dental caries increased progressively! reaching 57 7 per cent of all of the teeth e4amined at Telegraph Cree/! the point of contact *ith the *hite manBs foods As *e came do*n the "ti/ine &iver to the Alas/an frontier to*ns! the dental caries pro%lem increased to .; per cent of all of the teeth Careful in?uiry regarding the presence of arthritis *as made in the more isolated groups We neither sa* nor heard of a case in the isolated groups +o*ever! at the point of contact *ith the foods of modern civili6ation many cases *ere found including ten %ed>ridden cripples in a series of a%out t*enty (ndian homes "ome other affections made their appearance here! particularly tu%erculosis *hich *as ta/ing a very severe toll of the children *ho had %een %orn at this center (n #ig ,8 are seen t*o typical cases of tu%ercular involvement of glands of the nec/ The suffering from tooth decay *as tragic There *ere no dentists! no doctors availa%le *ithin hundreds of miles to relieve suffering

FI". 1/. At the #oint of moderni*ation including the use of the foods of modern commerce+ the health #roblem of the Indians is very different. $hese moderni*ed Indian children are dying of tuberculosis which seldom %ills the #rimitives.

The physi?ues of the (ndians of the far north *ho are still living in their isolated locations and in accordance *ith their accumulated *isdom *ere super% There *ere practically no irregular teeth! including no impacted third

molars! as evidenced %y the fact that all individuals old enough to have the molars erupted had them standing in position and functioning normally for mastication The e4cellence of the dental arches is sho*n in #ig ,9 Where the (ndians *ere using the *hite manBs food tooth decay *as very severe! as sho*n in #ig ,: (n the ne* generation! after meeting the *hite civili6ation and using his foods! many developed croo/ed teeth! so>called! *ith deformed dental arches! as seen in #ig ,2

FI". 13. =herever the Indians were living on their native foods+ chiefly moose and caribou meat+ their #hysical develo#ment including facial and dental arch form was su#erb with nearly com#lete immunity to dental caries. $hese two women and two girls are ty#ical.

FI". 14. =herever the Indians had access to the modern foods of commerce the dental conditions were e,tremely bad. $hese four individuals are ty#ical.

FI". 19. $he blight of the white man>s commerce is seen everywhere in the distorted countenances of even the first generation after the ado#tion by the

#arents of the foods of modern commerce. $hese young #eo#le with their deformed dental arches are ty#ical. 'ote the faulty develo#ment of the facial bones as evidenced by the narrow nostrils and crowded teeth.

Contact *as also made *ith representatives of relatively isolated primitive (ndian stoc/s in the district south of +udson Bay These groups *ere reached %y a ne*ly proAected railroad e4tending east*ard and north*ard from Winnipeg! Manito%a! and *e *ere thus %rought into contact *ith the (ndians that had come out of the *ater*ays draining the +udson Bay and from as far north as Dames Bay They had come do*n to dispose of their furs in e4change for ammunition! %lan/ets! etc "ince this contact *as made only once or t*ice a year! it *as ?uite impossi%le for the (ndians to carry %ac/ a sufficient ?uantity of the foods of the *hite man to have great influence on their total diet for the year They still lived on the *ild animal game of the land As in the northern country Aust revie*ed! their principal large animal *as the moose These are treaty (ndians! and many of them come out to this frontier to o%tain the government %ounty and! accordingly! *ere o%liged to %ring their families The %ounty here amounted to five dollars per head! a considera%le income in e4change for %lan/ets and other e?uipment "ome of these contact points *ere at the height of the land dividing the *aters running north and east to Dames Bay and +udson Bay! or south to 1a/e "uperior This *as historic country that had %een the meeting ground of the tri%es of the northern *aters *ith the tri%es of the $reat 1a/es district Many %attles had %een fought there #or comparison *ith these more primitive groups from the +udson and Dames Bay *atershed! ( had the opportunity here of studying families that had ta/en up residence along the railroad or in its vicinity in order that they might have the advantage of e4changing furs for the modern *hite manBs foods This gave us an e4cellent opportunity to study the effects of the modern dietary! of *hich an e4ample is sho*n in #ig 5; This (ndian and his *ife had %uilt their %odies %efore the contact *ith the *hite man +e is a%out si4 feet tall Both the parents had splendid dental arches and *ell formed faces +is teeth are sho*n in #ig 5; Hupper! leftI Their t*o children sho*n in the photograph *ere %orn after the adoption of the *hite manBs foods %rought in %y the railroad Both are mouth> %reathers and %oth have narro* dental arches and mar/ed underdevelopment of the middle third of the face The older girl has tu%erculosis Another adult man is sho*n in #ig 5; Hupper! rightI +e! li/e the generation he represents! has e4ceptionally fine dental arches and *ell developed face

FI". !<. $hese #rimitive Indians are in central 8anada. $he three #arents were develo#ed before their district was reached by modern civili*ation. 'ote their good #hysical and facial form in contrast with the #inched nostrils of the two children. $he oldest girl has tuberculosis. $hey are the #roduct of civili*ation>s contact with their #rimitive #arents.

At this point *e again found many of the younger generation ill *ith tu%erculosis or crippled *ith arthritis T*o of these are sho*n in #ig 5,

FI". !1. $hese are ty#ical cri##les met at the #oint of contact of our modern civili*ation with the #rimitive Indians. $he boy at the left has arthritis in nearly all of his @oints. 1e has several

abscessed teeth. $he boy at the right has tubercul sis of the s#ine.

#or further comparison of the more isolated and more highly moderni6ed groups a study *as made of the (ndians in the largest single (ndian &eservation in Canada! *hich is located at Brantford! )ntario (n this group there are a%out .!9;; (ndians living under highly moderni6ed conditions provided %y the Canadian $overnment They live on very fertile land and in close pro4imity to a modern Canadian city Each head of a family is provided *ith a tract of land from *hich he usually has an income sufficient to permit him to have an automo%ile They *ere a%le to %uy not only necessities and comforts according to the modern standards of the *hite man! %ut many of the lu4uries as *ell The government provides a *ell administered hospital and staff When ( as/ed the Director of this hospital! Dr Davis! *hat the principal use of the hospital *as at that time H,2--I! he said that the demand for %eds had completely changed in the t*enty>eight years he had %een there The principal services re?uested at the hospital in ,2-- related to the pro%lems of maternity +e stated that in his period of contact he had seen three generations of mothers The grandmothers of the present generation *ould ta/e a sha*l and either alone or accompanied %y one mem%er of their family retire to the %ush and give %irth to the %a%y and return *ith it to the ca%in A pro%lem of little difficulty or concern! it seemed +e stated that today the young mothers of this last generation are %rought to his hospital sometimes after they have %een in la%or for days They are entirely different from their grandmothers or even mothers in their capacity and efficiency in the matter of reproduction +e stated that that morning he had had t*o cases in *hich surgical interference *as necessary in order to ma/e %irth possi%le We had an opportunity here to study the effects of moderni6ation (ndians are great lovers of sports! particularly of their o*n national game *hich is lacrosse We *ere a%le to *itness one of these contests *ith a team from another reservation (ndian families came in modern automo%iles dressed in modern clothes and purchased pop and candy and modern confections at typical confection stands These *ere highly moderni6ed (ndians The group on this reservation! comprising appro4imately four thousand seven hundred (ndians! %elong to the follo*ing tri%es@ Moha*/s! )nondagas! Cayugas! "enecas! )neidas and Dela*ares ma/ing up the "i4 Nation or (ro?uois group A later addition to this group has %een the Tuscaroras from the Carolinas While there *ere many mi4ed %loods! there *ere also a goodly num%er of full>%looded (ndian families! so that there *as an opportunity to study comparatively the effects of intermingling of the (ndians *ith the *hites

As in previous investigations! a special effort *as made to study the children from eight to si4teen years of age Typical cases *ere selected from different environments #or e4ample! %oys and girls selected from a training school called Moha*/ (nstitute! *hich *as near the city of Brantford! represented one type of environment There are appro4imately one hundred and si4ty students under training here! and *e *ere informed that they study half a day and *or/ half a day The %oys are taught craftsmanship and farming! the girls! home economics and garment ma/ing! and such practical training as *ould prepare them for later home %uilding While most of the %oys and girls come from that reservation! a fe* are accepted from other reservations (t is of interest that 99 per cent of the children in this (nstitution had suffered from earlier dental caries and that ,9 per cent of all the teeth e4amined had already %een attac/ed %y dental caries But this had occurred apparently %efore their entrance to the (nstitute! for *e did not find a single case of active caries among those e4amined! and this is particularly important in connection *ith their e4cellent nutrition The (nstitute maintained a fine dairy herd and provided fresh vegeta%les! *hole *heat %read! and limited the sugar and *hite flour The children of this group *ere compared *ith children of appro4imately the same age in a pu%lic school of the reservation *here it *as found that 2; per cent had had dental caries! and that at present in 9; per cent of the cases the caries *as apparently active (t is important to note that in this group 5: 7 per cent of all the teeth e4amined had already %een attac/ed %y tooth decay A study *as made of patients at the reservation hospital *here free service of all /inds is provided We found that :- per cent had suffered from dental caries! and that 5- 5 per cent of all teeth had already %een attac/ed %y caries We *ere particularly interested in the conditions o%taining in the homes! especially *ith the mothers A typical young mother had appro4imately half her teeth attac/ed %y dental caries! as had also her son! aged seven The middle third of his face *as underdeveloped and all of his upper anterior teeth *ere decayed to the gum line A study *as made of an (ndian reservation in Ne* Yor/ "tate for comparison and for ma/ing an estimate of typical modern American (ndian life *ith regard to dental caries and nutrition #or this study a %and of .7; in the Tuscarora &eservation northeast of Niagara #alls *as visited +ere again *e *ere fortunate to see the people in holiday mood since the study *as made on Decoration Day and events of the year had %een scheduled! a lacrosse match and a %ase%all game! %et*een the (ndiansB teams and *hite teams from adAacent to*ns "everal hundred (ndians *ere congregated to e4hi%it their %est in

*earing apparel! transportation e?uipment! and physical pro*ess There *as evidence of a similarity of features in the older (ndians *ho had not %een highly moderni6ed! and a stri/ing deficiency in the facial development of many of the moderns A typical mother *as studied at her home "he had four children +er teeth *ere ravaged %y dental caries "he *as strictly modern! for she had gold inlays in some of her teeth The roots of the missing teeth had not %een e4tracted T*enty of her teeth had active dental caries +er little girl! aged four! already had t*elve very %adly carious teeth Another daughter aged eight had si4teen carious teeth! and her son aged ten had si4 The hus%and *as in %ed from an acute lung involvement! dou%tless tu%erculosis The children *ere eating their noon day meal *hen *e arrived! *hich consisted of a *hite %read and some ste*ed vegeta%les Mil/ *as availa%le for only the small %a%y in arms (n this Tuscarora group :- per cent of those e4amined had dental caries and -: per cent of all teeth had already %een attac/ed %y dental caries Every one studied in this reservation *as using *hite>flour products! none *ere using mil/ li%erally! and only a fe* in even limited amounts ( *as told that in %oth reservations a fe* years ago the (ndians gre* *heat and /ept co*s to provide a li%eral supply of natural cereal and mil/ for their families! %ut of late this practice had %een discontinued They *ere no* %uying their *heat in the form of *hite flour and their vegeta%les largely put up in cans (n %oth reservations they *ere using commercial vegeta%le fats! Aams and marmalades! s*eetened goods! syrups and confections very li%erally (t is remar/a%le ho* early the child life adopts modern civili6ationBs confections (n order to provide a further cross section of the moderni6ed (ndians of North America! ( made a study in a reservation on Winnipeg 1a/e in Manito%a This reservation lies north and east of Winnipeg and is ?uite highly moderni6ed These people *ere reached *ith much difficulty %ecause of the natural protection provided %y the location of their reservation at the mouth of Bro/enhead &iver They had %een provided *ith fertile lands and taught modern methods of farming Their pro4imity to a great %ody of *ater fairly *ell>stoc/ed *ith fish gave them an opportunity to secure fish! if they *ere disposed to ma/e the effort to do so! as their ancestors had done through previous centuries Their homes *ere found to %e in a dilapidated condition! and *hile their lands *ere stoc/ed *ith cattle and horses! such as *e found *ere in poor condition! and limited in num%er The people had %een provided *ith a government school and a government agent to assist in providing for their needs and in giving material assistance *hen needed They *ere *ithin

fairly easy distance of hospitals! and had availa%le modern medical service Not*ithstanding all these advantages! their physical condition *as very poor Dental caries *as so *ide>spread that -2 , per cent of all teeth studied *ere found to %e affected They *ere living almost entirely on modern foods! imported *hite flours! Aams! canned vegeta%les and li%eral ?uantities of sugar )ver 2; per cent of the individuals had rampant dental caries Their physical condition and their supply of necessities *as very much lo*er than *as that of either of the t*o preceding groups Distress *as evident even in late summer The (ndians so far reported *ere living inland *ith access to inland foods only The Pacific Coast (ndians *ere e4amined to determine the effect of sea foods To find evidence relating to the physical! and particularly to the dental condition of the (ndians *ho inha%ited the Pacific slope a thousand or more years ago! a visit *as made to the =ancouver Museum at =ancouver *hich fortunately possesses splendidly preserved specimens of prehistoric periods "ome of these s/ulls *ere uncovered *hile cutting through a hill for a street e4tension in the city of =ancouver A%ove *as a virgin forest of large si6e green firs and underneath them in the soil there *ere preserved fallen trun/s of other large trees "everal feet %elo* these! %urials *ere uncovered containing s/eletons of an early (ndian race This collection contains also s/ulls from several places and from prehistoric periods The teeth are all splendidly formed and free from dental caries The arches are very symmetrical and the teeth in normal and regular position (t *as important to study the conditions of their successors living in the same general community Accordingly! *e e4amined the teeth and general physical condition of the (ndians in a reservation in North =ancouver! so situated that they have the modern conveniences and modern foods (n this group of children %et*een eight and fifteen years of age! -8 2 per cent of all the teeth e4amined had already %een attac/ed %y dental caries No people *ere found in this group *ho *ere living largely on native foods =ancouver (sland *ith its salu%rious climate is one of the most favored places of residence on the Pacific Coast (t *as of particular interest to study the (ndians near =ictoria on this island in the Craigflo*er (ndian &eservation (ndeed! the city of =ictoria has %een partly %uilt on the original Craigflo*er (ndian &eservation As the need %ecame acute for the territory reserved for them! an arrangement *as consummated *here%y the (ndians *ere induced to e4change that land for ne* land in an adAoining district in *hich a ne* house *as %uilt free for each family Besides a house! an allotment of land and a sum of money! reported to %e ten thousand dollars! *as given to each family This

allo*ed them to %ecome very modern! and! accordingly! many of them o*ned automo%iles and other modern lu4uries The physical effects of the use of food lu4uries! resulting from ample funds for purchasing any foods that they might desire! *as mar/ed They *ere in close pro4imity to s/illed dental service and had practical training in oral prophyla4is Not*ithstanding this! .: 7 per cent of all teeth e4amined had already %een attac/ed %y dental caries Every individual e4amined *as suffering from tooth decay The original diet of the (ndians of the Pacific Coast *as! as *e shall see! very largely sea foods! *hich are pro%a%ly as a%undant today as ever %efore (t *ould re?uire a real urge to go to catch the fish since they can no* %e purchased canned in the open mar/et 1i/e most modern people! they *ere living on *hite>flour products! s*eet foods and pastries Pro%a%ly fe* cities of the Pacific Coast have had a greater a%undance and variety of edi%le sea foods! particularly the various /inds of salmon! than Getchi/an (t is %eautifully located on an island! and is the most southerly city in Alas/a Among the many fish that are a%undant along this part of the Pacific Coast is the oolachan or candle fish (t is a small fish! %ut very rich in oilF so much so that it gets its name from %eing %urned as a candle for light This oil is collected in large ?uantities and used as a dressing for many of their sea foods (t is also traded *ith the (ndians of the interior for furs and other products An (ndian settlement in this city *as studied and it *as found that .8 8 per cent of all teeth e4amined had already %een attac/ed %y tooth decay (n many of the homes individuals *ere ill *ith tu%erculosis or arthritis Tu%erculosis had ro%%ed many of the homes of one or more of its children At Duneau! the capital of Alas/a! t*o groups *ere studiedF one in the government hospital! and the other in an (ndian settlement (n the hospital *ere %oth (ndians and Es/imos! chiefly the former "eventy>five per cent of the patients *ere reported to have %een %rought %ecause they had tu%erculosis! and some *ho had come %ecause of accident and other conditions *ere reported to have tu%erculosis also Appro4imately 7; per cent of the total hospital enrollment *as under 5, years of age The dental conditions *ere %ad! for -2 , per cent of all the teeth e4amined had %een attac/ed %y tooth decay (n the (ndian settlement! a group of elderly primitives *as found! every one of *hom had complete dentitions in normal arrangement of the arches and *ithout dental caries (n a settlement of modern (ndians living principally on modern foods .; per cent of all teeth had %een attac/ed %y tooth decay At "it/a! the former capital! t*o important groups *ere studied 1ocated here is the "heldon Dac/son "chool for Es/imos and (ndian %oys and girls!

chiefly (ndians They have come from *idely scatterd territory throughout Alas/a! and represent the finest physical specimens that can readily %e secured for giving the advantages of an education )f necessity they came very largely from the moderni6ed districts (n this group 7- 9 per cent of all the teeth e4amined had already %een attac/ed %y tooth decay This gives an indication of the dental conditions in the large num%er of moderni6ed districts *hich they represented (n a settlement at "it/a! a group of (ndians of various ages *ere studied! and it *as found that -7 8 per cent of all their teeth had already %een attac/ed %y dental caries A *ell preserved native (ndian! seventy years of age! *as found *ho had come into to*n from another district +e stated that his diet had consisted chiefly of fish! fish eggs! sea*eed and deer +is teeth *ere of very high e4cellence and *ere entirely free from past or present dental caries +e is a splendid e4ample of the product of the native dietary provided for the Pacific Coast people of any period or stage of civili6ation The local physician at "it/a /indly gave very valua%le information relative to the attitude of the native (ndians in the matter of o%taining fresh sea foods *hen foods that *ere very satisfying could %e so easily o%tained in concentrated form at the various stores They could go to one of the piers at almost any time of the year and catch fish or secure them as they had %een accustomed to do %efore the arrival of modern foods! %ut there is a constant striving to %e li/e and live li/e the *hite people They seem to thin/ it is a mar/ of distinction to purchase their foods and that it is degrading to have to forage for oneBs foods They very readily come to depend on *hite flour and sugar! Aams and canned vegeta%lesF and much prefer to have the government or charita%le organi6ation supply these *hen they cannot purchase them! rather than go out and secure their o*n nutrition This physician stated that there *ere a%out :;; *hites living in the to*n and a%out .;; (ndians! and that not*ithstanding this difference in num%ers there *ere t*ice as many (ndian children %orn as *hite children! %ut that %y the time these children reached si4 years of age there *ere more *hite children living than (ndian and half>%reed children This he stated *as largely due to the very high child mortality rate! of *hich the most fre?uent cause is tu%erculosis While it does not ta/e many decades to record a distinct physical deterioration! a deteriorating parenthood greatly speeds up this process While physical defects ac?uired %y the parent *ill not %e transmitted as such! prenatal deficiencies may %e esta%lished %ecause of the physical defects of the mother resulting from her faulty nutrition! and these deficiencies! together *ith distur%ed nutrition of infancy and early childhood *ill go far in determining *hether there *ill %e for the child a physical %rea/do*n or *hether the normal

defense of the %ody *ill %e ade?uate to protect it from various infections to *hich it may later %e e4posed "it/a has furnished the longest history of contact *ith *hite men of almost any community on the Pacific Coast (ndeed! it *as a famous seaport long %efore any 3nited "tates Pacific Coast communities had %een esta%lished (t is of much interest that it *as a ship%uilding center for vessels in the &ussian trade (ts foundries *ere developed so efficiently that the %ells of the early monasteries of California *ere cast in this to*n %y the &ussians (t contains some of the %est e4amples of the early &ussian architecture! particularly in its cathedral Anchorage is the principal city of *estern Alas/a! since it is not only a %ase for the railroad running north to #air%an/s! %ut a %ase for aeroplane companies operating throughout various parts of Alas/a (t is accordingly a com%ination of a coast city *ith its retail activities and a *holesale %ase for outfitters for the interior (t has an e4cellent government hospital *hich pro%a%ly has %een %uilt around the life of one man *hom many people told us *as the most %eloved man in all Alas/a +e is Dr Dosef &omig! a surgeon of great s/ill and *ith an e4perience among the Es/imos and (ndians! %oth the primitives and moderni6ed! e4tending over thirty>si4 years ( am deeply inde%ted to him for much information and for assistance in ma/ing contacts +e too/ me! for e4ample! to several typically moderni6ed (ndian homes in the city (n one! the grandmother! *ho had come from the northern shore of Coo/ (nlet to visit her daughter! *as si4ty>three years of age! and *as entirely free from tooth decay and had lost only one of her teeth +er son! *ho had accompanied her! *as t*enty>four years of age +e had only one tooth that had ever %een attac/ed %y tooth decay Their diet had %een principally moose and deer meat! fresh and dried fish! a fe* vegeta%les and at time some cran%erries &ecently the son had %een o%taining some modern foods +er daughter! t*enty>nine years of age! had married a *hite man and had had eight children "he and they *ere living on modern foods entirely T*enty>one of her thirty>t*o teeth had %een *rec/ed %y dental caries Their diet consisted largely of *hite %read! syrup and potatoes +er children *hom *e e4amined ranged from five to t*elve years of age! and in that family -9 per cent of all the teeth have already %een attac/ed %y dental caries! not*ithstanding the young age of the children The mother of this family is sho*n in #ig ,: Hupper! leftI (t is of great importance that not only *as dental caries rampant! %ut that there *ere mar/ed deformity of the dental arches and irregularity of teeth in the cases of the children

Among the many items of information of great interest furnished %y Dr &omig *ere facts that fitted *ell into the modern picture of association of modern degenerative processes *ith moderni6ation +e stated that in his thirty> si4 years of contact *ith these people he had never seen a case of malignant disease among the truly primitive Es/imos and (ndians! although it fre?uently occurs *hen they %ecome moderni6ed +e found similarly that the acute surgical pro%lems re?uiring operation on internal organs such as the gall %ladder! /idney! stomach! and appendi4 do not tend to occur among the primitive! %ut are very common pro%lems among the moderni6ed Es/imos and (ndians $ro*ing out of his e4perience! in *hich he had seen large num%ers of the moderni6ed Es/imos and (ndians attac/ed *ith tu%erculosis! *hich tended to %e progressive and ultimately fatal as long as the patients stayed under moderni6ed living conditions! he no* sends them %ac/ *hen possi%le to primitive conditions and to a primitive diet! under *hich the death rate is very much lo*er than under moderni6ed conditions (ndeed! he reported that a great maAority of the afflicted recover under the primitive type of living and nutrition The institutions that have %een organi6ed for the care of orphans and for the education of Es/imo and (ndian %oys and girls provide an opportunity to study conditions A particularly favora%le institution is located at E/lutna on the railroad north of Anchorage Many of the individuals in the school had come from districts so remote from transportation facilities that their isolation had compelled them to live mostly on native foods! at least during their early childhood They had come from districts very *idely distri%uted throughout the Alas/an peninsula Credit is due to the management of this institution for preparing and storing dried salmon for use throughout the *inter The %eneficial effects of their good nutritional program *ere evident The percentage of teeth attac/ed %y dental caries *as ,. 8 A large percentage of these pupils *ere of mi4ed %lood of native Es/imos or (ndians *ith *hites The *hite parent had pro%a%ly %een largely responsi%le for their attendance at this training school There *ere several full>%looded Es/imos and (ndians from moderni6ed communities *here they had %een living on modern foods throughout their entire lifetime This gave an opportunity to study the rMle of nutritional deficiencies in the development of deformities and irregularities in the facial features! in the arrangement of the teeth! and in the inter>relationship %et*een the dental arches The typical irregularities and divergencies from normal *ere present in the full>%looded Es/imo and (ndian %oys and girls in as high percentage as in the mi4ed %loods "ome of the young people *ith parentage of mi4ed %lood have %eautiful features

Another important institutional group *as studied at "e*ard in the Desse 1ee +ome *hich had first %een esta%lished at Nome and had %een moved to "e*ard to avoid the e4treme isolation of that district This institution is located at &esurrection Bay *hich is one of the most %eautiful har%ors in the *orld (t gives shelter and educational opportunities to Es/imos and (ndians! chiefly of mi4ed %lood! from a large area of Alas/a! and particularly from the Aleutian Peninsula! the Aleutian (slands and the Bering "ea These individuals! *hether of mi4ed or pure %lood! had come chiefly from homes that *ere in large part moderni6ed The incidence of dental caries found here *as 59 7 per cent for all teeth e4amined +ere again all individuals *ere affected Not*ithstanding the unusually fine hygienic conditions and highly trained dietitians of this institution! a medical *ard and trained nurses! tu%erculosis *as reaping a heavy toll ( *as told that 8; per cent of all those students *ho had moved *ith the school from Nome to this location *ere already dead from tu%erculosis (t is common /no*ledge that tu%erculosis has played a very important rMle in decimating the (ndian and Es/imo population in the Pacific Coast to*ns and villages A very important phase of these investigations is the development of ne* light on the rMle of nutrition in lo*ering the defense of these individuals so that *ith their lo* inheritance of defensive factors they rapidly %ecome suscepti%le to tu%erculosis The pro%lem of evaluating the influence of a particular environment on racial and tri%al development is relatively simple *hen studying contemporary remnants of primitive racial stoc/s +o*ever! groups that have lived and disappeared in the past do not permit of so simple a procedure for ma/ing physical estimates #ortunately! *e have in the %urial grounds not only the s/eletons! %ut also many of the implements used in daily life "ometimes these contain samples of the foods We may find also their art *are and hunting e?uipment While the period may not %e definitely recorded! the /no*ledge of the history of the pottery of the tri%e often gives an important clue to the dates as *ill also the method of %urial Burials made %efore the advent of the Christian era *ill in many groups sho* the %odies in a fle4ed position *ith the arms in the lap! *hereas in the Christian %urials the %odies have %een laid prone and the arms crossed on the chest By this sign the pre>Colum%ian %urials can readily %e separated from the post>Colum%ian 3sing these guides! a study of the (ndians of #lorida! past and present! permits of comparing the pre>Colum%ians *ith those living today in that same territory We *ill! accordingly! consider the dental caries pro%lem and that of facial and dental arch form in the #lorida (ndians %y comparing three groups@ namely! the pre>Colum%ian! as evidenced from a study of the s/ull material in

the museumsF the tri%es of (ndians living in as much isolation as is possi%le in the Everglades and Cypress "*ampsF and the (ndians of the same stoc/ that are living in contact *ith the foods of modern civili6ation This latter group lives along the Tamiami trail and near Miami (n a study of several hundred s/ulls ta/en from the %urial mounds of southern #lorida! the incidence of tooth decay *as so lo* as to constitute an immunity of apparently one hundred per cent! since in several hundred s/ulls not a single tooth *as found to have %een attac/ed %y tooth decay Dental arch deformity and the typical change in facial form due to an inade?uate nutrition *ere also completely a%sent! all dental arches having a form and interdental relationship such as to %ring them into the classification of normal These are illustrated in #igs 55 and 5- The pro%lem of reaching the isolated groups living in the depth of the Cypress "*amps *as complicated %y the fact that these people had a dread of all *hites gro*ing out of their %elief that they had %een grossly ta/en advantage of in some of their early efforts to ma/e a treaty *ith the *hites With the assistance of three guides! one! an (ndian of their o*n group! another! a *hite man *hom they trusted! and the third! a government nurse *ho had %een very helpful in case of sic/ness! *e *ere a%le to ta/e the desired measurements and records and photographs A group of these more primitive representatives is sho*n in #ig 5. While their hunting territory had %een grossly encroached upon %y the *hite hunters! they *ere still a%le to maintain a very high degree of physical e4cellence and high immunity to dental caries )nly four teeth in each hundred e4amined *ere found to have %een attac/ed %y tooth decay

FI". !!. S%ulls of #rimitive Indians showing su#erb dental arches ty#ical of 'ature>s normal #lan. 'ote the s#lendid #osition of the third molars which are so fre(uently defective in #osition and (uality in our modern white civili*ation. In many districts where I have made studies among #rimitive Indians and in many collections of their s%ulls close to a hundred #er cent of the teeth have been free from dental caries or faulty #osition.

FI". ! . $he Indian s%ulls that have been uncovered in many #arts of the ;nited States and 8anada show a degree of e,cellence com#arable to those seen in this Figure. $hese levels of e,cellence were the rule with them+ not the e,ce#tion as with us. $he #arents of these individuals %new what they and their children should eatA

FI". !). $he Seminole Indians living today in southern Florida largely beyond contact with the white civili*ation still #roduce magnificent teeth and dental arches of which these are ty#ical. $hey live in the 7verglade forest and still obtain the native foods.

Practically all of the dental arches *ere normal in contour *ith freedom from facial distortion (n contrast *ith this! the (ndians of #lorida *ho are living today in contact *ith modern civili6ation present a pathetic picture #orty out of every hundred teeth e4amined *ere found to have %een attac/ed %y tooth decay! typically illustrated in #ig 57 (n the latest generation! many dental arches sho*ed a typical deformation *ith cro*ding of the teeth and narro*ing of the face! conditions that have %een found in all human stoc/s *hen on an inade?uate nutrition during the formative and early gro*th period A group of these is typically illustrated in #ig 58

FI". !-. $he Seminole Indians of Florida who are living in contact with our modern civili*ation and its foods suffer from ram#ant dental caries.

FI". !/. Seminole Indians. 'ote the change in facial and dental arch form in the children of this moderni*ed grou#. $hey have a mar%ed lac% of develo#ment of the

facial bones with a narrowing of the nostrils and dental arches with crowding of the teeth. $heir faces are stam#ed with the blight which so many often thin% of as normal because it is so common with us.

(t is of interest that the ?uality of the s/eletal material that is ta/en from the mounds sho*ed unusually fine physical development and freedom from Aoint involvements (n contrast *ith this! many of the individuals of the moderni6ed group *ere suffering from advanced deformities of the s/eleton due to arthritic processes The effects of the e4cellent nutrition of the pre>Colum%ian (ndians is indicated in the comparative thic/ness of the s/ulls (n #ig 59 are sho*n t*o pieces of a pre>Colum%ian s/ull in contrast *ith a modern s/ull The specimen of a trephined lo*er Aa*! sho*n in #ig 59 HrightI indicates a /no*ledge of surgery that is very remar/a%le The margins sho* ne* %one gro*th The operation opened a cyst

FI". !3. Left0 7,am#le of greater thic%ness of #re& 8olumbian Indian s%ulls in Florida than modern s%ulls. 2ight0 Illustration of bone surgery of ancient Florida Indians. 'ote healing of margins of tre#hined o#ening into a cyst+ of the lower @aw. $his is ty#ical of the advanced surgery of the ?eruvian Indians.

#or the study of a group of (ndians no* living in a high *estern state! Al%u?uer?ue! Ne* Me4ico! *as visited "everal other (ndian studies have %een made including studies of living groups! recently opened %urials and museum collections! all of *hich support the findings recorded here ( am inde%ted to the directors and to the staffs of these institutions for their assistance

Not*ithstanding the *ide range of physical and climatic conditions under *hich primitive (ndians had %een living! their incidence of tooth decay *hile on their native foods *as al*ays near 6eroF *hereas! the moderni6ed (ndians of these groups sho*ed very high incidence of dental caries A summary of percentages follo*s@ Primitive (ndians) Pelly Mountain! ; ,8 per centF Duneau! ; ;; per centF #lorida Pre>Colum%ian! ; ;; per centF #lorida "eminoles! . ; per cent Modernized (ndians) Telegraph Cree/! 57 7 per centF Alas/a #rontier! .; ; per centF Moha*/ (nstitute! ,9 per centF Brantford &eservation Pu%lic "chool! 5: 7 per centF Brantford &eservation +ospital! 5- 5 per cent! Tuscarora &eservation! -: ; per centF Winnipeg 1a/e &eservation! -2 , per centF North =ancouver &eservation! -8 2 per centF Craigflo*er (ndian &eservation! .: 7 per centF Getchi/an! .8 8 per centF Duneau +ospital! -2 , per centF "heldon Dac/son "chool! 7- 9 per centF "it/a! -7 8 per centF E/lutna! ,. 8 per centF Dessie 1ee +ome! "e*ard! 59 8 per cent! and #lorida "eminoles! .; ; per cent The foods used %y the primitives varies according to location and climate The foods of the moderni6ed groups in all cases *ere the typical *hite manBs foods of commerce While the primitive groups constantly presented *ell>formed faces and dental arches reproducing the tri%al pattern! the ne* generation! after the adoption of *hite manBs foods! sho*ed mar/ed changes in facial and dental arch form The (ndians li/e several primitive races ( have studied are a*are of the fact that their degeneration is in some *ay %rought a%out %y their contact *ith the *hite man The disli/e of the American (ndian for the modern *hite civili6ation has %een emphasi6ed %y many *riters (n my studies among the "eminole (ndians of #lorida ( found great difficulty in communicating *ith or ma/ing e4amination of the isolated "eminoles living deep in the Everglades and Cypress "*amp #ortunately! ( had the a%le assistance of one of their o*n tri%e! a government nurse *ho had %een very helpful to them and also a *hite man *ho had %efriended them and *hom they trusted With their assistance ( *as a%le to carry out very detailed studies (t *as of interest! ho*ever! that *hen *e arrived at a settlement in the %ush *e practically al*ays found it uninha%ited )ur (ndian guide *ould go into the surrounding scru% and call to the people assuring them it *as to their advantage to come out! *hich they finally did ( *as told that this attitude had gro*n out of the %elief on their part that their treaties had %een violated These isolated "eminole (ndian *omen had the reputation of turning their %ac/s on all *hite men

A 3nited "tates Press report H,I provides an article *ith the heading *Tribes +%ed Up+ Seek Solit!de, (ndians 'islike Civilization, Ask Land ,arred to -hite Men#* The article continues@ The Bureau of (ndian Affairs revealed today that five (ndian tri%es in )/lahoma are 'fed up' *ith *hite civili6ation and *ant ne*! secluded tri%al lands "o *idespread is the discontent among the ,;;!;;; (ndians living in )/lahoma! officials said! that serious study is %eing given to the possi%ility of providing ne* lands *here the redman may hunt and fish as his ancestors did Dissatisfaction has %een %re*ing for a long time as a result of an increasing (ndian population! decreasing (ndian lands and unsatisfactory economic conditions (t *as %rought officially to the notice of %ureau officials several days ago *hen a delegation! headed %y Dac/ $ouge! a Cree/ (ndian from +anna! )/la ! told (ndian Commissioner Dohn Collier that most of the )/lahoma (ndians *anted ne* tri%al lands a*ay from *hite civili6ation "o an4ious are his people to escape from the *hite man and his influences! Dac/ $ouge said! that an organi6ation of a%out ,;;; (ndians has %een formed to press the demands (t is /no*n as the '#our Mothers!' apparently representing four of the 'civili6ed tri%es'>>the Cree/s! Chocta*s! Chero/ees and Chic/asa*s The fifth civili6ed tri%e! the "eminoles of )/lahoma! are negotiating *ith the Me4ican government for tri%al lands in that country These tri%es are descri%ed as 'civili6ed' %ecause of the high degree of culture they attained in their original tri%al lands along the eastern coast As their eastern lands %ecame valua%le the (ndians *ere moved to the area *hich is no* )/lahoma At the turn of the century! ho*ever! *ith the discovery of oil there the ne* tri%al lands *ere %ro/en up The (ndians *ere forci%ly removed to small tracts despite their desire to remain together (ndian Bureau officials do not conceal their %itterness over the *hite manBs 'treachery ' )ne official pointed out that a%out -;; treaties have %een signed *ith the (ndians and that practically every one has %een violated (t *ill %e most fortunate if in the interest of science and human %etterment such a program as this *ill %e carried out in order to permit these (ndians to live in accordance *ith the accumulated *isdom of their various tri%es Their

preservation in isolation *ould preserve their culture The greatest heritage of the *hite man today is the accumulated *isdom of the human race )eference , Tri%es '#ed 3p' "ee/ "olitude Cleveland Press, Dune ,2! ,2-: Chapter * Isolated and modernized +elanesians "(NCE our ?uest *as to gather data that *ill thro* light upon the cause of modern physical degeneration among human racial stoc/s in various parts of the *orld! it %ecame necessary to include for study various groups living in the hot sultry climates of the tropics Again it *as desira%le to o%tain contact *ith %oth highly isolated and! therefore! relatively primitive stoc/s for comparison *ith moderni6ed groups of the same stoc/ (n order to accomplish this an e4pedition *as made in ,2-. to eight archipelagos of the "outhern Pacific to study groups of Melanesians and Polynesians The Melanesians descri%ed here *ere living in Ne* Caledonia and the #iAi (slands (f the causative factors for the physical degeneration of man/ind are practically the same every*here! it should %e possi%le to find a common cause operating! regardless of climate! race! or environment )*ing to the vast e4tent of the Pacific *aters and the limited num%er of transportation lines! it %ecame very difficult to arrange a convenient itinerary This! ho*ever! *as finally accomplished satisfactorily %y going south*ard through the more easterly archipelagosF namely! the Mar?uesas (slands! "ociety (slands and Coo/ (slands! then *est*ard to the Tongan (slands in the southern central Pacific near Ne* <ealand! and then *est*ard to Ne* Caledonia near Australia #rom this group *e *ent north*ard to the #iAi (slands! also in the *estern Pacific! then to the "amoan (slands in the central Pacific south of the e?uator! and then to the +a*aiian (slands north of the e?uator These island groups *ere all populated %y different racial stoc/s spea/ing different languages The movements from archipelago to archipelago *ere made on the larger ships! and %et*een the islands of the group in small crafts! e4cept in the +a*aiian (slands *here an aeroplane *as used The program in each group consisted in ma/ing contact *ith local guides and interpreters They had generally %een arranged for in advance %y correspondence *ith government officials By these means *e *ere a%le to

reach isolated groups in locations ?uite distant from contact *ith trade or merchant ships To reach these isolated groups often re?uired going over rough and difficult trails since most of the islands %eing of volcanic formation are mountainous

)n reaching the isolated groups our greetings and the purpose of the mission *ere conveyed %y our interpreters to the chiefs Much time *as often lost in going through necessary ceremonials and feasting (n every instance *e received a very cordial reception and e4cellent cooperation (n no instance *as there antagonism Through the underground telegraph they al*ays seemed to /no* *e *ere coming and had prepared for us When these formalities *ere once over and our *ishes made /no*n! the chiefs instructed the mem%ers of their tri%es to carry out our program for ma/ing e4aminations! recording personal data! ma/ing photographs! and collecting samples of foods for chemical analysis The food samples *ere either dried or preserved in formalin The detailed records for every individual included data on the tri%e! village and family! his age! previous residence! physical development! the /inds of foods eaten! the physical condition of every tooth! including presence or a%sence of cavitiesF the shape of the dental archesF the shape and development of the faceF and detailed notes on divergencies from racial type "pecial

physical characteristics *ere photographed A comparsion *as made of these factors for each of the more isolated mem%ers of the same tri%e and those in the vicinity of the port or landing place of the island Through the government officials detailed information *as secured! usually in the form of the annual government statistical reports! sho*ing the /ind and ?uantity of the various ingredients and articles that *ere imported! and similarly those that *ere e4ported Contact *as made in each island group *ith the health officers! and the studies *ere usually made *ith their assistance (n many instances the only contact *ith civili6ation had consisted of the call of a small trading ship once or t*ice a year to gather up the copra or dried coconut! sea shells and such other products as the natives had accumulated for e4change Payment for these products *as usually made in trade goods and not in money The follo*ing articles consisted nearly al*ays of 2; per cent of the total value@ *hite flour and sugar Ten per cent consisted of *earing apparel or material for that apparel While the missionaries have encouraged the people to adopt ha%its of modern civili6ation! in the isolated districts the tri%es *ere not a%le to depart much from their native foods %ecause of the infre?uency of the call of the trader ship Effort had %een made in almost all of the islands to induce the natives to cover their %odies! especially *hen in sight of strangers (n several islands regulatory measures had %een adopted re?uiring the covering of the %ody This regulation had greatly reduced the primitive practice of coating the surface of the %ody *ith coconut oil! *hich had the effect of a%sor%ing the ultra>violet rays thus preventing inAury from the tropical sun This coating of oil ena%led them to shed the rain *hich *as fre?uently torrential though of short duration The irradiation of the coconut oil *as considered %y the natives to provide! in addition! an important source of nutrition Their ne*ly ac?uired *et garments %ecame a serious menace to the comfort and health of the *earers The early navigators *ho visited these "outh "ea (slands reported the people as %eing e4ceedingly strong! vigorously %uilt! %eautiful in %ody and /indly disposed There *ere formerly dense populations on most of the inha%ita%le islands (n contrast *ith this! one no* finds that on many of the islands the death rate has come to so far e4ceed the %irth rate that the very e4istence of these racial groups is often seriously threatened The (sland of Ne* Caledonia is one of the largest of the Pacific (t is situated in the vicinity of 5- degrees south latitude and ,87 degrees east longitude The Ne* Caledonians are pure Melanesian stoc/ They are %road shouldererd! very muscular and in the past have %een very *arli/e These (slands are under

#rench control The foreign population is chiefly #rench! and limited mainly to the vicinity of the one port of Noumea The su%Augation of these people has %een very difficult and as recently as ,2,9 a %and from the interior in protest against efforts to esta%lish a *hite colony and sugar plantation on a desira%le section of coastal land s*ept do*n on the #rench colony in the night and massacred almost the entire population Their contact *ith the re?uired foods from the sea had %een cut off They %elieve they re?uire sea foods to maintain life and physical efficiency The physical development of the primitive people including their teeth and dental arches is of very high order A comparison of the individuals living near the ports *ith those living in the isolated inland locations sho*s mar/ed increase in the incidence of dental caries #or those living almost e4clusively on the native foods the incidence of dental caries *as only ; ,. per centF *hile for those using trade foods the incidence of dental caries *as 58 per cent The splendid facial and dental arch development of these ?uite primitive Caledonians is sho*n in #ig 5: Note also their /in/y hair and strong nec/ and face muscles

FI". !4. $hese Belanesians are ty#ical in general #hysical build and facial and dental arch form of their race which is s#read over a wide area of Islands in the southeastern ?acific. $he nutrition of all is ade(uate for them to develo# and maintain their racial #attern.

The #iAi (sland group lies %et*een ,7 and 55 degrees south latitude and %et*een ,99 degrees *est and ,97 degrees east longitude! thus straddling the international date line The #iAi (slanders are similar in physical development and appearance to the Ne* Caledonians! and li/e them are largely! if not *holly! Melanesian in racial origin The men have /in/y hair and %road shoulders (n the past! they have %een e4cellent *arriors They are not as tall as their hereditary enemies! the Tongans! to the east! and in order to ma/e themselves loo/ e?ually tall! they have adopted the practice of training their /in/y hair straight out from the head to a height often reaching si4 or more inches Typical facial and dental arch forms are sho*n in #ig 52 They are British su%Aects! and *here they have had supervision! in the districts near the ports and on those islands on *hich sugar plantations have %een esta%lished! they have suffered very greatly from the degenerative diseases

FI". !9. $he develo#ment of the facial bones determines the si*e and sha#e of the #alate and the si*e of the nasal air #assages. 'ote the strength of the nec% of the men above and the well #ro#ortioned faces of the girls below. Such faces are usually associated with #ro#erly #ro#ortioned bodies. $ooth decay is rare in these mouths so long as they use an ade(uate selection of the native foods.

"ince =iti 1evu! one of the islands of this group! is one of the larger islands of the Pacific )cean! ( had hoped to find on it a district far enough from the sea

to ma/e it necessary for the natives to have lived entirely on land foods Accordingly! *ith the assistance of the government officials and %y using a recently opened government road ( *as a%le to get *ell into the interior of the island %y motor vehicle! and from this point to proceed farther inland on foot *ith t*o guides ( *as not a%le! ho*ever! to get %eyond the piles of sea shells *hich had %een carried into the interior My guide told me that it had al*ays %een essential! as it is today! for the people of the interior to o%tain some food from the sea! and that even during the times of most %itter *arfare %et*een the inland or hill tri%es and the coast tri%es! those of the interior *ould %ring do*n during the night choice plant foods from the mountain areas and place them in caches and return the follo*ing night and o%tain the sea foods that had %een placed in those depositories %y the shore tri%es The individuals *ho carried these foods *ere never molested! not even during active *arfare +e told me further that they re?uire food from the sea at least every three months! even to this day This *as a matter of /een interest! and at the same time disappointment since one of the purposes of the e4pedition to the "outh "eas *as to find! if possi%le! plants or fruits *hich together! *ithout the use of animal products! *ere capa%le of providing all of the re?uirements of the %ody for gro*th and for maintenance of good health and a high state of physical efficiency Among the sources of animal foods *as the *ild pig from the %ush These *ere not native! %ut imported into nearly all of the islands! and they have %ecome *ild *here there is an a%undance of food for them Another animal food *as that from coconut cra%s *hich gro* to a *eight of several pounds At certain seasons of the year the cra%s migrate to the sea in great num%ers from the mountains and interior country They spend a%out three days in the sea for part of their reproductive program and return later to their mountain ha%itats Their routes of travel are as nearly as possi%le in straight lines At the season of migration! large num%ers of the cra%s are captured for food These cra%s ro% the coconut trees of fruit They clim% the trees during the dar/ness and return to the ground %efore the da*n They cut off the coconuts and allo* them to drop to the ground When the natives hear coconuts dropping in the night they put a girdle of grass around the tree fifteen or t*enty feet from the ground! and *hen the cra%s %ac/ do*n and touch the grass they thin/ that they are do*n on the ground! let go their hold and are stunned %y the fall The natives then collect the cra%s and put them in a pen *here they are fed on shredded coconut (n t*o *ee/sB time the cra%s are so fat that they %urst their shells They are then very delicious eating #resh *ater fish of various /inds are used *here availa%le from the mountain streams 1and animal foods! ho*ever! are not a%undant in the mountainous interior! and no places *ere found *here the native plant foods *ere not supplemented %y sea foods

)ur first visit to the #iAi (slands *as in ,2-.! and the second in ,2-8 )n our first trip *e had much personal assistance from &atu Popi! hereditary /ing +is residence *as on the royal island reserved e4clusively for the /ing and his retinue +is picture is sho*n in #ig -; *ith that of Mrs Price +e *as very solicitous for the *elfare of his people *hom he recogni6ed to %e rapidly %rea/ing do*n *ith moderni6ation The council house is also sho*n in #ig -; +e gave us very important information regarding the origin of canni%alism! relating it to a recognition of special food values of special organs! particularly the livers

FI". <. $he building above is the Fi@i 8ouncil house and shows the ty#ical form of native architectureC no nails or bolts are used. It is located on the 6ing>s Island Bbau. $he hereditary monarch+ 2atu ?o#i is seen with Brs. ?rice. 'ote his s#lendid features. Beneath his coat he wears a native s%irt and is barefooted.

There has %een a very e4tensive development of sugar plantations on the larger islands of several of the Pacific archipelagos The *or/ing of these plantations has re?uired the importation of large num%ers of indentured la%orers These have %een %rought chiefly from (ndia and China "ince they are nearly all men! those *ho have married have o%tained their *ives from among the natives This! the Chinese have done ?uite fre?uently "ince they are e4cellent *or/ers they provide good homes and are good %usiness men They

are! in many districts! rapidly %ecoming the lando*ners and are men of influence This influ4 of Asiatics! together *ith that of Europeans! has had an important influence upon the purity of the native race around the ports and provided an opportunity to study the effect of intermingling of races upon the suscepti%ility to dental caries No differences in e4tent of tooth decay due to ancestry *ere disclosed The incidence of dental caries at the points of contact *ith imported foods *as -; , per cent of teeth e4amined as compared *ith ; .5 for the more isolated groups living on the native foods of land and sea The physical changes *hich *ere found associated *ith the use of the imported foods included the loss of immunity to dental caries in practically all of the individuals *ho had displaced their native foods very largely *ith the modern foods Dental caries *as much *orse! ho*ever! in the gro*ing children and motherhood group due to the special demands of these individuals These conditions are illustrated in #igs -, and -5 The %oy sho*n in #ig -5 Hupper! leftI typifies the suffering %rought %y moderni6ation A%scessed teeth often cause suicide

FI". 1. $hese natives of the Fi@i Islands illustrate the effect of changing from the native food to the im#orted foods of commerce. $ooth decay becomes ram#ant and with it is lost the ability to #ro#erly masticate the food. "rowing children and child bearing mothers suffer most severely from dental caries.

FI". !. 'o dentists or #hysicians are available on most of these islands. $oothache is the only cause of suicide. $he new generation born after the #arents ado#t the im#orted modern foods often have a change in the sha#e of the face and dental arches. $he teeth are crowded as shown below.

Another important phase of the studies included a critical e4amination of the facial form and shape of the dental arches *hich include very definite and typical changes represented %y the narro*ing of the features and the lengthening of the face *ith cro*ding of the teeth in the arch These are illustrated in the lo*er half of #ig -5 The mem%ers of the Melanesian race living on the #iAi (slands of the Pacific! *hether volcanic or coral in origin! have developed a very high immunity to dental caries and *ell formed faces and dental arches Their native foods consisted of animal life from the sea eaten *ith plants and fruits from the land in accordance *ith a definite program of food selection (n their primitive state only ; .5 per cent of their teeth *ere attac/ed %y tooth decay (n the moderni6ed groups this incidence increased to -; , per cent The change in the nutrition included a mar/ed reduction in the native foods and their displacement *ith *hite>flour products! sugar and s*eetened goods! canned foods and polished rice (n the succeeding generations after the parents had

adopted the modern foods! there occurred distinct change in facial form and shape of the dental arches Chapter , Isolated and modernized Polynesians T+E characteristics of the Polynesian race included straight hair! oval features! happy! %uoyant dispositions and splendid physi?ues When the Pacific (slands *ere discovered the Polynesians *ere found inha%iting the +a*aiian (slands! the Mar?uesas (slands! the Tuamotu group including Tahiti! the Coo/ (slands! the Tongan (slands and the "amoan group The first group studied *as made up of the people of the Mar?uesas (slands *hich are situated 2 degrees south latitude and ,.; degrees *est longitude! a%out .!;;; miles due *est of Peru #e*! if any! of the primitive racial stoc/s of the "outh "ea (slands *ere so enthusiastically e4tolled for their %eauty and e4cellence of physical development %y the early navigators Much tooth decay prevails today They reported the Mar?uesans as vivacious! happy people num%ering over a hundred thousand on the seven principal islands of this group Pro%a%ly in fe* places in the *orld can so distressing a picture %e seen today as is found there A #rench government official told me that the native population had decreased to a%out t*o thousand! chiefly as a result of the ravages of tu%erculosis "erious epidemics of small>po4 and measles have at times ta/en a heavy toll (n a group of appro4imately one hundred adults and children ( counted ten *ho *ere emaciated and coughing *ith typical signs of tu%erculosis Many *ere *aiting for treatment at a dispensary eight hours %efore the hour it opened (n the past some of the natives have had splendid physi?ues! fine countenances! and some of the *omen have had %eautiful features They are no* a sic/ and dying primitive group A trader ship *as in port e4changing *hite flour and sugar for their copra They have largely ceased to depend on the sea for food Tooth decay *as rampant At the time of the e4amination! -8 2 per cent of the teeth of the people using trade food in conAunction *ith the land plants and fruits had %een attac/ed %y tooth decay The individuals living entirely on native foods *ere fe* "ome early navigators *ere so highly impressed *ith the %eauty and health of these people that they reported the Mar?uesas (slands as the $arden of Eden Tahiti is the principal island of the "ociety group (t is situated ,9 degrees south of the e?uator! ,.2 degrees *est longitude #ortunately degeneration has not %een so rapid nor so severe here The Tahitian population! ho*ever! has reduced from over t*o hundred thousand as early estimated! to a present native population estimated at a%out ten thousand These islands are also a part of #rench )ceania Many of

the a%le %odied men *ere ta/en from these #rench (slands to #rance to fight in the World War )nly a small percentage! ho*ever! returned! and they *ere mostly crippled and maimed The Tahitians are a %uoyant! light>hearted race! fully conscious! ho*ever! of their rapid decline in num%ers and health Many of the more primitive are very fine loo/ing and have e4cellent dental arches! as seen in #ig --

FI". . ?olynesians are a beautiful race and #hysically sturdy. $hey have straight hair and their color is often that of a sun tanned 7uro#ean. $hey have #erfect dental arches.

The capital of Tahiti! Papeete! is the administrative center for the #rench Pacific possessions (t has a large foreign population! and there is considera%le commerce in and out of this port Much imported food is used 1i/e on the Mar?uesas (slands! it *as difficult to find large num%ers of individuals living entirely on the native foods Those that *ere found had complete immunity to dental caries #or the natives living in part on trade foods! chiefly *hite flour! sugar and canned goods! -, 2 per cent of the teeth *ere found to %e attac/ed %y tooth decay Typical e4tensive destruction of the teeth amongst the moderni6ed Tahitians is sho*n in #ig -. There is a large colony of Chinese in Tahiti! %rought there as indentured la%orers They have not returned When the Tahitian men did not return from the *ar! their *ives married the Chinese! *ho are good *or/ers

FI". ). =herever the native foods have been dis#laced by the im#orted foods+ dental caries becomes ram#ant. $hese are ty#ical moderni*ed $ahitians.

The Coo/ (slands are British and under the direct guidance of the Ne* <ealand $overnment &arotonga is the principal island (t is situated in the Pacific )cean in the vicinity of 5, degrees south latitude and ,8; degrees *est longitude (t has a delightful climate the year around &acially according to legend! the Maori tri%e! the native tri%e of Ne* <ealand! migrated there from the Coo/ (slands (n addition to %eing similar in physical development and appearance! their languages are sufficiently similar so that each can understand the other! even though their separation occurred pro%a%ly over a thousand years ago (t is a matter of great importance that the inha%itants of these "outh "ea (slands *ere s/illful navigators and %oat %uilders (t *as a common occurrence for e4peditions %oth peaceful and aggressive to ma/e Aourneys of one and t*o thousand miles in crafts propelled %y man po*er and *ind and carrying in addition an ade?uate supply of *ater and food for their Aourney A large num%er *ere found in &arotonga living almost entirely on native foods! and only ; - per cent of the teeth of these individuals have %een attac/ed %y dental caries (n the vicinity of Avarua! the principal port! ho*ever! the

natives *ere living largely on trade foods! and among these 52 7 per cent of the teeth *ere found to have %een attac/ed %y dental caries (n #ig -7 HtopI are seen typically fine faces and teeth +o*ever at the lo*er left is sho*n a child at the port *hose parents *ere living on the imported food This %oyBs upper lateral teeth are erupting inside the arch (n the lo*er right is a child *ith normal spacing of the deciduous teeth

FI". -. $hese ?olynesians live on the island of 2arotonga. At the to# are two e,am#les of ty#ically fine faces and teeth. Below+ at left+ is seen a full blood ?olynesian child with the dental arch so small that the #ermanent laterals are develo#ing inside the arch. 1is #arents used im#orted food. At the right below is a mi,ed blood of white and ?olynesian. 'ote the normal s#acing of the tem#orary teeth before the #ermanent set a##ears. ?arents used native foods.

3nder British guidance the Coo/ (slanders have much %etter health than the Mar?uesans or the Tahitians Their population is not seriously decreasing! and is untrou%led e4cept for the progressive development of the degenerative diseases around the port They are thrifty and happy! and are rapidly developing a local culture including a school system supported %y natives The inha%itants of the Tongan (slands! the principal of *hich is Tongata%u! are Polynesian This group! containing over ,;; islands! is situated %et*een ,:

and 55 degrees south latitude and %et*een ,9- and ,98 degrees *est longitude! and has a native population of a%out 5:!;;; They have the distinction of %eing one of the last a%solute monarchies of the *orld While they are under the protection of $reat Britain! they largely manage their o*n affairs Their isolation is nearly complete e4cept for a call from an infre?uent trader They seem to %e credited %y the inha%itants of the other islands as %eing the greatest *arriors of the Pacific The Tongans at least ac/no*ledge that they are the greatest *arriors! and indeed the greatest people of the *orld They *ill not step aside to allo* anyone to pass since they say that *hen the *orld *as created and populated they *ere the first to %e made! ne4t *as the pig! and last the *hite man Ethnologically! they are said to %e a mi4ture of the dar/er Melanesians *ith their /in/y hair! and the fairer Polynesians of the eastern archipelagos *ith straight hair (t is said they have never %een defeated in %attle #or centuries they and the #iAian tri%es 9;; miles to the *est have fre?uently %een at *ar The British government has very s/illfully directed this racial rivalry into athletics While *e *ere in the #iAi (slands the British government provided a %attle cruiser to carry the foot%all team from #iAi to Nu/ualofa for the annual contest of strength These islanders have practiced eugenics %y selecting tall strong mates The ?ueen of the islands *as si4 feet three inches in height The limited importation of foods to the Tongan (slands due to the infre?uent call of merchant or trading ships has re?uired the people to remain largely on their native foods #ollo*ing the *ar! ho*ever! the price of copra *ent up from L.; ;; per ton to L.;; ;;! *hich %rought trading ships *ith *hite flour and sugar to e4change for the copra The effect of this is sho*n very clearly in the condition of the teeth The incidence of dental caries among the isolated groups living on native foods *as ; 8 per cent! *hile for those around the port living in part on trade foods! it is -- . per cent The effect of the imported food *as clearly to %e seen on the teeth of the people *ho *ere in the gro*th stage at that time No* the trader ships no longer call and this forced isolation is very clearly a %lessing in disguise Dental caries has largely ceased to %e active since imported foods %ecame scarce! for the price of copra fell to L. ;; a ton The temporary rise in tooth decay *as apparently directly associated *ith the calling of trader ships The "amoan (slands are located in the vicinity of ,. degrees south latitude and %et*een ,88 and ,9. degrees *est longitude The native population of the "amoan (slands is Polynesian The control of the (slands is divided %et*een t*o governments The eastern group is American The *estern group is British

since the World War! %efore *hich it *as under $erman control The *estern group is no* under a mandate to Ne* <ealand Through the /indness of the $overnor and Naval )fficers of American "amoa transportation *as provided on an au4iliary craft to the various islands of the American "amoan group We *ere particularly inde%ted to Commander "tephenson! Director of +ealth! *hose guests *e *ere! for continued personal assistance in ma/ing favora%le contacts in nearly all villages of the American "amoan group (n no islands of the Pacific did *e find so e4cellent an organi6ation for health service Dispensaries have %een esta%lished *ithin reach of nearly all the villages %esides hospital service at Pago Pago! the port of Tutuila This is the finest port in the Pacific )cean Not*ithstanding the regular monthly contact through merchant ships to and from America and Australia! many isolated groups *ere found living largely on the native foods A dental survey had recently %een made of this group %y 1ieutenant Commander #erguson H,I The e4cellent facial and dental arch development of the "amoans is illustrated in the upper half of #ig -8 The change in facial and dental arch form *hich follo*s the use of modern food %y the parents is sho*n in the lo*er half of #ig -8 Note the mar/ed irregularity of the teeth This is one of the fe* groups of islands in *hich the population is not rapidly decreasing! indeed there is some increase The Navy personnel includes one dentist Practically all his time is re?uired for the personnel and families of the Navy at this station Accordingly! he can do only a limited amount of emergency service such as e4tractions for the natives A%out 2; per cent of the inha%itants of American "amoa are on the largest island! Tutuila! and due to the development of roads! a considera%le num%er of the people have access to the main port! to *hich several of them come on ship days to sell their *ares and to %uy provisions to augment their native foods The incidence of dental caries among those individuals living in part on imported foods at the port as compared *ith those in remote districts living on native foods *as as follo*s@ Those almost e4clusively on native foods had ; - per cent of the teeth attac/ed %y dental caries! and for those on trade foods! ,: 9 per cent "ea foods used here include many shell fish *hich are gathered and sold largely %y the young people The octopus! the sea cra% and the %eche>de>mere eaten ra* *ere used

FI". /. 'ote the mar%ed difference in facial and dental arch form of the two Samoan #rimitives above and the two moderni*ed below. $he face bones are underdevelo#ed below causing a mar%ed constriction of the arches with crowding of the teeth. $his is a ty#ical e,#ression of inade(uate nutrition of the #arents.

The +a*aiian (slands lie %et*een ,: and 55 degrees north latitude and %et*een ,7. and ,8; degrees *est longitude These (slands are ?uite unli/e any of the other Pacific (sland groups previously discussed "ugar and pineapple plantations cover vast areas and together constitute %y far the most important industries of these (slands (n many districts the population is almost entirely foreign or of various %lends! chiefly of #ilipinos and Dapanese *ith +a*aiians There is a large American population and a considera%le European These different racial groups have largely %rought their o*n customs *hich are rapidly su%merging the native customs "ince the native population is so greatly reduced in comparison *ith the foreign population! and %ecause intermarrying has %een so general! it *as difficult to find large groups of relatively pure> %looded +a*aiians either living almost entirely on native foods or on moderni6ed foods Though the num%er of the individuals in these groups is accordingly not large! important data *ere o%tained for comparing the relative incidence of dental caries and other degenerative processes While the preparation of foods on the various Pacific (slands has many common factors!

all natives using the underground oven of hot stones for coo/ing! the +a*aiian (slands present one uni?ue difference in the method of preparation of their taro They coo/ the root as do all the other tri%es! %ut having done so they dry the taro! po*der it and mi4 it *ith *ater and allo* it to ferment for several hours! usually t*enty>four or more This preparation called 'poi' %ecomes slightly tart %y the process of fermentation and has the consistency of heavy strap molasses or a very heavy cream (t is eaten %y rolling it up on one or t*o fingers and suc/ing it from them (t accordingly offers no resistance to the process of mastication (n the districts *here the natives are living on native foods the incidence of dental caries *as only 5 per cent of the teeth! *hereas among those natives *ho are living in large part on the imported foods! chiefly *hite flour and s*eetened goods! -9 - per cent of the teeth had %een attac/ed %y tooth decay Typical +a*aiian faces are seen in #ig -9 Typical modern tooth decay is sho*n in #ig -: This girl has tu%erculosis also

FI". 3. =herever the ?olynesians are being moderni*ed a change is occurring in facial form which is #rogressively more severe in the younger members of the family. $hese girls of an 1awaiian family demonstrate this. 'ote the change in facial form in the sister to the right. $he face is longer and narrower+ the nostrils #inched and the chin is receding. $he tribal facial #attern is lost.

FI". 4. $he ?olynesian race is ra#idly disa##earing with moderni*ation. $ooth decay becomes e,treme as shown in the girl above. $his girl has tuberculosis+ one of the #hysical in@uries which accom#any moderni*ation. $his is one of the bodily in@uries as we will see later.

The study of the incidence of dental caries in these various "outh "ea (sland groups in its relation to diet *as only one of several of the pro%lems investigated "ince nutrition is the principal factor that has %een found related to the r8le of immunity and suscepti%ility to dental caries in my previous field studies! the collection of foods for chemical analysis and the gathering of detailed data regarding the articles of diet have %een very important phases of the activities of this group of studies Data *ere collected for relating the incidence of irregularities of the teeth and dental arches to the types of nutrition "imilarly! studies *ere made of the individuals *ho had %een hospitali6ed! in the fe* places *here hospitals e4isted! chiefly to o%tain data regarding the classification of the individuals *ho *ere suffering from tu%erculosis These *ere similar to the studies that ( have made among the Es/imos and (ndians of Alas/a and northern and central Canada

(f one *ill picture a community of several thousand people *ith an average of -; per cent of all the teeth attac/ed %y dental caries and not a single dentist or dental instrument availa%le for assistance of the entire group! a slight reali6ation is had of the mass suffering that has to %e endured Commerce and trade for profit %la6e the *ay in %rea/ing do*n isolationBs %arriers! far in advance of the development of health agencies and emergency relief un*ittingly made necessary %y the trade contact While dental caries *as most active in the periods of systematic overloads! such as gro*th! gestation and lactation! even the splendidly formed teeth of the adult men *ere *rec/ed %y dental caries *hen the native foods *ere displaced *ith modern foods (n all of the groups living on native foods *ith a li%eral inta/e of animal life of the sea! the health of the gums *as generally e4cellent When! ho*ever! the sea foods *ere ?uite limited in the dietary! heavy deposits formed and often *ere associated *ith a mar/ed destruction of the supporting tissues *ith gingival infection This condition *as particularly prevalent among all groups near the ports! *hen the groups *ere displacing part of their native foods *ith imported foods (n American "amoa through the cooperation of the educational authorities and the Director of the Department of +ealth! Commander "tephenson! and under the direct supervision of 1ieutenant Commander 1o*ry! the dental surgeon! a group of four young men of the native teaching staff *as selected and given instructions for the removal of the deposits E?uipment in the form of instruments has since %een provided! in part through the /indness and generosity of some dental manufacturers This pro%a%ly constitutes the only native dental service that has ever %een availa%le in any of the Pacific (sland groups The intelligence and aptness *ith *hich these men *ere a%le to learn the fundamental principles! and their s/ill in carrying out a highly commenda%le prophylactic operation *as indeed remar/a%le ( gave them pieces of soap and as/ed them to carve a reproduction of an e4tracted tooth *hich *as given as a model and in *hich they *ere re?uired to increase all diameters to a given amount Their *or/ *ould pro%a%ly e?ual if not e4ceed in e4cellence that of the first effort of 2; per cent of American dental students Many of these natives are very de4terous *ith their fingers and are s/illed artists in carving *ood and other material A great service could %e rendered to these people *ho are in the process of moderni6ation! %ut *ho have no opportunity for dental assistance! %y teaching some of the %right young men certain of the procedures for rendering first aid They could %e compensated %y contri%utions of native foods and native *ares

much as our itinerant dentists *ere in earlier days The people *ould not have money to pay an American or European dentist for his service until trade is carried on *ith currency Nearly all these racial stoc/s are magnificent singers for *hich Nature has *ell>e?uipped them physically Their artistry can %e Audged %y the fact that they sing very difficult music unaccompanied and undirected A large native chorus at Nu/ualofa! in the Tongan $roup! sang *ithout accompaniment 'The +alleluAah Chorus' from +andelBs Messiah *ith all the parts and *ith phenominal volume and modulation Much of their *or/! such as ro*ing their largest %oats! and many of their sports are carried out to the rhythm of hilarious music Many of the island groups recogni6e that their races are doomed since they are melting a*ay *ith degenerative diseases! chiefly tu%erculosis Their one over*helming desire is that their race shall not die out They /no* that something serious has happened since they have %een touched %y civili6ation "urely our civili6ation is on trial %oth at home and a%road The nutrition of the primitive Polynesians is continually reinforced *ith animal life from the sea *hich includes %oth soft> and hard>shell forms The incidence of tooth decay varied from ; 8 per cent for the most isolated groups to -- . per cent for the moderni6ed groups Those individuals living in their native environment on their native foods have universally normal facial and dental arch form reproducing the characteristics of the race Those living on the normal environment e4cept for using the imported foods of *hite flour! sugar! sugar products! syrup! polished rice! and the li/e! have in the succeeding generations mar/ed changes in facial and dental arch forms )eference , #E&$3")N! & A A dental survey of the school children of American "amoa .# Am# 'ent# A#, 5,@7-.! ,2-. Chapter Isolated and modernized (frican tri.es A#&(CA has %een the last of the large continents to %e invaded and e4plored %y our modern civili6ation (t has one of the largest native populations still living in accordance *ith inherited traditions Accordingly! it provides a particularly favora%le field for studying primitive racial stoc/s

This study of primitive racial stoc/s! *ith the e4ception of some (ndian groups! has %een largely concerned *ith people living under physical conditions ?uite different from those *hich o%tain in the central area of a large continent "ea foods are *ithin reach of the inha%itants of islands and coastal regions regardless of latitude The inha%itants of the interior of a continent! ho*ever! have not access to li%eral supplies of various forms of animal life of the sea (t *as important! therefore! in the interest of the inha%itants of the 3nited "tates! Canada! Europe! and other large continental interiors! to study primitive people living under environments similar to theirs Africa is one of the fe* countries that can provide %oth primitive living conditions and the modern life of the plains and plateau country in the interior The great plateau of eastern and central Africa has nurtured a score of tri%es *ith super% physi?ues and much accumulated *isdom We are concerned to /no* ho* they have accomplished this! and *hether they or any other people can survive in that environment after adopting the formulas of our modern civili6ations Considering that the most universal scourge of modern civili6ation is dental caries! though it is only one of its many degenerative processes! it is important that *e study these people to note ho* they have solved the maAor pro%lems of living in so severe and disciplining an environment as provided in Africa This *as done during the summer of ,2-7 )ur route too/ us through the &ed "ea and do*n the (ndian )cean to enter the African continent at Mom%asa %elo* the e?uator and then across Genya and 3ganda into Eastern Belgian Congo! and thence a%out .!;;; miles do*n the long stretch of the Nile through "udan to the moderni6ed civili6ation of Egypt This Aourney covered most of the country around Ethiopia and gave us contact *ith several of the most primitive racial stoc/s of that country These people are accordingly the neigh%ors of the A%yssinians or Ethiopians "ince the various tri%es spea/ different languages and are under different governments! it *as necessary to organi6e our safari in connection *ith the local government officials in the different districts

During these Aourneys in Africa *hich covered a%out 8!;;; miles! *e came in contact *ith a%out thirty different tri%es "pecial attention *as given to the foods! samples of *hich *ere o%tained for chemical analysis )ver 5!7;; negatives *ere made and developed in the field (f any one impression of our e4periences *ere to %e selected as particularly vivid! it *ould %e the contrast %et*een the health and ruggedness of the primitives in general and that of the foreigners *ho have entered their country That their superior ruggedness *as not racial %ecame evident *hen through contact *ith modern civili6ations degenerative processes developed =ery fe* of the many Europeans *ith *hom *e came in contact had lived in central Africa for as much as t*o years *ithout serious illness or distinct evidence of physical stress That the cause *as not the severity of the climate! %ut something related to the methods of

living! *as soon apparent (n all the districts it *as recogni6ed and e4pected that the foreigners must plan to spend a portion of every fe* years or every year outside that environment if they *ould /eep *ell Children %orn in that country to Europeans *ere generally e4pected to spend several of their gro*ing years in Europe or America if they *ould %uild even relatively normal %odies )ne e4acting condition of the environment that *e encountered *as the constant e4posure to disease Dysentery epidemics *ere so severe and fre?uent that *e scarcely allo*ed ourselves to eat any food that had not %een coo/ed or that *e had not peeled ourselves (n general! it *as necessary to %oil all drin/ing *ater We dared not allo* our %are feet to touch a floor of the ground for fear of Aiggers *hich %urro* into the s/in of the feet "carcely ever *hen %elo* 8!;;; feet *ere *e safe after sundo*n to step from %ehind mos?uito netting or to go out *ithout thorough protection against the malaria pests These malaria mos?uitoes *hich include many varieties are largely night feeders They *ere thought to come out soon after sundo*n We *ere advised that the most dangerous places for %ecoming infected *ere the pu%lic eating houses! since the mos?uitoes hide under the ta%les and attac/ the dinerBs an/les if they are not ade?uately protected We rigidly follo*ed the precaution of providing ade?uate protection against these pests Disease>carrying tic/s *ere so a%undant in the grass and shru%%ery that *e had to %e on guard constantly to remove them from our clothing %efore they %uried themselves in our flesh They *ere often carriers of very severe fevers We had to %e most careful not to touch the hides *ith *hich the natives protected their %odies from the cold at night and from the sun in the daytime *ithout thorough sterili6ation follo*ing any contact There *as grave danger from the lice that infected the hair of the hides We dared not enter several districts %ecause of the dreaded tsetse fly and the sleeping sic/ness it carries )ne *onders at the apparent health of the natives until he learns of the uni?ue immunity they have developed and *hich is largely transmitted to the offspring (n several districts *e *ere told that practically every living native had had typhus fever and *as immune! though the lice from their %odies could transmit the disease )ne also *onders *hy people *ith such resistance to disease are not a%le to com%at the degenerative diseases of modern civili6ation When they adopt modern civili6ation they then %ecome suscepti%le to several of our modern degenerative processes! including tooth decay Dr Anderson *ho is in charge of a splendid government hospital in Genya! assured me that in several years of service among the primitive people of that district he had o%served that they did not suffer from appendicitis! gall %ladder

trou%le! cystitis and duodenal ulcer Malignancy *as also very rare among the primitives (t is of great significance that *e studied si4 tri%es in *hich there appeared to %e not a single tooth attac/ed %y dental caries nor a single malformed dental arch "everal other tri%es *ere found *ith nearly complete immunity to dental caries (n thirteen tri%es *e did not meet a single individual *ith irregular teeth Where the mem%ers of these same tri%es had adopted modern civili6ation many cases of tooth decay *ere found (n the ne4t generation follo*ing the adoption of the European dietaries dental arch deformities fre?uently developed We are concerned to /no* something of the origin of these people including the Ethiopians and to *hat e4tent racial ancestry has protected them (f *e refer to an ethnographic map of African races *e find there is evidence of a great movement north*ard from "outh Africa These people had some things in common *ith the Melanesians and Polynesians of the "outh Pacific *hom *e studied the year previously Their language carries some *ords of similar meaning While there are many tri%es e4isting today! it is of significance that they each possess some identifying characteristics of language! dress and food ha%its Another great racial movement has apparently moved south*ard from Northern Africa These tri%es are of +amitic origin and include Nilotic tri%es and A%yssinians The Nilotic tri%es have a distinct physical pattern and mode of life These great racial movements have met in the 3pper Nile region of Eastern Africa near the e?uator! and have s*ayed %ac/ and forth *ith successive o%literation or a%sorption of those tri%es that *ere least sturdy The negro race occupied an area across Africa from the West to Central Africa They *ere e4posed to the aggression and oppression of these t*o great racial movements! resulting often in intermingling in various proportions of racial %loods The "emitic race! chiefly Ara%s! occupied Ara%ia and a great area in Northern Africa (n this %irdBs eye vie* *e are o%serving changes that have %een in progress during many hundreds or thousands of years The Ara%s have %een the principal slave dealers *or/ing in from the east coast of Africa They have maintained their individuality *ithout much %lending e4cept on the coast They have not %ecome an important part of the native stoc/ of the interior These primitive native stoc/s can %e largely identified on the %asis of their ha%its and methods of living The Nilotic tri%es have %een chiefly herders of cattle and goats and have lived primarily on dairy products! including mil/ and %lood! *ith some meat! and *ith a varying percentage of vegeta%le foods (t *as most interesting to o%serve that in every instance these cattle people dominated the

surrounding tri%es They *ere characteri6ed %y super% physical development! great %ravery and a mental acumen that made it possi%le for them to dominate %ecause of their superior intelligence Among these Nilotic tri%es the Masai forced their *ay farthest south and occupy a position %et*een t*o of the great Bantu tri%es! the Gi/uyu and the Wa/am%a Both of these latter tri%es are primarily agricultural people Masai Tribe# The Masai are tall and strong #ig -2 sho*s a typical %elle! also a Masai man *ho is much taller than our si4>foot guide (t is interesting to study the methods of living and o%serve the accumulated *isdom of the Masai They are reported to have /no*n for over t*o hundred years that malaria *as carried %y mos?uitoes! and further they have practiced e4posing the mem%ers of their tri%es *ho had %een infected *ith syphilis %y the Ara%s to malaria to prevent the serious inAuries resulting from the spirochetal infection Yet modern medicine %oasts of %eing the discoverers of this great principle of using malaria to prevent or relieve syphilitic infections of the spinal cord and %rain

FI" 9 $hese members of the Basai tribe illustrate the s#lendid nutrition #rovided by their diet of cattle #roducts namely0 meat+ mil% and blood. $he chief beside our guide is well over si, feet. $his Basai belle wears the customary decorations of coils of co##er wire bracelets and an%lets which largely constitute the attire of the girls.

( sa* the native Masai operating on their cattle *ith s/ill and /no*ledge The Masai have no currency and all their transactions are made *ith co*s or goats A valua%le co* *as not eating properly! and ( o%served them ta/ing a thorn out of the inside of her mouth The surgical operation *as done *ith a /nife of their o*n ma/ing and tempered %y pounding The *ound *as treated

%y ru%%ing it *ith the ashes of a plant that acted as a very po*erful styptic Their /no*ledge of veterinary science is ?uite remar/a%le ( sa* them treating a young co* that had failed to conceive They apparently /ne* the cause and proceeded to treat her as modern veterinaries might do in order to overcome her difficulties #or their food throughout the centuries they have depended very largely on mil/! meat and %lood! reinforced *ith vegeta%les and fruits They mil/ the co*s daily and %leed the steers at regular intervals %y a uni?ue process (n #ig .; *e see a native Masai *ith his %o* and arro*! the latter tipped *ith a sharp /nife *hich is guarded %y a shoulder to determine the depth to *hich the arro* may enter the vein (f the animal is sufficiently tame! the %lood is dra*n *hile it is standing (f the animal is frightened it is ?uic/ly ho%%led! as sho*n %elo* (n this figure the stream of %lood may %e seen spurting from the Augular vein into a gourd *hich holds a%out a gallon A tor?ue is placed around the nec/ %efore the puncture is made The animals did not even flinch *hen struc/ %y the arro*! the operation is done so ?uic/ly and s/illfully When sufficient %lood *as dra*n! the tor?ue *as removed and the %lood immediately stopped flo*ing A styptic made of ashes referred to a%ove *as used This serves also to protect the *ound from infection The %lood is defi%rinated %y *hipping in the gourd The fi%rin is fried or coo/ed much as %acon or meat *ould %e prepared The defi%rinated %lood is used ra* Aust as the mil/ is! e4cept in smaller ?uantities When availa%le! each gro*ing child receives a dayBs ration of %lood as does each pregnant or lactating *oman #ormerly! the *arriors used this food e4clusively These three sources! mil/! %lood and meat provide them *ith li%eral supplies of %ody>%uilding minerals and the special vitamins! %oth fat>solu%le and *ater solu%le Their estimate of a desira%le dairy stoc/ is %ased on ?uality not ?uantity They Audge the value of a co* for /eeping in their herd %y the length of time it ta/es her calf to stand on its feet and run after it is %orn! *hich is only a very fe* minutes This is in stri/ing contrast *ith the practice of our modern dairymen *ho are chiefly concerned *ith the ?uantity of mil/ and ?uantity of %utter fat rather than *ith its value as a source of special factors for nutrition Many of the calves of the modern high>production co*s of civili6ed countries are not a%le to stand for many hours after %irth! fre?uently t*enty>four This a%ility to stand is very important in a country infested *ith predatory animalsF such as lions! leopards! hyenas! Aac/als and vultures

FI". )<. An im#ortant source of fat soluble vitamins during the drought #eriod is the blood of the steers which is drawn about every thirty days. Above shows the lance ti##ed arrow being shot into the nec% vein. If the animal is wild it is hobbled as shown below where the stream of blood is seen s#urting into the gourd. $he flow ceases when the com#ress is removed.

This reminded me of my e4perience in Alas/a in studying the reindeer of the Es/imos ( *as told that a reindeer calf could %e dropped in a foot of sno* and almost immediately it could run *ith such speed that the predatory animals! including *olves! could not catch it And! moreover! that these fa*ns *ould go almost immediately after their %irth *ith a herd on a stampede and never %e /noc/ed do*n The pro%lem of com%ating the predatory animals! particularly the lions! calls for greater s/ill and %ravery than is re?uired %y other tri%es in Africa The lions live on the large gra6ing animals! particularly the cattle! from *hich they select the strongest (n driving over the veldt *e fre?uently sa* one or t*o men or %oys guarding an entire herd *ith only their spears Their s/ill in /illing a lion *ith a spear is one of the most super% of human achievements ( *as interested to learn that they much prefer their locally made spears to those that are manufactured outside and %rought in! %ecause of their certainty that they *ill not %rea/! *ill *ithstand straightening regardless of ho* much they are %ent and %ecause due to the process of manufacture *ill ta/e a very sharp edge

)n one occasion! after *e had %een /ept a*a/e much of the night %y the roaring of the lions and neighing of the 6e%ras that *ere %eing attac/ed %y the lions! *e visited a Masai manyata near%y in the morning to learn that *hen they let their cattle and goats out of the corral of acacia thorns! three or four spearsmen *ent ahead in search of the lions that might %e *aiting to am%ush the cattle They apparently did not have the slightest fear The lions evidentally had made a /ill near%y This the natives determined %y the num%er of coyotes The heart and courage of these people has %een largely %ro/en %y the action of the government in ta/ing a*ay their shields in order to prevent them pillaging the surrounding native tri%es as formerly They depended upon their shields to protect them from the arro*s of the other tri%es The efforts to ma/e agriculturists of these Masai people are not promising (n a typical manyata the chief has several *ives Each one has a separate d*elling Tim%er and shru%%ery are so scarce in this vicinity that the d*ellings are %uilt of clay mi4ed *ith co* dung *hich is plastered over a frame*or/ of t*igs Many chiefs are over si4 feet in height The Masai live in a very e4tensive game preserve in *hich hundreds of thousands of gra6ing animals enAoy an e4istence protected from man since even the natives are not allo*ed to /ill the animals as formerly They seemed to %e preserved for the numerous lions *hich occasionally %ecome very %old since they have an a%undance of food and no enemies &ecently the local government authorities found it necessary to shoot off eighty of the lions in a particular district %ecause of their aggressiveness (n the Masai tri%e! a study of 5!7,8 teeth in eighty>eight individuals distri%uted through several *idely separated manyatas sho*ed only four individuals *ith caries These had a total of ten carious teeth! or only ; . per cent of the teeth attac/ed %y tooth decay /ik!y! Tribe, /ianzb!, /enya# (n contrast *ith the Masai! the Gi/uyu tri%e! *hich inha%its a district to the *est and north of the Masai! are characteri6ed %y %eing primarily an agricultural people Their chief articles of diet are s*eet potatoes! corn! %eans! and some %ananas! millet! and Gafir corn! a variety of (ndian millet The *omen use special diets during gestation and lactation The girls in this tri%e! as in several others! are placed on a special diet for si4 months prior to marriage They nurse their children for three harvests and precede each pregnancy *ith special feeding

The Gi/uyus are not as tall as the Masai and physically they are much less rugged 1i/e many of the central African tri%es! they remove some lo*er incisors at the time these permanent teeth erupt This custom is reported to have %een esta%lished for the purpose of feeding the individuals in case of loc/>Aa* )ne of the stri/ing tri%al customs is the ma/ing of large perforations in the ears in *hich they carry many metal ornaments A typical Gi/uyu *oman is sho*n in #ig ., Hupper rightI Typical Gi/uyu men are also sho*n in #ig ., Note their fine teeth and dental arches

FI". )1. $he develo#ment of the faces and dental arches in many African tribes is su#erb. $he girl at the u##er right is wearing several earrings in the lobe of each ear. $he =a%amba tribe #oints the teeth as shown below. $his does not cause tooth decay while they live on their native food.

A study of ,!;., teeth in thirty>three individuals sho*ed fifty>seven teeth *ith caries! or 7 7 per cent These *ere -8 . per cent of the individuals affected Much of the territory occupied %y the Gi/uyu tri%es *as formerly forest Their practice has %een to %urn do*n a section of forest in order to get ne* lands for planting As soon as the virgin fertility is e4hausted! *hich is usually in three to five years! they %urn do*n another section of forest By this process

they have largely denuded their section of Genya of its tim%er This has resulted in a great *aste of %uilding material There are fe* stands of native forest *ithin easy reach of transportation -akamba Tribe, /enya# The Wa/am%a tri%e point their teeth as sho*n in #ig ., They occupy the territory to the east of the Masai! *ho in past centuries have driven themselves as a *edge %et*een the Gi/uyu and the Wa/am%a tri%es The Masai until chec/ed carried on a relentless *arfare! consisting largely of raids! in *hich they slaughtered the men and carried off the *omen and children and drove a*ay the cattle or goats The Wa/am%as are intellectually superior to the Gi/uyus and have distinct artistic s/ill in the carving of art o%Aects They are mechanical and li/e machinery Many of them have important positions in the shops of the Genya and 3ganda rail*ay An e4amination of ,!,,5 teeth of thirty>seven individuals sho*ed si4ty>nine teeth *ith caries! or 8 5 per cent T*enty>one and si4>tenths per cent of the individuals studied had dental caries .alo! Tribe, /enya# This tri%e occupies the territory along 1a/e =ictoria and Gisumu Bay They are one of the most intelligent and physically e4cellent native tri%es They *ere studied in t*o groups! one at Maseno! and the other at )gado The group studied at the Maseno school *ere %oys ranging from a%out ten years to t*enty>t*o! totaling a%out ,2; in all The principal of the school presented the %oys in military formation for inspection Through him as interpreter ( as/ed that all %oys *ho had ever had toothache hold up their hands! and nineteen did so )f the nineteen only one individual *as found to have cariesF t*o of his teeth *ere involved! *hich! out of 7.8 teeth for these individuals! gives ; . per cent of the teeth *ith caries (n the )gada Mission a study of 57: teeth for ten individuals revealed no teeth affected *ith dental caries .eannes S$hool, /enya# This school is located at Ga%ete (t is an institution *here young married couples are trained in domestic science! agriculture! and similar su%Aects (n -:: teeth of thirteen individuals! thirty>one teeth *ere found to have %een attac/ed %y dental caries! or 9 2 per cent These *ere in si4 individuals

P!m0ani Mission S$hool, /enya# This is a native su%ur% of Nairo%i! and there the people have come under the influence of recent European contact (n an e4amination of 7:: teeth of t*enty>one individuals t*enty>si4 teeth had caries! or . . per cent C# M# S# S$hool, !k!r!, /enya# The children of this school %elong to several tri%es! chiefly Dalou (n a study of -,5 teeth of eleven individuals! only one tooth *as found to have %een attac/ed %y tooth decay! or ; - per cent Che0ya at /is!rn!, /enya# The natives of this district %elong to the Maragoli tri%e They are very strong and physically *ell developed They live *ithin easy reach of 1a/e =ictoria from *hich they o%tain large ?uantities of fish *hich constitutes an important part of their diet! together *ith cereals and s*eet potatoes A study of 775 teeth of nineteen individuals revealed only one tooth *ith dental caries! or ; 5 per cent M!hima Tribe or An$hola, Uganda# This tri%e resides in southern 3ganda They! li/e the Masai! are primarily a cattle raising people and live on mil/! %lood and meat The district in *hich they live is to the east of 1a/e Ed*ard and the Mountains of the Moon They constitute one of the very primitive and undistur%ed groups While the Masai raise chiefly the hump>%ac/ed cattle! the herds of this Muhima or Anchola tri%e are characteri6ed %y their large *ide> spread horns 1i/e the Masai! they are tall and courageous They defend their herds and their families from lions and leopards *ith their primitive spears 1i/e the other primitive cattle people! they dominate the adAoining tri%es (n a study of ,!;.; teeth of thirty>seven individuals! not a single tooth *as found *ith dental caries This tri%e ma/es their huts of grass and stic/s -at!si Tribe# This is a very interesting tri%e living on the east of 1a/e Givu! one of the head*aters of the West Nile in &uanda *hich is a Belgian Protectorate They are tall and athletic Their faces differ mar/edly from those of other tri%es! and they %oast a very no%le inheritance According to legend! a &oman military e4pedition penetrated into central Africa at the time of Anthony and Cleopatra A phalan4 remained! refusing to return *ith the e4pedition They too/ *ives from the native tri%es and passed la*s that thereafter no marriage could ta/e place outside their group They have magnificent physi?ues Many stand over si4 feet *ithout shoes

"everal of the tri%es neigh%oring Ethiopia are agriculturists and gro* corn! %eans! millet! s*eet potatoes! %ananas! Gafir corn! and other grains! as their chief articles of food Physically they are not as *ell %uilt as either the tri%es using dairy products li%erally or those using fish from the fresh *ater la/es and streams They have %een dominated %ecause they possess less courage and resourcefulness The $overnment of Genya has for several years sponsored an athletic contest among the various tri%es! the test %eing one of strength for *hich they use a tug>of>*ar )ne particular tri%e has carried off the trophy repeatedly This tri%e resides on the east coast of 1a/e =ictoria and lives very largely on fish The mem%ers are po*erful athletes and *onderful s*immers They are said not to have %een con?uered in *arfare *hen they could ta/e the *arfare to the *ater )ne of their methods is to s*im under *ater to the enemyBs fleet and scuttle their %oats They fight *ith spears under *ater *ith marvelous s/ill Their physi?ues are magnificent (n a group of ,2; %oys *ho had %een gathered into a government school near the east coast of 1a/e =ictoria only one %oy *as found *ith dental caries! and t*o of his teeth had %een affected The people dry the fish *hich are carried far inland 3ganda *hich lies to the north and *est of 1a/e =ictoria and *est of Genya! is high and although on the e?uator! has an e?uita%le climate *ith an a%undance of native foods T*o crops per year are produced! and many varieties of %ananas gro* *ild The Buganda Tri%e! 3ganda! is the chief tri%e of this region 3ganda has %een called the $arden of Eden of Africa %ecause of its a%undance of plant foods! chiefly %ananas and s*eet potatoes! and %ecause of its a%undance of fresh *ater fish and animal life The natives are thrifty and mentally superior to those of most other districts They have a /ing and a native parliament *hich the British $overnment recogni6es and entrusts *ith local administrative affairs A typical group *as studied in a mission at Masa/a An e4amination of 88. teeth of t*enty>one individuals revealed only three teeth *ith caries! or ; . per cent -est ile Laborers from the ,elgian Congo# The West Nile 1a%orers studied at Masa/a represent a very strong and dependa%le group They come from districts north of 1a/e Al%ert in Belgian Congo They are much sought for in industrial enterprises and are often moved in groups for a considera%le distance A study of 2:. teeth of thirty>one individuals revealed that only three teeth had ever %een attac/ed %y tooth decay! or ; - per cent )nly one individual had dental caries

As one travels do*n the West Nile and later along the *estern %order of Ethiopia many uni?ue tri%es are met A typical negroid type of the upper Nile region is sho*n in #ig .5 Mem%ers of these tri%es *ear little or no clothing They have splendid physi?ues and high immunity to dental caries

FI". )!. $he reward of obeying nature>s laws of nutrition is illustrated in this west 'ile tribe in Belgian 8ongo. 'ote the breadth of the dental arches and the finely #ro#ortioned features. $heir bodies are as well built as their heads. 7,ceedingly few teeth have been attac%ed by dental caries while on their native foods.

After the confluence of the White Nile and West Nile! the former draining 1a/e =ictoria and the 3ganda la/es through 3ganda! and the latter! 1a/es Givu! Ed*ards and Al%ert and eastern Belgian Congo! the volume of *ater moving north*ard is very large A uni?ue o%struction to navigation has developed due to the fact that the Nile runs underground for a considera%le distance (n this district vegetation is ran/ and prolific! including large ?uantities of *ater plants *hich form islands that are often attached

temporarily to the shore The *ater carries large ?uantities of alluvia *hich furnish an a%undance of nutriment to the floating plant life Accordingly! in many of these floating islands a large ?uantity of soil is enmeshed in the plant roots At some period in the past the river %ecame %ridged across in upper "udan near its southern %order With the progressive addition of ne* material a large natural %ridge has %een raised on *hich trees are no* gro*ing! and across *hich are elephant trails This and a series of rapids re?uire a detour of over a hundred miles The elephants are so plentiful in this district that %oth in 3ganda and "udan the governments have %een re?uired to send in special hunters to reduce the herds (n one district in 3ganda t*o hundred *ere said to have %een slaughtered They are very destructive to %anana plantations They %rea/ the %anana trees over or pull them up %y the roots and eat the succulent heart as *ell as the fruits (n a night a herd may destroy an entire plantation The only people in the districts *ho are permitted to /ill the elephants *ithout license are the pygmies They are also the only ones not re?uired to pay a head ta4 There are many tri%es of them in the great forest area in Belgian Congo and 3ganda Their s/ill *ith spears is remar/a%le and they are a%le to /ill an elephant *hile the animal remains una*are of his danger (t ta/es them one to t*o days to hamstring an elephant %y *or/ing stealthily from %ehind! al*ays /eeping out of the elephantBs sight Although an elephant can scent a human for a long distance! these pygmies can disguise themselves so completely that the elephant is una*are of their presence After disa%ling him %y cutting the tendons of %oth hind legs! they attac/ him openly and! *hile one attracts his attention! the other slo*ly %ut progressively hac/s off his trun/ (n this manner he %leeds to death They are particularly fond of elephant meat and a slaughter means a great feast While *e *ere in one of the pygmy colonies t*o of them %rought in the tus/s of an elephant they had Aust /illed We had the rare opportunity of *itnessing the cele%ration in the colony! *hich included the special reproduction in pantomime of the attac/ and method of /illing the elephant The pygmy mother of these t*o men is sho*n in #ig .- Hlo*er halfI (t *ill %e noticed that she is a full head shorter than Mrs Price! *ho is five feet three inches tall This rugged! though small! *oman is the mother of five gro*n men! t*o of *hom are sho*n in #ig .- *ith the tus/s of the elephant Note their homemade spears As mar/smen *ith %o*s and arro*s and as trappers! these pygmies have *onderful s/ill Their arro*s are tipped *ith iron of their o*n manufacture and have receptacles for carrying drugs *hich they e4tract from plants These drugs temporarily paraly6e the animals #or animals *hich they *ish to destroy the arro*s carry a poison *hich rapidly produces death The home life of the pygmies in the forest is often filled *ith danger Dust

%efore our arrival t*o %a%ies had %een carried off %y a leopard This stealthy night pro*ler is one of the most difficult animals to com%at and pro%a%ly has %een one of the reasons the pygmies %uild ca%ins in the trees )rdinarily their homes are %uilt on the ground in a little clearing in the %ig forest They consist of lo* shelters covered *ith %anana leaves and other plants! %uilt over a frame *or/ The native missionary dispensed our gift of salt *hich is one of their most pri6ed gifts They put on a dance for us

FI". ) . $he ?ygmies of Belgian 8ongo are e,#ert hunters. $he two young men in the center above have slain single handed the large bull ele#hant whose tus%s they are holding. $he s#ears used are shown. $hey are two of five grown sons of the #ygmy mother standing ne,t to Brs. ?rice in the lower #icture. $heir teeth are e,cellent and their %nowledge of foods uni(ue.

Pygmies, (t!r! %orest, ,elgian Congo# These people are said to have originally lived in the trees and they *ere e4ceedingly shy and difficult to contact We *ere ta/en to several of their villages in the heart of the dense (turu forest We found them very *ell disposed through the confidence that has %een esta%lished %y the mission *or/ers Their shyness! ho*ever! together *ith the difficulty of ma/ing them understand through t*o transfers of languages! made an e4amination of their teeth very difficult

A study of -75 teeth of t*elve individuals revealed eight teeth had %een attac/ed %y tooth decay! or 5 5 per cent The native tri%es of Africa have depended to a great e4tent on fresh *ater fish from the numerous la/es and rivers for certain of their essential food factors After %eing dried in the sun these fish are carried long distances into the interior The Nile perch gro*s fre?uently to a *eight of ,7; pounds The natives of Africa /no* that certain insects are very rich in special food values at certain seasons! also that their eggs are valua%le foods A fly that hatches in enormous ?uantities in 1a/e =ictoria is gathered and used fresh and dried for storage They also use ant eggs and ants yank!nde Mission, (r!in!, ,elgian Congo# This group is made up of mem%ers of the Bahema! Ba%ira! Alur and Balendu tri%es We *ill consider the representatives of these different tri%es collectively since they live largely on a common dietary consisting chiefly of cereals )nly the Bahemas of this group have small herds of cattle "ome of the others have a fe* goats This district is located south*est of 1a/e Al%ert A study of 8!.8, teeth of 5,9 individuals revealed -2; teeth *ith dental caries! or 8 per cent Thirty>eight and seven>tenths per cent of the individuals suffered from dental caries ,ogora Mission, ,elgian Congo# This mission is located *est of 1a/e Al%ert and includes mem%ers of the Bahema and Balendu tri%es While the Bahema tri%e originally lived very largely on cattle products! mil/! %lood and meat! in this district! the herds *ere small and they *ere using a considera%le ?uantity of cereals! chiefly corn and %eans! some s*eet potatoes and %ananas These latter *ere the chief foods of the other tri%es! in addition to goatsB mil/ An e4amination of 5!,28 teeth of seventy>seven individuals revealed ,8; teeth *ith caries! or 9 5 per cent #ifty>three per cent of the individuals had caries /asenyi Port, Lake Albert, ,elgian Congo# These natives *ere mem%ers of several tri%es surrounding this district *ho *ere for the most part temporary residents as la%orers The people had %een living largely on a cereal diet and no* during their temporary residence at the port had had fish An e4amination of ,!2.; teeth of si4ty>three individuals revealed ,5; teeth *ith dental caries! or 8 , per cent of the teeth #ifty and eighttenths per cent of the individuals had dental caries

-anande Tribe, ,elgian Congo# This tri%e is located at 1u%ero in Belgian Congo Their diet consists largely of %ananas! s*eet potatoes! cereals and goatsB mil/ (n an e4amination of -8: teeth of thirteen individuals! there *ere eight teeth *ith caries! or 5 5 per cent #ifteen and four>tenths per cent of the individuals *ere affected ,ait! Tribe, y!nge, "!anda, ,elgian Prote$torate# This district lies south of 3ganda and east of Belgian Congo proper! north*est of Tanganyi/a (t lies Aust east of 1a/e Givu When *e learn that 1a/e Givu *as only discovered in ,:2.! even though it is one of the important sources of the Nile *aters! *e reali6e the primitiveness of the people of this and adAoining districts This group lives largely on dairy products from cattle and goats! together *ith s*eet potatoes! cereals and %ananas (n a study of -8. teeth of thirteen individuals! not a single tooth *as found to have %een attac/ed %y dental caries ative Hotel Staff at 1oina, ,elgian Congo# This group consisted of the inside and outside servants of a tourist hotel on 1a/e Givu An e4amination of -5; teeth of ten individuals revealed t*enty teeth *ith caries! or 8 - per cent (t is significant that all of these carious teeth *ere in the mouth of one individual! the coo/ The others all %oarded themselves and lived on native diets The coo/ used European foods Where the mem%ers of the African tri%es had attached themselves to coffee plantations aad *ere provided *ith the imported foods of *hite flour! sugar! polished rice and canned goods! tooth decay %ecame rampant This is typically illustrated in #ig ..

FI". )). =herever the Africans have aido#ted the foods of modern commerce+ dental caries was active+ thus destroying large numbers of the teeth and causing great suffering. $he cases shown here are ty#ical of wor%ers on #lantations which largely use im#orted foods.

Anglo>Egyptian "udan has an area appro4imately one>third that of the 3nited "tates (t is traversed throughout its length from south to north %y the Nile There are several tri%es living along this great *ater*ay! *hich are of special interest no* o*ing to their close pro4imity to Ethiopia There are *onderful hunters and *arriors among them (n hunting they use their long> %laded spears almost entirely The shores of the Nile for nearly a thousand miles in this district are lined *ith papyrus and other *ater plants to a depth of from several hundred yards to a fe* miles Bac/ of this area the land rises and provides e4cellent pasturage for the gra6ing cattle These tri%es! therefore! use mil/! %lood and meat from cattle and large ?uantities of animal life from the Nile &iver "ome of the tri%es are very tall! particularly the Neurs The *omen are often si4 feet or over! and the men seven feet! some of them reaching seven and a half feet in height ( *as particularly interested in their food ha%its %oth %ecause of their high immunity to dental caries *hich appro4imated one hundred per cent! and %ecause of their physical development ( learned that they have a %elief *hich to them is their religion! namely! that every man and *oman has a soul *hich resides in the liver and that a manBs character and

physical gro*th depend upon ho* *ell he feeds that soul %y eating the livers of animals The liver is so sacred that it may not %e touched %y human hands (t is accordingly al*ays handled *ith their spear or sa%er! or *ith specially prepared for/ed stic/s (t is eaten %oth ra* and coo/ed Many of these tri%es! li/e the Neurs! *ear no clothing and decorate their %odies *ith various designs! some of them representing strings of %eads produced %y putting foreign su%stances under the s/in in definite order They have maintained a particularly %itter *arfare against the Ara% slave dealers *ho have come across from the &ed "ea coast to carry off the *omen and children (n isolated districts even to this day they are suspicious of foreigners We *ere told that in one district adAoining Ethiopia all light s/inned people are in danger and cannot safely enter that territory *ithout a military escort Terraizeka, Upper ile, S!dan# These people are tall and live largely on fish and other animal life This part of "udan consists of many districts of great marshland called the sudd (t is covered *ith ran/ papyrus to the height of fifteen to thirty feet This Aungle of ran/ marsh gro*th s*arms *ith a *ide variety of animal life! large and small An e4amination of 7.: teeth of eighteen individuals revealed that not a single tooth had %een attac/ed %y dental caries! or ,;; per cent immunity e!rs, Malakal, S!dan# The Neurs at Mala/al on the Nile &iver are a uni?ue tri%e %ecause of their remar/a%le stature Many of the *omen are si4 feet tall and the men range from si4 feet to seven and a half feet in height Their food consists very largely of animal life of the Nile! dairy products! mil/ and %lood from the herds A study of ,!58: teeth of thirty>nine individuals revealed only si4 teeth *ith dental caries! or ; 7 per cent )nly three individuals had caries! or 9 9 per cent 'inkas, .ebelein, S!dan# This tri%e lives on the Nile (ts mem%ers are not as tall as the Neurs They are physically %etter proportioned and have greater strength They use fish from the Nile and cereals for their diet They decorate their %odies profusely *ith scars An e4amination of 725 teeth of t*enty>t*o individuals revealed only one tooth *ith caries! or ; 5 per cent Arab S$hools at /harto!m and 2md!rman, S!dan# The Ara%s are the chief occupants of the territory of Northern "udan )mdurman on the *est %an/ of

the White Nile opposite Ghartoum is the largest purely Ara% city in the *orld (t has %een %ut slightly influenced %y modern civili6ation Ghartoum! on the contrary! Aust across the river from )mdurman and the capital of Anglo> Egyptian "udan! has districts *hich are typically modern These include the government offices and administration organi6ation The Ara% section of Ghartoum has %een definitely influenced %y contact *ith the Europeans This ma/es possi%le a comparative study of similar groups in the t*o cities> moderni6ed Ghartoum and primitive )mdurman A study of ,!5:. teeth of fifty>t*o individuals in an Ara% school at Ghartoum revealed that 72 teeth or . 9 per cent had %een attac/ed %y dental caries! or .. 5 per cent of the individuals studied (n )mdurman a study of 9.. teeth in thirty>one individuals! revealed only nine teeth that had %een attac/ed %y tooth decay! or , 5 per cent (n this group only t*o or 8 . per cent of the individuals had dental caries The groups e4amined *ere selected *ith the assistance of the government officials and consisted of the higher grade pupils in t*o advanced native schools! one in Ghartoum and one in )mdurman (t is of interest that of the t*o %oys in the Ara% school at )mdurman *ith dental caries one *as the son of a rich merchant and used li%erally s*eets and European foods ative Hospital, /harto!m, S!dan# The individuals studied in this institution *ere from ?uite remote areas distri%uted through "udan "ome had traveled many days on camels to o%tain the help that the hospital provided A study of 5:: teeth of ten individuals revealed that thirteen had %een attac/ed %y tooth decay! or . 7 per cent (khlas S$hool, Cairo, 3gypt# This is a native school in *hich the individuals are compara%le in many respects to those in the native schools at Ghartoum and )mdurman Their nutrition is highly moderni6ed %y living in a modern city A study of 5!;25 teeth of eighty>five individuals revealed that -7- teeth or ,5 , per cent had %een attac/ed %y tooth decay "eventy>five per cent of the individuals of this group had dental caries The total num%er of teeth e4amined in the preceding groups *as 5:!.-: )f this num%er! ,!-.8 *ere found *ith dental caries or . 9 per cent This

represents a total of ,!;;5 individuals e4amined! of *hom -;; had one or more carious teeth! or had lost teeth %y caries! ma/ing 52 2 per cent of the individuals *ith dental caries )f this total num%er of individuals studied in t*enty>seven groups! there *ere several groups *ith practically complete immunity to dental caries! *hile other groups had relatively high incidence of that disease %a$ial and 'ental Ar$h 'eformities# The purpose of these studies has included the o%taining of data *hich *ill thro* light also on the etiology of deformities of the dental arches and face! including irregularity of position of the teeth A mar/ed variation of the incidence of irregularities *as found in the different tri%es This variation could %e directly associated *ith the nutrition rather than *ith the tri%al pattern The lo*est percentage of irregularity occurred in the tri%es living very largely on dairy products and marine life #or e4ample! among the Masai living on mil/! %lood and meat! only - . per cent had irregularities Among the Gi/uyu and Wa/am%a! ,: 5 and ,: 2 per cent respectively had irregularities These peapNe *ere largely agriculturists living primarily on vegeta%le foods (n the native Ara% school at )mdurman! among the pupils living almost entirely according to the native customs of selection and preparation of foods! 8 . per cent had irregularities! *hile in the native school at moderni6ed Ghartoum ,9 per cent had irregularities (n the (/hlas school at Cairo! under modern influence! ,8 7 per cent had irregularities (n the native hospital at Ghartoum! 9; per cent had irregularities (n the Pygmy group -- - per cent had irregularities! and among the grain eaters of the *est Nile! 57 7 per cent had irregularities The Deannes "chool had .8 , per cent and the )gada mission -; per cent While the primitive racial stoc/s of Africa developed normal facial and dental arch forms *hen on their native foods! several characteristic types of deformity fre?uently developed in the children of the moderni6ed groups )ne of the simplest forms! and one *hich corresponds *ith a very common deformity pattern in the 3nited "tates! involves the dropping in*ard of the laterals *ith narro*ing of the upper arch ma/ing the incisors appear a%normally prominent and cro*ding the cuspids outside the line of the arch Typical illustrations of this are sho*n in #ig .7 Where the nutritional deficiency is very severe! as at Mom%asa on the coast! more severe changes in facial form are found

FI". )-. In the new generations+ born after the #arents had ado#ted ty#ical moderni*ed diets of 7uro#eans+ there was a mar%ed change in the facial and dental arch forms of the adolescent children. 'ote the narrowing of the nostrils and dental arches and the crowding of the teeth in these four ty#ical young men.

Among the deformity patterns a lac/ of development for*ard of the middle third of the face or of the lo*er third of the face often appeared in the more highly moderni6ed groups An illustration of the former is seen in #ig .8 Hupper leftI! and of the latter in #ig .8 Hlo*er left and rightI (n the girl at the upper left! the upper arch tends to go inside the lo*er arch all around This girl is of the first generation! in a mission in Nairo%i! follo*ing the adoption of the moderni6ed foods %y the parents

FI". )/. Disturbed nature may #resent a variety nf deformity #atterns. In the u##er left the u##er arch is much too small for the lower and nearly goes inside it. $he u##er right is narrowed with crowding of the teeth. Both lower cases demonstrate an underdevelo#ment of the mandible of the lower @aw.

A more e4treme and severe type of facial change involves an a%normal narro*ing *ith mar/ed distortion of %oth upper and lo*er arches This is sho*n typically in #ig .9

FI". )3. As in our civili*ation+ even the first generation+ after the ado#tion of moderni*ed foods may show gross deformities. 'ote the e,treme #rotrusion of the u##er teeth with shortening of the lower @aw in the u##er #ictures and the mar%ed narrowing with lengthening of the face in the lower views. $he in@ury is not limited to the visible structures.

These e4treme deformities often produce facial e4pressions that are suggestive of the faces of some of the mon/eys This is illustrated %y the three %oys sho*n *ith the mon/ey in #ig .:

FI". )4. A very fre(uent in@ury a#earing in the offs#ring after the ado#tion of less efficient foods often involves a mar%ed de#ression of the middle third of the face as illustrated in the three boys in this view. 'ote the com#arison with the chim#an*ee face.

The Ara%s in several districts use camelsB mil/ e4tensively (t is nutritious! and in much of the desert country constitutes the mainstay of the nomads for months at a time The primitive Ara%s studied had fine dental arches *ith very little deformity Even the horses ridden %y the Ara% chiefs in moving their camel herds across the desert are often dependent! sometimes for as long as three months! upon the mil/ of the camels for their nutrition Typical Ara% faces and a camel caravan at rest are sho*n in #ig .2 The primitive Ara% girls have splendidly developed faces and fine dental arches Their natural %eauty! ho*ever! is rapidly lost *ith moderni6ation! as illustrated in #ig 7;

FI". )9. In the hot desert countries of Asia and Africa camel>s mil% is an im#ortant item of human nutrition. $he teeth of the Arahs+ as illustrated helow+ are e,cellent. Large areas could not maintain human life without the camel and its mil%.

FI". -<. Both girls and boys in the moderni*ed colonies in 8airo showed ty#ical deformity #atterns in faces and dental arches. $he health of these grou#s is not com#arable to that of those living on the native dietaries. 2e#roductive efficiency in these generations is greatly reduced.

Dr +rdlic/a has called attention to the occasional development in several racial stoc/s of individuals *ho travel on all fours instead of upright ( sa* several individuals of this type in Africa scooting around a%out as rapidly as the dogs They *ere! accordingly! difficult to photograph T*o are sho*n in #ig 7,

FI". -1. $hese two native African children scooted around on all fours so swiftly that it was difficult to ta%e their #ictures. =e did not see them stand u#. $hey behaved very much li%e tame chim#an*ees.

While slavery of the old form no longer e4ists in the so>called civili6ed countries! in its ne* form it is a most tragic reality for many of the people Ta4es and the ne* order of living ma/e many demands #or many of these primitive tri%es a ne* suit of clothes could formerly %e had every day *ith no more trou%le than cutting a ne* %anana leaf With the ne* order they are re?uested to cover their %odies *ith clothing Cloth of all /inds including the poorest cotton has to %e imported They must pay an e4cessive charge due to the long transportation cost for the imported goods! a charge *hich often e4ceeds the original cost in the European or American mar/ets %y several fold (n order to pay their head ta4 they are fre?uently re?uired to carry such products as can %e used %y the government officials! chiefly foods! over long distances and for part of each year These foods are often those *hich not only the adults! %ut particularly the gro*ing children sorely need for providing %ody gro*th and repair This naturally has produced a current of acute unrest and a chafing under the foreign domination

As *e encircled Ethiopia *e found the natives not only a*are of *hat *as going on in that %order country! %ut deeply concerned regarding the outcome #rom their temper and sympathetic attitude for the oppressed Ethiopians! it *ould not %e surprising if sympathi6ers pass over the %order into that country to support their crushed neigh%ors The pro%lem is accordingly very much larger than the interest of some particular foreign po*er (t deals directly *ith the future course of events and the attitude of the African natives in general to*ard foreign domination The native African is not only chafing under the ta4ation %y foreign overlords! %ut is conscious that his race %ecomes %lighted *hen met %y our modern civili6ation ( found them *ell a*are of the fact that those of their tri%es *ho had adopted European methods of living and foods not only developed rampant tooth decay! %ut other degenerative processes (n one of the most efficiently organi6ed mission schools that *e found in Africa! the principal as/ed me to help them solve a serious pro%lem +e said there *as no single ?uestion as/ed them so often %y the native %oys in their school as *hy it is that those families that have gro*n up in the mission or government schools *ere physically not so strong as those families *ho had never %een in contact *ith the mission or government schools These young men *ere thin/ing ( *as even as/ed several times %y them *hether or not ( thought that the native Africans must go the *ay of the &ed (ndians of America The happiness of the people in their homes and community life is every*here very stri/ing A mining prospector *ho had spent t*o decades studying the mineral deposits of 3ganda *as ?uoted to me as stating that if he could have the heaven of his choice in *hich to spend all eternity it *ould %e to live in 3ganda as the natives of 3ganda had lived %efore modern civili6ation came to it While inter>tri%al *arfare has largely ceased! a ne* scourge is upon them! namely the scourge *hich comes *ith modern civili6ation As in the primitive racial stoc/s previously studied and reported! *e found that moderni6ing forces *ere often associated *ith a very mar/ed increase of the death rate over the %irth rate (n some districts in Africa a mar/ed degeneration is ta/ing place $eoffrey $orer in his %oo/! 'Africa Dances!' H,I *hich *as *ritten after ma/ing studies in West Africa! discusses this pro%lem at length +e ?uotes figures given %y Marcel "auvage H5I in his article on #rench E?uatorial Africa@ 'B(n ,2,, #rench E?uatorial Africa had t*enty million negro inha%itantsF in ,25, there *ere seven and a half millionF in ,2-, there *ere t*o and a half million B'

+e states regarding the ?uotation@ 'These figures *ere given in a responsi%le #rench conservative paper and have not %een denied ' MaAor Bro*ne! a high official of the British $overnment Administrative Department of Genya! *ith long e4perience! states in the closing paragraph of his %oo/ entitled! 'The =anishing Tri%es of Genya!' H-I the follo*ing@ (t must also %e remem%ered that the '%lessings of civili6ation' are not in practice %y any means as o%vious as some simple>minded fol/ *ould li/e to %elieve (t can %e said *ith fair accuracy that among the tri%es *ith *hich *e have %een dealing there is! in their uncontaminated society! no pauperism! no paid prostitution! very little serious drun/enness! and on the *hole astonishingly little crimeF *hile practically everyone has enough to eat! sufficient clothing! and an ade?uate d*elling! according to the primitive native standard )f *hat civili6ed community can as much %e saidK Civili6ations have %een rising and falling not only through all the period of recorded history! %ut long %efore as evidenced %y archeological findings (f *e thin/ of NatureBs calendar as one in *hich centuries are days and civili6ations are years! the part current events are playing in the history of a great continent li/e Africa may %e mere incidents This much *e do /no* that throughout the *orld some remnants of several primitive racial stoc/s have persisted to this day even in very e4acting environments and only %y such could they have %een protected (n my studies of these several racial stoc/s ( find that it is not accident %ut accumulated *isdom regarding foods that lies %ehind their physical e4cellence and freedom from our modern degenerative processes! and! further! that on various sides of our *orld the primitive people /no* many of the things that are essential for life>things that our modern civili6ations apparently do not /no* These are the fundamental truths of life that have put them in harmony *ith Nature through o%eying her nutritional la*s Whence this *isdomK Was there in the distant past a *orld civili6ation that *as %etter attuned to NatureBs la*s and have these remnants retained that /no*ledgeK (f this is not the e4planation! it must %e that these various primitive racial stoc/s have %een a%le through a superior s/ill in interpreting cause and effect! to determine for themselves *hat foods in their environment are %est for producing human %odies *ith a ma4imum of physical fitness and resistance to degeneration Primitive native races of eastern and central Africa have in their native state a very high immunity to dental caries! ranging from ; to less than , per cent of

the teeth affected for many of the tri%es Where moderni6ed! ho*ever! the incidence increased to ,5 , per cent (n the matter of facial deformity thirteen tri%es out of t*enty>seven studied presented so high a standard of e4cellence that not a single individual in the group *as found *ith deformed dental arches Their nutrition varied according to their location! %ut al*ays provided an ade?uate ?uantity of %ody>%uilding and repairing material! even though much effort *as re?uired to o%tain some of the essential food factors Many tri%es practiced feeding girls special foods for an e4tended period %efore marriage "pacing of children *as provided %y a system of plural *ives )eferences , $)&E&! $ Africa Dances N Y ! Gnopf! ,2-7 5 "A3=A$E! M 1es secrets de lBAfri?ue Noire (ntransigeant, Duly>Aug ! ,2-. - B&)WNE! $ The =anishing Tri%es of Genya 1ondon! "eeley "ervice! ,257 Chapter 1/ Isolated and modernized (ustralian (.origines )3& pro%lem of thro*ing light upon the cause of the physical %rea/do*n of our modern civili6ation! *ith special consideration of tooth decay and facial deformity! re?uires a critical e4amination of individuals living in as *ide a range of physical conditions as may %e possi%le This re?uires that the A%origines of Australia %e included in this e4amination of human reactions to physical environments These *ere studied in ,2-8 (n selecting the individuals in the various groups special effort *as made to include children %et*een the ages of ten and si4teen years in order to have an opportunity to o%serve and record the condition of the dental arches after the permanent teeth had erupted This *as necessary %ecause the deciduous dentition or first set of teeth may %e in normal position in the arches *ith a correct relationship %et*een the arches! and the permanent dentition sho* mar/ed irregularity The shape of the dental arches of the infant at %irth and the teeth that are to ta/e their place in the arches have considera%le of their calcification at %irth The development of the adult face! ho*ever! does not occur until the permanent teeth have erupted The general shape or pattern is

largely influenced %y the position and direction of the eruption of the permanent teeth These studies! accordingly! have included a careful! detailed record of the shape of the dental arch of each individual The Australian A%origines constitute one of the most uni?ue primitive races that have come out of the past into our modern times and they are pro%a%ly the oldest living race We are particularly concerned *ith those ?ualities that have made possi%le their survival and cultural development The A%origines are of special interest %ecause they have come out of a very distant past and are associated *ith animal life *hich is uni?ue in %eing characteri6ed as a living museum preserved from the da*n of animal life on the earth Many of the animal species that are a%undant in Australia are found only in fossil form on other continents The evidence indicates that they crossed on a land %ridge *hich connected Australia *ith Asia After the %ridge *as su%merged the animals persisted in that protected island continent *hich never has /no*n any of the animal species of later development Among these animals the marsupials play an important role and constitute a large variety The American continent has only one or t*o of the many forms found in Australia These are the opossum of the marsupial family and the sloth )ne of the most curious animals living on the earth today! or that has left its remains in the petrified s/eletons of early periods of the earthBs history! is the duc/%ill platypus (t has the uni?ue distinction of having the characteristics of several animal species (t lays eggs li/e a %ird and hatches them *ith the heat of its %ody in its pouch (t has *e%%ed! five>toed feet! li/e the *ater %irds! a %ill li/e a duc/ and hair and tail li/e a %eaver The typical marsupial pouch for carrying its young! is another characteristic of this strange animal 1i/e other mammals it provides mil/ for its young (ts mil/ is similar in chemical constituents to that of other mammals Most rudimentary in form are the mammary glands of the platypus The young! *hen hatched in the pouch! nu66le the lining mem%rane of the pouch and the mil/ e4udes through minute openings There is no nipple The animal lives chiefly in the *ater (ts home is %uilt a%ove the *ater level on the %an/! %ut the entrance to it is underneath the *ater They are e4ceedingly playful creatures! apparently more at home in the *ater than on land They live on %oth animal life and plant food found under the *ater They seem to %e related to an early era of differentiation of animal species

The A%origines are credited *ith having the most primitive type of s/eletal development of any race living today The eyes are very deep set! the %ro*s very prominent giving them an e4pression that identifies them as a distinct racial type "ee #ig 75 Professor Weidenreich has sho*n that they resem%le in this regard the recently discovered ancient Pe/ing man While they are still in the "tone Age stage in their arts and crafts! they have developed further in some respects than has any other ancient race Their s/ill in trac/ing and out*itting the fleet and very cunning animal life of their land is so remar/a%le that they have %een accredited *ith a si4th sense They have %een a%le to %uild good %odies and maintain them in e4cellent condition in a country in *hich the plant life! and conse?uently the lo*er animal life can %e maintained at only a very lo* level %ecause of the a%sence of rain )ver half of Australia has less than ten inches of rain a year (t is significant that the natives have maintained a vigorous e4istence in districts in *hich the *hite population *hich e4pelled them is una%le to continue to live Among the *hite race there! the death rate approaches or e4ceeds the %irth rate

FI". -!. $he Aborigines of Australia are recogni*ed to be the oldest living race of man%ind. 'ote the #rominent eyebrows and dee# set eyes. $he man at the u##er right is holding his s#ears and wamara+ or s#ear thrower. $hey are very fond of decorations on their bodies. Little baldness was seen even in the very old.

They have developed a device for thro*ing spears! *hich ma/es them more deadly than any in the *orld ( *itnessed a group of the present>day natives thro*ing their spears at a target *hich consisted of a %anana stal/ much smaller than a manBs %ody They thre* the spears from a distance *hich ( estimated to %e seventy>five yards A%out thirty spears *ere thro*n and several pierced the %anana stal/ and the others *ere stuc/ in the ground close around it This *as accomplished %y means of a *amara or thro*ing stic/ appro4imately as long as the arm! *ith a strong hand grip at one end and a device on the other end for engaging in a depression in the %utt of the spear This *as thro*n %y poising the spear a%out the level of the shoulder! the spear supported %y the fingers of the hand *hich s*ung the thro*ing stic/ The latter e4tended %ac/ over the shoulder The impact of their spears has often %een demonstrated to %e sufficient to completely penetrate a manBs %ody Their method of tempering *ood for the points of the spears *as such that the spearheads offered great resistance A thro*ing stic/ is sho*n in #ig 75 Hupper rightI

These natives decorate their %odies *ith paints for dances and sports They /no* the ha%its of all of the animals and insects so *ell that they are a%le to reproduce the calls of the animals and thus decoy them into traps "ome of the *ater %irds maintain sentinels at loo/out points to guard those in the *ater The A%origines are a%le to decoy these %irds %y most ingenious methods They travel *ith their %odies disguised %y grass and shru%%ery and enter the *ater *ith a headgear made from feathers of one of the %irds )nce in the *ater! they then maneuver in a manner similar to that of the %irds and go among the floc/ of *ild duc/s or s*ans Wor/ing entirely under *ater! they dra* the %irds under one %y one and ta/e load after load to shore *ithout raising the suspicion of the floc/ When *or/ing among the /angaroos they are so s/illed in preparing mova%le %linds that they can /ill many in a gra6ing *ild pac/ *ithout alarming the rest! al*ays stri/ing *hen the animal is gra6ing Their s/ill at fishing pro%a%ly e4ceeds that of any other race They are so highly trained in the /no*ledge of the ha%its of the fish and the type of movement that the fish transmits to the *ater and to the reeds in the *ater! that one of their important contests %et*een tri%es is to see ho* many fish can %e struc/ in succession *ith a spear! the fish never %eing seen! their only information as to its *herea%outs %eing the change in the surface of the *ater and movement of grasses that are gro*ing in the *ater as the fish moves The fish are started %y the umpireBs stri/ing the *ater The e4perts %ring up a fish si4 times out of eight These fishing contests are held along the %an/s of la/es and rivers *here the *ater is deep enough for some of the reeds and grasses to come to the surface The contestants travel in canoes The native canoe is cut in one piece from the side of a tree! the cutting %eing done *ith stone a4es The canoe offers an e4ceedingly treacherous platform from *hich a standing man must thro* his spear #or some of the contests the canoe carries a paddler! %ut in the most e4acting contests the spear man must manage his o*n flat>%ottomed canoe The s/ill of the A%origines in trac/ing is so phenomenal that practically every large modern to*n or city in Australia has one or more of these men on its police staff today to trac/ criminals #or *ee/s! they carry the detailed information a%out the characteristics of the prisonerBs foot across the desert! and *hen they come across the man s foot print they recogni6e it among all others in the same path Every leaf that is turned over or grain of sand on %are roc/s has meaning for them Their social organi6ation is such that almost every person *ho had %een in intimate contact *ith them! testified that they had never /no*n any of the

A%origines to %e guilty of the theft of anything Even *here partly moderni6ed! as they are in the large government reservations they are trust*orthy A nurse in an emergency hospital told me that she continually left her money! Ae*elry and other o%Aects of personal property freely e4posed and availa%le *here many of the hundreds of primitives passing could pic/ them up! and that she had never /no*n them to ta/e anything The other nurses had had the same e4perience Every %oy and girl among these A%origines must pass many e4aminations Their early schooling includes the trac/ing of small animals and insects The small %oys %egin thro*ing spears almost as soon as they can stand up straight No young man can even *itness a meeting of the council! let alone %ecome a mem%er of it! until he has passed three supreme tests of manhood #irst! he is tested for his a%ility to *ithstand hunger *ithout complaint The test for this is to go on a march for t*o or three days over the hot desert and assist in preparing the meals of roast /angaroo and other choice foods and not parta/e of any himself +e must not complain (f he %ecomes too *ea/! he is given a small portion There are tests for fear in *hich he is placed under the most trying ordeals *ithout /no*ing that it is part of his e4amination! and he must demonstrate that he *ill accept death rather than flee No mem%er of their society *ould %e allo*ed to continue to live *ith the tri%e if he had defied the ideals of the group (mmorality is cause for immediate death The gro*ing %oys among the A%origines are taught deference and esteem for their elders in many impressive *ays A %oy may not /ill or capture a slo* moving animal That is left for the older men! *hom he must call +e must limit his hunting primarily to the fast fleeing and canny /angaroos and *alla%ies! *hom even a man on horse%ac/ cannot outdistance &ac/eteers and such unsocial %eings could not e4ist in this type of civili6ation Marriages are arranged according to very distinct tri%al patterns and every girl is provided *ith a hus%and at a time decided %y the council Their code of ethics is %uilt around the conception of a po*erful "upreme #orce that is related to the sun They %elieve that there is an after>e4istence in *hich the myriads of stars represent the spirits of the A%origines that lived %efore The %oys and girls are taught the names of the great characters that ma/e up the different constellations These *ere individuals *ho had con?uered all of the temptations of life and had lived so completely in the interest of others that they had fulfilled the great motivating principle of their religion! *hich is that life consists in serving others as one *ould *ish to %e served The seven stars of Pleiades *ere seven %eautiful maidens that had surpassed most other girls in

their devotion and service in the interest of their tri%e (t is most remar/a%le ho* closely this concept is related to the classical myth regarding the seven daughters of Atlas and the nymph! Pleione A part of a young menBs e4amination to determine his a%ility to *ithstand pain and his po*er of self>control consists in performing an operation at the time of his graduation This operation is at the same time calculated to provide him *ith his %adge of attainment (t consists of the %oyBs lying on his %ac/ and allo*ing the appointed operator to /noc/ out one of his front upper teeth This is done %y putting a peg against the tooth and hitting it a series of sharp %lo*s *ith a stone +e must endure this *ithout flinching We sa* scores that carried this diploma Prior to this! other very severe tests of physical endurance had %een successfully completed The marvelous vision of these primitive people is illustrated %y the fact that they can see many stars that our race cannot see (n this connection it is authoritatively recorded regarding the Maori of Ne* <ealand that they can see the satellites of Dupiter *hich are only visi%le to the *hite manBs eye *ith the aid of telescopes These people prove that they can see the satellites %y telling the man at the telescope *hen the eclipse of one of the stars occurs (t is said of these primitive A%origines of Australia that they can see animals moving at a distance of a mile *hich ordinary *hite people can not see at all While these evidences of superior physical development command our most profound admiration! their a%ility to %uild super% %odies and maintain them in e4cellent condition in so difficult an environment commands our genuine respect (t is a supreme test of human efficiency (t is dou%tful if many places in the *orld can demonstrate so great a contrast in physical development and perfection of %ody as that *hich e4ists %et*een the primitive A%origines of Australia *ho have %een the sole ar%iters of their fate! and those A%origines *ho have %een under the influence of the *hite man The *hite man has deprived them of their original ha%itats and is no* feeding them in reservations *hile using them as la%orers in modern industrial pursuits This contrast %et*een the primitive A%origines as they still e4ist in isolated communities in Australia and the modern mem%ers of the clans is not! ho*ever! much greater than that %et*een these e4cellent primitives and the *hites! near *hom they are living (n my comparative study of primitive races in different parts of the *orld! of moderni6ed mem%ers of their groups and of *hites *ho have displaced them! as *ell as in my study of our typical modern social organi6ation! ( have seldom! if ever! found *hites suffering so tragically from evidence of physical

degeneration! as e4pressed in tooth decay and change in facial form! as are the *hites of eastern Australia This has occurred on the very %est of the land that these primitives formerly occupied and %ecomes at once a monument to the *isdom of the primitive A%origines and a sign%oard of *arning to the modern civili6ation that has supplanted them Their super% physical e4cellence is demonstrated in every isolated group in the primitive stoc/s *ith *hich *e came in contact #or tri%es that have lived along the coast and had access to the sea foods! their stature *as large and *ell formed When living in the Bush they are largely *ithout clothing Where they are congregated in the reservations they are re?uired to *ear clothing (t is important to note in these people the splendid proportions of the faces! all of *hich are %road! *ith the dental arches *ide and *ell contoured This is NatureBs normal form for all humans and is sho*n in #igs 7- and 7. Hupper rightI The person in #ig 7- Hupper leftI is a *oman

FI". - . 'o other #rimitive race seems to deserve so much credit for s%ill in obeying nature>s laws as these #rimitive Aborigines because of the #er#etual drought ha*ards of much of the land they live in. 1alf of Australia has less than ten inches of rain #er year. 'ote the magnificent dental arches and beautiful teeth of these #rimitives. $ooth decay was almost un%nown in many districts.

FI". -). =herever the #rimitive Aborigines have been #laced in reservations and fed on the white man>s foods of commerce dental caries has become ram#ant. $his destroys their beauty+ #revents mastication+ and #rovides infection for seriously in@uring their bodies. 'ote the contrast between the #rimitive woman in the u##er right and the three moderni*ed women.

=arious factors in the changed environment *ere studied critically "amples of foods *ere gathered for chemical analysisF and the changes in the modern diet from that *hich *as characteristic of the primitives *ere studied When the teeth of the primitives and the teeth found in the s/ulls that had %een assem%led in the museums *ere e4amined! it *as found that dental caries or tooth decay *as e4ceedingly rare among the isolated groups Those individuals! ho*ever! *ho had adopted the foods of the *hite man suffered e4tremely from tooth decay as did the *hites Where they had no opportunity to get native food to com%ine *ith the *hite manBs food their condition *as desperate and e4treme This is readily disclosed in #ig 7. Note contrast *ith upper right (t is ?uite impossi%le to imagine the suffering that these people *ere compelled to endure due to a%scessing teeth resulting from rampant tooth decay As *e had found in some of the moderni6ed islands of the Pacific! *e discovered that here! too! discouragement and a longing for death had ta/en the place of a Aoy

in living in many #e* souls in the *orld have e4perienced this discouragement and this longing to a greater degree )ne of the most important phases of our special ?uest *as to get information that *ould thro* light on the degeneration of the facial pattern that occurs so often in our modern civili6ation This has its e4pression in the narro*ing and lengthening of the face and the development of croo/ed teeth (t is most remar/a%le and should %e one of the most challenging facts that can come to our modern civili6ation that such primitive races as the A%origines of Australia! have reproduced for generation after generation through many centuries>no one /no*s for ho* many thousands of years>*ithout the development of a conspicuous num%er of irregularities of the dental arches Yet! in the ne4t generation after these people adopt the foods of the *hite man! a large percentage of the children developed irregularities of the dental arches *ith conspicuous facial deformities The deformity patterns are similar to those seen in *hite civili6ations Typical illustrations of this *ill %e seen in #igs 77 and 78 "evere deformities of the face *ere fre?uently seen in the moderni6ed groups! as evidenced in #ig 79

FI". --. It is remar%able that regardless of race or color the new generations born after the ado#tion by #rimitives of deficient foods develo# in general the same facial and dental arch deformities and s%eletal defects. 'ote the characteristic narrowing of the dental

arches and crowding of the teeth of this moderni*ed generation of Aborigines and their similarity to the facial #atterns of modern whites.

FI". -/. $he disturbance in facial growth is often so serious as to ma%e normal breathing through the nose very difficult. $his is #rimarily due to faulty develo#ment of the ma,illary bones.

FI". -3. Deformity #atterns #roduced in the moderni*ed Aborigines of Australia by white men>s food. 'ote the undershot mandible+ u##er left+ the #inched nostrils and facial deformity of all four.

The data o%tained from a study of the native Australians *ho are located in a reservation near "ydney! at 1eParouse! revealed that among the A%origines .9 7 per cent of the teeth had %een attac/ed %y dental caries! and .; per cent of the individuals had a%normal dental arches #or the *omen of this group! :, per cent of all the teeth had %een attac/ed %y dental caries! and for the men! 8; . per cent! and for the children! ,8 7 per cent (n this group ,;; per cent of the individuals *ere affected %y dental caries Palm (sland is a government reservation situated in the ocean a%out fifty miles from the mainland! off the east coast of Australia! a%out t*o>thirds of the *ay up the coast (t *as reached %y a government launch (ncluded in the population of this reservation are a large num%er of adults *ho have %een moved from various districts on the mainland of Central and Eastern Australia and many children *ho *ere %orn either %efore or after their parents *ere moved to this reservation The food availa%le on the (sland is almost entirely that provided %y the government )f ninety>eight individuals e4amined and measured! 7- , per cent of them had dental caries #or the group as a *hole! : 2 per cent of all of the teeth *ere affectedF for the *omen! 5, 5 per centF for the

men! ,. 5 per centF and for the children! 7 : per cent #ifty per cent of the children had deformed dental arches! *hich occurred in only ,, per cent of the adults Cape Bedford is situated a%out three>fourths of the *ay up the east coast and is so isolated that it *as necessary for us to use a special aeroplane to reach it 1anding *as made on the %each This group of people is under the management of a $erman 1utheran missionary They are dependent almost entirely on the food provided %y the mission and the government The official in charge had spent fifty years in devoted service to these native people We found him e4ceedingly sad %ecause of the very rapid %rea/do*n that *as in progress among the natives in his care The dental caries for the group of eighty>three individuals studied *as ,5 . per cent of their 5!,98 teeth e4amined #or the *omen! this amounted to -9 5 per cent of the teethF for the men! : . per centF and for the children! 8 , per cent )f the eighty>three individuals! .: , per cent had %een affected %y dental caries Many of the adults in this group had %een %orn on plantations under the influence of the modern nutrition! and many of the children had %een %orn in the mission #or the adults! .8 per cent had a%normally formed dental arches! and for the children! ., 8 per cent We *ere advised that deaths occurred very fre?uently from tu%erculosis This reservation does not provide the natives *ith natural hunting grounds capa%le of providing the people *ith animal life for food The coast for some distance inland is a series of sand dunes *hich are slo*ly %eing transferred over the vegetation %y *ind! completely smothering it While the coast is *ell supplied *ith a variety of deep>*ater fish the natives have practically no e?uipment for o%taining them! a condition *hich restricts them very largely to the use of the imported foods supplied %y the officials )ur ne4t stop! using the special aeroplane! *as at 1oc/hart &iver! *hich is a%out four>fifths of the *ay up the east coast of Australia +ere again *e *ere a%le to land on the %each near a large group of primitive A%origines The isolation here is so nearly complete that they are dependent upon the sea and the land for their foods This part of Australia! namely! the Yor/ Peninsula! is still so primitive that there has %een very little encroachment %y the *hite population (t *ill %e remem%ered that in this area there are no roads! the country %eing a primitive *ilderness )f fifty>eight individuals e4amined! their ,!9:. teeth revealed that only . - per cent had %een attac/ed %y dental caries #or the *omen! this amounted to - . per centF for the men! 8 , per centF and for the children! - 5 per cent "ome of these men had at some time *or/ed on cattle ranches for the *hite men )f the children! only 8 - per cent had a%normal dental arches! and of the adults! : 9 per cent (n this group! therefore!

2, . per cent of all ages had reproduced the typical racial pattern as compared *ith 78 per cent of the group at Cape Bedford! 85 per cent of the group at Palm (sland! and 8; per cent at 1eParouse At 1oc/hart &iver! -5 9 per cent of the individuals had dental caries A reservation called Co*all Cree/ on the *est side of Yor/ Peninsula situated on the $ulf of Carpenteria! *as reached %y flying our special plane to +orn (sland in the Torres "trait north of Australia and proceeding from there %y %oat to Thursday (sland! and on! %y %oat! to Co*all Cree/ (n this reservation thirty>five individuals *ere studied and found to %e in a very pathetic condition We *ere told that deaths occurred fre?uently )f the 298 teeth e4amined! 5. 8 per cent had %een attac/ed %y tooth decay #or the *omen! this amounted to 8; 9 per centF for the men! -; . per centF and for the children! : 2 per cent #orty>nine and si4>tenths per cent of the individuals studied had a%normal dental arches )f the children 88 8 per cent had deformed dental arches! and 2 per cent of the adults Many of these adults had %een raised in the %ush )f the individuals studied! 8: 8 per cent had had dental caries )ne can scarcely visuali6e! *ithout o%serving it! the distress of a group of primitive people situated as these people are! compelled to live in a very restricted area! forced to live on food provided %y the government! *hile they are conscious that if they could return to their normal ha%its of life they *ould regain their health and again enAoy life Many individuals *ere seen *ith a%scessing teeth )ne girl *ith a fistula e4uding pus on the outside of her face is sho*n in #ig 7: Hupper rightI (n their native life *here they could get the foods that /eep them *ell and preserve their teeth! they had no need for dentists No* they have need! %ut have no dentists (t is easy to chide and %lame the officials *ho provide them *ith the moderni6ed foods under *hich they are %rea/ing! %ut it must %e remem%ered that practically all modern civili6ations are more or less in the same plight themselves

FI". -4. Aborigines in Australia living on a reservation. $he boy at the u##er left has su##urating tubercular a,illary glands. $he girl at the u##er right has #us running to the outside of her face from an abscessed tooth. $he boy whose legs are shown at the lower left has a badly deformed body from malnutrition. $he girl at the lower right has tubercular glands of the nec%.

An opportunity *as provided for e4amining a group of the native A%origines of Australia *ho made up the cre* of eighteen for a pearl>fishing %oat )f this group! 7 9 per cent of their 77. teeth had %een attac/ed %y tooth decay These individuals could %e readily divided into t*o groupsF namely! those *ho had %een raised in the Bush and those *ho had %een raised in missions #or the thirteen raised in the Bush! not a single tooth of their -8. teeth had ever %een attac/ed %y tooth decay and not a single individual had deformed dental arches (n contrast *ith this! of the five raised in the mission! ,2 - per cent of their ,.; teeth had %een attac/ed %y tooth decay and .; per cent of these individuals had a%normal dental arches The coo/ on the government %oat *as an a%original Australian from Northern Australia +e had %een trained on a military craft as a dietitian Nearly all his teeth *ere lost (t is of interest that *hile the native A%origines had relatively perfect teeth! this man *ho *as a trained dietitian for the *hites had lost nearly all his teeth from tooth decay and pyorrhea

(n the group of A%origines so far reported! there *ere many *ho had come from the interior districts of Australia and many *ho had al*ays lived near the coast These t*o types of districts provided ?uite different types of foods Those near the coast *ere a%le to o%tain animal life from the sea! including fish! dugong or sea co*! a great variety of shell fish! and some sea plants Those from the interior districts could not o%tain animal life of the sea! %ut did o%tain animal life of the land *hich *as eaten *ith their plant foods in each case (t *as ?uite important to reach a group of A%origines *ho had al*ays lived inland and *ho *ere on a reservation inland This contact *as made *ith the group at a government reservation called Cher%ourg A typical group of individuals *as e4amined )f forty>five individuals *ith ,!5-8 teeth! .5 7 per cent of the teeth had %een attac/ed %y tooth decay #or the *omen! this constituted .- 9 per centF for the men! 8. 8 per centF and for the children! 7 8 per cent )f all of the individuals here e4amined 8. 7 per cent had dental caries (t is of interest that many of these men had *or/ed on *hite menBs cattle ranches While the adults sho*ed ,, 9 per cent to have deformed dental arches! this rose to 7; per cent for the children of the group We *ere informed that in all of these groups tu%erculosis *as ta/ing a very heavy toll (n #ig 7:! upper left! *ill %e seen a %oy *ith a superating tu%ercular gland of the a4illaF at the right! a girl *ith a fistula draining pus onto the outside of the face from an a%scessed toothF %elo*! deformed legs and a girl *ith tu%ercular glands of the nec/ A reservation situated on the coast *here sea foods *ere availa%le might %e e4pected to ma/e availa%le a particular type of nutrition through sea foods The individuals in a reservation for the A%origines at T*eed +eads! *hich is so situated! *ere studied )f the t*enty>seven individuals e4amined! :2 per cent had dental caries )f their 99. teeth! -2 9 per cent had %een attac/ed %y dental caries #or the *omen! this amounted to 85 7 per centF for the men! 9; 2 per centF and for the children! 5; : per cent Most of these children had %een %orn in this environment *hile their parents *ere %eing fed! largely! the foods provided %y the government and mission (n this group! :- . per cent of the children had deformed dental arches! and -- - per cent of the adults An interesting incident *as %rought to my attention in one of the Australian reservations *here the food *as practically all supplied %y the government ( *as told %y the director in charge! and in further detail %y the other officials! that a num%er of native %a%ies had %ecome ill *hile nursing from their mothers "ome had died By changing the nutrition to a condensed *hole mil/ product! the %a%ies recovered When placed %ac/ on their motherBs %reast food they again %ecame ill The pro%lem *as@ Why *as not their mothersB mil/ ade?uateK

( *as later told %y the director of a condition that had developed in the pen of the reservationBs hogs *hich *ere /ept to use up the scraps and gar%age from the reservationBs /itchens +e reported that one after another the hogs *ent do*n *ith a type of paralysis and could not get up The symptoms *ere suggestively li/e vitamin A deficiency in %oth the %a%ies and the hogs! and indicated the treatment The rapid degeneration of the Australian A%origines after the adoption of the governmentBs modern foods provides a demonstration that should %e infinitely more convincing than animal e4perimentation (t should %e a matter not only of concern %ut deep alarm that human %eings can degenerate physically so rapidly %y the use of a certain type of nutrition! particularly the dietary products used so generally %y modern civili6ation The child life among the A%origines of Australia proved to %e e4ceedingly interesting Children develop independence very young and learn very early to ta/e care of themselves Mothers are very affectionate and sho* great concern *hen their children are not thriving T*o typical mothers *ith their children are sho*n in #ig 72 These children! as suggested in the picture! *ere /eenly interested in everything that ( did! %ut *ere not alarmed or frightened

FI". -9. $y#ical Aborigine mothers with their children.

The *onderful *isdom of these primitive people *as attested %y the principal of the pu%lic school at Palm (sland A mother died and her nursing infant *as ta/en care of %y its maternal grandmother! *ho had not recently given %irth to a child "he proceeded to carry out the primitive formula for providing %reast food %y artificial means +er method *as to ma/e an ointment of the fresh %odies of an insect *hich made its nest in the leaves of a certain tree This she ru%%ed on her %reast and in a short time produced mil/ li%erally for this foster child ( *as sho*n the type of insect! photographed its nest and the colony inside *hen the nest *as opened The people *ho vouched for this circumstance declared that they had seen the entire procedure and /ne* the facts to %e as stated They further stated that this *as common /no*ledge among the A%origines Another important source of information regarding the A%origines of Australia *as provided %y a study of the s/eletal material and s/ulls in the museums at "ydney and Can%erra! particularly the former ( do not /no* the num%er of s/ulls that are availa%le there for study! %ut it is very large ( e4amined many and found them remar/a%ly uniform in design and ?uality The dental arches *ere splendidly formed The teeth *ere in e4cellent condition *ith e4ceedingly little dental caries A characteristic of these s/ulls *as the evidence of a shortage of material for those that had %een transferred to a museum from the interior arid plains country Those s/ulls! ho*ever! that had come from coastal areas *here sea foods *ere availa%le! sho* much more massive dimensions of the general pattern (n #ig 8; *ill %e seen typical s/ulls sho*ing the normal dental arches and general design of the head (t is of interest to note the very heavy or%ital ridges *hich characteri6e this race

FI". /<. $he buried s%ulls throughout Australia #rovide a de#endable record of their #hysical e,cellence and s#lendid facial and dental arch forms. In the lower #ictures are shown the s%ull dome of a ty#ical Australian Aborigine for com#arison with that of the recently discovered ?e%ing man who #ossibly lived a million years ago.

( have previously referred to a report %y Professor Weidenreich regarding the resem%lance of the Australian nativeBs s/ulls to those of the recently discovered Pe/ing man in the caves of China (n #ig 8; are t*o vie*s for comparison The s/ull at the left is that of an Australian primitive photographed in a museum in "ydney! and an outline of the Pe/ing s/ull is sho*n at the right Professor Weidenreich has emphasi6ed the o%servations that *hen three s/ulls are put in series! namely! the Australian primitive! the Pe/ing s/ull and a chimpan6ee s/ull! the Pe/ing s/ull appears to %e a%out half *ay %et*een the t*o in design and developmental order The Australian primitiveBs s/ull is higher in the cro*n! sho*ing much greater %rain capacity The supra>or%ital depressions are less deep in the Pe/ing than in the chimpan6ee! and still less deep in the Australian primitive The supra>or%ital ridges *hich produce the prominent eye%ro*s are less pronounced in the Australian primitive than in the Pe/ing man! and still more prominent in the chimpan6ee The prominent supra> or%ital ridges of the chimpan6ee face are sho*n in #ig .:

The age of the Pe/ing s/ulls has %een variously placed from several hundred thousand to a million years A distinguished anthropologist has stated that the Australian primitives are the only people living on the earth today that could %e part of the first race of man/ind (t is a matter of concern that if a scale *ere e4tended a mile long and the decades represented %y inches! there *ould apparently %e more degeneration in the last fe* inches than in the preceding mile This gives some idea of the virulence of the %light contri%uted %y our modern civili6ation The foods availa%le for these people are e4ceedingly limited in variety and ?uantity! due to the a%sence of rains! and unfertility of the soil #or plant foods they used roots! stems! leaves! %erries and seeds of grasses and a native pea eaten *ith tissues of large and small animals The large animals availa%le are the /angaroo and *alla%y Among the small animals they have a variety of rodents! insects! %eetles and gru%s! and *herever availa%le various forms of animal life from the rivers and oceans Birds and %irdsB eggs are used *here availa%le They are a%le to %alance their rations to provide the re?uisites for splendid %ody %uilding and %ody repair (n several parts of Australia! *hich originally supported a large population of the primitives! none are left e4cept a fe* score in reservations These also are rapidly disappearing Their fertility has %een so greatly reduced that the death rate far e4ceeds the %irth rate This group provides evidence of e4ceptional efficiency in o%eying the la*s of Nature through thousands of years! even in a parched land that is e4ceedingly inhospita%le %ecause of the scant plant foods for either men or animals While the A%origines are credited *ith %eing the oldest race on the face of the earth today! they are dying out *ith great rapidity *herever they have changed their native nutrition to that of the modern *hite civili6ation #or them this is not a matter of choice! %ut rather of necessity! since in a large part of Australia the fe* that are left are cro*ded into reservations *here they have little or no access to native foods and are compelled to live on the foods provided for them %y our *hite civili6ation They demonstrate in a tragic *ay the inade?uacy of the *hite manBs dietary programs Chapter 11 Isolated and modernized Torres !trait islanders (N "T3DY(N$ the relationship %et*een nutrition and physical characteristics! it is important to ma/e o%servations at the point of contact *ith civili6ation *here as fe* factors as possi%le in the environment have %een modified %y that contact My previous studies have sho*n that *herever groups of people *ere

utili6ing sea foods a%undantly in connection *ith land plants including roots! greens and fruits! they enAoyed fine physical development *ith uniform reproduction of the racial pattern and a very high immunity to dental caries #or this particular study *e *ished to select a racial group living on islands in tropical or su%tropical climate! *hose ancestral stoc/s differed from those previously o%served! and *hich *as located at points of contact *ith modern civili6ation A high level of e4cellence might %e e4pected among the groups *ho *ere in process of %eing moderni6ed %ut *ere still utili6ing the native foods #or this study the inha%itants of islands north of Australia *ere chosen in order to record the effect on the Asiatic and Malay stoc/s at the points of contact of the north *ith the south and of the east *ith the *est (n the Torres "trait there are a num%er of fertile islands supporting populations of from several hundred to a fe* thousand individuals each These groups are in an area of the sea that is *ell stoc/ed *ith sea animal life! and during the past they have %een sufficiently isolated to provide protection The racial stoc/s have retained their identities and include Papuans! Ne* $uineans! Mo%uiags! Ara/uns! Gendals and Yon/as The splendid dental arches of these groups *ill %e seen in the various illustrations Many of the girls are ?uite prepossessing! as may %e seen in #ig 8,

FI". /1. $he inhabitants of the islands north of

Australia have s#lendidly built bodies with fine facial and dental arch form.

With the valua%le assistance of the officials of the Australian $overnment *e *ere a%le to ma/e investigations on several islands in the Torres "trait The local administrator provided us *ith a government %oat and personal introductions to the local chief and local representatives of the government We *ere accompanied %y the administrator and %y the general manager of the government stores These stores have %een located on the various islands! and the profit derived from them is used for administrative e4penses of the government They provide modern clothing in addition to foods! chiefly *hite flour! polished rice! canned goods! and sugar "tudies *ere made on the various islands in the order in *hich the stores had %een installed on them (t is important to have in mind the nature of these islands "ome are of volcanic origin and have rugged interiors *ith deep %aysF others are of coral origin All are in a 6one that is a%undantly supplied *ith sea animal life! this %eing the scene of the richest pearl fishing industry in the *orld Badu (sland had had the store for the longest period! namely t*enty>three years )f the 7:8 teeth of t*enty individuals e4amined! 5; 8 per cent had %een attac/ed %y tooth decay )f the individuals e4amined 27 per cent had dental caries 3nfortunately! our stay at this island *as accompanied %y a torrential do*npour *hich made it very difficult for us to carry for*ard our investigations +ad *e %een a%le to e4amine the mothers the figures dou%tless *ould have %een much higher The children *ere e4amined at the school and sho*ed ,: : per cent of the teeth to have %een attac/ed %y tooth decay The men e4amined sho*ed 5, 2 per cent #igures given me %y Dr $i%son! *ho had %een ta/en %y the government to the island to ma/e e4tractions! sho*ed that he found as high as 8; per cent of the teeth had %een attac/ed %y tooth decay #or the children of this group! -- - per cent had a%normal dental arches! *hereas only 2 , per cent of the adultsB arches *ere a%normally formed )n Yor/ (sland! ,!:98 teeth of si4ty>five individuals sho*ed that ,5 9 per cent had %een attac/ed %y tooth decay #or the *omen! this *as 5; 5 per centF for the men! ,5 , per centF and for the children! 9 per cent #or the children! .9 , per cent had a%normal dental archesF for the adults! 59 per cent *ere affected The individuals on this island had %een in contact *ith the pearl fisheries industry for several years "everal of the men had %een *or/ing on the fishing %oat )f the si4tyfive individuals e4amined! 89 8 per cent had dental caries

)n Darnley (sland! thirty>three individuals sho*ed that of their 2;; teeth 7 9 per cent had %een attac/ed %y tooth decay The store had %een esta%lished on this island recently #or the *omen! ,8 8 per cent of the teeth had %een attac/edF for the men! 8 - per centF and for the children! . , per cent )n this island! 52 8 per cent of the children sho*ed a%normal dental arches! and ,. per cent of the adults )f the *hole group! .8 , per cent had %een attac/ed %y dental caries )n Murray (sland *here a store had recently %een esta%lished! of the ,!;9. teeth e4amined for -2 individuals! only ; 9 per cent of the teeth had %een attac/ed %y tooth decay #or the *omen! this amounted to 5 per centF for the men! , 9 per centF and for the children! ; 58 per cent )nly ,5 : per cent of the group had dental caries (t is significant that the natives *ere conscious of a danger from the presence on the island of a store providing imported foods This had %een so serious a pro%lem that there *as a ?uestion *hether it *ould %e safe for us to land! since on the last visit of the government officials! %lood *as almost shed %ecause of the opposition of the natives to the government s program The result of our e4amination indicates that dental caries on these islands sho*s an incidence *hich has an apparent direct relationship to the length of time government stores have %een esta%lished there The immunity to dental caries on this island is nearly ,;; per cent )f the adults! ,. - per cent had a%normal dental arches! and of the children! -. . per cent Thursday (sland is the location of the administrative center for the group Although it is the %est sheltered har%or and affords protection for small %oats in the Torres "trait! it *as not originally inha%ited %y the natives They considered it unfit for ha%itation %ecause the soil *as so poor that it could not provide the proper plant foods to %e eaten *ith the sea foods *hich are a%undant a%out all of the islands Nearly all of the *hites inha%iting the islands of this district live on this island They are the families of the administrative officers and of merchants *ho are engaged in the pearl industry )*ing to the infertility of the soil! practically all of the food has to %e shipped in e4cept the little that the *hites o%tain from the sea )n the island there *ere many native families! *ith children attending the native school! *hile their fathers *or/ed in the pearling fleets Thirty individuals in three fleets *ere e4amined! and of their 28; teeth only thirty>five had %een attac/ed %y dental caries! or - 8 per cent )f these thirty individuals! five! or ,8 - per cent had a%normal dental arches The men *ho had teeth attac/ed %y dental caries informed me that this had happened after they had engaged on the pearling vessels and %egan to use the foods provided there (n the native school on Thursday (sland t*enty>three children *ere e4amined They *ere living in homes in *hich a considera%le part of the

food *as purchased at the company stores The incidence of tooth decay *as ,5 5 per cent of their 88. teeth Many of these Thursday (sland children had %een %orn since their parents had %egun using the commercial foods provided to the islanders Among t*enty>three individuals! .- 7 per cent had a%normal dental arches While these investigations *ere planned and carried out primarily to o%tain data on the condition of the native races in contact *ith modern *hite civili6ation! *herever possi%le! data *ere o%tained on the *hites also (n a school for *hites on Thursday (sland! fifty children *ere e4amined *ith regard to their dental arches! %ut an em%arrassing situation *as encountered *ith regard to the sensitiveness of the *hites in the matter of having their children e4amined for dental caries #igures *ere o%tained for the facial development *hich reveal that! out of the fifty children e4amined! 8. per cent had irregularities of facial and dental arch development (n the upper half of #ig 85! *ill %e seen a group of children photographed in the native school! and in the lo*er a group of *hite girls photographed at the *hite school The difference in their facial development is readily seen The son of the *hite teacher H#ig 88! leftI had mar/ed under development of his face The *hite population lived largely on canned food

FI". /!. School children from the two grou#s on $hursday Island. 'ote the beautifully #ro#ortioned

faces of the natives+ and the #inched nostrils and mar%ed disturbance in #ro#ortions of the faces of the whites. $he dental arches of the natives are broad+ while many of the whites have very crowded teeth. $he #arents and children of the natives used native foods while the #arents and children of the whites used the modern im#orted foods of commerce.

+ammond (sland adloins Thursday (sland sufficiently close %y to %e easily reached in small %oats Accordingly! the people of this island have access to the stores of the *hite settlement on Thursday (sland 3nli/e Thursday (sland! +ammond (sland is ?uite fertile )f t*enty>seven individuals! all of native stoc/! ,8 7 per cent of their 9-5 teeth had %een attac/ed %y dental caries! and .; per cent of the individuals sho*ed some deformity of the dental arches After e4amining the children at the mission school! ( in?uired *hether there *ere not families on the island that *ere living entirely isolated from contact *ith modern influences ( *as ta/en to the far side of the island to an isolated family This family had continued to live on their o*n resources They *ere raising vegeta%les including %ananas! pump/ins! and pa*pa*s (n the cases of the three girls in the family! one *ith a child five months of age! only si4 of their eighty>four teeth had %een attac/ed %y tooth decay! or 9 , per cent! as compared *ith ,8 7 per cent for the entire group on this island These three girls all had normally developed dental arches and normal features Three of the girls are sho*n in #ig 8- We in?uired a%out the mother and *ere told that she *as out fishing! not*ithstanding the fact that the sea *as ?uite rough While *e *ere there! she came in *ith t*o fish H#ig 8-I +ere *as one of the principal secrets of their happiness and success in life The Catholic priest *ho had charge of the mission on this island told me that this family practically never as/ed for assistance of any /ind! and *as al*ays in a position to help others They *ere happy and *ell nourished (t is important to note that the progressive degeneration in facial form *hich occurred in many of the families on the other islands *as not found in this family

FI". / . $hese #ictures tell an interesting story. $he grandmother shown in the lower right %new the im#ortance of sea food for her children and grandchildren and did the fishing herself. 'ote the beautiful teeth and well formed faces of her daughters.

The incidence of dental caries ranged from 5; 8 per cent of all of the teeth e4amined for the various age groups on Badu (sland to ; 9 per cent! on Murray (sland A group of individuals from this island *ill %e seen in #ig 8. Note the remar/a%le *idth of the dental arches Note also in this connection that the natives of this island are conscious of the superior food of their locality and *ish that their people *ere not re?uired to purchase food from the government store The island is situated on the Barrier &eef and has an a%undant supply of small fish The s*arms of fish are often so dense that the natives thro* a spear *ith several prongs into the school of fish and *hen the spear is dra*n %ac/! there are several fish on it This condition provides a%undant food for shar/s many of *hich could %e seen surrounding the schools of small fish Encircling the group! they dashed in! mouths open and gorged themselves *ith the mass of fish from the *ater (t seemed ?uite remar/a%le that the people *ere *illing to go into the *ater to spear the fish *ithin the 6one fre?uently approached %y the shar/s! %ut ( *as told %y the natives that *hen the fish are so a%undant the shar/s never attac/ human %eings )ne of the natives ro*ed me in his canoe to a point *here ( could photograph the shar/s at close range To sho* his disdain

for the shar/! he had no hesitancy in standing up in the end of the canoe and hurling his spear into the side of the monster The spear *as immediately thro*n out %y the shar/! *hich had not %een frightened sufficiently to ma/e it leave the scene of action The shar/s in my pictures *ere s*imming so close to the shore that the upper part of the tail *as forced out of the *ater! also the %ac/ fin! in order to clear the %ottom (t *as a great revelation to *atch the movement of the tail (nstead of s*inging it from side to side li/e other fish! *ith *hich ( *as familiar! the shar/ *ould rotate its tail half or three ?uarters of a turn in a motion li/e that of a propeller of a %oat! then reverse the motion for the return trip By a sudden increase of speed in this motion! the shar/ could dart ahead at a rapid rate! corral the small fish %y encircling them! and finally ma/e a dash through the school *ith its mouth open +undreds of the small fish! in order to escape! dart out of the *ater into the air This e4poses them to the %irds! a floc/ of *hich follo*s the shar/s *hen they are feeding on the fish The %irds dive do*n at the time they see the shar/ ma/ing his raid and catch the small fish as they dart out of the *ater (t is %y the %irds of prey that the native fishermen from their loo/out locate the schools of fish While there is a difference of opinion as to *hether some species of shar/ *ill attac/ human %eings! *e sa* one pearl diver *ho %ore enormous scars received from the Aa*s of a shar/

FI". /). 'atives on the islands of the "reat Barrier 2eef. $he dental arches here teach a high degree of

e,cellence.

The procedure on one island is to snare the shar/s %y calling them %y means of special sounds made %y clapping together t*o large half shells on the surface of the *ater This attracts the shar/! and then the men one at a time go into the *ater *ith a sharp stic/ *ith *hich they guard themselves against attac/ A noose made of rope of coconut fi%er is slipped over the shar/Bs head and over the %ac/ fin (t is then allo*ed to tire out and is %rought to shore (t *as not unusual in a good season for the shar/ fishers to %ring in three or four in a nightBs fishing The strength of the native s*immers is almost %eyond %elief The pearling %oats are fre?uently in great danger of %eing dashed to pieces on a coral reef! since in those *aters gales of fifty miles an hour are fre?uent We e4perienced some such gales )n one occasion! *hen a pearling %oat *as *rec/ed some distance from an e4posed roc/! one strong s*immer rescued and helped t*o do6en of the cre* to the roc/! and *as himself rescued after %eing in the *ater continuously for thirty>t*o hours The pearling %oats feed their cre* largely on commercial provisions When the men have %een continuously on the %oats for one or t*o years! or often *hen they have %een at sea using this food for si4 months! they have rampant tooth decay When the cavities approach or reach the pulp cham%ers the pain produced in the teeth %y the high pressure in deep *ater produces such agony that they often have to give up pearling Physical characteristics of all these residents of the Torres "trait (slands! regardless of their tri%al group! *ere! sturdy development throughout their %odies! %road dental arches! and for all of those *ho had al*ays lived only on their native food! a close pro4imity to one hundred per cent immunity to dental caries These men are natural mariners They do not hesitate to ma/e long trips even in rough seas in their homemade crafts They have an uncanny s/ill in determining the location of invisi%le coral reefs They relate the height of the s*ell as it rolls over the reef to particular color tones in the *ater! all of *hich *ere too vague for me to see even *hen they *ere pointed out Among the inha%itants of the Torres "trait (slands! almost all individuals *ho had %een %orn %efore the foods of modern civili6ation had %ecome availa%le *ere found to have dental arches normal in form (n many families! ho*ever! living on islands *here a store had %een esta%lished for some time! and on Thursday (sland *here imported foods had %een availa%le for several decades! many individuals *ere found *ho had %een %orn since the use of imported foods They had gross deformities of the dental arches This fact is illustrated in #ig 87 in *hich typical depression of the laterals and narro*ing of the upper arch and a%normal prominence of the cuspids due to the lac/ of

space for the normal eruption may %e seen The facial deformity in t*o *hite %oys is seen in #ig 88 &ampant tooth decay in *hite children is sho*n in #ig 89

FI". /-. $he contrast between the #rimitive and moderni*ed natives in facial and dental arch form is as stri%ing here as elsewhere. $hese young natives were born to #arents who had ado#ted our modern foods of commerce. 'ote the narrowed faces and dental arches with #inched nostrils and crowding of the teeth. $heir magnificent heredity could not #rotect them.

FI". //. $hese children are from the white colony on $hursday Island. 'ote the #inched nostrils and deformed dental arches with crowding of the teeth. $he boy at the left is a mouth breather.

FI". /3. As everywhere these whites #refer the moderni*ed foods and #ay the #enalty in ram#ant tooth decay. $hey are in #athetic contrast with the su#erb uns#oiled natives. $hey are within reach of some of the best foods to be found anywhere in the world and yet do not use themC a ty#ical characteristic of modern whites.

We are particularly concerned *ith data that *ill thro* light on the nature of the forces responsi%le for the production of these deformities "ince they do not appear to their full e4tent until the eruption of the permanent teeth as part of the development of the adult! it is easy for the a%normality to %e ascri%ed to the period of child gro*th As a result! it has %een related to faulty %reathing ha%its! thum% suc/ing! posture! or sleeping ha%its! of the child (t *ould %e difficult to find a more happy and contented people than the primitives in the Torres "trait (slands as they lived *ithout contact *ith modern civili6ation (ndeed! they seem to resent very acutely the modern intrusion They not only have nearly perfect %odies! %ut an associated personality and character of a high degree of e4cellence )ne is continually impressed *ith happiness! peace and health *hile in their congenial presence These people are not la6y! %ut they do not struggle over hard to o%tain food Necessities that are not readily at hand they do not have Their home life reaches a very high ideal and among them there is practically no crime

(n their native state they have e4ceedingly little disease Dr D & Nimmo! the government physician in charge of the supervision of this group! told me in his thirteen years *ith them he had not seen a single case of malignancy! and had seen only one that he had suspected might %e malignancy among the entire four thousand native population +e stated that during this same period he had operated several do6en malignancies for the *hite population! *hich num%ers a%out three hundred +e reported that among the primitive stoc/ other affections re?uiring surgical interference *ere rare The environment of the Torres "trait (slanders provides a very li%eral supply of sea foods and fertile islands on *hich an ade?uate ?uantity of tropical plants are readily gro*n Taro! %ananas! papaya! and plums are all gro*n a%undantly The sea foods include large and small fish in great a%undance! dugong! and a great variety of shellfish These foods have developed for them remar/a%le physi?ues *ith practically complete immunity to dental caries Wherever they have adopted the *hite manBs foods! ho*ever! they suffer the typical e4pressions of degeneration! such as! loss of immunity to dental cariesF and in the succeeding generations there is a mar/ed change in facial and dental arch form *ith mar/ed lo*ering of resistance to disease Chapter 12 Isolated and modernized 'ew 0ealand +aori BECA3"E of the fine reputation of the racial stoc/ in its primitive condition! it *as *ith particular interest that studies *ere made in Ne* <ealand Pic/erill H,I has made a very e4tensive study of the Ne* <ealand Maori! %oth %y e4amination of the s/ulls and %y e4amination of the relatively primitive living Maori +e states@ (n an e4amination of 57; Maori s/ulls>>all from an uncivili6ed age>>( found carious teeth present in only t*o s/ulls or ; 98 per cent By ta/ing the average of MummeryBs and my o*n investigations! the incidence of caries in the Maori is found to %e , 5 per cent in a total of -58 s/ulls This is lo*er even than the Es?uimau4! and sho*s the Maori to have %een the most immune race to caries! for *hich statistics are availa%le Comparing these figures *ith those applica%le to the present time! *e find that the descendants of the Britons and Anglo>"a4ons are afflicted *ith dental caries to the e4tent of :8 per cent to 2: per centF and after e4amining fifty Maori school children living under European conditions entirely! ( found that 27 per cent of them had decayed teeth

(t *ill %e noted that the %asis of computation in the a%ove is percentage of individuals *ith caries ( am using in addition to these figures the percentage of teeth attac/ed %y dental caries E4pressed in percentage of teeth affected the figure for Pic/erillBs group *ould %e ; ;7 or , in 5!;;; teeth We *ere deeply inde%ted to the government officials in Ne* <ealand for their invalua%le assistance (n anticipation of ma/ing these studies ( had %een in correspondence *ith the officials for over t*o years When *e arrived at Auc/land! Ne* <ealand! on our *ay to Australia! our ship *as in port for one day We *ere met %y Colonel "aunders! Director of )ral +ygiene in the Ne* <ealand Department of Pu%lic +ealth *ho had %een sent from the capitol at Wellington to offer assistance A personal representative of the $overnment *as sent as guide! and transportation to the various Maori settlements in *hich *e *ished to ma/e our studies *as provided

Ne* <ealand is setting a standard for the *orld in the care of gro*ing children as *ell as in many other health pro%lems A large percentage of the schools in Ne* <ealand are provided *ith dental service A specially trained *oman *as in charge of the *or/ in each school under Colonel "aundersB supervision The operations performed %y these young *omen on children far e4ceeded in ?uality the average that ( have seen %y dentists in America Their plan gives dental care to children t*elve years of age and under! provided the parents e4press a *ish that their children receive that care The service *as %eing e4tended rapidly to all communities "ince my return! ( have learned that the *or/ is %eing organi6ed to provide for every community of Ne* <ealand The art of the Maori gives evidence of their great a%ility and s/ill in sculpturing Boys and girls do %eautiful carving and *eaving All native %uildings and structures are em%ellished *ith carvings often in fine detail (t *as most gratifying to find neat and *ell>appointed dental office %uildings for %oth natives and *hites! located %eside a large num%er of the pu%lic schools throughout Ne* <ealand (n many communities t*o or three schools *ere served %y the same operator Children *ere either %rought to the central dental infirmary or provision *as made for an operating room in the vicinity of each school The operator *ent from district to district A typical dental infirmary is sho*n in #ig 8:! *ith Colonel "aunders and one of his efficient *omen operators in the foreground ( had suggested that ( should %e glad to have o%servers from the Department of +ealth accompany us or arrange to %e present at convenient places to o%serve the conditions and to note my interpretations of them #rom t*o to five such o%servers *ere generally present! including the official representative of the department The planning of the itinerary *as very greatly assisted %y a Maori mem%er of Parliament! Mr Aparana Ngata

FI". /4. $he 'ew Eealand government #rovides nearly universal free dental service for the children+ regardless of color+ to the age of twelve years. $his is a ty#ical dental clinic maintained in connection with the

school system. $hey are o#erated by trained dental hygienists. $he director of the system+ 8olonel Saunders+ is seen in the #icture.

Although Ne* <ealand is a ne* country *ith a relatively small population! there %eing appro4imately only a million and a half individuals! the %uilding of high*ays has rapidly %een e4tended to include all moderni6ed sections (n order to reach the most remote groups it *as often necessary to go %eyond the 6one of pu%lic improvements and follo* ?uite primitive trails #ortunately this *as possi%le %ecause it *as the dry season Even then many streams had to %e forded! *hich *ould have %een ?uite impossi%le at other seasons of the year We *ere a%le to average appro4imately a hundred miles of travel per day for eighteen days! visiting t*enty>five districts and ma/ing e4aminations of native Maori families and children in native schools! representing various stages of moderni6ation This included a fe* *hite schools and tu%ercular sanitariums "ince over 27 per cent of the Ne* <ealanders are to %e found in the North (sland! our investigations *ere limited to this island )ur itinerary started at Wellington at the south end of the North (sland and progressed north*ard in such a *ay as to reach %oth the principal centers of native population *ho *ere moderni6ed and those *ho *ere more isolated This latter group! ho*ever! *as a small part of the total native population Detailed e4aminations including measurements and photographic records *ere made in t*enty>t*o groups consisting chiefly of the older children in pu%lic schools (n the e4amination of 7-7 individuals in these t*enty>t*o school districts their ,7!--5 teeth revealed that -!.5; had %een attac/ed %y dental caries or 55 - per cent (n the most moderni6ed groups -, to 7; per cent had dental caries (n the most isolated group only 5 per cent of the teeth had %een attac/ed %y dental caries The incidence of deformity of dental arches in the moderni6ed groups ranged from .; to ,;; per cent (n many districts mem%ers of the older generations revealed ,;; per cent normally formed dental arches The children of these individuals! ho*ever! sho*ed a much higher percentage of deformed dental arches These data are in stri/ing contrast *ith the condition of the teeth and dental arches of the s/ulls of the Maori %efore contact *ith the *hite man and the reports of e4aminations %y early scientists *ho made contact *ith the primitive Maori %efore he *as moderni6ed These reports revealed only one tooth in 5;;; teeth attac/ed %y dental caries *ith practically ,;; per cent normally formed dental arches My investigations *ere made in the follo*ing places in the North (sland The Pu/erora Tu%ercular "anatorium provided forty native Maori for studies

These *ere largely young men and *omen and %eing in a modern institution they *ere receiving the modern foods of the *hites of Ne* <ealand Their moderni6ation *as demonstrated not only %y the high incidence of dental caries %ut also %y the fact that 2; per cent of the adults and ,;; per cent of the children had a%normalities of the dental arches The +u/arera College for Maori girls is at Napier These girls *ere largely from moderni6ed native homes and *ere no* living in a modern institution Their moderni6ation *as e4pressed in the high percentage of dental caries and their deformed dental arches At the Nuha/a school an opportunity *as provided through the assistance of the government officials to study the parents of many of the children Tooth decay *as *ide>spread among the *omen and active among %oth the men and children The Mahia Peninsula provided one of the more isolated groups *hich sho*ed a mar/ed difference %et*een the older generation and the ne* These people had good access to sea foods and those still using these a%undantly had much the %est teeth A group of the children *ho had %een %orn and raised in this district and *ho had lived largely on the native foods had only , 9 per cent of their teeth attac/ed %y dental caries The other places studied *ere &au/o/ore! Te/aha! &auto/i! &otarua! Tehoro! Waiomio! Teahuahu! Gai/ohe! Wha/arara! Mautauri Bay! Ahipara! Manu/au! &a*ena! Ellerslie! Cueen =ictoria "chool at Auc/land and Waipa*a Ne* <ealand has %ecome Austly famous for its scenery The "outh (sland has %een fre?uently termed the "outhern Alps %ecause of its sno*>capped mountains and glaciers )f the 9;!;;; mem%ers of the Maori race living in the t*o islands! a%out 5;;; are on the "outh (sland and the %alance on the North (sland While sno* is present on many of the mountains of the North (sland in the *inter season! only a fe* of the higher pea/s are sno* capped during the summer Most of the shoreline of the seacoast of the "outh (sland is very rugged! *ith glaciers descending almost to the sea The coastline of the North (sland is %ro/en and in places is ?uite rugged The approach to the Mahia Peninsula is along a roc/y coast s/irting the %ay The most important industries of Ne* <ealand are dairy products! and sheep raising for *ool The reputation of the Maori people for splendid physi?ues has placed them on a pedestal of perfection Much of this has %een lost in moderni6ation +o*ever! through the assistance of the government! ( *as a%le to see many

e4cellent physical specimens (n #ig 82 *ill %e seen four typical Maori *ho retained much of the tri%al e4cellence Note their fine dental arches A young Maori man *ho stands a%out si4 feet four inches and *eighs 5-; pounds *as e4amined The Maori men have great physical endurance and good minds Many fine la*yers and government e4ecutives are Maori The %rea/do*n of these people comes *hen they depart from their native foods to the foods of modern civili6ation! foods consisting largely of *hite flour! s*eetened goods! syrup and canned goods The effect is similar to that e4perienced %y other races after using foods of modern civili6ation Typical illustrations of tooth decay are sho*n in #ig 9; (n some individuals still in their teens half of the teeth *ere decayed The tooth decay among the *hites of Ne* <ealand and Australia *as severe This is illustrated in #ig 9, Particularly stri/ing is the similarity %et*een the deformities of the dental arches *hich occur in the Maori people *ho *ere %orn after their parents adopted the modern foods! and those of the *hites This is *ell illustrated in #ig 95 for Maori %oys (n my studies among other moderni6ed primitive racial stoc/s! there *as a very high incidence of facial deformity! *hich approached one hundred per cent among individuals in tu%erculosis sanatoria This condition o%tained also in Ne* <ealand

FI". /9. Since the discovery of 'ew Eealand the #rimitive natives+ the Baori+ have had the re#utation of having the finest teeth and finest bodies of any race in the world. $hese faces are ty#ical. 5nly about one tooth #er thousand teeth had been attac%ed by tooth

decay before they came under the influence of the white man.

FI". 3<. =ith the advent of the white man in 'ew Eealand tooth decay has become ram#ant. $he suffering from dental caries and abscessed teeth is very great in the most moderni*ed Baori. $he boy at the lower left has a dee# scar in his u##er li# from an accident.

FI". 31. =hereas the original #rimitive Baori had re#ortedly the finest teeth in the world+ the whites now in 'ew Eealand are claimed to have the #oorest teeth in the world. $hese individuals are ty#ical. An analysis of the two ty#es of food reveals the reason.

FI". 3!. In stri%ing contrast with the beautiful faces of the #rimitive Baori those born since the ado#tion of deficient moderni*ed foods are grossly deformed. 'ote the mar%ed underdevelo#ment of the facial bones+ one of the results being narrowing of the dental arches with crowding of the teeth and an underdevelo#ment of the air #assages. =e have wrongly assigned these distorted forms to mi,ture of racial bloods.

Through the /indness of the director of the Maori Museum at Auc/land! ( *as a%le to e4amine many Maori s/ulls T*o vie*s are sho*n in #ig 9- The s/ulls %elong in the pre>Colum%ian period Note the splendid design of the face and dental arches and high perfection of the teeth

FI". 3 . $he large collections of s%ulls of the ancient Baori of 'ew Eealand attest to their su#erb #hysical develo#ment and to the e,cellence of their dental arches.

)ne of the most important developments to come out of these investigations of primitive races is the evidence of a rapid decline in maternal reproductive efficiency after an a%andonment of the native foods and the su%stitution of foods of modern civili6ation This is discussed in later chapters (t *as particularly instructive to o%serve the diligence *ith *hich some of the isolated Maori near the coast sought out certain types of food in accordance *ith the tradition and accumulated *isdom of their tri%es As among the various archipelagos and island d*ellers of the Pacific! great emphasis *as placed upon shell fish Much effort *as made to o%tain these in large ?uantities (n #ig 9. Hlo*erI! *ill %e seen t*o %oys *ho have %een gathering sea clams found a%undantly on these shores Much of the fishing is done *hen the tide is out "ome groups used large ?uantities of the species called a%alone on the West Coast of America and paua in Ne* <ealand (n #ig 9. HupperI! a man! his *ife and child are sho*n The father is holding an a%aloneF the little

girl is holding a mollus/ found only in Ne* <ealand! the toharoaF the mother is holding a plate of edi%le /elp *hich these people use a%undantly! as do many sea %ordering races Maori %oys enAoy a species of gru%s *hich they see/ *ith great eagerness and pri6e highly The primitive Maori use large ?uantities of fern root *hich gro*s a%undantly and is very nutritious

FI". 3). 'ative Baori demonstrating some of the accessory essentials obtained from the sea. $hese include certain sea weeds and an assortment of shell fish. It is much easier for the moderns to e,change their labor for the #alate tic%ling devitali*ed foods of commerce than to obtain the native foods of land and sea.

Pro%a%ly fe* primitive races have developed calisthenics and systematic physical e4ercise to so high a point as the primitive Maori )n arising early in the morning! the chief of the village starts singing a song *hich is accompanied %y a rhythmic dance This is ta/en up not only %y the mem%ers of his household! %ut %y all in the adAoining households until the entire village is s*aying in unison to the same tempo This has a remar/a%ly %eneficial effect in not only developing deep %reathing! %ut in developing the muscles of the %ody! particularly those of the a%domen! *ith the result that these people maintain e4cellent figures to old age

"ir Ar%uthnot 1ane H5I said of this practice the follo*ing@ As to daily e4ercise! it is sho*n here that every person capa%le of movement can %enefit %y it! and ( am certain that the only natural and really %eneficial system of e4ercise is that developed through long ages %y the Ne* <ealand Maori and their race>%rothers in other lands The practical application of their *isdom is discussed in Chapter 5, The Maori race developed a /no*ledge of NatureBs la*s and adopted a system of living in harmony *ith those la*s to so high a degree that they *ere a%le to %uild *hat *as reported %y early scientists to %e the most physically perfect race living on the face of the earth They accomplished this largely through diet and a system of social organi6ation designed to provide a high degree of perfection in their offspring To do this they utili6ed foods from the sea very li%erally The fact that they *ere a%le to maintain an immunity to dental caries so high that only one tooth in t*o thousand had %een attac/ed %y tooth decay H*hich is pro%a%ly as high a degree of immunity as that of any contemporary raceI is a strong argument in favor of their plan of life )eferences , P(CGE&(11! + P The Prevention of Dental Caries and )ral "epsis Philadelphia! White! ,2,. 5 1ANE! A Preface to Maori "ym%olism %y Ettie A &out 1ondon! Paul Trench! Tru%ner! ,258

, Panama 5 Buenaventura - Manta . $uaya?uil

Gey to &oute #ollo*ed in Peru ,; +uaura ,2 "an &osa ,, Chim%ote 5; Cu6co ,5 "anta (sland 5, Calca ,- Chiclayo 55 Manchu Piccu

7 Talara 8 TruAillo 9 Callao : 1ima 2 +uacho

,. ,7 ,8 ,9 ,:

Eten +uara6 Are?uipa 1a/e Titicaca Duallanca

5- +uancayo 5. )roya 57 Perene

Chapter 1 (ncient civilizations of Peru (N T+E foregoing field studies among primitive races *e have %een dealing chiefly *ith living groups "ince the West Coast of "outh America has %een the home of several ancient cultures! it is important that they %e included *ith the living remnants of primitive racial stoc/s! in order to note the contri%utions that they may ma/e to the pro%lem of modern degeneration The relationship %et*een the Andes Mountain &ange and the coast and the sea currents is such that there has %een created a 6one! ranging from forty to one hundred miles in *idth %et*een the coast and the mountains! *hich for a distance of over a thousand miles is completely arid The air currents drifting *est*ard across "outh America from the Atlantic carry an a%undance of moisture When they stri/e the eastern foothills of the Andes they are proAected up*ard into a region of constant cold *hich causes the moisture to %e precipitated as rain on the eastern slopes! and as sno* on the eastern Cordillera &ange +ence the name of the eastern range is the White Cordillera! and that of the *estern range! *hich receives little of this rain! is the Blac/ Cordillera Bet*een these t*o ranges is a great plain! *hich in the rainy season is *ell *atered The great civili6ations of the past have al*ays utili6ed *ater from the melting sno* through irrigation ditches *ith the result that a vast acreage *as put to agricultural uses The +um%oldt Current *hich s*eeps north*ard from the southern ice fields and carries its chilly *ater almost to the e?uator has influenced the development of the West Coast of "outh America The effect of the current on the climate is generally noticea%le )ne of the conspicuous results is the presence of a cloud %an/ *hich hovers over the coastal area at an altitude of from one thousand to three thousand feet a%ove sea level for several months of the year Bac/ from the coast these clouds rest on the land and constitute a nearly constant fog for e4tended periods When one passes inland from the coast up the mountains he moves from a 6one *hich in *inter is clammy and chilly! into the fog 6one! and then suddenly out of it into clear s/y and %rilliant

sunlight (t is of interest that the capital! 1ima! is so situated that it suffers from this unhappy cloud and fog situation When Pi6arro sent a commission to search out a location for his capital city the natives commented on the fact that he *as selecting a very undesira%le location Either on the coast or farther inland than 1ima the climate is much more favora%le! and these *ere the locations in *hich the ancient civili6ations have left some very ela%orate foundations of fortresses and e4tended residential areas The great e4panse of desert e4tending from the coast to the mountains! *ith its great moving sand dunes and *ith scarcely a sign of green life! is one of the least hospita%le environments that any culture could choose Not*ithstanding this! the entire coast is a succession of ancient %urial mounds in *hich it is estimated that there are fifteen million mummies in an e4cellent state of preservation The fe* hundred thousand that have %een distur%ed %y grave ro%%ers in search of gold and silver! have %een left %leaching on the sands Where had these people come from and *hy *ere they %uried hereK The ans*er is to %e found in the fact that pro%a%ly fe* locations in the *orld provided such an ine4hausti%le supply of food for producing a good culture as did this area The lac/ of present appreciation of this fact is evidenced %y the a%sence of flourishing modern communities! not*ithstanding the almost continuous chain of ancient *alls! fortresses! ha%itations! and irrigation systems to %e found along this coast The +um%oldt Current coming from the ice fields of the Antarctic carries *ith it a prodigious ?uantity of the chemical food elements that are most effective in the production of a vast population of fish Pro%a%ly no place in the *orld provides as great an area teeming *ith marine life The ancient cultures appreciated the value of these sea foods and utili6ed them to the full They reali6ed also that certain land plants should %e eaten *ith the sea foods Accordingly! they constructed great a?ueducts used in transporting the *ater! sometimes a hundred miles! for the purpose of irrigating river %ottoms *hich had %een collecting the alluvial soil from the Andes through past ages These river %eds are to %e found from t*enty to fifty miles apart and many of them are entirely dry e4cept in the rainy season in the high Andes (n the river %ottoms these ancient cultures gre* large ?uantities of corn! %eans! s?uash! and other plants These plant foods *ere gathered! stored! and eaten *ith sea foods The people on the coast had direct communication *ith the people in the high plateaus (t is of more than passing interest that some t*enty>one of our modern food plants apparently came from Peru Where there is such a ?uantity of animal life in the sea in the form of fish one *ould e4pect to find the predatory animals that live on fish )ne group of these attac/ the fish from the air and they constitute the great floc/ of guanayes! pi?ueros and pelicans #or a thousand miles along the coast! these

fish>eating %irds are to %e seen in great *inding ?ueues going to and fro %et*een the fishing grounds and their nesting places At other times they may %e seen in great clouds! %eyond computation in num%er! fishing over an area of many s?uare miles )n one island ( *as told %y the careta/er that t*enty>four million %irds had their nests there We passed through a floc/ of the %irds fishing! *hich the careta/er estimated to contain %et*een four and five million %irds )n one island ( found it impossi%le to step any*here! off the path! *ithout treading on %irdsB nests (t is of interest that a product of these %irds has constituted one of the greatest sources of *ealth in the past for Peru! namely! the guano! *hich is the droppings of the %irds left on the islands along the coast *here they have their nests Through the centuries these deposits have reached to a depth of ,;; feet in places When it is reali6ed that only one>fifth of the droppings are placed on the islands! it immediately raises the great ?uestion as to the ?uantity of fish consumed %y these %irds As high as seventy>five fish have %een found in the digestive tract of a single %ird The ?uantity of fish consumed per day %y the %irds nesting on this one island has %een estimated to %e greater than the entire catch of fish off the Ne* England coast per day (n addition to the %irds! a vast num%er of sea lions and seals live on the fish The sea lions have a roo/ery in the vicinity of "anta (sland! *hich *as estimated to contain over a million These enormous animals devour great ?uantities of fish (t *ould %e difficult to estimate ho* far the fish destroyed %y this one group of sea lions *ould go to*ard providing e4cellent nutrition for the entire population of the 3nited "tates The guano! consisting of the partially digested animal life of the sea! constitutes *hat is pro%a%ly the %est /no*n fertili6er in the *orld (t is thirty>three times as efficient as the %est %arnyard manure At one time it *as sent in shiploads to Europe and the 3nited "tates! %ut no* the Peruvian $overnment is retaining nearly all of it for local use They have loc/ed the %arn door after the horse *as stolen! figuratively spea/ing! since the accumulation of ages had %een carried off %y shiploads to other countries %efore its e4port *as chec/ed At the present time all islands are under guard and the %irds are protected They are coming %ac/ into many of the islands from *hich they had %een driven and are re>nesting Birds are given t*o or three years of undistur%ed life for producing deposits These are then carefully removed from the surface of the islands and the %irds are allo*ed to remain undistur%ed for another period A very important and fortunate phase of the culture of the primitive races of the coast has %een their method of %urial Bodies are carefully *rapped in many layers of raiment often %eautifully spun With the mummies articles of special interest and value are usually %uried (mplements used %y the individuals in

their lifetime *ere also put in the grave With a fisherman there *ere placed his nets and fishing tac/le Almost al*ays! Aars containing foods to supply him on his Aourney in the transition to a future life *ere left in the tom% (n some of the cultures the various domestic and industrial scenes *ere reproduced in pottery These disclosed a great variety of foods *hich are familiar to us today Even the designs of their ha%itations *ere reproduced in pottery "imilarly their methods of performing surgical operations! in *hich they *ere very s/illful! *ere depicted #ortunately! the different cultures had ?uite different types of pottery as *ell as ?uite different types of clothing This ma/es it possi%le to identify various groups and indicate the %oundaries of their ha%itations Their engineering feats disclosed s/ill in planning fortresses Their forts *ere pro%a%ly impregna%le from assault in that day The materials used for %uilding their temples! a%odes! and fortifications differ some*hat in various locations Throughout the greater e4tent of the coast of Peru! the *alls of %uildings *ere made of ado%e often many feet thic/ and sometimes si4ty feet high They had *alled cities protected %y inner and outer lines of fortifications (t is particularly significant that the hardest metals that they are /no*n to have had *ere copper and %ron6e "ilver and gold *ere ?uite plentiful Their surgical instruments *ere flints and the operations that they *ere a%le to perform *ith these instruments *ere very remar/a%le An important instrument in *arfare consisted of a clu% *ith a star on the end made of copper or stone With this the opponentBs s/ull *as crushed in )ne of the ama6ing features in the various collections of s/ulls is the large num%er that sho* the results of surgical operations These operations *ere apparently done for the purpose of saving the life of the individual The procedure *as to remove a section of %one in the center of the depressed area and raise the depressed edges surrounding that area The fact that a large num%er of these sho* a%undant evidence of healing and repair clearly indicates that the individual lived for an e4tended period follo*ing the operation (n some cases! the opening is apparently entirely closed in *ith ne* %one "ome of these trepanning operations removed a ?uantity of %one over an area large enough for a human hand to pass through A group of these operated s/ulls are sho*n in #ig 97 The o*ner of the one on the lo*er ro*! left! pro%a%ly died follo*ing the operation! as there is no evidence of repair The others sho* good healing! *hich in some is very e4tensive A study of these trephined s/ulls reveals that 85 per cent lived for months or years (n #ig 97 Hlo*er rightI! is seen a s/ull *hich sho*s a large operation A part of the surgical procedure *as to place a plate of gold over the opening in the s/ull for protection )ne of these is sho*n in the upper half of #ig 98 Belo* is sho*n the healed scar after removal of the gold plate

FI". 3-. $re#hined s%ulls of the ancient #eo#les of ?eru. $heir war wea#ons were designed to #roduce s%ull fractures. $heir surgeons tre#hined the s%ulls+ thus removing the de#ressed area. $he large #ercentage of o#erated s%ulls showing e,tensive healing indicates a large #ercentage lived for months and years afterwards. $heir surgical flesh cutting %nives were made of co##er and bron*e+ the bone cutting of mounted crystals. $hey used cocoa leaves 9cocaine: as a sedative as the natives do today.

FI". 3/. $hese ancient surgeons #laced a gold #late over the s%ull o#ening beneath the scal# to #rotect the brain. Above+ two views are shown of a s%ull with a gold #late in #osition and below the same s%ull with the gold #late removed. 'ote that the s%ull o#ening is nearly healed in. $o the right below an e,tensive o#eration is shown.

The s/ill of the surgeons in amputations is illustrated %y the pottery reproductions of amputated parts )ne of these! for e4ample! sho*s a man *ith an amputated foot holding the stump of his leg *ith one hand *hile putting on a soc/ over the end of the stump *ith the other hand The technic of amputation is sho*n in pottery form in #ig 99 A serious disease of the foot is suggested! re?uiring amputation of the leg! high up Note ho* the thigh %one *as cut so as to provide a fleshcovered stump Belo* in #ig 99 is sho*n a healed o%li?ue fracture *ith good adaptation

FI". 33. $he s%ill of the ancient surgeons in #lastic and bone surgery is illustrated in the #ottery @ar above. In order to #rovide flesh for a #ad over the am#utated bone stum# the flesh is cut lower than the bone by #ushing the flesh u# at the time the bone is cut. In the lower view good healing is shown of a difficult obli(ue fracture.

When the "paniards arrived to carry for*ard the con?uest of Peru they found the entire coastal area and upper plateaus under the control of a culture organi6ed under the (nca rulers Prior to the domination of that culture! *hich had its origin in the high plateau country! several other cultures had developed along the coast in succeeding eras of domination (n northern Peru the Chimus developed a great culture that e4tended over a long period of time Their capital city *as at Chan Chan! inland from the present coastal port of "aliverry and near TruAillo This city is estimated to have contained a million people The argument is sometimes presented that at the time these ancient cultures lived the coastal areas *ere not arid desert %ut *ell supplied *ith rain That this *as not so is clearly evidenced %y the fact that the *alls *ere %uilt of stucco made

%y mi4ing *ater *ith the availa%le sand and ru%%le either in continuous molds or in %loc/s that *ere %uilt into the fort "ince these %loc/s *ere only sun>dried they had very little resistance to rain (n this rainless desert land they have continued to stand through many centuries! many of them pro%a%ly through several thousand years There has %een a vast change in the *alls of the ruined city of Chan Chan *ithin a decade and a half (n ,257 this district *as visited %y a heavy do*npour of rain *hich apparently e4ceeded any precipitation! not only through historic times! %ut for many centuries preceding Temples! courtyards and military defenses *hich *ere in splendid preservation %efore that do*npour *ere reduced to a mere sem%lance of their former structure Clearly these great cities and their defenses could not have %een %uilt of this material in the period *hen do*npours *ere even occasional! let alone fre?uent (t *as! of course! the *ealth of the ancient cultures that spurred on the con?uistadors (t is very difficult to estimate the per capita ?uantity of gold availa%le in those early cultures That gold and silver *ere a%undant is evidenced %y the e4tensive use that *as made of these metals for covering the *alls of rooms and decorating pu%lic %uildings *ith massive plates! sometimes entirely encircling a %uilding and the *alls of its various rooms A considera%le ?uantity of gold and silver has %een ta/en from the %urial mounds )ne %urial mound is reported to have yielded %et*een si4 and seven million dollars *orth of gold "o great has %een the activity of the grave ro%%ers that the Peruvian $overnment has placed a %an on this enterprise though for a period it *as allo*ed on condition that a stated percentage *as given to the $overnment )ne of the principal characteristics of the Chimu culture of the coastal area of northern Peru is sho*n in the type of pottery they produced All articles *ere realistic in design The pots sho* hunting scenes! fishing and domestic scenes! as illustrated a%ove They *ere very s/illful in reproducing features in nearly natural si6e Many thousands of these portrait Aars have %een ta/en from the mounds of this district The local museum in the vicinity of Chan Chan! under the s/illful direction of Mr 1arco +errera at Chiclyan *as reported to contain over t*enty thousand Aars and specimens ta/en from the mounds To the south of the domain of the Chimu culture! a very strong culture *as %uilt up *ith very different characteristics /no*n as the Nas/a While many of their ha%its of life! including their methods of providing food! *ere similar to those of the Chimu culture! they *ere uni?ue in the designs of their pottery! *hich *ere characteri6ed %y %eing allegorical They used ela%orate color designs and fantastic patterns =ery little is /no*n as yet of the meaning of

much that they have left While sundials of ancient design and %uild have %een found in many parts of Peru! it is not /no*n to *hat e4tent they developed a /no*ledge of astronomy The pilot of the plane that fle* us from 1ima to Are?uipa too/ us over some very strange architectural designs of geometrical patterns *hich he had discovered and *hich he suggested had not %een reported upon nor interpreted ( photographed some of these from the air The straight lines constituting the sides of some of the geometric figures are over a thousand feet long and reveal a precision of the angles and a straightness of the ground structures *hich indicate the use of competent engineering e?uipment and a high /no*ledge of surveying )ne of the principal purposes of my trip to Peru *as to study the effect of the +um%oldt Current! *ith its supply of human food! on the ancient cultures *hich *ere %uried along the coast (n other parts of the *orld! *here Nature had provided the sea *ith an a%undance of sea life *hich *as %eing utili6ed %y native races! ( found ?uite routinely e4cellent physical development *ith typical %road! *ell>developed facial forms and dental arches *ith normal contours (n each of these groups! the people have reproduced ?uite closely the racial type in practically all mem%ers of the group ( have emphasi6ed *ith illustrations this fact in connection *ith the Melanesians and Polynesians on eight archipelagos of the Pacific )cean! the Malay races on the islands north of Australia! the A%origines of Australia along the east coastF also the $aelics in the )uter +e%rides! and the Es/imos of Alas/a The activity of grave ro%%ers in the ancient %urial mounds has left s/eletons stre*n helter s/elter *here many of them have %een *eathering! pro%a%ly for years While many of these had apparently %een deli%erately smashed! large num%ers *ere intact! and in a good state of preservation "ome of the ancient cemeteries apparently e4tended over areas covering a s?uare mileF and as far as the eye could see the *hite %leaching %ones! particularly the s/ulls! dotted the landscape "ince there *ere several distinct cultures! ( endeavored to ma/e a cross section study of a num%er of these %urial grounds in order that a fair average of specimens might %e o%tained The s/ulls *ere handled %y me! personally! and large num%ers of them *ere photographed As ( have mentioned! it *as the ancient custom *hen ma/ing the %urials to inter o%Aects that *ere of special interest to the individuals! including the implements *ith *hich he had *or/ed #ishermenBs s/ulls are sho*n in #ig 9: *ith their nets (t *ill %e noted that all these arches are %road and *ide! that the third molars are *ell formed and almost al*ays *ell developed! and in good masticating position Not*ithstanding the long period of interment the fa%rics %uried *ith these people *ere often in a remar/a%ly good state of preservation Even the

hair *as *ell preserved A characteristic of the method of preparation for %urial involved placing over the teeth a preparation that *as held in position %y a strip of cloth *hich cemented the teeth ?uite firmly to this strip *ith the result that *hen the mummy cases *ere torn open the removal of this %andage removed the straight rooted teeth! and therefore large num%ers of the s/ulls that *ere %leaching on the sandy *astes *ere *ithout the straight rooted teeth )f course! these *ould readily tum%le out at the slightest Aar! after the mummified tissues had decomposed from e4posure The teeth lost in this *ay *ould include practically all of the upper and lo*er incisors! some of the %icuspids and third molars

FI". 34. $he two s%ulls in the u##er #hotogra#h a##arently belonged to fishermen of the 8himu culture as evidenced by the flattened bac% of the head. 'ote the s#lendidly formed dental arches. In an e,amination of one thousand two hundred and seventy&si, s%ulls in succession I did not find one with the ty#ical deformities of our moderns.

"ince our study *as primarily concerned *ith the shape of the dental arches and facial form! these characteristics could %e studied and recorded *ith the straight rooted teeth removed #ortunately! there are some e4cellent collections of s/ulls in museums in Peru! *ith the s/ulls in position *here they can %e readily studied for the shape of the dental arches When *e have in mind that

from 57 to 97 per cent of individuals in various communities in the 3nited "tates have a distinct irregularity in the development of the dental arches and facial form! the cause and significance of *hich constitutes one of the important pro%lems of this study! the stri/ing contrast found in these Peruvian s/ulls *ill %e seen to constitute a challenge for our modern civili6ations (n a study of ,!598 s/ulls of these ancient Peruvians! ( did not find a single s/ull *ith significant deformity of the dental arches "ince these investigations have apparently esta%lished the fact that this pro%lem is related directly to nutrition! and chiefly to nutrition in the formative period! and! as *e shall see! to a very early part of the formative period! *e have here evidence of a system of living that is very closely in accord *ith NatureBs fundamental la*s of reproduction "everal studies have %een made dealing *ith the incidence of dental caries or tooth decay among these ancient cultures The author of 'Bird (slands of Peru' H,I states that in his e4amination of fifty mummies in succession he found only four *ith a tooth *ith dental caries This again is in stri/ing contrast to our moderni6ed communities in *hich from 27 to ,;; per cent of all the mem%ers of a community group suffer from dental caries ( have sho*n in connection *ith the (ndians of the *estern coast of Canada that in si4 highly moderni6ed communities *here the (ndians *ere using *hite manBs foods! .; per cent of all the teeth had %een attac/ed %y dental caries A similar high percentage *as found in the (ndians no* living in #lorida The ancient %urials in southern #lorida revealed apparent! complete immunity These *ere pre>Colum%ian %urials The s/ill of the primitive cultures of Peru in engineering as evidenced %y the irrigation systems has al*ays %een a su%Aect of ama6ement to modern engineers ( visited in a valley fifteen miles from the "anta &iver an ancient a?ueduct *hich *as said to %e a hundred miles long )ur guide informed me that he had *al/ed in it for thirty>five miles With its even grades! overflo*s and au4iliary channels for distri%ution! its adaptation to the area to %e *atered! and the s/ill *ith *hich it *as cut through roc/ shoulders and its retaining *alls %uilt! it constitutes a monument to engineering a%ility Modern engineers have estimated that this a?ueduct could deliver si4ty million cu%ic feet of *ater a day (n #ig 92 *ill %e seen a section *here it has %een carried through a roc/ cutting and %eyond *ill %e seen a retaining *all used to carry the flume along the sheer face of a roc/ The modern inha%itants of this community have carried a*ay this retaining *all for use in the foundations of their huts Belo*! in #ig 92! *ill %e seen a district of many hundreds of acres! possi%ly a thousand! *here the fields are laid out Aust as they *ere left hundreds of years

ago *hen the primitive people *ere driven from this ha%itat All this valley needs is *ater

FI". 39. $he ancient civili*ations of ?eru had s%illed engineers. In the u##er view is seen one of the ancient a(ueducts still intact for thirty&five miles which modern scientists estimate was ca#able of delivering si,ty million cubic feet of water #er day. $hey had no hardened tools or blasting #owder+ yet they cut this channel through boulders and roc%s. Below is seen a valley covering thousands of acres once made fertile by irrigation but now an arid desert.

(n order to reach the %urial places it *as necessary to drive many hundreds of miles over the arid desert inland from the coast We *ere e4ceedingly fortunate in having as our interpreter and guide Dr Al%ert $iesec/e! *ho for fourteen years *as the Chancellor of Cu6co 3niversity With his e4cellent /no*ledge of the country and its languages! *ith the credentials *hich gave us entry to the secluded places! together *ith the /indness and helpfulness of the Peruvian $overnment officials in almost all localities! *e *ere a%le to o%tain much valua%le information (n an estimate of this culture not only their arts! %ut their scientific s/ill should %e included "ince the primary o%Aect of this ?uest *as to learn of the efficiency of these primitive people in the art of living in harmony *ith NatureBs la*s and their

methods for accomplishing this! it *as desira%le to find! if possi%le! some living descendants of these people to gain from them the information that had %een handed do*n We *ere told that there *ere a fe* villages in an isolated section of the coast in northern Peru *here the inha%itants claimed descent from the ancient Chimu cultures of that area This group *as characteri6ed %y a flattening of the s/ull at the %ac/ *hich classified them as short heads and is readily identified We *ere very fortunate in having the assistance of Commander Daniel Matto of the Peruvian Army +e *as a%le to utili6e the police facilities for locating typical old residents *ho could tell us much of the story of their race and its recent history as it had %een handed do*n %y *ord of mouth (n #ig :; *ill %e seen one of these nonagenarians +e told us of incidents that had %een related to him %y his great>greatgrandfather and %y the old people of that area! of the coming of Pi6arro four hundred years ago The height of this man can %e Audged as he is seen standing %eside Mrs Price! *ho is five feet three +is head is sho*n %oth front and side vie*! revealing the flattened surface at the %ac/ An ancient s/ull *ith typical flattening is also sho*n #ortunately these people are living very closely in accordance *ith the customs of their ancestors They are fisherfol/! *ith a hardihood and s/ill that is in stri/ing contrast *ith the lethargy of the moderni6ed groups Their fine physical development! the %readth of their dental arches and the regularity of their facial features are in stri/ing contrast to the characteristics noted among individuals in the moderni6ed colonies (n #ig :, *ill %e seen typical mem%ers of these colonies

FI". 4<. $he ancient 8himus flattened the bac% of the head+ as shown in the lower left+ by #lacing the infant on a board. A descendant of the 8himus is shown in the u##er left with Brs. ?rice+ and in front and side views at the right. 'ote that the bac% of his head is similarly flattened.

FI". 41. Some descendants of the ancient 8himu culture are still living in a few fishing villages in the north of ?eru. $hey live+ as did their ancestors+ largely on the sea food. $y#ical faces of this native stoc% are shown in this #hotogra#h. 'ote the breadth of the dental arches and full develo#ment of the facial bones.

The s/ill *ith *hich these men manage their fishing %oats is inspiring Even though the surf *as rolling in great com%ers they did not hesitate to go out in either their small crafts carrying one individual or in their large sail%oats carrying a do6en men The a%undance of the fish in this district is demonstrated %y the large catch that each succeeding %oat %rought to shore At the time the "panish Con?uistadors arrived in Peru one of the most uni?ue of the ancient cultures held s*ay over %oth the mountain plateaus and the coastal plains from "antiago of Chile north*ard to Cuito! E?uador! a distance of a%out ,5;; miles This culture too/ its name from the ruling emperors called (ncas The capital of their! great /ingdom *as Cu6co! a city located %et*een the East and West Cordillera &anges of the Andes These parallel ranges are from fifty to t*o hundred miles apart Bet*een them is situated a great plateau ranging from ,;!;;; to ,-!;;; feet a%ove the sea The mountain ranges are sno*>capped and include in Peru alone fifty pea/s that are over ,:!;;; feet in altitude! ranging up to 55!,:7 feet in Mount +uascaran )nly Mount Aconcagua in Chile is higher (t is 5-!;97 feet>>the highest

mountain in the Americas The air drift is across "outh America from east to *est! carrying vast ?uantities of *ater received %y evaporation from the Atlantic )cean This moisture is precipitated rapidly *hen the clouds are forced into the chill of the higher Andes (n the rainy season the great plateau area is fre?uently *ell *atered! though not in sufficient ?uantity to meet the needs of agriculture for much of the territory (n the past the precipitation has %een supplemented %y vast irrigation proAects using the *ater from the melting sno*s (t is estimated that the population ruled over %y the reigning (ncas at the time of the coming of the "paniards reached five millions (t is pro%a%le that fe*! if any! of the ancient or modern cultures of the *orld have ever attained a more highly perfected organi6ation of society than had this (nca culture The ruling (nca *as a %enevolent despot! and according to history uni?ue in that he practiced most diligently all of the la*s he promulgated for his people There *as no poverty! *ant or crime Every man! *oman and child *as specifically provided *ith all necessities The entire amount of tilla%le land *as divided so that every man! *oman and child had his assigned parcel Everyone *or/ed as assigned %y the proper official While it is not appropriate here to go into details! it is important that *e have a %irdBs eye vie* of this great culture for *hich ( *ill ?uote a paragraph from Agnes &otheryBs '"outh America! The West Coast and The East ' H5I The people *ho erected this temple lived in order and health! under the most successful communism the *orld has ever seen Their land *as divided into three portions>>one portion for the (nca! one for the "un! and one for the people! *ith seventy s?uare meters for every %oy and thirty>five for every girl The live stoc/ and implements *ere similarly apportioned and the land *as ploughed! planted! and the crops gathered in strict rotation #irst the fields of the "un *ere cultivated! and then the land of the aged! the sic/! *ido*s! and orphans *as tendedF then the lands of the people! neigh%ors assisting one anotherF and last of all the lands of the (nca! *ith songs of praise and Aoy! %ecause this *as the service of their Ging To every living soul *as given his tas/s! according to his physical and mental capacities +e *as prevented from over*or/! prohi%ited from idleness! cared for in illness and old age Children *ere ta/en %y the $overnment *hen they *ere five and trained to the profession *here they *ere most needed There *as no hunger! no crime in the *hole empire The (nca held his /ingly office over the docile! industrious! and contented mass not only through his royal %lood! %ut through his *isdom and /indness in caring for and guiding his su%Aects! his %ravery in *ar! and his statesmanship at home Although he set an e4ample to his su%Aects %y follo*ing every la*

*hich he promulgated Hastonishing idea to our modern la*ma/ersNI! he lived! as %ecame his ran/! in lu4ury (n his garden *ere ro*s of corn moulded from pure gold *ith leaves of pure silver! and a tassel of spun silver! as fine as sil/! moving in the air 1lamas and alpacas! life>si6ed and cunningly fashioned from the same metal! stood upon his la*ns! as they did in the courts of the Temple of the "un Cu6co! the capital! is reported to have housed a%out t*o hundred thousand people at the time of the "panish Con?uest (t is situated on a %ranch of the 3ra%am%a &iver in a %eautiful valley surrounded %y fertile mountain sides and to*ering sno*>capped pinnacles The 3ra%am%a &iver drains a large area of the plateau lying to the south of Cu6co and has cut a magnificent gorge through the southern range of the Andes *here it passes from the plateau to the eastern *atershed and thence to the Ama6on A little to the south of Cu6co the eastern and the *estern ranges of mountains approach and com%ine in a cluster of magnificent pinnacles and intervening valleys and gorges! that are to %e e?ualled %y no mountain scenery in the *orld Today! almost all travel from the Andean Plateau north of this region! as *ell as from all areas along the coast! must proceed to the coast! thence do*n the coast %y %oat to the port of Mollendo *hich is often dangerous or impossi%le of approach %ecause of the heavy seas The Aourney is made %y train up through Are?uipa and over the *estern Cordillera &ange of the Andes into the plateau country and from there north*ard to Cu6co "o great is this natural %arrier that the detour re?uires many days! and the crossing of several divides ranging from fourteen to si4teen thousand feet a%ove the sea This *as not necessary for the (ncas *ho had %uilt roads and suspension %ridges through these mountains from Cu6co to all parts of the great empire (t is in this mountain vastness that the (nca rulers had constructed their most super% fortresses While the early "panish con?uerors of the country /ne* that the no%ility had great defenses to *hich they might retreat! the location of the fortresses *as not /no*n Their greatest fortress *as discovered and e4cavated %y Professor C W Bingham of Yale! under the auspices of Yale 3niversity and the American Museum of Natural +istory This fortress and retreat is no* *orld famous as Macchu Piccu! and pro%a%ly represents the highest development of engineering! ancient and in some respects modern! on the American continent We are particularly concerned *ith the type of men that *ere capa%le of such great achievement! since they *ere re?uired to carry for*ard their great underta/ings *ithout the use of iron or the *heel While the great (nca culture dominated the "ierras and the coast for several centuries prior to the coming of the "panish! and *hile they had their seat of government and vast agricultural

enterprises in the high "ierras! it is of special interest that many of the most magnificent monuments remaining today in stone *ere not constructed %y the (nca culture! %ut %y the Tauhuanocan culture *hich preceded the (nca The (ncas *ere a part of the Cuechu linguistic stoc/! *hile the Tauhuanocans *ere a part of the Aymara linguistic stoc/ The (ncas had their capital in the high plateau country a%out the center of Peru The earlier Tauhuanocan culture centered in southern Peru near 1a/e Titicaca *here their most magnificent structures are to %e found today )ne of the largest single stones to %e moved and put into the %uilding of a great temple in the history of the *orld is to %e found near 1a/e Titicaca According to engineers! there is no ?uarry /no*n in an easily reached locality *here such a stone could %e ?uarried (t is conAectured that it *as %rought t*o hundred miles over mountainous country (t is important to note that many magnificent structures! evidently %elonging to this ancient Tauhaunocan culture! are found distri%uted through the Andean Plateau from Bolivia to E?uador Their masonry *as characteri6ed %y the fitting together of large stones faced so perfectly that in many of the *alls it *as difficult to find a crevice *hich had enough space to allo* the passage of the point of my pen /nife! not*ithstanding that these stones *ere many>sided *ith some of them fifteen to t*enty feet in length (n #igure :5 a%ove *ill %e seen a section of *all of the great fortress "acsahuaman overloo/ing Cu6co Modern engineers seem una%le to provide a satisfactory ans*er as to ho* these people *ere a%le to cut these stones *ith the limited facilities availa%le! nor is it e4plained ho* they *ere a%le to transport and hoist some of their enormous monoliths The *alls and fortress of Macchu Piccu! as *ell as the residences and temples! *ere %uilt of *hite granite *hich apparently *as ta/en from ?uarries in the %an/ of the river 3ra%am%a! t*o thousand feet %elo* the fortress Without modern hoisting machinery! ho* did they raise those mammoth stonesK (n #ig :5 %elo* is sho*n a typical section of *all )ne stone sho*n has t*elve faces and t*elve angles! all fitting accurately its %oundary stones (t is as though the stones *ere plastic and pressed into a mould

FI". 4!. $he #rimitive #eo#les of the Andean Sierra built wonderful fortresses and tem#les of cut stones which are assembled without mortar and cut to interloc%. $he central stone+ above+ is estimated to weigh one hundred and forty thousand #ounds. Below the largest stone has twelve faces and twelve angles.

The country is rugged )ver it passes the highest standard>gage railroad in the *orld!>>a%out ,8!;;; feet a%ove sea level The %an/s of this river are protected for long distances %y ancient stone retaining *alls The native (ndians live and herd their floc/s of llamas and alpacas up near the sno* line! largely %et*een ,7!;;; and ,:!;;; feet The (ncas and their descendants no* occupying the high "ierras in the Andes have %een thrifty agriculturists They turn the soil *ith a very narro*! long! slender %laded spade *hich they force into the ground! and *ith *hich they pry the ground up in chun/s They then %rea/ up the chun/s These spades *ere originally made of copper *hich they mined themselves Cu6co is the archeological capital of "outh America! %ut its glory is in the ancient fortresses and temples! rather than in the modern structures As one passes through the streets! he *ill note that in many instances the foundations and parts of the *alls of many of the modern "panish cathedrals and pu%lic %uildings are of old (nca construction! of fine stone *or/ surmounted %y cheap ru%%le *or/ and mortar superstructure Whereas the original Cu6co had running *ater and an e4cellent sanitation system! modern Cu6co has deplora%le sanitary conditions The follo*ing is ?uoted from the

West Coast 1eader! pu%lished in 1ima! dated Duly 5;! ,2-9@ ')f a total -!8;; houses in the city of Cu6co 2;; are *ithout *ater or drainageF 5!.;; are *ithout light H*indo*sI and ,!;:; completely lac/ any sanitary systems (t is not surprising! therefore! that in some years the death rate e4ceeds the %irth rate We are particularly concerned in studying these people to /no* the sources of their great capacity for developing art! engineering! government and social organi6ation Can such a magnificent culture %e %rought a%out unless founded on a super% physical development resulting from purely %iologic forcesK Earth?ua/es are very fre?uent in the Andes We e4perienced several *hile in Peru )ne of these opened up a cave in the mountainside in the 3ra%am%a =alley near *hich *e *ere ma/ing studies The cave had Aust %een e4plored and a num%er of ancient %urials found ( *as a%le to e4amine a num%er of s/ulls from this cave *hich apparently represented a pre>"panish period The date of the %urials could not %e determined The s/ulls *ere interpreted as %elonging to an early (ndian period (n #ig :- may %e seen t*o typical s/ulls Note the %road s*eep of the dental arches and freedom from tooth decay The third molars H*isdom teethI are *ell developed and in normal position for mastication These are typical of the entire group found in this %urial place (t is very evident that these individuals *ere provided *ith an ade?uate nutrition throughout the formative and gro*th periods! as *ell as during their adult life This is significant %ecause of the limited variety of foods easily o%taina%le for the people in the high plateau country of the Andes

FI". 4 . $y#ical s%ulls of 1igh Sierra Indians from a recently o#ened burial cave. 'ote the breadth of the dental arches #rovided by e,cellent develo#ment of the bones of the head.

The ancient Peruvians of %oth the coastal area and high plateau country had developed super% physical %odies in each of the several cultures This development had %een %rought a%out in spite of the %ad conditions prevailing *ith arid desert land e4tending from the coast to the mountains! and in spite of the severe climate of the high "ierras The people utili6ed the *ide variety of animal life from the sea in conAunction *ith the e4cellent plant foods gro*n in the river %asins *ith the aid of irrigation )ver t*enty of our common plants had their origin in ancient Peru (n the high "ierras! their animal foods *ere largely limited to the llama! alpaca and *ild animals Each household! ho*ever! maintained a colony of guinea pigs )*ing to the difficulty of %oiling in the high altitudes! they found it necessary to roast their cereals and meats Their vegeta%le foods included potatoes! *hich *ere preserved in po*der form %y free6ing and drying and pulveri6ing Corn and several varieties of %eans and ?uinua *ere their principal cereals The latter is a small seed of very high nutritive value &E#E&ENCE" , M3&P+Y! & C Bird (slands of Peru Ne* Yor/! Putnam! ,257 5 &)T+E&Y! A "outh America! The West Coast and the East Ne* Yor/! +oughton! Muffin! ,2-; Chapter 1" Isolated and modernized Peruvian Indians (N )&DE& to understand the living descendants of the ancient residents of the high Andes it is essential that *e /no* their environment Their climate is cold at night the year around While during the *inter the sno* is deep in the high mountains! there is very little on the plateau! since Peru is near the e?uator e4tending from 7 to ,8 degrees south latitude The sunshine is %right and *arm even in *inter Conse?uently they have pasturage for their animals the year around The only native domesticated animals of the Andean Plateau are the llama and the alpaca Both of these %elong to the camel species! as does the vicuna The llama is the (ndiansB %east of %urden in the Andes )nly the males are used The animals are very docile and respond *ith gentleness *hen treated *ith /indness )ne continually marvels at the ease *ith *hich the (ndian guides his loaded caravan *ith soft *ords or motions! never *ith harshness The llama has many uni?ue features as a %east of %urden (t forages as it moves along and conse?uently must %e driven very slo*ly Each animal *ill carry a %urden not

e4ceeding a hundred pounds! and if more is placed on its %ac/ it *ill immediately lie do*n until the e4tra %urden is removed The llama has %road dou%letoed feet li/e the camel *hich ma/e it very sure>footed (t re?uires no shoeing and e4ceedingly little care (t can thrive! ho*ever! only in the high altitudes The *ool of the llama is coarse and is used for heavy! rough garments The alpaca is a little smaller than the llama and produces a very heavy *ool of fine ?uality Accustomed as this animal is to the severe cold and the high altitudes! as *ell as to the rain and sun! its fleece is %oth dura%le and *arm (t is used e4tensively throughout the *orld for suits for aviators The native colors vary from *hite to %luish tints and from light to very dar/ %ro*ns (t accordingly provides very sta%le colors for *eaving directly into ponchos and native apparel The vicuna is a much smaller animal than either the llama or alpaca (t has one of the most highly pri6ed coats of fur produced any*here in the *orld This animal has never %een domesticatedF vast herds have lived *ild on the high slopes of the Andes mountains The demand for vicuna fur %ecame so great that a million and a half of these animals *ere slain in one year to o%tain their fur pelts The result is that the Peruvian $overnment has no* completely for%idden their destruction The garments of the ruling class of the (ncas *ere made of the vicuna *ool )ne of the important o%Aectives of my trip to Peru *as to find and study! if possi%le! some descendants of these Andean stoc/s #ortunately! large num%ers of the Aymara linguistic stoc/! the descendants of the Tauhuanocan culture! are still residing in southern Peru and Bolivia *here they are said to retain the essentials of their ancient methods of living They constitute the principal native populations in the vicinity of 1a/e Titicaca and the high mountain plateaus of southern Peru and northern Bolivia ( have al*ays encountered difficulty in persuading the native peoples to allo* themselves to %e photographed in their primitive costumes They are usually *illing to %e photographed provided one *ill *ait for them to put on some modern garment ( am reminded of an e4perience on one of the "outh "ea (slands *here there *as need for roads! %ut no money *ith *hich to %uild them 1a*s *ere passed %y the chiefs that anyone approaching a high*ay in native gar% *here he might %e seen %y a foreigner *as su%Aect to arrest and to payment of a fine *hich had to %e *or/ed out as la%or in %uilding roads )f course! on that island no one *ould allo* himself to %e photographed *ithout some modern clothing )ne %oy presented himself *earing a single garment! a manBs full dress vest! *hich had evidently reached the island in a missionary %arrel

The hats in the pictures in #ig :. are of native design and manufacture They are made of fur and are li/e our modern der%ies in construction

FI". 4). Descendants of the $auhuanocans who were the most famous ancient wor%ers in stone. $hey live in the high Sierras of southern ?eru and northern Bolivia. $hey belong to the Aymara linguistic division. $hey ma%e fur felt hats and are s%illed agriculturists.

(t is important to note the roundness of the features of the Aymaras! the *ide development of the nostrils for air inta/e and the %readth of the dental arches Many of them had %een transported several hundreds of miles to a coffee plantation %ecause of their adeptness and s/ill in sorting imperfect coffee %eans from the run As ( *atched them ( found it difficult to move my eyes fast enough to follo* their fingers and pic/ out from the moving run the undesired or imperfectly formed /ernels This revealed a super% development of coordination The *isdom of these Aymaras is discussed in Chapter 5, ( *as very an4ious to study the (ncas in different parts of the high Andes! particularly some of the original type in the vicinity of Cu6co! their ancient capital Throughout the Andean Plateau! the (ndians from the higher elevations %ring do*n their *ares on mar/et days to e4change *ith (ndians from other localities! as *ell as to meet and visit *ith their friends They are very industrious and one seldom sees a *oman! either shepherding the stoc/ or

carrying a %urden! *ho is not %usily engaged in spinning *ool While their *ool is o%tained in part from sheep that have %een imported! a great deal of it is o%tained from the alpacas *hich! li/e the llamas! are raised in the high altitudes *here the (ndians al*ays prefer to live ( *as fortunate in ma/ing contact *ith several groups of (ndians in high altitudes through the /indness of the prefects A group of (ndians from the high mountains of the 3ra%am%a =alley near Cu6co is sho*n in #ig :7 An e4amination of this group of t*enty>five revealed the fact that not one tooth had %een attac/ed %y dental caries and that! at all ages! the teeth normally due *ere present

FI". 4-. $he Fuichua Indians living in the high Andes are descendants of the Incas. $hey live at high elevations+ u# to 14+<<< feet+ where they raise herds of llamas and al#acas. $hey weave their own garments and have great #hysical endurance. $hey can carry over !<< #ounds all day at high altitudes in the manner shown at the lower right.

(n #ig :7! lo*er right! may %e seen a typical (ndian of the Andes carrying a heavy load The (ndians of this region are a%le to carry all day t*o hundred to three hundred pounds! and to do this day after day At several of the ports! these mountain (ndians have %een %rought do*n to the coast to load and unload coffee and freight from the ships Their strength is phenomenal

(n approaching the study of the descendants of the (nca culture! it is important to /eep in mind a little of their history and persecution under the "panish rule To this day they are %itter against the *hite man for the treachery that has %een meted out to them on many occasions Their leader *as sei6ed under treachery The agreement to free him! if the designated rooms *ere filled *ith gold as high as a man could reach! *as %ro/en and their chief /illed after the gold *as o%tained (t is recorded that some si4 million of them died in the mines under forced la%or and poor foods under the lash of their "panish oppressors (n many places they still /eep themselves aloof %y staying in the high mountains of the Andes *ith their floc/s of llamas and alpacas They come do*n only for trading As in the past! they still *eave their o*n garments (ndeed! they provide practically all of their necessities from the local environment Their capacity for enduring cold is *onderful They can sleep comforta%ly through the free6ing nights *ith their ponchos *rapped a%out their heads and *ith their legs and feet %are They *ear t*o types of head cover! one inside the other "everal individuals are seen in #ig :7 Many of them have faces that sho* strong character and personality The *omen of this district *ear felt hats *hich can %e turned up or do*n according to the *eather #ine e4amples of *eaving *ere *orn %y the *omen (n #ig :8 *ill %e seen t*o young men *ho had Aust come do*n from the high mountains to a government school The one in the lo*er photograph is still *earing his native costume The one in the upper has discarded his native costume for *hite manBs trousers Note the fine development of his chest! the splendid facial development and fine teeth and dental arches (t is important to /eep in mind that these people are living in a rarified atmosphere and that! %ecause of the high altitude! they need greater lung capacity and stronger hearts than do the people living at sea level The ratio of o4ygen content is reduced a%out half at ,;!;;; feet

FI". 4/. $he chest develo#ment+ of necessity+ must have large lung ca#acity for living in the rare atmos#here of the high Andes. $he boy shown above has a magnificent #hysi(ue+ including facial and dental arch develo#ment. Below is seen the ty#ical clothing worn u# among the snows. 7ven in frosty weather they are bare below the %nees.

The %road dental arches of these (ndians are sho*n in #ig :9 Note the e4tensive *ear of the teeth at the upper left Much of the food is eaten cold and dry as parched corn and %eans "uch rough foods as these *ear the teeth do*n

FI". 43. $he su#erb facial and dental arch develo#ment of these high Andean Indians is shown above. $he man at the u##er left was said to be very old yet he climbs the mountains u# into the snows herding the llamas and al#acas. $he teeth have a very high state of #erfection. Long and vigorous use has worn the teeth of the old #eo#le.

Mar/et days *hich usually occur on "unday present an interesting scene The (ndians travel long distances *ith their *ares for e4change They have no currency and e4changes are made %y %argaining Where these (ndians have %ecome moderni6ed! the ne* generation sho*s typical changes in facial and dental arch form as reported for the other groups There is also a mar/ed character reaction *hich *ill %e discussed in detail in Chapter ,2 (n #ig :: are sho*n four typical modification patterns due to the influence of moderni6ation after the foods of the *hite man have displaced the native dietary

FI". 44. $he moderni*ation of the Sierra Indians through the introduction of foods of modern commerce has #roduced a sad wrec%age in #hysi(ue and often character. $he boy at the u##er left is a mouth breather because his nostrils are too small to carry sufficient air. $he girl at the u##er right has a badly underdevelo#ed chin and #inched nostrils. Both boys below have badly narrowed arches with crowding teeth.

An important item in the life of the Andean (ndians is the satisfaction they get from che*ing cocoa leaves from *hich is made our modern cocaine (n order to e4tract the al/aloid they che* *ith these leaves the ash produced %y the %urning of a particular plant This drug is che*ed as to%acco! one large ?uid *ill last for several hours Practically every (ndian carries in a little pouch a ?uantity of these leaves in dried form The effect of this drug is to increase their capacity for endurance (t ma/es them unconscious of hunger and fatigue Through our interpreter *e fre?uently as/ed them regarding the comfort or nourishment they o%tained from the leaves and *ere told that they often preferred these leaves to food *hen they *ere on a Aourney and carrying heavy loads ( *as informed that they can increase the ?uantity of the drug used to a point at *hich they are ?uite unconcious of pain and a%le to endure inAuries *ithout suffering! and operations *ithout discomfort "ince pac/ets of these leaves *ere found in the %urials near the coast! it is clear that the drugs *ere used throughout Peru in early times (t is also of interest that several of the

s/ulls ta/en from the cave in the high Andes! *ere found *ith trephine operations in the s/ulls similar to those found in the %urials along the coast The physical perfection and development of the present and past Andean population has %een accomplished in spite of the difficulty of %uilding and maintaining good %odily structure at the high altitude *here dairy products have not %een and are not at present a large part of the nutritional program (n this regard the ancient and contemporary peoples of the Andes differ radically from the present and past groups of people *ho live in the high valleys of "*it6erland and Ti%et *here mil/ is plentiful The co*! sheep! horse and pig have %een imported into the high Andean countries during the last four hundred years since the "panish Con?uests! %ut they have not acclimati6ed easily The earlier cultures *ere of course! dependent upon the llama! alpaca! *ild deer! %irds and guinea pig for animal foods While there have %een vast %urial mounds %uilt and preserved in the coastal regions *here the a%sence of rain and the dry sand have added materially to their preservation! the rainy seasons have esta%lished very different conditions for s/eletal preservation in the high altitudes Nevertheless! a large num%er of s/eletons in good state of preservation have %een recovered The high Andean plateau e4tends throughout the length of Peru %et*een the mountain chains The present (ndian stoc/ *as studied in four different places in the high plateau country! the farthest north %eing +uaras (n this area *e *ere materially assisted %y the governor of the province *ho very /indly sent messengers and %rought do*n (ndian families from high altitudes to the police head?uarters at +uaras This place is at an elevation of a%out ,,!;;; feet We had an opportunity to study also many *ho had come from the higher altitudes to the mar/ets to sell their *ares +uaras lies in a fertile valley that has %een in contact *ith modern civili6ation for many decades This vicinity! therefore! provided a *ide range in classes of people! from (ndians *ho are isolated to those *ho are living in highly moderni6ed groups (n addition to the opportunity for studying the older people there *ere opportunities for studying adolescents in the t*o high schools! one for girls and one for %oys "ome *ere pure>%loods *ho had %een highly isolated in their formative and childhood periods The mi4ed>%loods had %een considera%ly moderni6ed There *ere some *hites ( *as told %y the prefect and others *ho *ere *ell informed that there *as ?uite a distinct difference %et*een the (ndians *ho *ere living in the high northern Cordillera! the *estern Andean range called the Blac/ Mountains! and those living in the eastern range or White Mountains The latter *ere physically much %etter %uilt and *ere least moderni6ed Typical lo*

immunity to caries and changes in facial and dental arch form *ere found in these moderni6ed groups Another important area in *hich the native (ndians *ere studied *as Chiclayo This district is uni?ue in large part %ecause of the influence of the modern civili6ation at 1ima *ith *hich it is connected %y the railroad The native mar/et here is very large and occupies a%out a mile of the main street of the to*n! through *hich no traffic e4cept pedestrian traffic can pass *hile the mar/et is in session The to*n has %een under the influence of the "panish since the time of the Con?uest (t has many colonial %uildings and a large cathedral (t has not! ho*ever! accommodations for the influ4 of tourists *ho come out of curiosity for the purchase of (ndian *ares With the aid of the prefect! even though no pu%lic accommodations *ere availa%le! *e *ere made very comforta%le in the soldiersB %arrac/s As the (ndians came do*n from the mountains to display and sell their *ares! they *ere %rought to us at the %arrac/s "ince this district has %een in ?uite intimate contact *ith the nutrition of the moderni6ed capital! *e found here many individuals sho*ing typical degeneration of the teeth and dental arches The adaptation of racial characteristics to the environment in *hich they have developed is very stri/ingly illustrated in the (ndian cultures of the Ama6on Aungle district We *ere very fortunate in %eing a%le to ma/e studies of some groups living at present as did their ancestors through countless centuries in the Ama6on %asin We *ere greatly pleased and impressed *ith the splendid physi?ues and fine personalities of many of the individuals of the groups The a%undance of rain! the fertility of the soil and the *arm climate ma/e plant gro*th most lu4uriant on the eastern slopes of the Andes (t is of interest that in passing from the capital! 1ima! across the desert stretch %et*een the ocean and the mountains and then up the *all of the Andes to an altitude of si4teen thousand feet and then do*n to the plateau at a%out t*elve thousand feet and up again over the eastern range and do*n into the Ama6on %asin! one has passed through the tropics! temperate 6one and su%>arctic 6ones *ith varieties of plant life corresponding to each A distance of a fe* hundred yards *ill often divide the limits of particular %irds and flo*ers When one reaches the foothills of the Andes on the eastern side! he is in a region of rushing streams teeming *ith fish! a region of tropical fruits and vegeta%les (t is in this setting that some of the finest (ndians *e have seen *ere enAoying life in its fullness The type of shelter is very simple! indeed! consisting as it does of a frame*or/ covered *ith %anana and palm leaves We *ere privileged to meet

%y special arrangement a%out thirty of this tri%e *ho had %een %rought from some distance %y the officials of the Perene Colony! o*ned and operated %y the Peruvian Corporation (n #ig :2 *ill %e seen the chief and one of the no%le *omen of his retinue They understood that they *ould have their pictures ta/en and came dressed in royal regalia Typical countenances are seen in #igs 2; and 2, These people have very /ind faces *ith %road dental arches! and a high sense of humor They decorated their faces especially for their photograph (n the entire group associated *ith this chief ( did not find a single tooth that had %een attac/ed %y dental caries The fine dental arches are illustrated in #igs 2; and 2, Many of these young men had really no%le countenances! such as *ould rate them as leaders in modern science and culture

FI". 49. Gungle Indians from the Ama*on. $his is the chief of a tribe who came #re#ared to have their #ictures ta%en in their tribal regalia. 'ote the s#lendid features of both and the noble carriage of the woman.

FI". 9<. $he facial and dental arch develo#ment of the @ungle Indians was su#erb and the teeth were e,cellent and free from dental caries. 'ote the com#lete develo#ment of the dental arches and nostrils.

FI". 91. $he e,cellence of s%eletal develo#ment of the

@ungle Indians as e,#ressed in the faces and dental arches+ is illustrated in these views. $heir foods were selected from the animal life of the streams and the bush together with native #lants.

(n another tri%e! ho*ever! of the same racial stoc/! efforts to moderni6e had %een in operation for some time %y a mission The food of this latter group had %een distinctly affected %y their contact *ith the modern group By reducing the animal foods! the change in physical efficiency! and appearance of tooth decay! is most mar/ed (n #ig 25 a%ove *ill %e seen typical cases of rampant tooth decay *ith e4tensive loss of the teeth (n #ig 25 %elo* are sho*n t*o of the first generation follo*ing the adoption of the moderni6ed type of diet in this group Note the narro*ing of the faces *ith cro*ding of the teeth Note the deformed dental arches

FI". 9!. At the #oint of contact of these @ungle Indians with moderni*ation where it included a change from their native diet tooth decay became ram#ant as shown. A mar%ed change in facial form occurred accom#anied by crowding of the teeth in the new generation.

The native foods of these Ama6on Dungle (ndians included the li%eral use of fish *hich are very a%undant in %oth the Ama6on and its %ranches! particularly in the foothill streamsF animal life from the forest and thic/etsF %ird life!

including many *ater fo*l and their eggsF plants and fruits They use very large ?uantities of yucca *hich is a starchy root ?uite similar to our potato in chemical content This is not the yucca of North America The Peruvian (ndians! in the highlands and in the eastern *atershed of the Andes! and also in the Ama6on Basin! have %uilt super% %odies *ith high immunity to dental caries and *ith splendidly developed facial and dental arch forms *hile living on the native foods in accordance *ith their accumulated *isdom Whenever they have adopted the foods of modern civili6ation and have displaced their o*n nutrition! dental caries has %een found to %e *ide> spreadF and in the succeeding generations follo*ing the adoption of modern foods! a change in facial and dental arch forms has developed The moderni6ed foods *hich displaced their native foods *ere the typical *hite manBs dietary of refined>flour products! sugar! s*eetened foods! canned goods! and polished rice Chapter 1$ Characteristics of primitive and modernized dietaries (# P&(M(T(=E races have %een more efficient than moderni6ed groups in the matter of preventing degenerative processes! physical! mental and moral! it is only %ecause they have %een more efficient in complying *ith NatureBs la*s We have t*o procedures that *e can use for evaluating their programs@ first! the interpretation of their data in terms of our modern /no*ledgeF and second! the clinical application of their procedures to our modern social pro%lems "pecifically! since the greater success of the primitives in meeting NatureBs la*s has %een %ased primarily on dietary procedures! it %ecomes desira%le first! to evaluatetheir dietary programs on the %asis of /no*n %iologic re?uirements for comparison *ith the foods of our modern civili6ationF and second! to test their primitive nutritional programs %y applying their e?uivalents to our modern families The advance in our /no*ledge of %ody>%uilding and %ody>repairing materials from a %iochemical standpoint ma/es it possi%le even *ith our limited /no*ledge of organic catalysts! to dra* comparisons %et*een the primitive and moderni6ed dietaries (f *e use the generally accepted minimal and optimal ?uantities of the various minerals and vitamins re?uired! as indicated %y "herman! H,I *e shall have at once a yardstic/ for evaluating the primitive dietaries

)f the eighteen elements of *hich the human %ody is composed! all of *hich are presuma%ly essential! several are needed in very small ?uantities A fe* are re?uired in li%eral ?uantities The normal adult needs to receive from the foods eaten one>half to one gram of calcium or lime per day #e* people receive more than one>half of the minerals present in the food The re?uirements of phosphorus are appro4imately t*ice this amount )f iron *e need from one> seventh to one>third of a gram per day "maller amounts than these are re?uired of several other elements (n order to utili6e these minerals! and to %uild and maintain the functions of various organs! definite ?uantities of various organic catalysts *hich act as activating su%stances are needed These include the /no*n and un/no*n vitamins 3nli/e some e4perimental animals human %eings have not the a%ility to create some special chemical su%stances Hnot elementsI such as vitamins *ithin their %odies "everal animals have this capacity #or e4ample! scurvy! *hich is due to a lac/ of vitamin C! cannot %e produced readily in rats %ecause rats can manufacture vitamin C "imilarly! ric/ets cannot %e produced easily in guinea pigs! %ecause they can synthesi6e vitamin D The a%sence of vitamin D and ade?uate minerals produces ric/ets in young human %eings Neither ric/ets nor scurvy can %e produced readily in dogs %ecause of the dogsB capacity to synthesi6e %oth vitamins C and D We are not so fortunate "imilarly! the a%sence of vitamin B HB,I produces in %irds and man severe nervous system reactions! such as %eri>%eri These symptoms are often less pronounced! or ?uite different! in other animals #rom our /no*ledge of the dietaries used %y the various primitive racial stoc/s *e can calculate the appro4imate amounts of the minerals and vitamins provided %y those dietaries! for comparison *ith the amounts provided %y moderni6ed foods )ur pro%lem is simplified %y the fact that the food of the *hite man in various parts of the *orld %eing %uilt from a fe* fundamental food factors! has certain ?uite constant characteristics +ence the displacing diets are similar for the several moderni6ed groups here*ith considered As a further approach to our pro%lem! it is important to /eep in mind that! in general! the *ild animal life has largely escaped many of the degenerative processes *hich affect modern *hite peoples We ascri%e this to animal instinct in the matter of food selection (t is possi%le that man has lost through disuse some of the normal faculty for consciously recogni6ing %ody re?uirements (n other *ords! the only hunger of *hich *e no* are conscious is a hunger for energy to /eep us *arm and to supply po*er (n general! *e stop eating *hen an ade?uate amount of energy has %een provided! *hether or not the %ody

%uilding and repairing materials have %een included in the food The heat and energy factor in our foods is measured in calories (n planning an ade?uate diet! a proper ratio %et*een %ody %uilding and energy units must %e maintained (t is important to /eep in mind that *hile the amount of %ody>%uilding and repairing material re?uired is similar for different individuals of the same age and *eight! it is mar/edly different for t*o individuals! one of *hom is leading a sedentary! and the other! an active life "imilarly! there is a great difference %et*een the amount of %ody>%uilding and repairing material re?uired %y a gro*ing child or an e4pectant mother and an average adult There are certain characteristics of the various dietaries of the primitive races! *hich are universally present *hen that dietary program is associated *ith a high immunity to disease and freedom from deformities (n general! these are the foods that provide ade?uate sources of %ody>%uilding and %ody> repairing material The use %y primitives! of foods relatively lo* in calories has resulted in forcing them to eat large ?uantities of these foods! in order to provide the heat and energy re?uirements of the %ody The primitives have o%tained! often *ith great difficulty! foods that are scarce %ut rich in certain elements (n these rare foods *ere elements *hich the %ody re?uires in small ?uantities! including minerals such as iodine! copper! manganese and special vitamins (n connection *ith the vitamins it should %e /ept in mind that our /no*ledge of these uni?ue organic catalysts is limited The medical profession and the pu%lic at large thin/ of vitamin D as consisting of Aust one chemical factor! *hereas! investigations are revealing continually ne* and additional factors A recent revie* H5I descri%es in considera%le detail eight distinct factors in vitamin D and refers to information indicating that there may %e at least t*elve Clearly! it is not possi%le to underta/e to provide an ade?uate nutrition simply %y reinforcing the diet *ith a fe* synthetic products *hich are /no*n to represent certain of these nutritional factors By the mass of the people at large! as *ell as %y mem%ers of the medical profession! activated ergosterol is considered to include all that is necessary to supply the vitamin D group of activators to human nutrition The various dietary programs of primitive races *hich appear to %e successful in controlling dental caries and deformities may %e divided into three groups %ased upon the sources from *hich they derive the minerals and fat>solu%le activators ( do not use the term vitamins e4clusively %ecause as yet little is /no*n a%out the *hole group of organic catalysts! although *e have considera%le /no*ledge of the limited num%er *hich are designated %y the first half do6en letters of the alpha%et Most lay people and mem%ers of the medical and dental professions assume that the si4 or eight vitamins constitute

practically all that are needed in an ade?uate nutrition These organic activators can %e divided into t*o main groups! *ater>solu%le and fat>solu%le An essential characteristic of the successful dietary programs of primitive races has %een found to relate to a li%eral source of the fat>solu%le activator group When *e discuss the successful dietary programs of the various groups from the standpoint of their a%ility to control tooth decay and prevent deformity *e find that for the people in the high and isolated Alpine valleys their nutrition is dependent largely on entire rye %read and dairy products *ith meat a%out once a *ee/ and various vegeta%les! fresh in the summer season and stored for the *inter season An analysis in my la%oratory of the dairy products o%tained from the 1oetschental =alley in "*it6erland through a series of years has sho*n the vitamin content to %e much higher than the average throughout the *orld for similar foods during the same seasons The mil/ in these high valleys is produced from green pasturage and stored green hay of e4ceptionally high chlorophyll content The mil/ and the rye %read provided minerals a%undantly The diet of the people in the )uter +e%rides *hich proved ade?uate for maintaining a high immunity to dental caries and preventing deformity consisted chiefly of oat products and sea foods including the *ide variety of fish availa%le there This diet included generally no dairy products since the pasture *as not ade?uate for maintaining cattle )at grain *as the only cereal that could %e matured satisfactorily in that climate "ome green foods *ere availa%le in the summer and some vegeta%les *ere gro*n and stored for *inter This diet! *hich included a li%eral supply of fish! included also the use of livers of fish )ne important fish dish *as %a/ed codBs head that had %een stuffed *ith oat meal and chopped codsB livers This *as an important inclusion in the diets of the gro*ing children The oats and fish! including livers! provided minerals and vitamins ade?uate for an e4cellent racial stoc/ *ith high immunity to tooth decay #or the Es/imos of Alas/a the native diet consisted of a li%eral use of organs and other special tissues of the large animal life of the sea! as *ell as of fish The latter *ere dried in large ?uantities in the summer and stored for *inter use The fish *ere also eaten fro6en "eal oil *as used freely as an adAunct to this diet and seal meat *as specially pri6ed and *as usually availa%le Cari%ou meat *as sometimes availa%le The organs *ere used Their fruits *ere limited largely to a fe* %erries including cran%erries! availa%le in the summer and stored for *inter use "everal plant foods *ere gathered in the summer and stored in fat or fro6en for *inter use A ground nut that *as gathered %y the Tundra mice and stored in caches *as used %y the Es/imos as a vegeta%le

"tems of certain *ater grasses! *ater plants and %ul%s *ere occasionally used The %ul/ of their diet! ho*ever! *as fish and large animal life of the sea from *hich they selected certain organs and tissues *ith great care and *isdom These included the inner layer of s/in of one of the *hale species! *hich has recently %een sho*n to %e very rich in vitamin C #ish eggs *ere dried in season They *ere used li%erally as food for the gro*ing children and *ere recogni6ed as important for gro*th and reproduction This successful nutrition provided ample amounts of fat>solu%le activators and minerals from sea animal life #or the (ndians living inside the &oc/y Mountain &ange in the far North of Canada! the successful nutrition for nine months of the year *as largely limited to *ild game! chiefly moose and cari%ou During the summer months the (ndians *ere a%le to use gro*ing plants During the *inter some use *as made of %ar/ and %uds of trees ( found the (ndians putting great emphasis upon the eating of the organs of the animals! including the *all of parts of the digestive tract Much of the muscle meat of the animals *as fed to the dogs (t is important that s/eletons are rarely found *here large game animals have %een slaughtered %y the (ndians of the North The s/eletal remains are found as piles of finely %ro/en %one chips or splinters that have %een crac/ed up to o%tain as much as possi%le of the marro* and nutritive ?ualities of the %ones These (ndians o%tain their fat>solu%le vitamins and also most of their minerals from the organs of the animals An important part of the nutrition of the children consisted in various preparations of %one marro*! %oth as a su%stitute for mil/ and as a special dietary ration (n the various archipelagos of the "outh Pacific and in the islands north of Australia! the natives depended greatly on shell fish and various scale fish from adAacent seas These *ere eaten *ith an assortment of plant roots and fruits! ra* and coo/ed Taro *as an important factor in the nutrition of most of these groups (t is the root of a species of lily similar to 'elephant ears' used for garden decorations in America %ecause of its large leaves (n several of the islands the tender young leaves of this plant *ere eaten *ith coconut cream %a/ed in the leaf of the tia plant (n the +a*aiian group of islands the taro plant is coo/ed and dried and pounded into po*der and then mi4ed *ith *ater and allo*ed to ferment for t*enty>four hours! more or less! in accordance *ith the stiffness of the product desired This is called poi (ts use in this form *as compara%le in efficiency *ith its use on other archipelagos as a %oiled root served much as *e use potatoes #or these "outh "ea (slanders fat>solu%le vitamins and many of the minerals *ere supplied %y the shell>fish and other animal life from the sea

The native tri%es in eastern and central Africa! used large ?uantities of s*eet potatoes! %eans! and some cereals Where they *ere living sufficiently near fresh *ater streams and la/es! large ?uantities of fish *ere eaten $oats or cattle or %oth *ere domesticated %y many tri%es )ther tri%es used *ild animal life ?uite li%erally "ome very uni?ue and special sources of vitamins *ere used %y some of these tri%es #or e4ample! in certain seasons of the year great s*arms of a large *inged insect develop in 1a/e =ictoria and other la/es These often accumulated on the shores to a depth of many inches They *ere gathered! dried and preserved to %e used in puddings *hich are highly pri6ed %y the natives and are *ell spo/en of %y the missionaries Another insect source of vitamins used fre?uently %y the natives is the ant *hich is collected from great ant hills that in many districts gro* to heights of ten feet or more (n the mating season the ants develop *ings and come out of the ant hills in great ?uantities and go into the air for the mating process These e4peditions are fre?uently made during or follo*ing a rain The natives have developed procedures for inducing these ants to come out %y covering over the opening *ith %ushes to give the effect of clouds and then pounding on the ground to give an imitation of rain We *ere told %y the missionaries that one of the great lu4uries *as an ant pie %ut unfortunately they *ere not a%le to supply us *ith this delicacy Parts of Africa li/e many other districts are often plagued %y vast s*arms of locusts These are gathered in large ?uantities! to %e coo/ed for immediate use or dried and ground into a flour for later use They provide a rich source of minerals and vitamins The natives of Africa used the cereals mai6e! %eans! linga linga! millet! and Gaffir corn! coo/ed or roasted Most of these *ere ground Aust %efore coo/ing Among the A%origines of Australia *e found that those living near the sea *ere using animal life from that source li%erally! together *ith the native plants and animals of the land They have not cultivated the land plants during their primitive life (n the interior! they use freely the *ild animal life! particularly *alla%y! /angaroo! small animals and rodents All of the edi%le parts! including the *alls of the viscera and internal organs are eaten The native Maori in Ne* <ealand! used large ?uantities of foods from the sea! *herever these *ere availa%le Even in the inland food depots! mutton %irds *ere still availa%le in large ?uantities These %irds *ere captured Aust %efore they left the nests They developed in the roc/eries a%out the coast! chiefly on the e4treme southern coast of the "outh (sland At this stage! the flesh is very tender and very fat from the gorging that has %een provided %y their parent The value of this food for the treatment of tu%erculosis *as %eing heralded ?uite *idely in %oth Australia and Ne* <ealand (n the primitive state

of the islands large ?uantities of land %irds *ere availa%le and %ecause of the fertility of the soil and favora%le climate! vegeta%les and fruits gre* a%undantly in the *ild 1arge ?uantities of fern root *ere used Where groups of the Maori race *ere found isolated sufficiently from contact *ith modern civili6ation and its foods to %e dependent largely on the native foods! they selected *ith precision certain shell>fish %ecause of their uni?ue nutritive value A splendid illustration of the primitive Maori instinct or *isdom regarding the value of sea foods *as sho*n in an e4perience *e had *hile ma/ing e4aminations in a native school on the east coast of the North (slands ( *as impressed *ith the fact that the children in the school gave very little evidence of having active dental caries ( as/ed the teacher *hat the children %rought from their homes to eat at their midday lunch! since most of them had to come too great a distance to return at noon ( *as told that they %rought no lunch %ut that *hen school *as dismissed at noon the children rushed for the %each *here! *hile part of the group prepared %onfires! the others stripped and dived into the sea! and %rought up a large species of lo%ster The lo%sters *ere promptly roasted on the coals and devoured *ith great relish )ther sea foods are pictured in #ig 9. The native diet of the tri%es living in the islands north of Australia consisted of li%eral ?uantities of sea foods These *ere eaten *ith a variety of plant roots and greens! together *ith fruits *hich gre* a%undantly in that favora%le climate #e* places in the *orld have so favora%le a ?uantity of food for sea> animal life as these *aters *hich provide the richest pearl fisheries in the *orld This is evidence of the enormous ?uantity of shell>fish that develop there +ere! as off the east coast of Australia! are to %e found some of the largest shell>fish of the *orld (t *as a common occurrence to see these shells %eing used %y natives for such purposes as *ater storage and for %ath tu%s of a si6e appro4imately that of a *ash tu% Australia and Ne* <ealand are near enough to the Antarctic ice cap to have their shores %athed *ith currents coming from the ice fields! currents *hich a%ound in food for sea animals The great %arrier reef off the east coast of Australia e4tends north to *ithin a fe* leagues of Ne* $uinea Murray (sland is near the north end of this %arrier The fish in the *ater at times form such a dense mass that they can %e scooped into the %oats directly from the sea #ishermen *ading out in the surf and thro*ing their spears into the schools of fish usually impale one or several The incidence of tooth decay on this island *as less than one per cent of all of the teeth e4amined Another important sea food in these *aters *as dugong! referred to as sea co* in northern *aters This animal is very highly pri6ed %ut

is %ecoming scarce We found its meat very much li/e lam% (t lives on the vegetation of the sea floor in shallo* *ater As *e fle* over the %ays of Eastern Australia going north*ard in search of colonies of native A%origines! *e could see these sea animals pasturing in the clear *ater among the ocean plants During these investigations of primitive races! ( have %een impressed *ith the superior ?uality of the human stoc/ developed %y Nature *herever a li%eral source of sea foods e4isted These 6ones of a%undant marine life *ere largely in the *a/e of the ocean currents drifting from the ice fields of the poles The +um%oldt Current is pro%a%ly the most li%eral carrier of marine life of any of the ocean currents (t leaves the ice field of the Antarctic and %athes the *est coast of "outh America from its southern tip nearly to the e?uator! *here the coast line changes direction and the +um%oldt Current is deflected out into the ocean (t meets here a *arm current coming do*n from the coast of Central America! Panama and Colum%ia (f the super% physi?ues that Nature has esta%lished among the Maori of Ne* <ealand! the Malays of the (slands north of Australia! the $aelics of the )uter +e%rides and the natives on several of the archipelagos of the Pacific! o*e their superior physical development to sea foods! *e should e4pect to find that the tri%es *hich have had contact *ith the great +um%oldt Current food *ould also have super% physi?ues 3nfortunately! very little has %een /no*n of the ancient cultures that have developed along the coast of Chile and Peru (t has %een reported that of all the (ndian tri%es of "outh America! those in Patagonia *ere the most stal*art While the *est coast of Peru is %athed %y the +um%oldt Current *ith its nearly ine4hausti%le supply of human nutrition! the lands %ordering that shore are among the most desolate deserts of the *orld The 6one %et*een the Andes Mountains and the coast for appro4imately a thousand miles is utterly %arren! consisting of moving sand dunes and Aagged promontories Practically the only %rea/ in this *aterless! treeless desert is to %e found in the fe* ri%%ons of *ater that tric/le do*n from the melting sno*s of the Andes Coastal &ange This coast has no rainy seasons Any vegetation gro*n! no* or in the past thousands of years! has had to %e *atered from the limited supply afforded %y these rivers *hich seem so insignificant *hen compared *ith the vastness of the territory These river %ottoms contain the alluvial deposits from the Andes and are very rich *hen *atered (t has %een only %y means of gigantic engineering underta/ings that the *ater from these rivers has %een carried through great irrigation ditches! sometimes fifty to a hundred miles long for the purpose of ma/ing it possi%le to utili6e these river %ottom lands for agriculture

(n many of the primitive tri%es living %y the sea *e found emphasis on the value of fish eggs and on some animal forms for insuring a high physical development of gro*ing children! particularly of girls! and a high perfection of offspring through a reinforcement of the motherBs nutrition (t is also important to note that in several of the primitive tri%es studied there has %een a consciousness that not only the mother should have special nutrition! %ut also the father (n this group very great value *as placed upon a product o%tained from a sea form /no*n locally as the angelote or angel fish! *hich in classification is %et*een a s/ate and a shar/ The young of the angelota are %orn alive! ready for free s*imming and capa%le of foraging for themselves immediately at %irth T*enty to thirty young are %orn in one litter The eggs of the female %efore fertili6ation are a%out one inch in diameter! slightly oval %ut nearly spherical They are used as food %y all! %ut the special food product for men is a pair of glands o%tained from the male These glands *eigh up to a pound each! *hen they are dried They have a recogni6ed value among the natives for treating cases of tu%erculosis! especially for controlling lung hemorrhages The sea foods *ere used in conAunction *ith the land plants and fruits raised %y means of irrigation in the river valleys Together these foods provided ade?uate nutrition for maintaining high physical e4cellence (n Chapter ,- ( have discussed the pro%a%le order of these ancient cultures and the possi%le e4tent of their duration =ery little is /no*n of their origin Evidence has recently %een discovered in Panama indicating that %oth the *ealth and the culture of Peru *ere carried north*ard %y maritime con?uerors and that the cultures of Central America! including the Maya culture may have had their origins in these ancient cultures of Peru While the coastal area of Peru sa* the development of many magnificent cultures through past ages! the highlands of Peru also have left much evidence of superior attainments and *isdom The t*o great (ndian linguistic groups of the Andean highlands of today are the Aymara of "outhern Peru and Bolivia and the Cuichus of central and northern Peru The Aymara are credited *ith %eing the descendants of the Tauhuanocan culture *hich preceded the (ncan culture in the highlands The Cuichu are credited *ith %eing the descendants of the (ncan culture *hich had its 6enith Aust prior to the coming of the "paniards (n Chapter ,. ( have sho*n photographs of these racial stoc/s as they are found today in the Andean "ierras (t may %e possi%le that in former times the vast mountain ranges provided large herds of gra6ing *ild animals of the deer family Because of the vastness of the population and the e4tent to *hich all availa%le land surfaces *ere utili6ed for agriculture! it does not seem possi%le that *ild animal life could have %een an ade?uate source of nutrition The

mem%ers of the camel family! the llamas! alpacas! and vicunas *ere utili6ed for food )f these the first t*o *ere used to considera%le e4tent as they are today When it is recogni6ed that in the "ierra the availa%le *ater is largely that provided to the streams from the melting sno*s and from rains in the rainy season! it *ill %e reali6ed that these sources of fresh *ater could not provide the li%eral ?uantity of iodine essential for human gro*th and development (t *as! accordingly! a matter of great interest to discover that these (ndians used regularly dried fish eggs from the sea Commerce in these dried foods is carried on today as it no dou%t has %een for centuries When ( in?uired of them *hy they used this material they e4plained that it *as necessary to maintain the fertility of their *omen ( *as informed also that every e4change depot and mar/et carried these dried fish eggs so that they *ere al*ays availa%le Another sea product of very great importance! and one *hich *as universally availa%le *as dried /elp 3pon in?uiry ( learned that the (ndians used it so that they *ould not get '%ig nec/s' li/e the *hites The /elp provided a very rich source of iodine as *ell as of copper! *hich is very important to them in the utili6ation of iron for %uilding an e4ceptionally efficient ?uality of %lood for carrying o4ygen li%erally at those high altitudes An important part of their dietary consists today as in the past of potatoes *hich are gathered and fro6en! dried and po*dered! and preserved in the po*dered form This po*der is used in soups *ith llama meat and other products "ince the vitamin D group of activators is a%sent from nearly all plant products %ut must %e synthesi6ed in animal %odies from the plant foods! *here it is largely stored in organs! an ade?uate source had to %e provided The (ndians of the highlands of Peru maintained colonies of guinea pigs *hich *ere used in their ste*s The ancient %urials also sho* that the guinea pig *as a common source of food since mummified %odies of this animal *ere found This is significant since of all the animals that are used for e4perimental *or/ the guinea pig is pro%a%ly the most efficient in synthesi6ing vitamin D from plant foods They are very hardy They live on a great variety of green plant foods and t*igs and are very prolific They apparently played a very important part in the physical e4cellence of the ancient cultures (t is unfortunate that as the *hite man has come into contact *ith the primitives in various parts of the *orld he has failed to appreciate the accumulated *isdom of the primitive racial stoc/s Much valua%le *isdom has %een lost %y this means ( have referred to the s/ill of the (ndians in preventing scurvy and to the many drugs that *e use *hich the *hite man has learned of from the primitives

(n this connection the (ndians of British Colum%ia! *ho have %een so efficient in preventing scurvy! have a plant product for the prevention and cure of dia%etes This has recently %ecome /no*n to the *hite man through the e4perience of a patient *ho *as %rought into the hospital at Prince &upert! British Colum%ia! as reported in the Canadian Medical Dournal! Duly ,2-: Prince &upert is near the %oundary %et*een British Colum%ia and Alas/a on the coast The patient came to that hospital for an operation and suddenly sho*ed signs of dia%etes! *hich re?uired treatment *ith large doses of insulin Dr &ichard $eddes 1arge as/ed him regarding the history of his affection and *hat he had %een ta/ing +e *as told that for several years he had %een using an (ndian preparation *hich *as a hot *ater infusion of a root of devilBs>clu% *hich is a spiny! pric/ly shru% This medicine *as in common use %y the British Colum%ia (ndians The material *as o%tained and used in this hospital for the treatment of dia%etes and *as found to %e ?uite as efficient as insulin and had the great advantage that it *ould %e ta/en %y mouth *hereas the insulin *hich is destroyed in the stomach %y the process of digestion must %e inAected They could see very little difference in the efficiency of this preparation *hether ta/en internally or used hypodermically This promises to %e a great %oon to a large group of individuals suffering from dia%etes (t is also pro%a%le that its use *ill prevent the development of dia%etes and since the (ndians used it for other affections it may also %ecome a very important adAunct in modern preventive medicine )ne of the sources that ( have found to %e helpful in studying primitive races is an investigation of /napsac/s ( have as/ed for the privilege of seeing *hat is carried in their /napsac/s ( found dried fish eggs and dried /elp in the /napsac/s in the high Andes (t is also of interest that among this group in the Andes! among those in central Africa! and among the A%origines of Australia! each /napsac/ contained a %all of clay! a little of *hich *as dissolved in *ater (nto this they dipped their morsels of food *hile eating Their e4planation *as to prevent 'sic/ stomach ' This is the medicine that is used %y the native in these countries for com%ating dysentery and food infections (t is the treatment that *as given me *hen ( developed dysentery infection in central Africa *hile ma/ing studies there The English doctor in Nairo%i *hom ( called in said he *ould give me the native treatment of a suspension of clay (t proved very effective An illustration of the *ay in *hich modern science is sio*iy adopting practices that have %een long in use among primitive races! is to %e found in the recent e4tensive use that is made of clay H/aolinI in our modern medicine This is illustrated in the follo*ing@ H-I

(n the course of an e4pedition to 1a/e Titicaca! "outh America! financed %y the Percy "lade Trustees in *hich one of us H+ P M I too/ part! an interesting o%servation *as made in regard to the diet of the Cuetchus (ndians on the Capachica Peninsula near Puno These people are almost certainly descendants of the (ncas and at the present time live very primitively They e4ist largely on a vegeta%le diet of *hich potatoes form an important part (mmediately! %efore %eing eaten! the potatoes are dipped into an a?ueous suspension of clay! a procedure *hich is said to prevent 'souring of the stomach ' We have e4amined this clay and found it to consist of /aolin containing a trace of organic material! possi%ly coumarin! and presuma%ly a decomposition product of the grass from underneath *hich the clay is dug The local name for the clay is Chacco! and the (ndians distinguish %et*een good and %ad ?ualities This dietetic procedure is universal among the (ndians of the Puno district! and is pro%a%ly of very ancient origin "uch a practice %y a primitive people *ould appear rather remar/a%le in vie* of the comparatively recent introduction of /aolin into modern medicine as a protective agent for the gastric and intestinal mucosa and as a remedy for %acterial infections of the gut (t is of interest that %oth the British and American Pharmacopeias have added /aolin to their list during the last t*o decades The (ndians of the past %uried! *ith their dead! foods to carry them on their Aourney #rom an e4amination of these one learns that in many respects the (ndians living in the high "ierras are living today very much as their ancestors did during past centuries (tems of importance no* and in the past are parched corn and parched %eans *hich are ni%%led as the people *al/ along carrying their heavy %urdens Today these are the only foods eaten on many long Aourneys We found the parched %eans pleasant to taste and very satisfying *hen *e *ere hungry The (ndians of the Ama6on Basin have had a history very different from either those of the high "ierras of the Andes or those of the coastal region The fact that vast areas of the Ama6on Basin have not only never %een surveyed! %ut never even penetrated! indicates the nature of the isolation of these groups =ery little progress has %een made in the effort to con?uer or moderni6e these (ndians A fe* e4plorers have made e4peditions into parts of the interior and have reported the characteristics of the plant and animal life! as *ell as of the native races )ur sole contact *as *ith the tri%e *hich came to the coffee plantation to assist in the gathering and the harvest of the coffee %eans (n

Chapter ,. ( have descri%ed these people in considera%le detail "ince the Ama6on Basin has vast ?uantities of rain as *ell as a%undant streams from the eastern *atershed of the Andes! the tri%es live largely in tropical Aungles *here there is an a%undance of *ater They are e4pert! accordingly! in the use of river crafts and in fishing for the various types of marine life 3nli/e the (ndians of the high Andes or of the coast regions they are not agriculturists They live on *ild native foods almost entirely They are e4pert *ith the %lo* gun! *ith the %o* and arro* and in snaring *ith %oth nets and loops They use very large ?uantities of a tu%er root called yucca *hich has many ?ualities similar to the roots of the edi%le variety of the lily family This plant is %oiled and eaten much as are potatoes They use also large ?uantities of fish from the streams! %irds and small animals of the land! together *ith the native fruits including %ananas Their dietary provides a very li%eral supply of minerals and vitamins together *ith an ade?uate ?uantity of car%ohydrates! fats and proteins (n evaluating the nutritive value of the dietary programs of primitive races and our moderni6ed cultures! it is important that *e have a yardstic/ ade?uately adAusted to ma/e computation in terms of specific %ody needs for %uilding good %odies and maintaining them in good health The advance in modern chemistry has gone far to*ard ma/ing this possi%le The pro%lem of estimating the mineral and activator contents! in other *ords the %ody>%uilding and repairing ?ualities of the displacing foods used %y the various primitive races! is similar in many respects to estimating these ?ualities in the foods used in our modern *hite civili6ations! e4cept that modern commerce has transported usually only the foods that *ill /eep *ell These include chiefly *hite flour! sugar! polished rice! vegeta%le fats and canned goods =ery important data for typical American dietaries are no* availa%le provided %y the Bureau of +ome Economics! 3nited "tates Department of Agriculture! and also %y the Bureau of 1a%or "tatistics! 3nited "tates Department of 1a%or These surveys provide a %asis of estimating the nutrition of various income groups %oth *ith regard to the type of foods selected in our American communities and the ?uantities of each type used! together *ith the chemical content of these foods e4pressed ?uantitatively Those *ho *ish to have detailed reports are referred to the %ulletins of the a%ove departments (n my clinical studies of the mineral constituents of individuals! affected *ith dental caries and other distur%ances of physical deficiency! ( find a *ide range of variation in the calcium! phosphorus and fat>solu%le activator content of the dietaries used! although in general the calorie content is ade?uate This latter

factor is controlled %y appetite These computations reveal that the individuals studied have a calcium inta/e ranging from ; - to ; 7 gramsF and a phosphorus inta/e of from ; - to ; 8 grams The minimum adult re?uirements as provided %y such an authority as "herman! *hose figures are used %y the 3nited "tates Department of 1a%or! are for the average adult ; 8: of a gram of calcium and , -5 grams of phosphorus per day (t can %e seen readily that the amounts given a%ove are far short of the minimum even if individuals a%sor%ed from the foods all of the minerals present A ?uestion arises at this point as to the efficiency of the human %ody in removing all of the minerals from the ingested foods E4tensive la%oratory determinations have sho*n that most people cannot a%sor% more than half of the calcium and phosphorus from the foods eaten The amounts utili6ed depend directly on the presence of other su%stances! particularly fat>solu%le vitamins (t is at this point pro%a%ly that the greatest %rea/do*n in our modern diet ta/es place! namely! in the ingestion and utili6ation of ade?uate amounts of the special activating su%stances! including the vitamins needed for rendering the minerals in the food availa%le to the human system A recent report %y the Council on #oods of the American Medical H.I Association ma/es this comment on spinach@ "pinach may %e regarded as a rich source of vitamin A and as a contri%utor of vitamin C! iron and roughage to the diet (t is therefore a valua%le food HButI the iron is not *ell utili6ed %y infants HandI the feeding of spinach is of no value during early infancy as a source of calcium Even though calcium is present in spinach children cannot utili6e it Data have %een pu%lished sho*ing that children a%sor% very little of the calcium or phosphorus in spinach %efore si4 years of age Adult individuals vary in the efficiency *ith *hich they a%sor% minerals and other chemicals essential for mineral utili6ation (t is possi%le to starve for minerals that are a%undant in the foods eaten %ecause they cannot %e utili6ed *ithout an ade?uate ?uantity of the fat>solu%le activators

FI". 9 . $his figure shows the ra#id healing of a fractured femur of a boy four and onehalf years of age suffering from convulsions due to malnutrition. 1is fracture occurred when he fell in a convulsion. $here was no healing in si,ty days. After reinforcing his nutrition with butter vitamins the healing at the right occurred in thirty days. =hole mil% re#laced s%im mil% and a whole wheat gruel made from freshly ground whole wheat re#laced white bread.

This is illustrated in the follo*ing case A minister in an industrial section of our city! during the period of severe depression! telephoned me stating that he had Aust %een called to %apti6e a dying child The child *as not dead although almost constantly in convulsions +e thought the condition *as pro%a%ly nutritional and as/ed if he could %ring the %oy to the office immediately The %oy *as %adly emaciated! had rampant tooth decay! one leg in a cast! a very %ad %ronchial cough and *as in and out of convulsions in rapid succession +is convulsions had %een getting *orse progressively during the past eight months +is leg had %een fractured t*o or three months previously *hile *al/ing across the room *hen he fell in one of his convulsions No healing had occurred +is diet consisted of *hite %read and s/immed mil/ #or mending the fracture the %oy needed minerals! calcium! phosphorus and magnesium +is convulsions *ere due to a lo* calcium content of the %lood All of these *ere in the

s/immed mil/ for the %utter>fat removed in the cream contains no calcium nor phosphorus! e4cept traces The program provided *as a change from the *hite flour %read to *heat gruel made from freshly ground *heat and the su%stitution of *hole mil/ for s/immed mil/! *ith the addition of a%out a teaspoonful of a very high vitamin %utter *ith each feeding +e *as given this meal that evening *hen he returned to his home +e slept all night *ithout a convulsion +e *as fed the same food five times the ne4t day and did not have a convulsion +e proceeded rapidly to regain his health *ithout recurrence of his convulsions (n a month the fracture *as united T*o vie*s of the fracture are sho*n in #ig 2-! one %efore and one after the treatment "i4 *ee/s after this nutritional program *as started the preacher called at the home to see ho* the %oy *as getting along +is mother stated that the %oy *as playing a%out the doorstep! %ut they could not see him "he called %ut received no ans*er Presently they spied him *here he had clim%ed up the do*nspout of the house to the second story )n %eing scolded %y his mother! he ran and Aumped over the garden fence! thus demonstrating that he *as pretty much of a normal %oy This %oyBs imperative need! that *as not provided in *hite %read and s/immed mil/! *as the presence of the vitamins and other activators that are in *hole mil/ %ut not in s/immed mil/! and in *hole *heat! freshly ground! %ut not in *hite flour +e *as restored to health %y the simple process of having NatureBs natural foods restored to him This pro%lem of %orro*ing from the s/eleton in times of stress may soften the %ones so that they *ill %e %adly distorted This is fre?uently seen as %o* legs An illustration of an e4treme condition of %one softening %y this process is sho*n in #ig 2.! lo*er section! *hich is the s/eleton of a mon/ey that *as a house pet (t %ecame very fond of s*eets and *as fed on *hite %read! s*eetened Aams! etc ! as it ate at the same ta%le *ith its mistress Note that the %ones %ecame so soft that the pull of the muscles distorted them into all sorts of curves Naturally its %ody and legs *ere seriously distorted (n this condition my patient! *hom ( *as serving professionally! as/ed me for advice regarding her mon/eyBs deformed legs and distorted %ody ( suggested an improved nutrition and provided fat>solu%le vitamins consisting of a mi4ture of a high vitamin %utter oil and high vitamin cod liver oil *ith the result that minerals *ere deposited on the %orders of the verte%rae and Aoints and on the surfaces of the %ones as sho*n in the illustration This of course! could not correct the deformity and the animal *as chloroformed

FI". 9). $his boy+ age -+ had suffered for two and one& half years from inflammatory rheumatism+ arthritis and heart involvement. ;##er left shows limit of movement of nec%+ left wrist+ swollen %nees and an%les. $he middle u##er view shows the change in si, months after im#rovement of his nutrition+ and at right his change in one year. Below is shown the grossly deminerali*ed and deformed s%eleton of a #et mon%ey being fed on sweets and #astries.

The necessity that the foods selected and used shall provide an ade?uate ?uantity of fat>solu%le activators Hincluding the /no*n fatsolu%le vitaminsI is so imperative and is so important in preventing a part of our modern degeneration that ( shall illustrate its need *ith another practical case A mother as/ed my assistance in planning the nutritional program for her %oy "he reported that he *as five years of age and that he had %een in %ed in hospitals *ith rheumatic fever! arthritis and an acute heart involvement most of the time for the past t*o and a half years "he had %een told that her %oy *ould not recover! so severe *ere the complications As is so generally the case *ith rheumatic fever and endocarditis! this %oy *as suffering from severe tooth

decay (n this connection the American +eart Association has reported that 97 per cent of heart involvements %egin %efore ten years of age My studies have sho*n that in a%out 27 per cent of these cases there is active tooth decay The important change that ( made in this %oyBs dietary program *as the removal of the *hite flour products and in their stead the use of freshly crac/ed or ground *heat and oats used *ith *hole mil/ to *hich *as added a small amount of specially high vitamin %utter produced %y co*s pasturing on green *heat "mall doses of a high>vitamin! natural cod liver oil *ere also added At this time the %oy *as so %adly crippled *ith arthritis! in his s*ollen /nees! *rists! and rigid spine! that he *as %edfast and cried %y the hour With the improvement in his nutrition *hich *as the only change made in his care! his acute pain rapidly su%sided! his appetite greatly improved! he slept soundly and gained rapidly in *eight (n the first vie*! to the left! in #ig 2.! the %oy is sho*n sitting on the edge of the %ed at the end of the first month on this program +is Aoints *ere still %adly s*ollen and his spine so rigid that he could not rotate his head farther than sho*n in the picture (n the center vie* he is sho*n a%out si4 months later! and in the third vie*! one year later This occurred si4 years ago As ( *rite this a letter has %een received from the %oyBs mother "he reports that he is taller and heavier than the average! has a good appetite and sleeps *ell (n the ne*er light regarding the cause of rheumatic fever! or inflammatory rheumatism Hdiscussed in Chapter 5,I there appear to %e three underlying causes@ a general lo*ered defense against infection in *hich the fat>solu%le vitamins play a very important partF minute hemorrhages in Aoint tissues as part of the e4pression of deficiency of vitamin C! a scurvy symptom! and a source of infecting %acteria such as streptococcus This could %e provided %y his infected teeth These typical e4pressions of modern degeneration could not occur in most of the primitive races studied %ecause of the high factor of safety in the minerals and vitamins of their nutrition (t is important to emphasi6e the changes that *ere made in our modern dietary program to ma/e this %oyBs nutrition ade?uate for recovery "ugars and s*eets and *hite flour products *ere eliminated as far as possi%le #reshly ground cereals *ere used for %reads and gruels Bone marro* *as included in ste*s 1iver and a li%eral supply of *hole mil/! green vegeta%les and fruits *ere provided (n addition! he *as provided *ith a %utter that *as very high in vitamins having %een produced %y co*s fed on a rapidly gro*ing green grass The %est source for this is a pasturage of *heat and rye grass All green grass in a state of rapid gro*th is good! although *heat and rye grass are the %est found 3nless hay is carefully dried so as to retain its chlorophyll! *hich is a precursor of vitamin A! the co* cannot synthesi6e the fat>solu%le vitamins

These t*o practical cases illustrate the fundamental necessity that there shall not only %e an ade?uate ?uantity of %ody>%uilding minerals present! %ut also that there shall %e an ade?uate ?uantity of fat>solu%le vitamins )f course! *ater>solu%le vitamins are also essential While ( have reduced the diets of the various primitive races studied to definite ?uantities of mineral and calorie content! these data are so voluminous that it *ill not %e appropriate to include them here (t *ill %e more informative to discuss the ratios of %oth %ody> %uilding and repairing material in the several primitive dietaries! in comparison *ith the displacing foods adopted from our modern civili6ation The amount of food eaten %y an individual is controlled primarily %y the hunger factor *hich for our moderni6ed groups apparently relates only to need for heat and energy The dietaries adopted have all %een %uilt on the %asis of the heat and energy re?uirements of the %ody for the groups living in the several districts and under their modes of life These have %een calculated for the principal foods eaten %y the various groups The figures *ill %e pu%lished in detail in a more technical report There are t*o simple *ays in *hich these comparisons can %e made )ne is in terms of normal %ody re?uirementsF and the other in terms of the ratio %et*een the mineral and the vitamin content of the native foods and the displacing foods (f *e use as a %asis the a%ility of individuals to remove half of the minerals present even though their %odies need more than this! *e *ill %e more generous than the average individualBs capacity *ill Austify This *ill re?uire that *e dou%le the amount! as specified for minimum %ody use %y the 3nited "tates Department of 1a%or! Bureau of 1a%or "tatistics! in their Bulletin & .;2! that is! for calcium ; 8: gramsF for phosphorus , -5 gramsF for iron ; ;,7 grams The figures that *ill %e used! therefore! are for t*ice the a%ove amounts@ , -8 grams of calciumF 5 8. grams of phosphorusF ; ;-; grams of iron #e* people *ho have not %een in contact *ith e4perimental data on meta%olism can appreciate ho* little of the minerals in the food are retained in the %ody %y large num%ers of individuals *ho are in need of these very chemicals We have seen that infants cannot a%sor% calcium from spinach (f *e are to provide nutrition that *ill include an ade?uate e4cess as a factor of safety for overloads! and for such periods as those of rapid gro*th Hfor childrenI! pregnancy! lactation and sic/ness! *e must provide the e4cess to the e4tent of a%out t*ice the re?uirements of normal adults (t *ill therefore! %e necessary for an ade?uate nutrition to contain appro4imately four times the minimum re?uirements of the average adult if all stress periods are to %e passed safely

(t is of interest that the diets of the primitive groups *hich have sho*n a very high immunity to dental caries and freedom from other degenerative processes have all provided a nutrition containing at least four times these minimum re?uirementsF *hereas the displacing nutrition of commerce! consisting largely of *hite>flour products! sugar! polished rice! Aams! canned goods! and vegeta%le fats have invaria%ly failed to provide even the minimum re?uirements (n other *ords the foods of the native Es/imos contained 7 . times as much calcium as the displacing foods of the *hite man! five times as much phosphorus! , 7 times as much iron! 9 2 times as much magnesium! , : times as much copper! .2 ; times as much iodine! and at least ten times that num%er of fat>solu%le vitamins #or the (ndians of the far North of Canada! the native foods provided 7 : times as much calcium! 7 : times as much phosphorus! 5 9 times as much iron! . - times as much magnesium! , 7 times as much copper! : : times as much iodine! and at least a ten fold increase in fat> solu%le activators #or %revity! *e *ill apply the figures to calcium! phosphorus! magnesium! iron and fat>solu%le activators in order The ratio in the "*iss native diets to that in the displacing diet *as for calcium! - 9 foldF for phosphorus! 5 5 foldF for magnesium! 5 7 foldF for iron! - , foldF and for the fat>solu%le activators! at least ten fold #or the $aelics in the )uter +e%rides! the native foods provided 5 , times as much calcium! 5 - times as much phosphorus! , - times as much magnesium! and , ; times as much ironF and the fat>solu%le activators *ere increased at least ten fold #or the A%origines of Australia! living along the eastern coast *here they have access to sea foods the ratio of minerals in the native diet to those in the displacing moderni6ed foods *as! for calcium! . 8 foldF for phosphorus! 8 5 foldF for magnesium! ,9 foldF and for iron 7; 8 foldF *hile for the fatsolu%le activators! it *as at least ten fold The native diet of the Ne* <ealand Maori provided an increase in the native foods over the displacing foods of the moderni6ed *hites of 8 5 fold for calcium! 8 2 fold for phosphorus! 5- . fold for magnesium! 7: - fold for ironF and the fatsolu%le activators *ere increased at least ten fold The native diet of the Melanesians provided similarly an increase over the provision made in the moderni6ed foods *hich displaced them of 7 9 fold for calcium! 8 . fold for phosphorus! 58 . fold for magnesium! and 55 . fold for ironF *hile the fat> solu%le activators *ere increased at least ten fold The Polynesians provided through their native diet for an increase in provision over that of the displacing imported diets! of 7 8 fold for calcium! 9 5 fold for phosphorus! 5: 7 fold for magnesium! ,: 8 fold for ironF and the fat>solu%le activators *ere increased at least ten fold The coastal (ndians of Peru provided through their native primitive diets for an increase in provision over that of the displacing moderni6ed diet of 8 8 fold for calcium! 7 7 fold for phosphorus! ,- 8 fold for magnesium! 7 , fold for ironF and an e4cess of ten fold *as provided for fat>

solu%le vitamins #or the (ndians of the Andean Mountains of Peru! the native foods provided an increase over the provision of the displacing modern foods of " fold for calcium! 7 7 fold for phosphorus! ,- - fold for magnesium! 52 fold for ironF and an e4cess of at least ten fold *as provided for fat>solu%le vitamins #or the cattle tri%es in the interior of Africa! the primitive foods provided an increase over the provision of the displacing moderni6ed foods of 9 7 fold for calcium! : 5 fold for phosphorus! ,2 , fold for magnesium! ,8 8 fold for iron and at least ten fold for fat>solu%le activators #or the agricultural tri%es in Central Africa the native diet provided an increase over the provision of the displacing modern diet of - 7 fold for calcium! . , fold for phosphorus! 7 . fold for magnesium! ,8 8 fold for iron and ten fold for fat>solu%le activators All the a%ove primitive diets provided also a large increase in the *ater>solu%le vitamins over the num%er provided in the displacing modern diets

FI". 9-. 7ffect of different wheat #roducts on rats. Left0 whole wheat. 8enter0 white flour. 2ight0 bran and middlings mi,ture. $he gra#hs record actual amount of indicated minerals #resent+ as milligrams #er cent. 5nly the rats on the whole wheat develo#ed normally without tooth decay. $hose on white flour had tooth decay+ were underweight+ had s%in infections and were irritable. $hey did not re#roduce. $he third grou# were undersi*e. $he balance of the ration was the same for all.

#rom the data presented in the preceding chapters and in this comparison of the primitive and moderni6ed dietaries it is o%vious that there is great need that the grains eaten shall contain all the minerals and vitamins *hich Nature has provided that they carry (mportant data might %e presented to illustrate this phase in a practical *ay (n #ig 27 *ill %e seen three rats all of *hich received the same diet! e4cept for the type of %read The first rat Hat the leftI received *hole>*heat products freshly ground! the center one received a *hite flour product and the third Hat the rightI a %ran and middlings product The amounts of each ash! of calcium as the o4ide! and of phosphorus as the pento4ideF and the amounts of iron and copper present in the diet of each group are sho*n %y the height of the columns %eneath the rats Clinically it *ill %e seen that there is a mar/ed difference in the physical development Cf these rats "everal rats of the same age *ere in each cage The feeding *as started after *eaning at a%out t*enty>three days of age The rat at the left *as on the entire grain product (t *as fully developed The rats in this cage reproduced normally at three months of age The rats in this first cage had very mild dispositions and could %e pic/ed up %y the ear or tail *ithout danger of their %iting The rats represented %y the one in the center cage using *hite flour *ere mar/edly undersi6ed Their hair came out in large patches and they had very ugly dispositions! so ugly that they threatened to spring through the cage *all at us *hen *e came to loo/ at them These rats had tooth decay and they *ere not a%le to reproduce The rats in the ne4t cage Hillustrated %y the rat to the rightI *hich *ere on the %ran and middlings mi4ture did not sho* tooth decay! %ut *ere considera%ly undersi6ed! and they lac/ed energy The flour and middlings for the rats in cages t*o and three *ere purchased from the miller and hence *ere not freshly ground The *heat given to the first group *as o%tained *hole and ground *hile fresh in a hand mill (t is of interest that not*ithstanding the great increase in ash! calcium! phosphorus! iron and copper present in the foods of the last group! the rats did not mature normally! as did those in the first group This may have %een due in large part to the fact that the material *as not freshly ground! and as a result they could not o%tain a normal vitamin content from the em%ryo of the grain due to its o4idation This is further indicated %y the fact that the rats in this group did not reproduce! pro%a%ly due in considera%le part to a lac/ of vitamins B and E *hich *ere lost %y o4idation of the em%ryo or germ fat There is a misapprehension *ith regard to the possi%ility that humans may o%tain enough of the vitamin D group of activators from our modern plant foods or from sunshine This is due to the %elief viosterol or similar products %y other names! derived %y e4posing ergosterol to ultraviolet light! offer all of the nutritional factors involved in the vitamin D group ( have emphasi6ed that

there are /no*n to %e at least eight D factors that have %een definitely isolated and t*elve that have %een reported as partially isolated Coffin has recently reported relative to the lac/ of vitamin D in common foods as follo*s@ H7I , A representative list of common foods *as carefully tested! %y approved techni?ue! for their vitamin D content 5 With the remote possi%ility of egg yol/s! %utter! cream! liver and fish it is manifestly impossi%le to o%tain any amount of vitamin D *orthy of mention from common foods - =egeta%les do not contain vitamin D (t *ill %e noted that vitamin D! *hich the human does not readily synthesi6e in ade?uate amounts! must %e provided %y foods of animal tissues or animal products As yet ( have not found a single group of primitive racial stoc/ *hich *as %uilding and maintaining e4cellent %odies %y living entirely on plant foods ( have found in many parts of the *orld most devout representatives of modern ethical systems advocating the restriction of foods to the vegeta%le products (n every instance *here the groups involved had %een long under this teaching! ( found evidence of degeneration in the form of dental caries! and in the ne* generation in the form of a%normal dental arches to an e4tent very much higher than in the primitive groups *ho *ere not under this influence Many illustrations might %e presented sho*ing the special *isdom of the primitives in the matter of reinforcing their nutrition *ith protective foods #e* people *ill reali6e ho* reluctant mem%ers of the primitive races are! in general! to disclose secrets of their race The need for this is compara%le to the need for secrecy regarding modern *ar devices The (ndians of the Yu/on have long /no*n the cure for scurvy and history ma/es an important contri%ution to their *isdom in treating this disease (t is of interest that W N Gemp H8I of =ancouver states@ The earliest recorded successful treatment of scurvy occurred in Canada in ,7-7 *hen Dac?ues Cartier! on the advice of a friendly (ndian! gave his scurvyprostrated men a decoction of young green succulent BshootsB from the spruce trees *ith successful results These happy effects apparently *ere not appreciated in Europe! for scurvy continued to %e endemic

"ince that time untold thousands of mariners and *hite land d*ellers have died *ith this dreaded disease "hortly %efore our arrival in Northern Canada a *hite prospector had died of scurvy Beside him *as his *hite manBs pac/et of canned foods Any (ndian man or *oman! %oy or girl! could have told him ho* to save his life %y eating animal organs or the %uds of trees Another illustration of the *isdom of the native (ndians of that far north country came to me through t*o prospectors *hom *e rescued and %rought out *ith us Aust %efore the fall free6e>up They had gone into the district! *hich at that time *as still uncharted and unsurveyed! to prospect for precious metals and radium They *ere %oth doctors of engineering and science! and had %een sent *ith very ela%orate e?uipment from one of the large national mining corporations )*ing to the inaccessi%ility of the region! they adopted a plan for reaching it ?uic/ly They had flo*n across the t*o ranges of mountains from Alas/a and *hen they arrived at the inside range! i e ! the &oc/y Mountain &ange! they found the altitude so high that their plane could not fly over the range! and! as a result! they *ere %rought do*n on a little la/e outside The plane then returned %ut *as una%le to reach the outside *orld %ecause of shortage of fuel The pilot had to leave it on a *ater*ay and trudge over the mountains to civili6ation The t*o prospectors undertoo/ to carry their e?uipment and provisions over the &oc/y Mountain &ange into the interior district *here they *ere to prospect They found the distance across the plateau to %e a%out one hundred miles and the elevation ranging up to nine thousand feet While they had provisions and e?uipment to stay t*o years they found it *ould ta/e all of this time to carry their provisions and instruments across this plateau They accordingly a%andoned everything! and rather than remain in the country *ith very uncertain facilities and prospects for o%taining food and shelter! made a forced march to the 1iard &iver *ith the hope that some e4pedition might %e in that territory )ne of the men told me the follo*ing tragic story While they *ere crossing the high plateau he nearly *ent %lind *ith so violent a pain in his eyes that he feared he *ould go insane (t *as not sno* %lindness! for they *ere e?uipped *ith glasses (t *as 4eropthalmia! due to lac/ of vitamin A )ne day he almost ran into a mother gri66ly %ear and her t*o cu%s #ortunately! they did not attac/ him %ut moved off +e sat do*n on a stone and *ept in despair of ever seeing his family again As he sat there holding his thro%%ing head! he heard a voice and loo/ed up (t *as an old (ndian *ho had %een trac/ing that gri66ly %ear +e recogni6ed this prospectorBs plight and *hile neither could understand the language of the other! the (ndian after ma/ing an e4amination of his eyes! too/ him %y the hand and led him to a

stream that *as coursing its *ay do*n the mountain +ere as the prospector sat *aiting the (ndian %uilt a trap of stones across the stream +e then *ent upstream and *aded do*n splashing as he came and thus drove the trout into the trap +e thre* the fish out on the %an/ and told the prospector to eat the flesh of the head and the tissues %ac/ of the eyes! including the eyes! *ith the result that in a fe* hours his pain had largely su%sided (n one day his sight *as rapidly returning! and in t*o days his eyes *ere nearly normal +e told me *ith profound emotion and gratitude that that (ndian had certainly saved his life No* modern science /no*s that one of the richest sources of vitamin A in the entire animal %ody is that of the tissues %ac/ of the eyes including the retina of the eye (n Chapter ,: ( refer to the *or/ of Wald on studies of vitamin A tissues +e states that e4tracts of eye tissue Hretina! pigment! epithelium! and choroidI sho* the characteristic vitamin A a%sorption %and and that they are potent in curing vitamin A deficient rats +e sho*s also that the concentration of vitamin A is constant for different mammals ( have %een impressed to find that primitive racial stoc/s in various parts of the *orld are familiar *ith the fact that eyes constitute an invalua%le adAunct for nutrition Even the one time canni%als of the #iAi (slands! and the hereditary /ing of the #iAi (slands! told me in detail of the practices *ith regard to the use of eyes as an adAunct to diet The chief! his father! and grandfather had the privilege of reserving the eyes of captives for their personal use When among the natives of the islands north of Australia! ( learned to enAoy greatly fish head soup made from certain selected tissues After the fish had %een cleaned the heads *ere split and the eyes left in The space of the entire %oo/ might %e used for discussing the nutritional *isdom of the various primitive races (t is a pity that so much of their *isdom has %een lost through lac/ of appreciation %y the *hites *ho early made contact *ith them )eferences , "+E&MAN! + C Chemistry of #oods and Nutrition Ne* Yor/! Macmillan! ,2-5 B(11"! C E Ne* #orms and "ources of =itamin D .#A#M#A#, ,;:@,5! ,2-9! !trition Abstra$ts and "evie0s, ,2-: - 1AW")N! A and M))N! + P A clay adAunct to potato dietary at!re, ,.,@ .;! ,2-:

&eport Council on #oods Nutritional value of spinach .#A#M#A#, ,;2@,2;9! ,2-9 7 C)##(N! D 1ac/ of vitamin D in common foods .# Am# 'ietet# A#, ,,@,,2! ,2-7 8 GEMP! W N The sources of clinical importance of the vitamins ,!ll# 4an$o!ver Med# A#, Dec ! ,2-9
.

Chapter 1& Primitive control of dental caries T+E essential differences in the diets of the primitive races and those of the moderni6ed groups have %een discussed in the preceding chapter We are concerned no* *ith discovering *hether the use of foods! *hich are e?uivalent in %ody>%uilding and repairing material to those used %y the primitives *ill! *hen provided to our affected moderni6ed groups! prevent tooth decay or chec/ it *hen it is active There are t*o approaches to this pro%lem of the control of tooth decay %y nutritional means )ne is %y the presentation of clinical results and the other %y the consideration of the characteristics of those nutritional programs *hich have %een successful in producing a high immunity to tooth decay We may divide the primitive racial stoc/s into groups! classified according to the physical environment in *hich they are living and the manner in *hich the environment largely controls their availa%le foods (t is significant that ( have as yet found no group that *as %uilding and maintaining good %odies e4clusively on plant foods A num%er of groups are endeavoring to do so *ith mar/ed evidence of failure The variety of animal foods availa%le has varied *idely in some groups! and %een limited among others (n the preceding chapter *e have seen that the successful dietaries included in addition to a li%eral source of minerals! car%ohydrates! fats! proteins! and *ater> solu%le vitamins! a source of fat>solu%le vitamins =itamin D is not found in plants! %ut must %e sought in an animal food The dietaries of the efficient primitive racial stoc/s may %e divided into groups on this %asis@ in the first place those o%taining their fatsolu%le activators! *hich include the /no*n fat>solu%le vitamins! from efficient dairy products This includes the "*iss in the high Alps! the Ara%s Husing camelBs mil/I! and the Asiatic races Husing mil/ of sheep and mus/ o4I (n the second place there are those using li%erally the organs of animals! and the eggs of %irds! *ild and

domesticated These include the (ndians of the far North! the %uffalo hunting Plains (ndians and the Andean tri%es (n the third place there are those using li%erally animal life of the sea These include Pacific (slanders and coastal tri%es throughout the *orld (n the fourth place there are those using small animals and insects These include the Australian A%origines in the interior! and the African tri%es in the interior Many of the a%ove groups use foods from t*o or more sources Each of the groups has provided an ade?uate ?uantity of %ody>%uilding material from %oth animal and plant tissues (t does not matter *hat the source of minerals and vitamins may %e so long as the supply is ade?uate (n our modern life! the location of a group *ill determine the most efficient and most convenient source for o%taining the essential foods Clearly! for those near the coast! the sea may %e most convenient! *hile for those in the interior or in the far North! dairy products or the organs of animals may %e the only availa%le source (t *ould %e fortunate indeed! if our pro%lems *ere as simple as this statement might indicate We have! ho*ever! in the first place! the need for a strength of character and *ill po*er such as *ill ma/e us use the things our %odies re?uire rather than only the foods *e li/e Another pro%lem arises from the fact that our modern sedentary lives call for so little energy that many people *ill not eat enough even of a good food to provide for %oth gro*th and repair! since hunger appeals are for energy only! the source of heat and po*er! and not for %ody>%uilding minerals and other chemicals "till another pro%lem confronts us! i e ! the sources of fatsolu%le activators indicated a%ove! namely@ dairy products! organs of animals and sea foods! may vary through a *ide range in their content of the fat>solu%le activators or vitamins! depending upon the nutrition availa%le for the animals Co*s fed on third grade hay! too lo* in carotene! not only cannot produce strong calves %ut their mil/ *ill not /eep healthy calves alive HChapter ,: I The 1eague of NationsB Committee on Nutrition has estimated the amount of pasture land re?uired per capita to provide ade?uate mil/ and meat )*ing to the density of population and cost of land near large cities! it is not possi%le to provide an ade?uate acreage for dairy cattle This results in stall feeding of shipped fodder )nly those co*s can %e /ept in a herd *hose production of mil/ and %utter fat can pay in volume for their /eep 3nfortunately mil/ may have a high cream line or %utter fat content and still %e lo* in essential fat> solu%le vitamins This constitutes an e4ceedingly important phase of our modern pro%lem Butter ships %est *hen hard and this ?uality can %e largely controlled %y the fodder given to the cattle and hence %ecomes an important factor in the *holesale %utter industry "ince ,259! ( have %een analy6ing

samples of dairy products! chiefly %utter! from several parts of the *orld for their vitamin content These samples are received every t*o to four *ee/s from the same places! usually for several years They all sho* a seasonal rise and fall in vitamin content The high level is al*ays associated *ith the use of rapidly gro*ing young plant food This tide in plant life! fluctuating *ith the seasons! controlled the migration of the %uffalo south*ard in the autumn and *inter and north*ard in the spring They moved at the rate of a%out t*elve miles per day! travelling *ith the sun in order to provide the highest>vitamin mil/ for the young calves %orn in the south No dou%t these tides in nutrition control also the migration of %irds By far the most efficient plant food that ( have found for producing the high>vitamin content in mil/ is rapidly gro*ing young *heat and rye grass )at and %arley grass are also e4cellent (n my clinical *or/ small additions of this high>vitamin %utter to other*ise satisfactory diets regularly chec/s tooth decay *hen active and at the same time improves vitality and general health "imilarly the value of eggs for providing fat>solu%le vitamins depends directly upon the food eaten %y the fo*l The fertility of the eggs also is a direct measure of the vitamin content! including vitamin E "ince the sea foods are! as a group! so valua%le a source of the fatsolu%le activators! they have %een found to %e efficient throughout the *orld not only for controlling tooth decay! %ut for producing a human stoc/ of high vitality 3nfortunately the cost of transportation in the fresh state often constitutes a factor limiting distri%ution Many of the primitive races preserved the food value! including vitamins! very efficiently %y drying the fish While our modern system of canning prevents decomposition! it does not efficiently preserve some of the fatsolu%le activators! particularly vitamin A "ince the organs! particularly the livers of animals! are storage depots of the vitamins an important source of some of the fat>solu%le activators can %e provided %y e4tracting the fat of the livers and shipping it as liver oils Modern methods of processing have greatly improved the ?uality of these oils There are some factors! ho*ever! *hich can %e provided to great advantage for humans from dairy products of high efficiency ( have sho*n in the preceding chapter the ?uantities of several of the minerals that are essential in suita%le chemical form to maintain an adult in good health and ma/e possi%le tissue repair The dietaries of the various primitive groups have all %een sho*n to have a mineral content several times higher than that *hich o%tains in the inade?uate food eaten %y moderni6ed primitives and the people of our moderni6ed cultures

Modern commerce has deli%erately ro%%ed some of natureBs foods of much of their %ody>%uilding material *hile retaining the hunger satisfying energy factors #or e4ample! in the production of refined *hite flour appro4imately eighty per cent or four>fifths of the phosphorus and calcium content are usually removed! together *ith the vitamins and minerals provided in the em%ryo or germ The evidence indicates that a very important factor in the lo*ering of reproductive efficiency of *omanhood is directly related to the removal of vitamin E in the processing of *heat The germ of *heat is our most readily availa%le source of that vitamin (ts role as a nutritive factor for the pituitary gland in the %ase of the %rain! *hich largely controls gro*th and organ function! apparently is important in determining the production of mental types "imilarly the removal of vitamin B *ith the em%ryo of the *heat! together *ith its o4idation after processing! results in depletion of %ody>%uilding activators &efined *hite sugar carries only negligi%le traces of %ody>%uilding and repairing material (t satisfies hunger %y providing heat and energy %esides having a pleasant flavor The heat and energy producing factors in our food that are not %urned up are usually stored as fat (n the preceding chapter *e have seen that appro4imately half of the foods provided in our modern dietaries furnish little or no %ody>%uilding or repairing material and supply no vitamins Appro4imately 57 per cent of the heat and energy of the American people is supplied %y sugar alone *hich goes far in th*arting NatureBs orderly processes of life This per capita use is unfortunately on the increase Therefore *e must %egin %y radically reducing the foods that are so deceptive! and often inAurious in overloading the system Even this much change in our modern nutrition *ill raise the factor of safety sufficiently to chec/ tooth decay in a large percentage of people (t *ill not! ho*ever! %e ade?uate for most children in *hom the additional demands of rapid gro*th must %e satisfied ( have found the highest incidence of tooth decay in the high school and %oarding school girls! and the ne4t in the %oarding school %oys These groups suffer even more than the child%earing mothers (n discussing the technical aspects later ( shall consider the defensive factors in the saliva as controlled %y the nutrition through the %lood stream! and also the role of oral prophyla4is (t is appropriate at this point to note some characteristics of a decaying tooth The process of tooth decay never starts from *ithin %ut al*ays from *ithout and is most li/ely to start at the contact points %et*een the teeth or in the pits and grooves! especially *hen these are incompletely formed Teeth never have caries *hile they are covered *ith flesh %ut decay most easily soon after

eruption! *hen conditions are unfavora%le (f the saliva is normal the surfaces of the teeth progressively harden during the first year after eruption While there are many theories regarding the relative importance of different factors in the process of decay practically all provide for a local solution of the tooth su%stance %y acids produced %y %acteria The essential difference in the various theories of tooth decay is the difference in theories relative to the control of these decalcifying organisms! and relative to their ?uantity and activity The dental profession has %een *aiting for decades for this ?uestion to %e solved %efore ta/ing active steps to prevent the *hole process The primitive approach has %een to provide a program that *ill /eep the teeth *ell! that is! prevention of dental caries %y ade?uate food com%inations ( have Aust stated that teeth harden after eruption if the saliva is normal This occurs %y a process of minerali6ation much li/e the process %y *hich petrified *ood is produced The tooth is made up of four structures The first is the pulp *ithin! *hich carries %lood vessels and nerves This structure is surrounded in %oth the root and cro*n %y the dentine or tooth %one *hich is nourished from *ithin The dentine of the root is covered %y cementum *hich receives nourishment from the mem%rane *hich attaches the root to the Aa* %one The dentine of the cro*n or e4posed part of the tooth is covered *ith enamel Tooth decay proceeds slo*ly through the enamel and often rapidly in the dentine! al*ays follo*ing the minute channels to*ard the pulp! *hich may %ecome infected %efore the decay actually reaches the pulp to e4pose itF nearly al*ays the decay infects the pulp *hen it destroys the dentine covering it When a tooth has a deep cavity of decay! the decalcified dentine has a%out the density of rotten *ood With an ade?uate improvement in nutrition! tooth decay *ill generally %e chec/ed provided t*o conditions are present@ in the first place! there must %e enough improvement in the ?uality of the salivaF and in the second! the saliva must have free access to the cavity )f course! if the decay is removed and a filling placed in the cavity! the %acteria *ill %e mechanically shut out )ne of the most severe tests of a nutritional program! accordingly! is the test of its po*er to chec/ tooth decay completely! even *ithout fillings There are! ho*ever! t*o further tests of the sufficiency of improvement of the chemical content of the saliva (f it has %een sufficiently improved! %acterial gro*th *ill not only %e inhi%ited! %ut the leathery decayed dentine *ill %ecome minerali6ed from the saliva %y a process similar to petrification Note that this minerali6ed dentine is not vital! nor does it increase in volume and fill the cavity When scraped *ith a steel instrument it fre?uently ta/es on a density li/e very hard *ood and occasionally ta/es even a glassy surface When such a tooth is placed in silver nitrate! the chemical does not penetrate this deminerali6ed dentine! though it does rapidly penetrate the decayed dentine of a tooth e4tracted *hen

decay is active This process is illustrated in #ig 28 *hich sho*s t*o deciduous teeth e4tracted from the same child! one %efore! and the other a fe* months after improving the nutrition These deciduous molars *ere replaced %y the %icuspids of the second dentition The tooth at the left had deep caries and *as removed %efore the treatment *as %egun Note that the silver nitrate has %lac/ened the tissue to the depth of the decay The tooth at the right *as removed a%out three months after the nutrition *as changed Note that the decayed dentine is so dense that the silver nitrate has not penetrated deeply and discolored it

FI". 9/. A+ illustrates the #ermeability of decayed dentin to silver nitrate. B+ illustrates the decreased #ermeability of decayed dentin to silver nitrate due to minerali*ation+ after saliva has been im#roved by correcting the nutrition.

There is still another test that demonstrates NatureBs protective mechanisms )rdinarily! *hen the pulp of a tooth is e4posed %y dental caries! the pulp %ecomes not only infected! %ut dies opening up a high*ay of infection direct from the infected mouth to the inside of the fort at the end of the root )ne e4pression of this is a dental a%scess! the e4istence of *hich is usually un/no*n to the individual for sometime and the infecting germs pass more or less freely throughout the %ody %y *ay of the %lood stream and lymph channels This infection may start the degeneration of organs and tissues of other parts of the %ody Among some of the primitive races! *hose nutritional programs provided a very high factor of safety! even though the teeth *ere *orn do*n to the gum

line and into *hat *as formerly the pulp cham%er! the pulp *as not e4posed Nature had %uilt a protecting 6one! not in the cavity of the tooth in this case! %ut *ithin the pulp cham%er This entirely %loc/ed off a threatened e4posure and /ept the *alls of the fort sealed against %acteria This process does not occur in many instances in people of our modern civili6ation Pulp cham%ers that are opened %y *ear provide e4posed pulp *hich %ecomes infected *ith su%se?uent a%scess formation (f a reinforced nutrition as efficient as that of many of the primitive races! is adopted! the pulp tissue *ill seal up the opening made %y decalcification of the dentine! %y %uilding in a ne* layer of normal dentine *hich is vital and ?uite unli/e the petrified decay e4posed to the saliva! thus completely *alling off the impending danger This is illustrated in #ig 29 *ith three cases At the left are sho*n 4>rays of teeth of three children in one of my e4perimental clinics in a poor district in Cleveland The pulp cham%ers and pulp tissues of the root canals are sho*n as dar/ strea/s in the center of the tooth The very large cavities *hich had decalcified the tooth to the pulp cham%er are sho*n as large dar/ areas in the cro*n Temporary fillings had to %e placed %ecause of pain produced %y the pressure of food on the pulp %elo* the decayed dentine After the nutrition *as improved! the tissues of the pulp %uilt in secondary dentine thus reincasing itself in a closed cham%er This process is sho*n in each of the three cases presented in #ig 29! in the vie*s to the right

FI". 93. $hree cases that illustrate how nature can close an e,#osure of the #ul# due to dental caries

by building a #rotecting wall within the #ul# chamber when the nutrition is ade(uately im#roved.

3nder the stress of the industrial depression the family dietary of the children sho*n in #ig 29 *as very deficient They *ere %rought to a mission *here *e fed them one reinforced meal at noon for si4 days a *ee/ The home meals *ere not changed nor the home care of the teeth The preliminary studies of each child included complete 4>rays of all of the teeth! a chemical analysis of the saliva! a careful plotting of the position! si6e and depth of all cavities! a record of the height! and *eight! and a record of school grades! including grades in deportment These chec/s *ere repeated every four to si4 *ee/s for the period of the test! usually three to five months (t is important to note that the home nutrition *hich had %een responsi%le for the tooth decay *as e4ceedingly lo* in %ody %uilding and repairing material! *hile temporarily satisfying the appetite (t usually consisted of highly s*eetened strong coffee and *hite %read! vegeta%le fat! panca/es made of *hite flour and eaten *ith syrup! and doughnuts fried in vegeta%le fat The nutrition provided these children in this one meal included the follo*ing foods A%out four ounces of tomato Auice or orange Auice and a teaspoonful of a mi4ture of e?ual parts of a very high vitamin natural cod liver oil and an especially high vitamin %utter *as given at the %eginning of the meal They then received a %o*l containing appro4imately a pint of a very rich vegeta%le and meat ste*! made largely from %one marro* and fine cuts of tender meat@ the meat *as usually %roiled separately to retain its Auice and then chopped very fine and added to the %one marro* meat soup *hich al*ays contained finely chopped vegeta%les and plenty of very yello* carrotsF for the ne4t course they had coo/ed fruit! *ith very little s*eetening! and rolls made from freshly ground *hole *heat! *hich *ere spread *ith the high>vitamin %utter The *heat for the rolls *as ground fresh every day in a motor driven coffee mill Each child *as also given t*o glasses of fresh *hole mil/ The menu *as varied from day to day %y su%stituting for the meat ste*! fish cho*der or organs of animals #rom time to time! there *as placed in a t*o ?uart Aar a helping similar to that eaten %y the children This *as %rought to my la%oratory for chemical analysis! *hich analysis sho*ed that these meals provided appro4imately , .: grams of calcium and , 5: grams of phosphorus in a single helping of each course "ince many of the children dou%led up on the course! their inta/e of these minerals *as much higher ( have sho*n in the preceding chapter that the accepted figures for the re?uirements of the %ody for calcium and phosphorus are ; 8: grams of calcium and , -5 grams of phosphorus (t is o%vious that this one meal a day plus the other t*o meals at home provided a

real factor of safety Clinically this program completely controlled the dental caries of each mem%er of the group The chemical analysis of the saliva H,! 5I revealed a mar/ed improvement *hich progressively increased At the %eginning of the test the average for the group sho*ed a very lo* factor of safety! so lo* that *e should e4pect tooth decay to %e active (n si4 *ee/s the average changed to a condition *hich *e should e4pect *ould %e accompanied %y a cessation of tooth decay The saliva factor of safety continued to improve for five months at *hich time the special program *as discontinued for the summer "everal incidents of special interest occurred T*o different teachers came to me to in?uire *hat had %een done to ma/e a particular child change from one of the poorest in the class in capacity to learn to one of the %est Dental caries is only one of the many e4pressions of our modern deficient nutritions ( have referred to the importance of a high vitamin %utter for providing the fat>solu%le activators to ma/e possi%le the utili6ation of the minerals in the foods (n this connection! it is of interest that %utter constitutes the principal source of these essential factors for many primitive groups throughout the *orld (n the high mountain and plateau district in northern (ndia! and in Ti%et! the inha%itants depend largely upon %utter made from the mil/ of the mus/ o4 and the sheep for these activators The %utter is eaten mi4ed *ith roasted cereals! is used in tea! and in a porridge made of tea! %utter and roasted grains (n "udan Egypt! ( found considera%le traffic in high vitamin %utter *hich came from the higher lands a fe* miles from the Nile Basin This *as %eing e4changed for and used *ith varieties of millet gro*n in other districts This %utter! at the temperature of that area! *hich ranged from 2;O to ,,;O #ahrenheit! *as! of course! al*ays in li?uid form (ts %rilliant orange color testified to the splendid pasture of the dairy animals The people in "udan! including the Ara%s! had e4ceptionally fine teeth *ith e4ceedingly little tooth decay HChapter 2I The most physically perfect people in northern (ndia are pro%a%ly the Pathans *ho live on dairy products largely in the form of soured curd! together *ith *heat and vegeta%les The people are very tall and are free of tooth decay Pro%a%ly every house*ife is familiar *ith the lo* melting ?uality of the %utter produced in early summer *hen the co*s have %een put on the green pastures This is particularly true of %utter that has the grassy flavor and the deep yello* to orange color This %utter is usually several times as high in fat> solu%le activators including vitamins A and D as %utter produced from stall fed cattle or cattle on poorer pasturage (n Chapter ,7! ( have e4plained *hy this

%utter is not favora%le for shipping and *hy dairymen so fre?uently give the co*s a ration that *ill produce less of these ?ualities )ne of the principal foods used for accomplishing this is made of cotton seed meal and cereals There are many illustrations of the lo* efficiency of this type of fodder for providing vitamins essential for dairy products (n one of the recent severe droughts in the Mississippi =alley several thousand cattle *ere shipped to )hio for *ater and green pasture as a means of saving their lives They *ere fed enroute on concentrates said to consist of cotton seed meal and grain Professor )scar Erf of the Department of Dairying of )hio "tate 3niversity has given me the follo*ing detailed information@ With reference to the cattle from the south>*estern and central>northern states of the drought area *hich *ere %rought into )hio in the fall of ,2-7 on a 8;; acre farm north of Dela*are! *ill say that ( had the privilege of vie*ing some of these cattle previous to the time that they *ere %rought to )hio in ,2-7 Because of the e4treme drought period and the hot sun! it *as rare to see green grass on the prairies The sedges *ere nearly all dried up The tum%le*eed *as a%out the only thing that *as availa%le for the cattle in some instances The corn *as dried up and very little green *as in evidence (n the particular location that ( *as in *e found the cattle suffering terri%ly Many had infected eyes There *ere a good many deaths on the plains *hich *ere literally dried up "ometimes there *as even a small amount of decomposition after death (n the fall! those that survived on the plains! *ere loaded up and driven to the corrals! loaded into cars and sent east )nly the good ones *ere loaded and even a large num%er of these passed out in transit ( *as informed that the crop of grass the year %efore *as very scant Conse?uently! a large num%er of calves *ere %orn *ith *ea/ eyes and these *ere the early ones to pass out on the plains The lo* vitality of the individuals *hich ( considered *as due to the lac/ of vitamin A or the green grass factors *as the cause of the serious infection! ho*ever their %eing secondary to the primary cause The first train load of the t*enty>eight hundred cattle that *ere %rought to this ranch *ere fed on green corn stal/s There *as a nine acre patch of corn in this area The fences *ere ta/en do*n one afternoon at - oBcloc/ and %y 2 oBcloc/ there *as no evidence of stu%%les or roots This had all %een eaten in a very short space of time We had ?uite a time getting hays and green stuff *hich *e demanded %ecause of its carotin content and its green grass factor

There *as not enough grass availa%le in the %eginning so *e had to %uy a%out .;; tons of hay a day to /eep the animals fed They got no grain of any /ind %ecause it *as a ?uestion of %ringing the cattle to a more or less normal condition *ith no intention of fattening the animals After they had made arrangements for feeding operations and made feed rac/s in sufficient num%ers! *e *ent over the herd to estimate the num%ers that *ere %lind and had sore eyes! *hich ( assume from past e4perience! *as due to a vitamin A deficiency As near as *e can estimate! nearly : ,5 animals *ere affected H52 per centI There *ere ,79 calves %orn and appro4imately 7; per cent *ere deformed and not normal We did not get the complete figures %ut they pro%a%ly ranged a little higher than that The *orst infected co*s *ere calves and animals that *ere ,: to 5; months old ( could not get the story of these individuals %ut they must have %een in the area of dry grass for 5 years There *as a slight improvement in those that *ere not seriously infected after they *ere fed here They improved decidedly in )cto%er and Novem%er and *ere practically all slaughtered %efore the middle of Decem%er The mil/ of these vitamin deficient co*s *ould not properly nourish either their calves or human %eings Many children have tooth decay even *hile using *hole mil/! in part %ecause the mil/ is too lo* in vitamin content! due to the inade?uacy of the food given the co*s The means for improving this condition have %een discussed in Chapter ,7 "ome of the current theories of the chemistry of tooth decay place the responsi%ility on the local condition in the mouth as affected %y the contri%uting factors provided %y sugars and starches *hich enhance the gro*th of acid producing organisms A phase of this has %een closely related to the slogan that a clean tooth cannot decay Among the difficulties in applying this interpretation is the physical impossi%ility of /eeping teeth %acteriologically clean in the environment of the mouth Another difficulty is the fact that many primitive races have their teeth smeared *ith starchy foods almost constantly and ma/e no effort *hatsoever to clean their teeth (n spite of this they have no tooth decay (n many of the primitive groups that ( have studied the process of moderni6ation includes teaching oral hygiene and prophyla4is Yet! even *ith the addition of this important adAunct to health! they have in most cases lost their immunity to tooth decay and dental caries has %ecome active This *ill %e seen in many of the illustrations of the primitive races in the preceding chapters )f course everyone should clean his teeth! even the primitives! in the interest of and out of consideration for others

(n my clinical *or/ ( have sought for e4treme cases of active tooth decay in order to test the primitive *isdom Many of these cases have %een furnished %y mem%ers of the dental profession in other cities and states By the simple procedure of studying the nutrition of the individual! o%taining a sample of saliva for analysis! seeing 4>rays of the individualBs teeth and supporting %one! and getting a history of the systemic overloads! ( have %een a%le to outline a nutritional program *hich! in *ell a%ove 2; per cent of the cases has controlled the dental caries (mprovement in the condition of the teeth has %een confirmed %y later 4>rays and reports %y the patientsB dentists (n a fe* cases *here ( had contact *ith the patients only through correspondence the cooperation *as not ade?uate for accomplishing complete improvement While it is true that there is a mar/ed difference in the suscepti%ility of different individuals to dental caries! even those *ho *ould ordinarily %e classed as highly suscepti%le! have generally received permanent %enefit from the treatment These principles of treatment have no* %een applied to many hundreds of patients as indicated %y the fact that over 5!:;; chemical analyses of the saliva have %een made The dietary programs that have %een recommended have %een determined on the %asis of a study of the nutrition used %y the patient! the data provided %y the 4>rays! from the saliva analysis and case history The diets have %een found to %e deficient in minerals! chiefly phosphorus #at>solu%le vitamins have %een deficient in practically every case of active tooth decay The foods selected for reinforcing the deficient nutritions have al*ays included additional fatsolu%le vitamins and a li%eral source of minerals in the form of natural food +uman %eings cannot a%sor% minerals satisfactorily from inorganic chemicals $reat harm is done! in my Audgment! %y the sale and use of su%stitutes for natural foods )ne of our greatest difficulties in underta/ing to apply the *isdom of the primitives to our modern pro%lems involves a character factor The (ndians of the high Andes *ere *illing to go hundreds of miles to the sea to get /elp and fish eggs for the use of their people Yet many of our modern people are un*illing to ta/e sufficient trou%le to o%tain foods that are competent to accomplish the desired results Do%%ers and middlemen as *ell as supply depot managers *ant %utter sold in accordance *ith its la%el rather than in accordance *ith its vitamin content )ne large distri%utor *hom ( as/ed to cooperate %y maintaining a stoc/ of high>vitamin %utter to *hich ( could refer people! told me fran/ly that he *ished ( *ould stop telling people a%out the difference in the vitamins in %utter +e did not *ish them to thin/ of %utter in terms of its vitamin content

Another large concern told me that *hen ( had *or/ed up a sufficiently large mar/et they *ould %ecome interested in supplying the demand ( counsel people to put in storage some of that %utter *hich has the grassy flavor and *hich melts easily and is produced *hen the co*s go onto the rapidly gro*ing young grass 3nfortunately! co*s that have %een on a sta%le fodder lo* in carotene and under the stress of gestation often are so depleted in their o*n %ody vitamins that it ta/es them three or four *ee/s to replenish their o*n %odies *hen they get on good pasture Then the vitamins *ill appear in li%eral ?uantity in their mil/ This has made it necessary for me to assist many patients in o%taining a supply %y analy6ing %utter for its vitamin content and then putting this material in storage and ma/ing it availa%le for special cases as needed The program that ( have found most efficient has %een one *hich includes the use of small ?uantities of very high vitamin %utter mi4ed in e?ual parts *ith a very high vitamin cod liver oil A simple method of preparing the %utter is %y melting it and allo*ing it to cool for t*enty>four hours at a temperature of a%out 9;O # ! then centrifugali6ing it *hich provides an oil that remains li?uid at room temperature When this %utter oil is mi4ed in e?ual parts *ith a very high>vitamin cod liver oil! it produces a product that is more efficient than either alone (t should %e used *ithin a couple of *ee/s of the time it is mi4ed (t is desira%le that this material %e made availa%le in various parts of the country Even the high>vitamin %utter produced on the early summer gro*th of grass put in storage and used during the *inter *ill go far to*ard solving our great national pro%lem of shortage of fat>solu%le vitamins The ?uantity of the mi4ture of %utter oil and cod liver oil re?uired is ?uite small! half a teaspoonful three times a day *ith meals is sufficient to control *ide>spread tooth decay *hen used *ith a diet that is lo* in sugar and starches and high in foods providing the minerals! particularly phosphorus A teaspoonful a day divided %et*een t*o or three meals is usually ade?uate to prevent dental caries and maintain a high immunityF it *ill also maintain freedom from colds and a high level of health in general This reinforcement of the fat>solu%le vitamins to a menu that is lo* in starches and sugars! together *ith the use of %read and cereal grains freshly ground to retain the full content of the em%ryo or germ! and *ith mil/ for gro*ing children and for many adults! and the li%eral use of sea foods and organs of animals! produced the result descri%ed ( have previously reported H-I seventeen cases of e4tensive dental caries (n these patients there *ere found 5-9 open cavities of apparently active caries Most of the individuals *ere %et*een t*elve and t*enty years of age and accordingly had t*enty>eight permanent teeth each! or a total of .98 (t *ill %e

noted that if one cavity is allo*ed per tooth! appro4imately half of the total num%er of teeth *ere affected! or precisely .2 9 per cent of all the teeth had open cavities This group includes only persons of *hom ( have %een ma/ing critical e4amination every si4 to t*elve months over a three>year period (n practically all cases! &oentgen>ray e4aminations *ere made in addition to clinical e4aminations of the teeth While these persons have %een on the reinforced nutritional program during the *inter and spring months of the past three years! only t*o ne* cavities have developed in the group! or ; . per cent The length of time during *hich the cavities previously found had %een developing is not /no*n %eyond the fact that all of the patients *ere receiving fre?uent and thorough dental service! most of them t*ice a year and many of them more fre?uently (t is accordingly pro%a%le that the cavities found had developed in less than a year That dental caries *as not a ne* pro%lem *ith these persons *as indicated %y the very e4tensive and numerous dental restorations that had %een made in their mouths (t is! therefore! apparent that 57; times as many cavities developed in the period preceding the starting of the nutritional program as in the three years follo*ing its adoption (f these data *ere reduced to a yearly %asis! the comparison *ould sho* a much *ider variation (n a group of fifty persons! including the a%ove mentioned seventeen! *ho had %een on the special nutritional program for from one to si4 years! most of them three years or more! only t*o ne* cavities developed Allo*ing these persons to have an average of t*enty>eight teeth per person! or a total of ,!.;; teeth! this *ould represent an incidence of dental caries in a period of three years of ; ,. per cent (n this group of fifty! there are many instructive and stri/ing cases #or e4ample! + # did not have a single cavity from )cto%er! ,2-5! to Dune! ,2--! *hile ta/ing additional vitamins and high mineral foods #rom Dune! ,2--! to May! ,2-.! *hile not ta/ing the special vitamins! she developed ten ne* cavities " G ! prior to ,2-, had rampant tooth decay *ith pulps nearly e4posed in all first permanent molars The remaining deciduous teeth had %een reduced to shells "he *as on the special nutritional program from Decem%er! ,2-,! to Dune! ,2-5! during *hich time caries *as completely arrested "he discontinued ta/ing special oil in Dune! ,2-5! and did not ta/e it again until )cto%er! ,2--! during most of *hich time she *as ta/ing viosterol under a physicianBs prescription to prevent dental caries "he came in )cto%er! ,2--! *ith fourteen ne* cavities "he *as immediately placed again on the special

program! from )cto%er! ,2--! to May! ,2-. During this period! the dental caries *as completely under control During the time that she *as not on the special program! there developed on many of the surfaces of the permanent teeth *hite patches of decalcifying enamel 3nder the reinforced nutritional program! these largely disappeared! and those that did not regain their translucency turned dar/ Among the group of seventeen D + ! sent in from another city! had thirty> eight open cavities in Dune! ,2- , (n addition to active caries! he had ?uite distur%ing heart symptoms! *hich curtailed his activity! and he also had a mar/ed sense of lassitude and *eariness +e has %een on the reinforced nutritional program during the fall! *inter and spring of each year since that time During this time! he has not developed a single ne* cavity The density of all the teeth has progressively improved as evidenced %y &oentgen>ray records +is physical condition has %een greatly improved so that he is a%le to carry on his college activities and heavy outside *or/ to earn money to maintain his college e4penses +e is not conscious of a heart limitation When as/ed *hat the principal change *as that he had noticed! he said that in addition to not feeling tired! he *as more rested *ith si4 hoursB sleep than formerly *ith ten hoursB A W had thirty>t*o ne* cavities in the t*o years previous to %eginning the special nutritional reinforcement "he continued this regularly during the *inter and spring months for three years and has not had a single ne* cavity since that time (n a group of children *hose mothers had the special nutritional reinforcement during gestation and lactation and *ho had %een provided *ith the same dietary adAuncts during the *inter and spring months of infancy and early childhood! not a single carious cavity has developed A num%er of these children are no* in pu%lic schools Their physical development is distinctly a%ove that of the average children of their age! as is also their efficiency in school *or/ (t is important that ( emphasi6e here some dangers that are not usually recogni6ed or properly emphasi6ed in the literature When fish oils including cod liver oils are given in too large doses to some patients they e4perience ?uite definite symptoms of depression The availa%le evidence indicates that fish oils that have %een e4posed to the air may develop to4ic su%stances My *or/ and that of others *ith e4perimental animals has demonstrated that paralysis can %e produced readily %y over>dosing "erious structural damage can %e done to hearts and /idneys ( have reported this in considera%le detail H.I My

investigations have sho*n that *hen a high vitamin natural cod liver oil is used in conAunction *ith a high vitamin %utter oil the mi4ture is much more efficient than either alone . This ma/es it possi%le to use very small doses E4cept in the late stages of pregnancy ( do not prescri%e more than half a teaspoonful *ith each of three meals a day This procedure appears to o%viate completely the undesira%le effects As stated else*here fish oils should %e stored in small containers to avoid e4posure to the air &ancid fats and oils destroy vitamins A and E! H7I the former in the stomach H8I ( am fre?uently reminded that ancient s/ulls are often found *ith e4tensive dental caries thus disproving that the primitive groups *ere more free from dental caries than the modern groups (t must %e /ept in mind that the fundamental la*s of Nature have %een in operation as long as animals and men have %een on the earth (n my investigations among primitive races! ( have %een concerned particularly *ith the study of changes that have ta/en place %oth in immunity to dental caries and in the environment! including the foods used (t has %een important that ( find large groups *ith relatively high immunity to dental caries to %e used as controls There is great need! accordingly! that additional data %e provided #ortunately! this need is %eing met There have Aust come to my des/ t*o interesting reportsF one! from Dr Arne +oygaard H9I and the other from Dr P ) Pedersen H:I These t*o distinguished scientists have spent a year in East $reenland among the Es/imos in that very %arren and isolated region The percentage of teeth found attac/ed %y dental caries among the isolated Es/imos of East $reenland is e4ceedingly lo*! less than , per cent Where the Es/imos *ere in contact *ith moderni6ed store foods at the port! tooth decay *as active The conditions *hich they have found *ere apparently not ?uite so favora%le as in the groups ( studied in Alas/a The $reenland Es/imos apparently are living in a more difficult environment The data provided %y these investigations are in accord *ith the data ( have o%tained among isolated Es/imos and other primitive racial stoc/s Eastern $reenland! %y international agreement! is administered %y the Danish $overnment and no one is permitted even to visit the coast of $reenland *ithout special permission This permission is very difficult to o%tain Even Danish citi6ens are not free to travel there We are! accordingly! very grateful to Dr +oygaard and Dr Pedersen for their contri%ution from studies made in that protected field We shall loo/ for*ard *ith interest to their detailed reports 3nfortunately! the pu%lic is very much at sea %ecause of the e4travagant claims that are made for many of the products advertised over the radio! in Aournals! and %y door to door solicitation A dependa%le and helpful %oo/let on the vitamin content of foods has %een pu%lished %y the 3nited "tates

Department of Agriculture! Miscellaneous Pu%lications! No 597 The fact should al*ays %e emphasi6ed that foods as Nature ma/es them have much more nutritional value than after they are processed so that insect life cannot live on them When foods cannot support insect life they cannot support human life A report has Aust appeared in the "eptem%er num%er of the Ne* <ealand Dental Dournal %y + + Toc/er on %ehalf of the +a*/es Bay Branch of the Ne* <ealand Dental Association in *hich he reports the results of the application of my suggestions in the +u/arere "chool for native Maori girls at Napier ( have reported my studies there in Chapter ,5 They used only one part of my suggestions for chec/ing the activity of dental caries The diet of %oth their control group and tested group *as the same e4cept for one item! i e ! 'one heaped teaspoonful t*ice daily of malt and cod liver oil ' (n a group of si4ty>si4 native girls the thirty>three *ith the %est teeth *ere used as a control group The remaining thirty>three *ere given the additional fat>solu%le vitamins (n si4 monthsB time Presistance of this group *as raised %y ., 97 per cent' as compared *ith the control group The nutrition of the test group *as not ade?uately reinforced to o%tain the %est results There *as a mar/ed inade?uacy of mineral carrying foods in proportion to the energy and heat providing factors in the foods An ade?uate ?uantity of such efficient foods should %e as readily availa%le today as %efore the *hite men came to Ne* <ealand (t is important to summari6e at this point some of the data that ( have developed in other chapters %ecause of their direct relation to the control of dental caries and other degenerative processes "ince human life li/e other animal life has %een developed in NatureBs la%oratory to fit NatureBs natural foods *e run a great ris/ *hen *e underta/e to modify seriously these foods Ba/ersB so>called *hole *heat %read is not compara%le to NatureBs foods that provide entire *heat and other cereals! %ecause of the factors that have %een removed from the *heat either mechanically or %y o4idation This is so large a pro%lem that ade?uate changes in the availa%le grain foods cannot %e made until there ,7 sufficient pu%lic demand to produce them through the normal channels of supply and demand (t is primarily a pro%lem for our #ederal and "tate governments Pac/aged foods containing dry cereals can undergo important changes! even *hile the material is %eing processed or *hile in pac/ages on the shelves The determinations of the loss of vitamins in pac/aged foods as reported in ,2-: %y the Agricultural E4perimental "tation of )/lahoma Agricultural and Mechanical College! reveal that a material loss

occurs in t*o *ee/sB time and a very serious loss in one to t*o monthsB time in certain stoc/ rations An important source of misapprehension is the literature and teachings of fadists "uch! for e4ample! as the misapprehension of many people that they must use only al/aline producing foods and that a great danger is associated *ith the use of acid producing foods (n the primitive races ( have found practically no difference %et*een the acid %alance meat diet of the isolated Es/imos of the far north and the less acid vegeta%le and mil/ diet of other groups as efficient factors in control of caries (t is important to /eep in mind that our %odies have a mechanism for maintaining proper acid and al/ali %alance in the %lood and this varies through only a very narro* limit *hether the %alance of the total food eaten is acid or al/aline (t is also important to have in mind that there are certain fat>solu%le vitamins provided in dairy products in ade?uate ?uantity that cannot all %e supplied in fish oils Also that overdosing *ith cod liver oil and other fish oils can %e definitely detrimental When pac/ages of cod liver oil are purchased from the trade the material should %e received in full containers not e4posed to air and *hen opened should %e transferred to small units so it is not progressively o4idi6ed during the period of its use The e4cess of calories over %ody %uilding minerals is e4ceedingly high in s*eets of various /inds regardless of their special %randing and the methods of manufacture and storage There is very little of the %ody %uilding minerals in maple syrup! cane syrup from sugar or honey They can all defeat an other*ise efficient dietary The pro%lem is not so simple as merely cutting do*n or eliminating sugars and *hite flour though this is e4ceedingly important (t is also necessary that ade?uate mineral and vitamin carrying foods %e made availa%le (t is also necessary to reali6e that many of our important foods for providing vitamins are very lo* in %ody %uilding material #or e4ample! one *ould have to eat nearly a %ushel of apples a day or half a %ushel of oranges to o%tain a li%eral factor of safety for providing phosphorusF similarly one *ould %e re?uired to eat nine and one half pounds of carrots or eleven pounds of %eets each day to get enough phosphorus for a li%eral factor of safety! *hile this ?uantity *ould %e provided in one pound of lentils or %eans! *heat or oats ( have discussed else*here the availa%ility of phosphorus depending upon its chemical form "ince the calories largely determine the satisfying of the appetite and since under ordinary circumstances *e stop *hen *e have o%tained a%out t*o thousand to t*enty>five hundred very little of the highly s*eetened fruits defeats our nutritional program We *ould have to consume daily the contents of thirty>t*o one pound Aars of marmalade! Aellies or Aams to

provide a t*o gram inta/e of phosphorus This ?uantity *ould provide -5!7;; caloriesF an amount impossi%le for the system to ta/e care of Mil/ is one of the %est foods for providing minerals %ut it may %e inade?uate in several vitamins )f all of the primitive groups studied those using sea foods a%undantly appear to o%tain an ade?uate ?uantity of minerals particularly phosphorus *ith the greatest ease! in part %ecause the fat>solu%le vitamins provided in the sea foods H%y *hich ( mean animal life of the seaI are usually high This ena%les a more efficient utili6ation of the minerals! calcium and phosphorus As ( study routinely the sample dietaries %eing used %y people suffering from dental caries! usually associated *ith other distur%ances! ( find large num%ers *ho are not getting in their food even half the minimum re?uirements of calcium! phosphorus and magnesium and iron and usually only a fraction of the minimum re?uirements of the fat>solu%le vitamins These latter have a role *hich in many respects is li/e the %attery of an automo%ile *hich provides the spar/ for igniting the fuel Even though the tan/ is filled *ith gasoline there is no po*er *ithout the igniting spar/ There are t*o programs no* availa%le for meeting the dental caries pro%lem )ne is to /no* first in detail all the physical and chemical factors involved and then proceed The other is to /no* ho* to prevent the disease as the primitives have sho*n and then proceed The former is largely the practice of the moderns The latter is the program suggested %y these investigations Availa%le data indicate that the %lood and saliva normally carry defensive factors *hich *hen present control the gro*th of the acid producing organisms and the local reactions at tooth surfaces When these defensive factors are not present the acid producing organisms multiply and produce an acid *hich dissolves tooth structure The origin of this protective factor is provided in nutrition and is directly related to the mineral content of the foods and to /no*n and un/no*n vitamins particularly the fat>solu%le Clinical data demonstrate that %y follo*ing the program outlined dental caries can %e prevented or controlled *hen active in practically all individuals This does not re?uire either permission or prescription %ut it is the inherent right of every individual A properly %alanced diet is good for the entire %ody )eferences
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T("DA11! # # and G&AME&! B Methods for the direct ?uantitative determination of sodium! potassium! calcium! and magnesium .# ,iol# Chem#, .:@,! ,25,

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7
8

9 :

G3TTNE&! T and C)+EN! + Micro colorimetric studies ( A moly%dic acid! stannous chloride reagent .# ,iol# Chem#, 97@ 7,9! ,259 P&(CE! W A Es/imo and (ndian field studies in Alas/a and Canada .# Am# 'ent# A#, 5-@.,9! ,2-8 P&(CE! W A Control of dental caries and some associated degenerative processes through reinforcement of the diet *ith special activators .# Am# 'ent# A#, ,2@,--2! ,2-5 MATT(11! + A The o4idative destruction of vitamins A and E .#A#M#A#, :2@,7;7! ,259 1EA"E! E D ! et al Destruction of vitamin A %y rancid fats .# !trition, ,8@79,! ,2-: +)Y$AA&D! A "ome investigations into the physiology and nasology of Es/imos from Angmagssli/ in $reenland )slo! Dy%*ad! ,2-9 PEDE&"EN! P ) (nvestigations into dental conditions of a%out -;;; ancient and modern $reenlanders 'ent# "e$#, 7:@,2,! ,2-: Chapter 1* 1ne origin of physical deformities

#ACE" are classified on the %asis of physical characteristics and appearances *hich identify them as having a common ancestry The constant reproduction of ancestral patterns constitutes one of the fundamental la*s of heredity We are concerned here *ith the divergences from the normal course of reproduction The precision *ith *hich Nature reproduces *idely distri%uted racial stoc/s demonstrates ho* deeply seated and controlling are the Mendelian la*s (n #ig 2: may %e seen four young men of the Melanesian race %orn on four different islands They have never seen each other! yet they loo/ li/e %rothers "imilarly! in #ig 22 are sho*n four Polynesian girls +ere again they loo/ so much ali/e that they might readily %e ta/en for sisters Yet! they live in four different groups of Polynesian islandsF the +a*aiian! the "amoan! the Tahitian! and the &arotongan

FI". 94. $hese four Belanesian boys born on different islands loo% li%e brothers but are not blood relations. $hey illustrate the role of heredity in re#roducing racial ty#e. 1eredity+ however+ can only o#erate normally when the germ cells have not been in@ured.

99. $hese four ?olynesian girls live on different islands and are not related though they loo% li%e sisters. $hey record their racial ty#e by undisturbed heredity.

The %lending of different racial stoc/s produces typical characteristics of either or %oth ancestral patterns When! ho*ever! mar/ed divergences appear *ithout mi4ing of racial stoc/s! the result is not due to heredity! %ut occurs in spite of heredity (n the previous chapters! ( have sho*n that in the moderni6ed groups of various primitive racial stoc/s! ccrtain individuals developed mar/ed changes in facial and dental arch form from the racial pattern We are interested to /no* the nature of the forces responsi%le for this distortion of the ancestral pattern (n a study of ,!598 s/ulls of the ancient civili6ations of Peru! ( did not find one *ith a typical divergence from normal such as *e find in modern *hites or in children of primitive racial stoc/s after the parents have adopted the foods of our modern civili6ation (t is important that *e study this phase in further detail (n #ig ,;; are sho*n t*o (ndian fathers and their sons! *hom *e studied in Peru The father and son sho*n a%ove lived at Talara! in a highly moderni6ed (ndian colony The father *or/ed in the oil fields on the coast This district is an arid desert into *hich practically all food has to %e shipped for the large colony engaged in the oil industry The father *as %orn *hile his parents *ere using the native foods of the coast! including an a%undance of sea foods The son *as %orn to his parents after they had adopted the foods of modern civili6ation The father and son sho*n %elo*! lived in the high "ierras The father is an (ndian descendant of the (ncas and *as %orn *hile his parents *ere living on the native dietary of the high plateau country! near Cu6co After the adoption of the modern foods %y the parents! the son sho*n to the right *as %orn (t is important to /eep in mind that the mar/ed change in these fathers and sons has occurred in the first generation after the parents have adopted the *hite manBs foods! and has occurred in spite of heredity

FI". 1<<. Disturbed heredity. Above+ father a #rimitive coastal Indian of ?eru with normal facial and dental arch develo#ment. Son at right #resents distortions of both facial and dental arch form. Below+ father a #rimitive Andean Indian with e,cellent facial and dental arch form. 1is son at right has not re#roduced the racial #attern. Both sons are full blood.

(n #ig ,;, a%ove is sho*n a Wa/am%a father in central Africa! a man *ho is *or/ing for the railroad company *hich contri%uted largely to the food supply for the la%orers The %oy sho*n at the right *as %orn after the parents had adopted the imported foods (n the lo*er picture! in #ig ,;,! is seen a #iAi (slander and his son The father *as %orn to parents living on the native foods! and his son *as %orn after the adoption of the *hite manBs foods All these are typical cases of the inhi%ition of NatureBs normal procedure We have additional data *hich indicate that our pro%lem is associated *ith a progressive lo*ering of reproductive capacity on the part of one or %oth of the parents

FI". 1<1. Disturbed heredity. Above+ the father is a #rimitive =a%amba of 8entral Africa. 1is son at right has not re#roduced the tribal #attern. Below+ the father #resents the ty#ical Fi@ian #rimitive facial and dental arch form. 1is son at right has a narrowed arch and change in facial form. Both sons are full blood.

(n photographing the mem%ers of moderni6ed families! regardless of racial stoc/s! *e fre?uently find that changes in facial e4pression appear in the younger mem%ers of the family This change in facial contour *ithin a family does not occur in the primitive races! *hile on their native dietary (n contrast *ith this *e see! in #ig ,;5! t*o sisters and t*o %rothers (n each pair there is a mar/ed change in the facial form of the younger The arches and the nostrils of the younger child are narro*er and there is a mar/ed lac/ of development in %oth the middle and lo*er thirds of the face

FI". 1<!. Disturbed heredity. Fuichua Indians. 'ote the mar%ed change in sha#e of the face and dental arches of the younger sister at the right. Also of the younger brother at the right. $hese families demonstrate a lowering of re#roductive ca#acity of the #arents with the later born children.

=ery stri/ing illustrations of this progressive degeneration in the children of a given family *ere found among the moderni6ed a%origines of Australia T*o vie*s of %rothers are sho*n in #ig ,;- HupperI The father and mother of these t*o %oys *ere %orn in the Bush They *ere living! *hen photographed! in one of the reservations! on the imported modern foods *hich *ere provided %y the government This is also illustrated in the lo*er photograph Note the mar/ed underdevelopment of the middle third of the face of the girl

FI". 1< . Disturbed heredity. $hese children are Australian Aborigines. 'ote the mar%ed change in facial and dental arch form in the younger child at the right in both families. $his is de#ressed re#roductive ca#acity of the #arents.

"tri/ing instances *ere fre?uently seen among the moderni6ed Maori of Ne* <ealand T*o sisters presenting t*o e4tremes of facial form are sho*n in the upper section of #ig ,;. The girl to the left is the older "he has the typical tri%al pattern *hich has %een completely lost in her younger sister to the right

FI". 1<). Above+ two Baori girls in 'ew Eealand and below+ two white girls in ?eru. 'ote the facial change in the girls at the right com#ared with their older sisters.

(f the change in facial form *ere the result of racial admi4ture! *e should not have the types of deformity patterns that these cases sho* (ndeed! in the same family *e should not find several different deformity patterns The lac/ of development do*n*ard of the upper anterior incisors and the %one supporting them is illustrated for the younger child! in #ig ,;- lo*er right (t *ill %e noted that *hen this girlBs molar teeth are in contact her front teeth still miss occluding %y a considera%le distance Mem%ers of the *hite race are affected in a similar manner (n #ig ,;. Hlo*erI are sho*n t*o sistersF the younger to the right reveals stri/ingly the lac/ of development of the middle and lo*er third of the face The fact that this condition so fre?uently sho*s a progressively severe inAury in the younger mem%ers of the family is a matter of great importance in tracing the causative factors (t is important to /eep in mind that *hen the inAury sho*s in the face of the young child it %ecomes *orse *hen the adult face forms This increase in deformity occurs at the time of the development of the permanent dentition! at from ten to fourteen years of age

(n the islands north of Australia *here contact *ith modern civili6ation is Aust %eing made! the adult individuals sho*ed a constant reproduction of the tri%al pattern! *hile those %orn since contact *as made! had many divergences from normal (n #ig ,;7 *ill %e seen a family of si4 individuals #our *ere %orn %efore the modern store *as put on that island and t*o after the parents had come into contact *ith the influence of the imported foods (t *ill %e seen that the four older %rothers sho* mar/ed uniformity of facial design! and that all have reproduced the tri%al pattern The t*o younger mem%ers sho* definite change in facial pattern This is also illustrated in #ig ,;8 a%ove! in *hich the oldest %rother *as %orn %efore the store *as put on Badu (sland! and the three younger! after the esta%lishment of the store t*enty>three years ago

FI". 1<-. 5f these si, brothers the four older were born on Badu Island before the white man>s store was established. $he two younger at right below+ after. 'ote change in facial form.

FI". 1</. Above+ the brother at the right was born before the store was #ut on Badu Island+ the three younger+ after. 'ote the change in facial form. Below+ note that the dental arches are too constricted to #rovide s#ace for the eru#ting cus#ids. $his boy is the one shown at the left in Figure 1<3.

This pro%lem of progressive degeneration in the younger mem%ers of the family is again illustrated %y the group sho*n in #ig ,;9 The older girl has reproduced the tri%al pattern of the race *ith normal %road! dental arches The second girl sho*s mar/ed narro*ing and lengthening of the face The third child! a %oy! sho*s very mar/ed divergence from the tri%al pattern This group is sho*n %elo* *ith their teeth e4posed (t *ill %e seen that the oldest girl has %road dental arches typical of NatureBs normal design The second girl has a mar/ed depression laterally in the molar and %icuspid region producing a narro*ing of the palate The third child has in addition to the narro*ing of the face a mar/ed deficiency in %one gro*th so that the cuspids %oth a%ove and %elo* are forced entirely outside the arch The total circumference as *ell as the %readth of the upper arch is so reduced that space is not availa%le for the cuspids They *ill %e seen im%edded high in the tissue! as illustrated in the lo*er picture of #ig ,;8

FI". 1<3. 'atives from islands north of Australia. Above+ note the #rogressive facial change in the younger sister and brother with lengthening and narrowing of the face and body. Below+ note the broad arches of the oldest girl at the right+ lateral de#ression of the bicus#ids and molars of the ne,t girl and inade(uate bone develo#ment of the boy>s face. $hese are on an island north of Australia.

#ig ,;: sho*s three *hite girl scouts in Ne* <ealand Note that progressive narro*ing of the %ody including %oth shoulders and hips has occurred in the younger mem%ers of the family This is also sho*n in #ig ,;9

FI". 1<4. =hite "irl Scouts+ 'ew Eealand. 'ote the #rogressive lengthening and narrowing of the face and narrowing of the hi#s in the younger girl at the left.

(t *ould %e remar/a%le if these distur%ances in the physical pattern *ere limited to the face and dental arches An illustration of other deficiency inAuries is sho*n in #ig ,;2! *hich sho*s three children in a moderni6ed Maori family (t *ill %e seen that *hile the oldest girl has the typical Maori racial pattern of face! there is a mar/ed lac/ of development of the middle third of the face! *ith progressive severity of distortion in her t*o younger %rothers )n o%serving the feet it *ill %e seen that she has splendidly formed feet *hile the second child has flat feet! and the third child has clu%%ed feet

FI". 1<9. 'ew Eealand Baori. 'ote the #rogressive change in facial form of the two younger boys as com#ared with their older sister. $hen note the #rogressive change in their feet. 'ormal feet+ flat feet and club feet.

( have found similar e4amples in several of the moderni6ed primitive racial stoc/s The severity of the distur%ing factors may %e different under different circumstances Drought! industrial depression! unemployment! and the li/e! all have their influence (n #ig ,,; *ill %e seen three Maori children of Ne* <ealandF the second child is smaller in stature than the third and gives more evidence of facial inAury While his older sister and younger %rother have normal feet! his ?uite severe distur%ance in facial gro*th is associated *ith clu% feet

FI". 11<. 'ew Eealand Baori. 'ote the mar%ed undersi*e of the second child and underdevelo#ment of the face associated with mar%ed deformity of the feet.

( have one patient *ho *as the seventh of a family of eleven children All the children in the family have good facial development! e4cept this patient "he *as %orn in the midst of a severe financial depression *hen the total amount of money availa%le for the food for the family *as reduced to a very lo* level The other children *ere %orn %efore or after the depression! and *ere not inAured (n addition to this patientBs severe facial deformity! she has had some arthritis and a general rheumatic tendency +er facial inAury is mar/ed and is characteri6ed %y a lac/ of development of the middle third Deformities of the feet associated *ith facial deformity have %een found in several moderni6ed groups of primitive racial stoc/s A typical case among the moderni6ed (ndians of Peru is sho*n in #ig ,,, The face of this %oy sho*s a%normal development *ith narro*ing of the upper arch and displacement of the teeth This is associated *ith gross deformity of one foot and shortening of the leg +e lives in the high country This phase is stri/ingly illustrated in #ig ,,5 *here the face is very %adly inAured and %oth feet are seriously clu%%ed This %oy is a Coastal (ndian

FI". 111. $his boy is a moderni*ed Indian in the high Sierra of ?eru. 'ote the disturbed develo#ment of the face associated with the deformity of one foot.

FI". 11!. $his is a moderni*ed coastal Indian of 7cuador. 'ote the serious facial and dental arch distortion associated with club feet.

The serious e4pressions of physical deformities *hich *e found had occurred in several primitive racial stoc/s! after they have %ecome moderni6ed sufficiently to %e using the foods of our modern civili6ation! are occurring in our modern American families *ith e?ual severity and great fre?uency )ne method for determining the cause of these deformities is through an e4amination of %irth and death certificates to note the recorded data relative to physical deformities An outstanding contri%ution to this approach has %een made %y Dr D P Murphy! of the 3niversity of Pennsylvania (n an e4amination of ,-;!,-5 individual death certificates that have %een recorded %et*een ,252 and ,2--! he found physical deformities recorded in ,!.98 cases Dr Murphy sent field *or/ers to ma/e a personal study of the family histories %y contacting the mothers or grandmothers! of *hom they *ere a%le to locate :2; #rom this group he *as a%le to select .;7 *ith sufficiently complete family histories to allo* ta%ulation in a form that *ould thro* light upon the %irth ran/ and other data +is studies strongly emphasi6e the presence of a period of lo* reproductive activity (n concluding one of his reports he states@ H,I Miscarriages! still%irths! and premature %irths occurred more often than *ould %e e4pected %y chance in the pregnancies immediately preceding and immediately follo*ing the pregnancy *hich resulted in the %irth of a defective child! and less often than *ould %e e4pected %y chance in the remaining pregnancies Miscarriage! still%irth! and premature %irth occurred most often in the pregnancy immediately preceding that of the defective child #rom the a%ove o%servations! it is concluded that the %irth of a congenitally malformed child may %e only one e4pression of a prolonged decrease in functional reproductive activity! the other e4pressions %eing miscarriages! still%irths! and premature %irths (t is suggested that the o%stetrician has unusual reason to suspect the possi%le e4istence of a congenital malformation in the pregnancy *hich follo*s immediately after a miscarriage! a still%irth! or a premature %irth "hute! of the 3niversity of Western )ntario! 1ondon! Canada! in a personal communication! states that he has %een impressed! in his studies of a%orted fetuses! *ith the large percentage that are malformed This seems to lin/ the

malformations *ith the causative factors *hich have resulted in decreased reproductive activity (n connection *ith the production of imperfect infants! the period in the formative process at *hich the inAury occurs and also its origin are important Murphy has thro*n important light on this phase in his study of the cause of the defectives in forty families *ith t*o or more malformed H5I +e concludes@ 'Many if not most of the congenital malformations met *ith in this study resulted from defects in the germ plasm! *hich *ere present %efore fertili6ation ' Among the important ?uestions that arise is the relative responsi%ility of the t*o parents As an approach to this phase Murphy H5I has made a study *hich deals *ith a consecutive series of ::. families in each of *hich there appeared at least one congenitally malformed child (n forty of these families! there *ere t*o or more malformed %rothers and sisters +e presents e4tensive data in ta%ular form from *hich he ta/es e4amples to illustrate his interpretation +e states under the 'Clinical =alue of "tudy' the follo*ing@ (t is evident from the a%ove data Hta%lesI that there is a strong tendency for congenital malformations to duplicate in si%lings that %elong to a consecutive series of families And also that such defects tend to appear rather fre?uently among their more distant relatives This duplication of malformations is to %e o%served in the case of the more serious types of defects! Aust as it is noticed in the less serious ones These findings lend support to the theory that congenital malformations are primarily the result of influences *hich affect the germ cells prior to! rather than after! fertili6ation The validity of this theory is emphasi6ed %y three e4amples ta/en from Ta%les ( and (( #amily ,9 in Ta%le ( contained children *ith pyloric stenosis! t*o of *hich *ere t*ins #amily 8 in Ta%le (( possessed 5 si%lings *ith cleft palate! conceived %y the same father! %ut %orn to different mothers #amily : in Ta%le (( contained 5 children %oth e4hi%iting an a%sence of the right half of the diaphragm (t does not seem li/ely that such se?uences of events as these could %e the result of any forces that did not operate until after fertili6ation had ta/en place "ince! as has %een sho*n in a previous report! congenital malformations are 5. times more common in si%lings of defective children than in the population at large! the present o%servations should %e of added clinical interest !ummary and Conclusions

, A consecutive series of .; families having 5 or more congenitally malformed children has %een studied *ith respect to the duplication of defects in si%lings 5 The defect o%served in the first malformed child reappeared in a su%se?uent malformed si%ling in a%out 7; per cent of all casesF the 7; per cent remaining including all other possi%le defects - (n a second group of -2 consecutive families! in *hich a malformed child possessed a malformed relative! the malformation in the child and in the relative *ere identical in a%out ., per cent of cases . (n ,2 non>consecutive families *ith 5 or more malformed children! the defect of the first child repeated in a su%se?uent child in over half of the families (t is significant that *hile these important factors are Aust coming to light in our moderni6ed civili6ation! the evidence clearly indicates that several so> called primitive races have %een conscious of the need for safeguarding motherhood from reproductive overloads *hich *ould reduce the capacity for efficient reproduction #or e4ample! $ T Baden H-I in his %oo/ 'Among the (%os of Nigeria' states@ (t is not only a matter of disgrace %ut an actual a%omination! for an (%o *oman to %ear children at shorter intervals than a%out three years The idea of a fi4ed minimum period %et*een %irths is %ased on several sound principles The %elief prevails strongly that it is necessary for this interval to elapse in order to ensure the mother %eing a%le to recuperate her strength completely! and thus %e in a thoroughly fit condition to %ear another child "hould a second child %e %orn *ithin the prescri%ed period the theory is held that it must inevita%ly %e *ea/ and sic/ly! and its chances Aeopardi6ed "imilarly! the (ndians of Peru! Ecuador and Colum%ia have %een familiar *ith the necessity of preventing pregnancy overloads of the mother Whiffen H.I in his %oo/ 'North>West Ama6ons' states@ The num%ers Hof pregnant *omenI are remar/a%le in vie* of the fact that hus%ands a%stain from any intercourse *ith their *ives! not only during pregnancy %ut also throughout the period of lactation>>far more prolonged *ith them than *ith Europeans The result is that t*o and a half years %et*een each child is the minimum difference of age! and in the maAority of cases it is even greater

(t may also %e important to note that the Ama6on (ndians have %een conscious of the fact that these matters are related to the nutrition of %oth parents Whiffen states that@ These (ndians share the %elief of many peoples of the lo*er cultures that the food eaten %y the parents>>to some degree of %oth parents>>*ill have a definite influence upon the %irth! appearance! or character of the child This pro%lem of the consciousness among primitives of the need for spacing children has %een emphasi6ed %y $eorge Bro*n H7I in his studies among Melanesians and Polynesians in *hich he reports relative to the natives on one of the "olomon (slands as follo*s@ After the %irth of a child the hus%and *as not supposed to coha%it *ith his *ife until the child could *al/ (f a child *as *ea/ or sic/ly! the people *ould say! spea/ing of the parents! 'Ah! *ell! they have only themselves to %lame ' These ne* data have a very important %earing on the pro%lems of degeneration in our modern civili6ation "ince it is true that a racial pattern can %e changed in a single generation our modern concept and teaching *ith regard to the role of heredity must %e modified! in its relationship to cause and effect A deformity arising from intercepted heredity is Aust as truly %iologic as a deformity arising from accumulated impacts as e4pressed in heredity (nstead of %laming the past generations for the distortions or frailties of our modern generation and thus relieving our o*n generation of responsi%ility these ne* data indicate that the social organi6ation that is creating these divergencies from normal must alone accept the responsi%ility This completely changes some aspects of the theories and practice of modern social education (nstead of planning the care and management of distorted personality as though the lesion *ere the result of environmental influences upon a normally organi6ed individual! it should %e loo/ed upon as a distortion affecting one lin/ in the chain of heredity *hich is neither the result of the distortions of previous lin/s nor a controlling factor for future lin/s in the chain The prognosis! in other *ords! *hile %eing %ad for the individual is not necessarily %ad for his or her descendants While many of the individuals *ho have suffered physical distortions have apparently practically normal %rain development *e shall see in the follo*ing chapter that a certain percentage have so great a distur%ance in %rain organi6ation that they cannot and should not %e considered as individually responsi%le for their %ehavior

(t is urgent therefore that the data presented in this chapter %e loo/ed upon as an important /ey to the progressive degeneration that is ta/ing place in many parts of the *orld under the influence of our so>called modern civili6ation (t is a matter of profound significance that the most primitive races *ere originally a%le to avoid the physical degeneration so general in many communities today (t is also a matter of importance that the primitives recogni6ed not only these dangers %ut *ere conscious of and practiced ade?uate means for preventing them They had sufficient character to achieve the ends *hich they deemed essential Wea/ness in character may constitute the greatest %arrier in the reorgani6ation and conservation of our modern civili6ation T*o serious defects from *hich many individuals in our moderni6ed civili6ation suffer are impacted teeth and the a%sence of teeth due to their failure to develop (t is significant that in the arches of the primitive races practically all teeth form and erupt normally! including the third molars (n the moderni6ed primitives and among our modern *hites *ith deformed dental arches many teeth are impacted and often several of the permanent teeth have never formed The evidence indicates that this! li/e the facial and dental arch deformities is due to an a%sence of vitamin A in the diet of the mother during the gestation period or of one or %oth of the parents prior to conception The cause is discussed in the ne4t chapter )eferences
, 5

. 7

M3&P+Y! D P &eproductive efficiency and malformed children S!rg# 1yne$# and 2bst#, 85@7:7! ,2-8 M3&P+Y! D P The duplication of congenital malformations in %rothers and sisters and among other relatives S!rg# 1yne$# and 2bst#, 8-@..-! ,2-8 BADEN! $ T Among the (%os of Nigeria Phila ! 1ippincott! ,25, W(##EN! T North>West Ama6ons N Y ! Duffield! ,2,7 B&)WN! $ Melanesians and Polynesians 1ondon! Macmillan! ,2,; Chapter 1, Prenatal nutritional deformities and disease types

A &E1AT()N"+(P %et*een physical types and certain disease suscepti%ilities has %een recogni6ed %y diagnosticians for centuries The s/ill of many physicians in reading intuitively and from e4ternal signs the nature of their patientsB trou%les *hen these could not %e classified *ith precision played an important part in the successful *arfare against disease in the period preceding

the advance in modern la%oratory techni?ue #or many of the old>time physicians! these constitutional ?ualities *ere e4pressed as diathesis An individual *ould %e recogni6ed as having a phthisical diathesis Ha suscepti%ility to tu%erculosisI "imilarly! the arthritis group had a rheumatic diathesis While modern science has underta/en to e4press its findings numerically! the pro%lem of reducing the diatheses to mathematical formulas has re?uired so many overlappings! that it has %een impossi%le to esta%lish definite limiting %oundaries (n my investigations regarding the types of individuals *ho develop rheumatic group lesions as a result of dental focal infections! H,I ( found that individuals could %e divided into very definite groups in *hich ,7 ;7 per cent *ith severe lesions %elonged to families in *hich similar disease symptoms had occurred Evidence *as disclosed of a systemic factor that played a controlling role in determining *hether or not the individual *ould %e seriously inAured from dental focal infections (t %ecame very clear that the soil *as ?uite as important a determining factor as *as the type of infection This finding led me to %roaden the scope of my investigations to include a search for control cases that *ere free from the degenerative processes ( *as not a%le to find these controls in the clinical material afforded %y our modern civili6ation! and therefore e4tended the search to isolated primitive racial stoc/s Associated *ith a fine physical condition the isolated primitive groups have a high level of immunity to many of our modern degenerative processes! including tu%erculosis! arthritis! heart disease! and affections of the internal organs When! ho*ever! these individuals have lost this high level of physical e4cellence a definite lo*ering in their resistance to the modern degenerative processes has ta/en place To illustrate! the narro*ing of the facial and dental arch forms of the children of the moderni6ed parents! after they had adopted the *hite manBs food! *as accompanied %y an increase in suscepti%ility to pulmonary tu%erculosis (n #ig ,,- *ill %e seen four young people! e4amined in the tu%erculosis *ards of the Duneau HAlas/aI +ospital for (ndians and Es/imos All e4hi%ited mar/ed evidence of prenatal inAury Note the cuspids erupting outside the line of the arch The teeth of the upper arch of the %oy at the upper left! pass inside the teeth of the lo*er arch +is upper arch is so narro* that even a finger could not %e passed %et*een the lateral *alls These pictures had to %e ta/en *ith short e4posures in the poor light of the *ards They reveal! ho*ever! the conditions

FI". 11 . 7s%imo children seriously ill in the tuberculosis wards of the government hos#ital at Guneau+ Alas%a. $hey were too ill to be moved to good light for #hotogra#hing. 7very tubercular child in these wards had disturbed facial develo#ment and deformed dental arches. $he #arents were living on modern foods.

(n #igs ,,. and ,,7 are sho*n several individuals photographed in the tu%erculosis hospital in Ne* <ealand Note the lac/ of development of the middle third of the face and the narro*ing and lengthening of the face (n several individuals the teeth of the upper arch closed inside the teeth of the lo*er arch! instead of outside! as in normal persons +ere again! ,;; per cent of the young people *ith tu%erculosis gave evidence of inAury in the formative period! and 2, 5 per cent of the total num%er of patients *ere found to have distur%ed dental arches

FI". 11). $hese are #atients in the Baori 1os#ital for tuberculosis in 'ew Eealand. 'ote the very mar%ed underdevelo#ment of the middle third of the face above and of both middle and lower thirds of the face below. 7very #atient under thirty years of age in these wards had deformed dental arches and disturbed facial develo#ment.

FI". 11-. $hese girls are also in the tuberculosis ward of the 'ew Eealand 1os#ital for Baori. 'ote the mar%ed disturbance in develo#ment of the face and dental arches. All have #inched nostrils.

(n #ig ,,8 are sho*n four typical individuals in the tu%erculosis hospitals in +a*aiiF one in +ilo and the other in +onolulu (n each of these hospitals ,;; per cent of the individuals had a%normal development of the face and dental arches

FI". 11/. $hese are native 1awaiians in tuberculosis hos#itals. 7very child in the wards showed mar%ed disturbance of facial develo#ment and dental arch form.

While *e /no* many of the factors contri%uting to the nature of diatheses! ( have found no data dealing *ith the forces *hich determine diatheses! e4cept the influence of heredity The data ( am presenting in this volume! deal *ith forces other than heredity An outstanding advance in organi6ing the data *hich relate the physical characteristics of individuals to their disease suscepti%ilities has %een made %y the Constitutional Clinic of Colum%ia 3niversity and the Pres%yterian +ospital of Ne* Yor/! under the a%le direction of Dr $eorge Draper +e has found it necessary in order to study man as a *hole! to vie* him from four different angles@ 'his form! his function! his immunity mechanism and his psychology ' These four attri%utes he has designated as the 'four panels of personality ' Dr Draper has pu%lished several communications including t*o te4t%oo/s! one entitled! '+uman Constitution!' H5I and the other! 'Disease and the Man ' H-I Dr Draper has approached this pro%lem from the data provided in the medical clinics! and therefore! from the characteristics of affected individuals! *hereas my approach has %een through a study of the primitive groups and the physical changes and disease suscepti%ilities *hich occur as a result of their moderni6ation The similarity of our conclusions greatly emphasi6es the

importance of the findings of each Dr Draper has emphasi6ed the importance of the face and of the dental arches in the general matter of suscepti%ility to disease +e closes one of his chapters! entitled The "elation of %a$e, .a0s and Teeth to H!man Constit!tion and (ts ,earing on 'isease, as follo*s@ The lessons *hich *e have learned from these o%servations! ho*ever! is that the face and Aa*s hold much information of value to the student of the human %eing As clinicians in the field of internal medicine *e have %een taught to o%serve the gums and teeth in order to detect possi%le foci of infection But for the student of clinical organismalism! the teeth and Aa*s hold much valua%le information a%out the total personality #or the *or/er in the dental %ranch of medicine it *ould seem that an unusual opportunity is offered for e4tending such o%servations and correlations (t may very *ell %e that the dental student *ho %ecomes interested in the relation of the mouth to the organism may form a most important lin/ *ith the responsi%ilities of internal medicine The more *e come to vie* man as a totality! as an organism *hich functions as a *hole and not as a collection of separate elements! the more do all the special %ranches of medicine %ecome fused *ith the general concept *hich forms the %asis of this discussion! namely! the relation of the human organism as a *hole to those various reactions of maladAustment *ith environment *hich *e call disease (t is clear that a definite association of a%normal facial patterns *ith specific disease suscepti%ilities e4ists #rom my studies it is also clear that these a%normal facial patterns are associated *ith influences resulting from a change in the nutrition of the parents of the individual We are at this point concerned *ith the forces that underlie these phenomena (n approaching this pro%lem as it applies to human %eings! much can %e learned from a study of domestic and *ild animals 3ntil recent years it has %een common /no*ledge among the superintendents of large 6oos of America and Europe that mem%ers of the cat family did not reproduce efficiently in captivity! unless the mothers had %een %orn in the Aungle #ormerly! this made it necessary to replenish lions! tigers! leopards and other felines from *ild stoc/ as fast as the cages *ere emptied %y death or as rapidly as ne* stoc/ should %e added %y enlargement The story is told of a trip to Africa made %y a *ild animal specialist from the 1ondon 6oo for the purpose of o%taining additional lions and studying this pro%lem While in the lion country! he o%served the lion /ill a 6e%ra The lion proceeded then to tear open the a%domen of the 6e%ra and eat the entrails at the

right flan/ This too/ him directly to the liver After spending some time selecting different internal organs! the lion %ac/ed a*ay and turned and pa*ed dirt over the carcass *hich he a%andoned to the Aac/als The scientist hurried to the carcass and drove a*ay the Aac/als to study the dead 6e%ra to note *hat tissues had %een ta/en This gave him the clue *hich *hen put into practice has entirely changed the history of the reproduction of the cat family in captivity The addition of the organs to the foods of the captive animals %orn in the Aungle supplied them *ith foods needed to ma/e reproduction possi%le Their young! too! could reproduce efficiently As ( studied this matter *ith the director of a large lion colony! he listed in detail the organs and tissues that *ere particularly selected %y animals in the *ilds and also those that *ere provided for animals reproducing in captivity +e e4plained that! *hereas the price of lions used to %e fifteen hundred dollars for a good specimen! they *ere no* so plentiful that they *ould scarcely %ring fifteen cents (f *e o%serve the parts of an animal that a cat eats *hen it /ills a small rodent or %ird! *e see that it does not select e4clusively the muscle meat During my %iological investigations using animals! ( have had %arn rats gna* their *ay into the room *here the ra%%its *ere /ept and /ill several animals during a night )n t*o different occasions! only the eyes of the ra%%its had %een eaten! and the %lood may have %een suc/ed )n another occasion the %rains had %een eaten (t *as evident that these rats had a conscious need for special food elements that *ere provided %y these tissues No phases of the pro%lem of physical degeneration can %e as important as /no*ledge of the forces that are at *or/ and the methods %y *hich they operate (t is clear from the data presented in previous chapters that these forces can %ecome operative *ith sufficient speed to ma/e a difference in t*o generations! one succeeding the other (t is also clear from preceding data that these forces originate in the change of the nutrition of the parents A chemical analysis of the food HChapter ,7I! discloses a mar/ed reduction in the inta/e of some of the vitamins and minerals in individuals *ho are undergoing a degenerative process Many investigators have presented important data dealing *ith the role of vitamin A in prenatal as *ell as postnatal gro*th processes (t is /no*n that the eye is one of the early tissues to develop inAury from the a%sence of vitamin A! hence the original name for this vitamin *as the 4erophthalmic vitamin The importance of vitamin A to the eye! and the fact that this vitamin is stored in eye tissue have %een emphasi6ed %y several investigations

Wald H.I in discussing vitamin A in eye tissues states@ E4tracts of eye tissue Hretina! pigment epithelium and choroidI sho*ed the characteristic vitamin A a%sorption %and at 85; mu *ith the "%C,- test and *ere also potent in curing vitamin A deficient rats The concentration of vitamin A *as very constant for different mammals! at a%out 5; Y per g dry tissue =alues for frog tissues *ere much higher This comment is of interest in connection *ith the o%servation that ( have previously ?uoted regarding the raid of %arn rats on the ra%%it cages in the stress of deep *inter While it has %een sho*n that vitamin A is essential for the normal function of eyes! its role in the formation of eye tissues has not %een clearly understood Pro%a%ly the most sensitive procedure for testing the depletion of vitamin A in domestic animals today is %y o%serving their %ehavior in semi>dar/ness Ed*ard Mellan%y H7I has presented important ne* data dealing *ith vitamin A deficiency and deafness +e states in an a%stract of a paper read %efore the Biochemical "ociety! in 1ondon in Novem%er ,2-9! the follo*ing@ (n previous pu%lications ( have sho*n that a prominent lesion caused %y vitamin A deficiency in young animals! especially *hen accompanied %y a high cereal inta/e! is degeneration of the central and peripheral nervous systems (n the peripheral system it is the afferent nerves *hich are principally affected! including the eighth nerve! %oth cochlear and vesti%ular divisions (t has no* %een possi%le to sho* that vitamin A deficiency produces in young dogs degenerative changes in the ganglia! nerves and organs of %oth hearing and %alance inside the temporal %one All degrees of degeneration have %een produced! from slight degeneration to complete disappearance of the hearing nerve The nerves and ganglion cells supplying the organ of Corti are more easily damaged than those of the vesti%ular division As might %e e4pected *hen once the spiral ganglion cells have disappeared! additions of vitamin A to the diet have no effect! and the organ of Corti remains completely denervated The 'inattention' of dogs on these diets *hich ( previously ascri%ed to cere%ral defect is undou%tedly due to deafness (t no* remains to determine *hether these results may %e e4tended to e4plain certain forms of deafness in man The serious effects of deficiency in vitamin A on pregnant rats has %een investigated and reported %y Mason H8I as follo*s@ A%normalities are descri%ed in the pregnancies of rats maintained on diets deficient in vitamin A in varying degree Prolongation of the gestation period

up to 58 days in severe cases and a long and difficult la%our *hich might last 5 days and often resulted in death of %oth mother and young *ere characteristic Defects due to deficiencies in vitamin A in the diet of dairy animals! Hpregnant co*s! their offspring and normal calves fed on the mil/ from those co*sI have %een reported upon %y Meigs and Converse H9I as follo*s@ (n ,2-5 *e reported from Beltsville evidence that farm rations fre?uently fed to calves may %e dangerously lo* in vitamin A! and that mil/ produced %y co*s fed hay *hich has lost its green color may %e an unsafe source of vitamin A in the calf ration This preliminary paper reported results dealing *ith four co*s *hich had %een fed over t*o years on a good grain mi4ture and late>cut lo*>color timothy hay )f si4 calves %orn of these co*s! t*o *ere dead! one *as una%le to stand and died shortly after %irth! and three *ere %oth *ea/ and %lind The fact that co*s so fed *ere una%le to properly nourish their calves %efore %irth led to the ?uestion *hether the mil/ from these co*s might not %e deficient for normal gro*th of calves from other co*s fed on rations ade?uate in vitamin A This preliminary report included results on three normal calves fed mil/ from those co*s fed lo*>color timothy hay The three calves died at fifty>seven! si4ty>t*o! and seventy>one days of age! respectively "ince gro*th! prenatal and postnatal! is related directly to the pituitary %ody! *e are specially interested in the /no*ledge availa%le on the functioning of this gland The *or/ of Barrie H:I thro*s important light on this su%Aect +e has reported as follo*s@ Partial deficiency of vitamin E as sho*n in the female rat fed on a diet containing only a trace of vitamin E %ut *hich is other*ise complete! results in the prolongation of gestation! *hich may %e continued as long as ,; days %eyond the normal period The offspring under these conditions are a%normal These young may develop slo*ly and %e thin and undersi6ed in spite of sufficiently profuse lactation! or they may %ecome e4tremely fat and develop a leg *ea/ness and carpopedal spasm a%out ,: days after %irth Animals of %oth types have thin s/ulls and short sil/y fur Complete E deficiency in the adult also produces the soft fur and imperfectly calcified s/ull Partially E deficient animals occasionally give %irth to a litter %ut fail to lactate The changes o%served are similar in several *ays to those produced %y hypophysectomy Hsurgical removal of pituitary glandI Mar/ed degranulation of the anterior pituitary is found in %oth the a%normal young and the adult

sterile animals 1ac/ of vitamin E therefore produces a virtual nutritional hypophysectomy in the young rat The ina%ility of various species to complete gestation *hen vitamin E is not provided in ade?uate ?uantity has %een reported %y many investigators A 1 Bacharach! E Allehorne and + E $lynn have used their study of this factor as a means of estimating the ?uantity of vitamin E in the diet H2I They state@ A diet suita%le for *or/ on vitamin E causes female rats! fed on this diet from *eaning! to sho* a gestation>resorption rate not significantly differing from ,;; per centF *hen the diet is supplemented *ith ade?uate amounts of vitamin E! also administered from *eaning! the live litter rate does not differ significantly from ,;; per cent (t is found that! on such a diet! the percentage of implantations HconceptionsI is mar/edly different %et*een animals that have %een su%mitted to a single gestation>resorption! o*ing to lac/ of vitamin E! and animals that are mated for the first time The authors suggest that the process of undergoing gestation>resorption %rings a%out some deep>seated changes in the reproductive mechanism of the rat! of a /ind not hitherto recogni6ed as characterising the vitamin E deficiency syndrome )ne of the outstanding changes *hich ( have found ta/es place in the primitive races at their point of contact *ith our modern civili6ation is a decrease in the ease and efficiency of the %irth process When ( visited the "i4 Nation &eservation at Brantford! )ntario! ( *as told %y the physician in charge that a change of this /ind had occurred during the period of his administration! *hich had covered t*enty>eight years and that the hospital *as no* used largely to care for young (ndian *omen during a%normal child%irth HChapter 8I A similar impressive comment *as made to me %y Dr &omig! the superintendent of the government hospital for Es/imos and (ndians at Anchorage! Alas/a +e stated that in his thirty>si4 years among the Es/imos! he had never %een a%le to arrive in time to see a normal %irth %y a primitive Es/imo *oman But conditions have changed materially *ith the ne* generation of Es/imo girls! %orn after their parents %egan to use foods of modern civili6ation Many of them are carried to his hospital after they had %een in la%our for several days )ne Es/imo *oman *ho had married t*ice! her last hus%and %eing a *hite man! reported to Dr &omig and myself that she had given %irth to t*entysi4 children and that several of them had %een %orn during the night and that she had not %othered to *a/en her hus%and! %ut had introduced him to the ne* %a%y in the morning

"herman! H,;I *ho has made many important contri%utions to our /no*ledge of vitamin A! has sho*n in a recent communication that an amount of vitamin A sufficient to support normal gro*th and maintain every appearance of good health in animals! may still %e insufficient to meet the added nutritive demands of successful reproduction and lactation With the failure to reproduce successfully! there usually appears in early adult life an increased suscepti%ility to infection! and particularly a tendency to lung disease at an age corresponding to that at *hich pulmonary tu%erculosis so often develops in young men and *omen +e states! further! that vitamin A must %e supplied in li%eral proportions not only during the gro*th period %ut during the adult period as *ell! if a good condition of nutrition and a high degree of health and vigor are to %e maintained +ughes! Au%el and 1ienhardt H,,I have sho*n that a lac/ of vitamin A in the diets of pigs has resulted in e4treme incoordination and spasms They also emphasi6e that gilts %red prior to the onset of the nervous symptoms either a%orted or farro*ed dead pigs +art and $il%ert H,5I have sho*n that the symptoms most commonly seen in cattle having a vitamin A deficiency are the %irth of dead or *ea/ calves! *ith or *ithout eye lesions They report also a condition of ne*%orn calves *hich simulates *hite scours! and the development of eye lesions in immature animals +ughes H,- has sho*n that s*ine did not reproduce *hen fed %arley and salt! %ut did so *hen cod liver oil *as added to this food "ure H,.I has sho*n that a lac/ of vitamin A produces in females a distur%ance in oestrus and ovulation! resulting in sterility #urther! he states! that resorption of the fetus may %e produced %y lac/ of vitamin A! even on a diet containing an a%undance of vitamin E! *hich is /no*n as the anti>sterility vitamin )ne of the most important contri%utions in this field has %een made %y Professor #red +ale! of the Te4as Agricultural E4periment "tation! at College "tation! Te4as +e has sho*n that many physical deformities are readily produced %y curtailing the amount of vitamin A in the ration of pigs +e produced fifty>nine pigs H,7I that *ere %orn %lind! every pig in each of si4 litters>*here the mothers *ere deprived of vitamin A for several months %efore mating and for thirty days thereafter (n pigs! the eye%alls are formed in the first thirty days +e found! as have several others! that depriving pigs of vitamin A for a sufficient period produced severe nerve involvements including paralysis

and spasms! so that the animals could not rise to their feet +e reported that one of these vitamin A deficient pigs that had previously farro*ed a litter of ten pigs! all %orn *ithout eye%alls! *as given a single dose of cod liver oil t*o *ee/s %efore mating "he farro*ed fourteen pigs *hich sho*ed various com%inations of eye defects! some had no eyes! some had one eye! and some had one large eye and one small eye! %ut all *ere %lind

FI". 113. Above+ this #ig was one of fifty&nine born without eyeballs and with other serious deformities due to lac% of vitamin A in the mother>s diet. 5ffs#ring of these blind #igs when normally fed had #erfect eyes and no deformities. Below+ A+ at left shows normal eye of a #ig at nine months. B+ at right shows #artial eyeballs and o#tic nerves #roduced in offs#ring when one dose of vitamin A was given two wee%s before mating. 98ourtesy of ?rofessor Fred 1ale.:

(n #ig ,,9 ( am a%le through Professor +aleBs /indness! to sho* an eyeless pig and a normal eye of a pig Hat the leftI and Hat the rightI a pair of incomplete eyes from a pig %orn in the litter Aust mentioned This one dose of vitamin A made possi%le the partial formation of optic nerves and eye%alls A typical eyeless pig is sho*n in #ig ,,: Hlo*erI Note its deformed ears Among the many physical inAuries *hich develop in the pigs %orn to so*s fed on a diet deficient in vitamin A are serious defects of the snout! dental arches! eyes and

feet This pig *as %orn *ithout eye%alls (t also had clu% feet and t*o tumors (n #ig ,,: Hupper rightI is sho*n a pig *ith cleft palate! and in #ig ,,2 Hupper rightI one *ith dou%le hairlip (n #ig ,,: Hupper leftI is sho*n a %oy *ith cleft palate and defective eyes )ne of the very important results of Professor +aleBs investigations has %een the production of pigs *ith normal eyes! %orn to parents %oth of *hom had no eye%alls due to lac/ of vitamin A in their motherBs diet The pro%lem clearly *as not heredity T*o litters! one containing nine pigs and the other eight! *hich *ere %orn to mothers that had %een deprived of vitamin A %efore mating and for thirty days thereafter! produced the follo*ing lesions@ All had complete a%sence of eye%allsF some lac/ed development of the opening of the e4ternal earF others had cleft palate! harelip! displaced /idneys! displaced ovaries! or displaced testes

FI". 114. ;##er left0 Boy has cleft #alate+ and hareli#. ;##er right0 ?ig has cleft #alate+ no eyes. Below+ ?ig has club feet+ deformities of the ears+ two tumors and no eyeballs due to lac% of ade(uate vitamin A in the mother>s diet. 96indness of ?rofessor 1ale.:

FI". 119. Bany young of modern domestic animals are born with deformities. At the u##er left is seen a #u# with cleft #alate. In two #revious litters all the #u#s were deformed and unable to live. At the u##er right is one of ?rofessor 1ale>s #igs with double hareli#. Below two blind lambs and one with club foot.

(t is of interest that in )cto%er! ,2-7! Professor +ale reports that the Te4as Agricultural E4periment "tation *as informed that a litter of fourteen pigs had %een %orn %lind in Dune! ,2-7! on a farm at &alls! Te4as )f these! si4 pigs *ere raised and %rought to the "tation for further study The farmer o*ning the pigs stated that no green feed *as availa%le on his farm from March! ,2-.! until May! ,2-7 (t *ill %e noted that this condition paralleled the e4perimental conditions at the station under *hich %y restricting vitamin A %efore and immediately after gestation fifty>nine pigs *ere produced *ithout eye%alls Professor +ale reports that in April! ,2-7! a litter of seven pigs *ere %orn %lind at Mc$lean! Te4as! *hich *as suffering from drought conditions! similar to those at &alls The litter and dam *ere purchased %y the E4perimental "tation Matings *ere made %et*een %lind pigs These *ere fed rations containing ample vitamin A! and normal pigs *ith normal eye%alls *ere produced Even the mating of a %lind son *ith his mother *ho had produced him *hen on deficient diet! produced only normal pigs *hen %oth had ample vitamin A +e states! '(f an hereditary factor had %een the cause of this

congenital %lindness! these matings *ould have produced some %lind pigs! even if vitamin A *ere present in the ration ' The pro%lem of congenital cleft palate has %een very em%arrassing to those parents *hose children have %een so afflicted (t is of interest that %reeders of fancy dogs are fre?uently em%arrassed %y having this pro%lem develop in their /ennels or among litters %orn to parent stoc/ o%tained from their /ennels (n #ig ,,2 Hupper leftI ( have sho*n a *ater spaniel pup *ith cleft palate This pup *as not a%le to nurse %ecause of the impossi%ility of producing suction *ithout a palate When fed artificially the mil/ *as e4pelled through the nostrils The mother had given %irth to t*o previous litters all of *hich *ere dead at %irth or died soon after +er diet had %een reinforced *ith mineral calcium phosphate in ta%let form hoping to insure normal offspring This is not natureBs method ( am informed %y a veterinary that he has e4perienced trou%le *ith harelip! cleft palate or serious facial deformities among dogs that are pets in homes *here they are lavishly coddled and fed the things they li/e %est +e stated that he has more trou%le *ith head defects in %ulldog pups than any other %reed There are fe* if any pro%lems connected *ith modern degeneration on *hich so much light is thro*n as that supplied %y recent investigations on the pro%lems of paternal responsi%ility for defects in the offspring There are several reasons for this Because the mother has the sole responsi%ility for the nourishment of the fetus during the formative period and she alone provides the handicaps incident to the process of %irth! it is very natural that defects are practically all interpreted as %eing associated *ith these processes This unfortunately! has %een em%arrassed further %y the fact that since distortions in %ehavior do not appear until sometime after %irth! normality *as largely assumed to %e present up to the time of their appearance! and therefore of necessity *ould %e contri%utions from the childBs environment As such they *ould %e su%Aect naturally to treatment %y applying influences to change the mental environment +ence the entire pro%lem of the role of the se4 cells through controlling the architecture of the %ody including the %rain has %een largely overloo/ed =ery important light is thro*n on this pro%lem in the data provided on the pup sho*n in #ig ,5; This sho*s a dachshund pup *ith cleft palate and a very severe spinal deformity This is not unli/e deformities fre?uently seen! or unli/e that of the pup sho*n in #ig ,,2 The highly significant circumstance is the fact that these same deformities not only appeared also in another pup of this same litter %ut in one pup in each of three other litters a%out the same time While four mothers *ere involved these four

litters *ere all sired %y one father The paternal responsi%ility is clearly esta%lished

FI". 1!<. $his #u# had cleft #alate+ as seen above+ and grossly deformed s#ine+ as shown below. It was one of two #u#s born in the same litter with the same defects and one of five #u#s born in four litters with these same defects. Five different mother dogs were involved but all #u#s were from the same father dog.

At the right in #ig ,,2 a lam% is sho*n *ith clu% feet and t*o lam%s *ithout eye%alls ( am told that in some of the sheep raising states ?uite a num%er of deformities occur in lam%s at %irth )ne *riter states@ These deformities may maintain themselves in any num%er of *ays We have them t*o>headed! 7 and 8 legs! 5 tails! %orn *ithout eyes! hermaphrodites! %orn *ith ri%s on one side and any num%er of such deformities A common deformity in sheep is under>shot and over>shot Aa*s This simply means that the upper Aa* e4tends farther to the front that the under Aa* and the front teeth do not meet This is called over>shot and the reverse is called under>shot (t *ill %e noted that a common deformity in sheep relates to an under> development of either the upper or lo*er Aa* *hich is one of the most common e4pressions of distur%ed development in humans

"ome illustrations of the deformities that may occur in domestic animals are sho*n in #ig ,5, A%ove are seen t*o co*s each *ith an e4tra foreleg attached to the shoulderF %elo*! to the left is sho*n a dou%le>faced calf *hich also had a cleft palateF to the right a cat *ith deformed legs

FI". 1!1. $y#ical deformities in domestic animals. Above+ two cows with an e,tra foreleg hanging from the shoulder. Below+ left+ double faced calf. 2ight+ cat with deformed legs.

(n corresponding *ith Professor +ale! ( in?uired *hether they had information as to the effect of vitamin A deficiency on the sire +e replied! '(f *e reduceed the vitamin A content of the %ody of the sire! he *ould %ecome sterile and! therefore! *e could not try this procedure ' The ?uestion arises as to *hat the effect *ould %e of a less severe depletion of vitamin A of %oth parents (t is a very easy matter to place the full responsi%ility on the mother! *hen defects develop in the children These data indicate that either parent may contri%ute directly to certain of the defects of the children! due to defects in the germ plasm A practical case from my field studies includes a full>%looded Es/imo *oman *ho *as married t*ice! the second time to a *hite man! %y *hom she

had several children "he had insisted on selecting and preparing the native foods for herself! though she prepared the *hite manBs imported foods for him With a total of t*enty>si4 pregnancies she did not have any tooth decay +e had rampant tooth decay! and a mar/ed a%normality in the development of face and of the dental arches "everal of the children had incomplete development of the face and of the dental arches )ne of the girls *ho *as married had very narro* dental arches and nostrils and a typical %oyish type of %ody %uild 3nli/e her mother! this girl had a very severe e4perience in the %irth of her only child and insisted that she *ould not ta/e the ris/ of having another "everal daughters have narro* arches The ?uestion arises *hether the deficient nutrition of the father may have %een the contri%uting factor in the inAury of their children Ne* light is %eing thro*n on human pro%lems %y animal investigations )ne study that is particularly instructive has %een conducted %y McGen6ie and Berliner of the 3niversity of Missouri HBulletin No 587 I The e4perimental animals used *ere sheep Their studies indicated to them that they could predict the level of fertility of the sire %y studies made on the seminal fluid They found that the percentage of a%normal spermato6oa increased to :. per cent under unfavora%le conditions and reduced to less than ,7 per cent under favora%le conditions When the unfavora%le conditions characteri6ed %y these a%normal spermato6oa prevailed the females did not conceive +igh temperature proved to %e an important controlling factor as indicated %y variation in percentage of a%normal sperm (n one %reed the average variation *as from 5 7 per cent in Danuary to 55 per cent defective in AugustF in another %reed from ,: per cent in Danuary to 9- per cent defective in August They also found that the same result could %e produced in the *inter %y /eeping the sires in heated rooms or %y applying heat e4ternally They further found that *hen the percentage of a%normal sperm *as high a condition of sterility *as apparently esta%lished (n a personal communication from Professor McGen6ie he states that their inference is that *ith a high percentage of a%normal sperm the ova either are not fertili6ed or that fertili6ation ta/es place and that prenatal death occurs in a certain num%er of the cases! and that there is an apprecia%le prenatal death loss in sheep! horses! cattle! and s*ine ( have referred to the data presented %y Mall indicating that ,7 per cent of human conceptions in England are e4pelled as deformities in the second and third month of gestation McGen6ie also presents data relating to s*ine in *hich a sire that sho*ed a high percentage of a%normal sperm *as %red to t*o groups of so*s of similar %reed )ne *as maintained in a %arn *ithout access to pasture! the other received similar rations plus access to pasture The group *ithout pasture produced a high percentage of mummies! small litters! and a%normal pigs Hopen

a%dominal *alls *ith viscera protruding and e4posed spine in the region of the lum%ar verte%raeI The second group on the same food *ith the addition of pasturage produced normally large>si6e litters *ithout mummies The follo*ing year this e4periment *as repeated reversing the groups of so*s and using a similar high percentage of defective sperm in the same sire The same results occurred! *ith the group maintained *ithout access to pasture This emphasi6es the need for the vitamins and minerals that are provided in natural foods! particularly vitamin A and seems to relate to the studies of +ale in *hich the a%sence of vitamin A produced gross defects These studies on domestic animals strongly emphasi6e the necessity that %oth parents shall have ade?uate nutrition %efore conception occurs and su%se?uently for the mother 3ntil very recently there has %een e4ceedingly little literature dealing *ith the factors contri%uting to the a%normal development of fetuses in either domestic animals or humans Williams! *ho is one of the fe* students of this pro%lem as it relates to domestic animals! in referring to this phase has commented that there is no treatise in the English language on teratology Hdevelopment of monstersI in domestic animals H,8I +e emphasi6es that these defects are gro*ing in num%ers and economic importance +e refers to Bur/iBs studies in "*it6erland indicating that this difficulty has constantly and enormously increased in his territory This veterinary has as/ed 'Are our co*s degeneratingK' (t is of interest that a type of deformity commonly recogni6ed among veterinaries as a distortion of the head presenting a lac/ of development of the %ones of the middle part of the face including the upper Aa* is commonly called '%ull>dog calf ' This is particularly important in connection *ith the fre?uent human deficiency of lac/ of development in the middle third of the face Williams emphasi6es the common /no*ledge that Boston %ull>dogs are not prolific and %ecause of the difficulty of giving %irth to their young! some veterinarians resort routinely to caesarian section #ortunately! seriously deformed specimens are seldom %orn alive and usually do not continue to term Williams states that 1oAe has o%served ten grossly deformed calves of a particular type that *ere traced to the same sireF also a series of five *ith this deformity reported %y +utt *ere traced to one sire Among the deformities in domestic animals cleft palate or a%sence of palate is very common These studies on domestic animals strongly emphasi6e t*o factsF first! that deformities among these animals are very similar to those that develop in humans! and second! that the defects are largely related to the original germ cells and that the male may provide the defect ?uite as *ell as the female "everal of the primitive races have understood and provided against these mishaps

Moench and +olt of the Cornell Medical "chool and Ne* Yor/ +ospital H,9I have made important studies on humans and have found a very high incidence of sterility *hen a%normal forms of spermato6oa reached 57 per cent Among the a%normal forms they found one particular family *ith a particular type of a%normal sperm reaching ,5 per cent Their %reeding record *as decidedly %ad and fetal malformations repeatedly occurred (n their group! in 8- sterile matings the men *ere normal 5, times and a%normal -9 times They listed over .; different a%normal or deformed types of sperm They conclude@ , (n a normal semen the a%normal sperm heads do not e4ceed ,2 to 5; per cent 5 When the sperm head a%normalities reach 5; to 5- per cent! impaired fertility can %e assumed - When the sperm head a%normalities are a%ove 57 per cent! clinical sterility is usually present An important contri%ution to the ?uestion of the relation of the germ cells of the father to the type of defects that are prevalent in his family history has %een made in recent studies conducted in $ermany H,:I T*o $erman surgeons concerned *ith enforcing the sterili6ation la* in Berlin have ta/en advantage of their opportunities to ma/e an important contri%ution to the study of fecundity "everal studies have %een pu%lished previously! of the spermato6oa of normal men This %oo/ offers a study of the spermato6oa of men *ho had %een diagnosed as hereditarily defective At the time of the operation! the upper part of the vas deferens *as *ashed out! and the sperm thus o%tained *ere studied in great detail! 5; different types of a%normality %eing distinguished (n their control studied! the normal man is found to produce ,2 per cent of morphologically defective sperm By contrast! the chronic alcoholic patient produces 97 per cent of defective sperm Previously it has %een assumed that as much as 57 per cent or -; per cent of a%normal sperm *ere a good evidence of lo*ered fertility if not of sterility But the fertility of these chronic alcoholics *as not diminished! the authors claim (n cases of inherited mental defect! 85 per cent of a%normal sperm *ere produced! accompanied %y lo* fecundity!>>as is the case generally *ith the mentally defective male )n the other hand! in hereditary deafness! 85 per cent and in hereditary %lindness 97 per cent of defective sperm appeared

Epilepsy and schi6ophrenia Hdementia praeco4I %oth supposed to %e constitutional in origin! sho* less a%normality of spermato6oa H7: per cent and 7. per cent respectivelyI than %lindness and deafness The fact that in the past almost the entire emphasis of change in physical! mental and moral ?ualities has %een assigned to the forces of heredity! strongly emphasi6es the lac/ of information regarding the nature of the forces at *or/ and the points at *hich their influence constitute the determining factors The data previously presented in this chapter dealing *ith the role of vitamins A and E thro* valua%le ne* light on this phase (t is important! ho*ever! that ne* data are availa%le dealing *ith the factors *hich inAure the germ cells and *hich Tredgold has spo/en of as 'poisoned germ cells ' (n a personal communication received from Professor T " "utton of the College of Agriculture! )hio "tate 3niversity! he ma/es the follo*ing o%servation@ #or several years *e have %een interested in the study of the effects of vitamin A deficiency &ight no* our main consideration is the effect of this deficiency on reproduction We find that a diet lo* in vitamin A *ill cause reproductive failure! *hich seems to %e caused chiefly %y a degeneration of the germinal epithelium of the gonad This is particularly true in the case of the male ( thin/ *e have rather convincing evidence that this is a direct dietary damage to the gonad Hovary or testisI! rather than a disruption of the endocrine %alance *hich might result in sterility as appears to %e the case in vitamin B deficiency The degenerative processes *hich occur in nerve tissues due to vitamin A deficiency have %een studied %y Professor "utton and his associates H,2I They have %een a%le to sho* detailed progressive degeneration *ithin nerve fi%ers as a result of vitamin A deficiency (n the light of the ne*er information it is ?uite clear *hy *e may have anyone of the follo*ing distinct e4pressions in the reproductive process! namely! physical e4cellence of succeeding generations Hsuch as o%tains among many of the primitive races as ( have sho*nIF complete reproductive failure or sterility or partial failure resulting in defectives of various types at the %orderline %et*een these t*o phases (t is the rapid and progressive increase in this last group *hich constitutes the progressive degeneration of our modern civili6ation

)ne of the main pro%lems in this study has to do *ith the relation of nutrition to the modification of the gro*th of the child! %oth in its formative period and in the stage of adolescence ( have sho*n that in many of these primitive racial stoc/s there occurs in the first generation after the displacement of native foods %y imported foods a mar/ed change in facial and dental arch forms These changes happen most fre?uently in the later children in the families and come a%out not*ithstanding the impact of heredity through all the previous generations of e4cellent physical development Clinically! the evidence is a%undant! that this change occurs in these primitive racial stoc/s regardless of color! geographic location! temperature! and climate We are apparently dealing here *ith a factor *hich! *hile it may %e related to the germ plasm and to the prenatal gro*th period! clearly involves other forces than those that are at *or/ in the case of hereditary defectives "ince these changes have to do directly *ith distur%ances in gro*th of the head! particularly of the face and of the dental arches! *e are concerned *ith such evidence as may %e availa%le as to the nature of the forces that readily affect the anatomy of the s/ull The general architecture of the %ody is apparently determined primarily %y the health of the t*o germ cells at the time of their union This architectural design may not %e completely fulfilled due to interference *ith nutritive processes %oth %efore and after %irth (n this large pro%lem of the relationship %et*een physical design of the %ody and resistance or suscepti%ility to disease! *e may have determining factors operating at different periods in prenatal and postnatal gro*th The accumulating evidence strongly emphasi6es that disease suscepti%ility is a *idely varia%le factor and associated *ith certain types of developmental distur%ances (n a discussion of tu%erculosis suscepti%ility %efore a meeting of specialists in that field! emphasis *as placed upon the fact that other factors than the %acteria played controlling roles in the matter of suscepti%ility to tu%erculosis Weisman has recently made an important contri%ution to the pro%lem of physical development and suscepti%ility to tu%erculosis +e has presented H5;I statistical data indicating the type of chest deformity *hich predisposes an individual to tu%erculosis +e states@ (n a study previously made on the shape of the normal and of the tu%erculosis chest! it *as found that the average normal chest *as flat and *ide and that the average tu%erculous chest *as deep and narro* (t *as also sho*n that the deep chest *as an underdeveloped! primitive type of chest! resem%ling an infantBs chest in shape 1ater studies on the shape of the chest and on

environment sho*ed that children from the poorer socio>economic environments had on the average a deeper chest! *eighed less and *ere shorter than the children from the higher socio>economic levels An investigation recently made on the incidence of tu%erculosis in the various school districts in Minneapolis revealed that there is a very high incidence of tu%erculosis among the children from the slums *here the deep chest prevails Ten times as many cases of tu%erculosis *ere reported from a school district *hich is perhaps the poorest in the city as *ere reported from the %est school districts This study! *hich sho*s that there is a definite correlation %et*een the deep chest and the positive reaction to tu%erculin adds one more lin/ to the chain of evidence supporting the contention that the deep chest is more or less associated *ith tu%erculosis (t also helps to e4plain *hy there is such a high incidence of tu%erculosis among the poor in the slum districts The children in the slums are physically underdeveloped They are not only shorter and lighter %ut they have on the average a deep! primitive! infantile type of chest! one that has not gone through the normal process of development Even the ne*>%orn and infants are shorter and lighter and have a deeper chest than the average infant from a %etter environment (t is important to note that Dr Weisman associated the type of chest *hich predisposes the individual to tu%erculosis! *ith a prenatal condition since he states 'even the ne*>%orn and infants are shorter and lighter and have a deeper chest than an average infant from a %etter environment ' This *or/ thro*s important light on *hy in the primitive groups the children %orn to parents *ho are living on the imported nutrition lo*er in vitamins and minerals than the native foods! not only sho*ed a greatly increased incidence of tu%erculosis over the children %orn to parents on the native diet %ut also proved to %e those individuals *ho! in facial and dental arch form! presented positive evidence of prenatal inAury We also have a direct e4planation for the o%servations that have %een emphasi6ed %y Dr $eorge Draper! that physical form has a direct relationship to disease suscepti%ility of certain types! fre?uently spo/en of as diatheses (t is important in this connection to call to mind the statement made %y some clinicians that tu%erculosis patients *ith narro* nostrils tend to ma/e a poor fight These narro* nostrils are clearly related to prenatal inAury resulting primarily from defective germ cells *hich determine the architecture! not heredity %ut intercepted heredity (t is very easy to understand the effects of gross physical lesions such as the a%sence of eye%alls! harelip and cleft palate These defects can readily %e seen

The pro%lem is very different! ho*ever! *hen *e are dealing *ith distur%ances of function due to minute anatomical lesions in either e4ternal or internal organs such as the %rain These latter *ill %e discussed in the ne4t chapter )eferences , P&(CE! W A Dental (nfections Cleveland! Penton! ,255 D&APE&! $ +uman Constitution Phila ! "aunders! ,25. - D&APE&! $ Disease and the Man N Y ! Macmillan! ,2-; . WA1D! $ =itamin A in Eye Tissues .# 1en# Physiol#, ,:@2;7! ,2-7 7 ME11ANBY! E =itamin A deficiency and deafness ,io$hem# .# (n press 8 MA")N! G E #oetal death! prolonged gestation and difficult parturition in the rat as a result of vitamin A deficiency Am# .# Anat#, 79@-;-! ,2-7 9 ME($"! E B and C)N=E&"E! + T "ome effects of different /inds of hay in the ration on the performance of dairy co*s .# 'airy S$i#, ,8@-,9! ,2-: BA&&(E! M M Nutrition anterior pituitary deficiency ,io$hem# .# (n press 2 BAC+A&AC+! A 1 ! A11E+)&NE! E ! $1YNN! + E (nvestigations into the method of estimating vitamin E , (nfluence of vitamin E deficiency on implantation ,io$hem# .#, 5,@55:9! ,2-9 ,; "+E&MAN and MAC1E)D The relation of vitamin A to gro*th! reproduction and longevity .# Am# Chem# So$#, .9@,87:! ,257 ,, +3$+E"! A3BE1 and 1(EN+A&DT (mportance of vitamins A and C in the ration for s*ine! concerning especially their effect on gro*th and reproduction /ansas Agri$# Sta# Te$h# ,!ll#, No 5-! ,25: ,5 +A&T and $(1BE&T =itamin A deficiency as related to reproduction in range cattle Univ# of Calif# Agri$# 35per# Sta# ,!ll#, No 78;! ,2-,- +3$+E"! E + Effects of vitamin A deficient diet of so*s .# Agri$# "es#, .2@2.-! ,2-. ,. "3&E! B Dietary re?uirements for fertility and lactationF dietary sterility associated *ith vitamin A deficiency .# Agri$# "es#, -9@:9! ,25: ,7 +A1E! # The relation of maternal vitamin A deficiency to microphthalmia in pigs Te5as S# .# Med#, --@55:! ,2-9 ,8 W(11(AM"! W 1 The pro%lem of teratology in clinical veterinary medicine Cornell 4eterinarian, 58@,! ,2-8 ,9 M)ENC+! $ 1 and +)1T! + "perm morphology in relation to fertility Am# .# 2bst# and 1yne$#, 55@,22! ,2-,

,: "T(A"NY! + and $ENE&A1E"! G Er%/ranheit and #ertilitaet

#erdinand En/e =erlag! "tuttgart! ,2-9 &evie*! .# Heredity, 52@2! ,2-:


,2 "3TT)N! T " ! "ETTE&#(E1D! + E and G&A3""! W E Nerve

degeneration associated *ith avitaminosis A in the *hite rat 2hio Agri$# 35per# Sta# ,!ll#, No 7.7! ,2-. 5; WE("MAN! " A Correlation of the positive reaction to tu%erculin and the shape of the chest .#A#M#A#, ,;2@,..7! ,2-9 Chapter 1Physical2 mental and moral deterioration A#TE& one has lived among the primitive racial stoc/s in different parts of the *orld and studied them in their isolation! fe* impressions can %e more vivid than that of the a%sence of prisons and asylums #e*! if any! of the pro%lems *hich confront modern civili6ation are more serious and distur%ing than the progressive increase in the percentage of individuals *ith unsocial traits and a lac/ of irresponsi%ility 1aird H,I has emphasi6ed some phases of this in an article entitled! The Tail That -ags the ation, in *hich he states@ 'The countryBs average level of general a%ility sin/s lo*er *ith each generation "hould the %allot %e restricted to citi6ens a%le to ta/e care of themselvesK )ne out of four cannot ' +e has illustrated the seriousness of this degeneration %y presenting details as follo*s@ Although *e might cite any one of nearly t*o do6en states! *e *ill first mention =ermont %y name %ecause that is the place studied %y the late Dr Pearce Bailey '(t *ould %e!' he *rote! 'safe to assume that there are at least -; defectives per ,;;; in =ermont of the eight>year>old mentality type! and -;; per ,;;; of %ac/*ard or retarded persons! persons of distinctly inferior intelligence (n other *ords! nearly one>third of the *hole population of that state is of a type to re?uire some supervision #rom a %road vie* of the pro%lem of modern degeneration it *ill %e helpful to note the o%servations %y Tredgold H5I in mental deficiency +e states@ (t is thus evident that the condition of mental deficiency! *hilst presenting many interesting pro%lems to the physician! the pathologist! and the psychologist! has also a much *ider interest and importance "ince in Man the predominate feature is Mind! and since it is %y its development and evolution that human progress has ta/en! and must ta/e place! it is clear that the ?uestion

of its disease! and particularly of its defect! is one of supreme importance to the statesman! the sociologist! the philosopher! and the *hole community (n connection *ith these investigations among primitive races it is interesting to note that the data are in complete harmony *ith the data *hich clinical pathologists! clinicians and anatomists have o%tained in their study of the physical and structural characteristics of individuals *ho ma/e up the deficiency groups (n discussing the pro%lem of the significance of the shape of the palate! Tredgold H5I states@ Palate>>The association of a%normalities of the palate *ith mental deficiency has long %een recogni6ed! and there is no dou%t that it is one of the commonest malformations occurring in this condition Many years ago 1angdon Do*n dre* attention to the su%Aect! and more recently Clouston has recorded a large num%er of o%servations *hich sho* conclusively that! although deformed palates occur in the normal! they are far and a*ay more fre?uent in neuropaths and the mentally defective +e states that deformed palates are present in ,2 per cent of the ordinary population! -- per cent of the insane! 77 per cent of criminals! %ut in no less than 8, per cent of idiots Petersen! *ho has made a most e4haustive study of this ?uestion! and has compiled an ela%orate classification of the various anomalies found palatal deformities present in no less than :5 per cent of aments! Hmental defectivesI! in 98 per cent of epileptics! and in :; per cent of the insane Pro%a%ly every city in the 3nited "tates has made special provision for %oth mentally deficient groups and unsocial individuals! either in special schools or in special classes (n Cleveland! *e have had a large school devoted to the pro%lems of the so>called pre>delin?uent %oys! of *hom nearly all have %een %efore the courts and are assigned to this institution %ecause they are not *ell enough adAusted to %e /ept in their normal school environment (n discussing the characteristics of these %oys *ith the principal of that school! ( as/ed him *hat the pro%a%ilities *ere that many of these %oys *ould finally %ecome involved in crime +is comment *as! in effect! that they *ere virtually in the vesti%ule of a penal institute! *hen Audged %y the e4perience of previous %oys from that school (n approaching a study of this group! it is helpful to o%serve the e4perience of the *ell>e?uipped institutions organi6ed for the correction of the a%normal trend *hich characteri6es these %oys (n this connection! there is a helpful report %y the 3nited "tates Dept of 1a%or! Pu%lication No 5;-! *hich gives the result of tracing the after careers of 85, %oys *ho *ere in five of the %est> /no*n correctional institutions (t *as found that 88 per cent had %een arrested

and 7: per cent convicted one or more times after having %een paroled from the institution (t is apparent from data of this type that pro%a%ly the forces that produce these a%normal e4pressions cause irrepara%le damage in the %rain tissue Practically all recent crime reports are recording an increase in Auvenile crime The ChildrenBs Bureau of the Dept of 1a%or stated HNov .! ,2-:I@ 'that Auvenile delin?uency spurted during ,2-9 for the first time since ,2-;!' %ut it cannot e4plain *hy until further study &eports to the %ureau from 5: courts in ,9 states and the District of Colum%ia sho*ed that they handled -,!;-: cases during ,2-9! an increase of -!;;; over ,2-8 The report sho*ed that .. per cent of the cases involved children %et*een ,. and ,7 years oldF 55 per cent those %et*een ,5 and ,years! and ,; per cent those %et*een ,; and ,, BoysB cases comprised : 7 per cent of the total As an approach to this pro%lem ( have made an e4amination of ,:2 %oys in the Cleveland school for pre>delin?uents ( gave particular attention to those physical signs of nutritional inAury! *hich seemed to %e definitely assigned to the formative period of the child We endeavored to o%tain detailed information relative to the family history and to the %irth of the child We *ere fortunate in having the assistance of the officers! and of a nurse in the dental service of the +ealth Department of the Board of Education! a nurse *ho made visits to the homes of many of these %oys to o%tain the information directly from the mothers (n this group of %oys! there *ere t*enty>nine for *hom ( had not sufficient details to include their cases in the studies )f the ,:2 in the group! there *ere only three *ith sufficiently normal dental arches to %e classified as normal Accordingly! 2: . per cent proved to %e individuals *ith more or less mar/ed a%normality Many of the faces *ere very %adly deformed While often it *ill %e difficult to place the responsi%ility entirely on either parent for the childBs a%normal physical development! it is of interest to study the %irth ran/ of these children The average num%er of children in the families represented %y these ,8; children is . 97 )f these! thirty>five! or 5, 2 per cent! are first children in the families representedF thirteen! or 2 , per cent! are only childrenF thirty>nine! or 5. . per cent! are last childrenF and thirty>si4 or 55 7 per cent! are fifth children or later "i4ty>t*o! or -: 9 per cent! are either the first or last child (t *ill %e seen from these data that the first or last child! or even a late child in a large family! tended to have a distinctly poorer chance than the intermediate children in the families in *hich these studies *ere made "tatistical data relating the age of the mother and father to prenatal deficiency

of their offspring reveal that a%normally young parents have a much higher percentage of defective children than do those in the most favora%le child> %earing period of life The group at the Cleveland school included only those %oys *ho have %een %efore the courts %ecause of more or less serious phases of delin?uency (f they are in a considera%le part the products of a defective society! it seems ?uite unfair that they should %e held entirely responsi%le for that delin?uency! *hich has put them in this institution (f they are destined for a penal institute in *hich they *ill %e held entirely responsi%le for that a%normality *hich resulted in their misdemeanor! as has %een the procedure in the past! are they receiving Aust considerationK "ociety may %e Austified in protecting itself from their misdeeds %y placing restrictions a%out them! %ut it does not seem that society is Austified in shifting the entire responsi%ility to the affected individuals &ecent studies of the mental capacity of felons %rought %efore the Common Pleas Court in Cleveland have sho*n that of -!,29 convicted felons e4amined in the medical clinic only .5 - per cent *ere classified as normal #ifty>five and nine>tenths per cent *ere classed as defective delin?uents and only , : per cent as insane The outgro*th of this study has resulted in the drafting %y the Cleveland Bar Association of a ne* criminal la* for )hio to %e presented to the coming "tate 1egislature This %ill provides for the creation of a ne* criminal class composed of *hat are called defective delin?uents This includes morons and others of a%normal mentality %ut not insane *ho commit felonies or misdemeanors The purpose of this legislation is to afford special treatment for la* violators falling *ithin the ne* classification! ma/ing it possi%le to segregate delin?uents in separate institutions The )hio la* li/e that of most other states no* recogni6es only t*o types of criminals! sane and insane! and if not insane they must %e punished (t is proper that *e should as/ *ho is to %lame for the a%normalities *hich render these young men incapa%le of ma/ing the necessary adaptation to our environment An important characteristic of the %oys in the Cleveland school *as their lo* intelligence Practically all *ere recorded as retarded or mentally %ac/*ard prior to their transfer to this institution (t is important that *e note the characteristics of groups that are similarly retarded! %ut *ho have not demonstrated sufficiently unsocial characters to have to %e placed in the pre>delin?uent groups We shall recogni6e them as individuals *ho may never commit unsocial acts sufficient to get them into trou%le! though they *ill dou%tless continue in the group of mentally %ac/*ard

persons "uch a group is to %e found in the )ut*aithe "chool in Cleveland The children in this school! *hich enrolls a%out one thousand students! *ere e4amined in order to ascertain *hether there might %e groups that are similarly afflicted physically The school is distinctive %ecause it has a very high percentage of children *ho are %ac/*ard mentally Many of these children have %een concentrated there in order to %ring them under the influence of special teachers (n an e4amination of a cross section of the children! almost all *ere found to have had distinct inAury in the formative period! as evidenced %y the changes in facial form A preliminary survey of the %ac/*ard children of this institution *as made %y having typical classes selected %y an official of the school from ages ranging from eleven to seventeen ( e4amined the arches and made measurements of the head and face With the assistance of the school nurse ( o%tained records of the other children in the families selected This latter survey *as supplemented %y field *or/ %y the nurse The intelligence ?uotients! as reported in the records! *ere also provided (n the t*enty>nine individuals so studied! seven! or t*enty>five per cent *ere first childrenF fourteen! or fifty per cent last children in the families )nly one individual *as found *ith appro4imately normal dental arches! that is! appro4imately three per cent of the individuals T*enty>eight children! or 29 per cent! had a%normality of one or %oth dental arches These children *ere placed in this institution %ecause they *ere %ac/*ard mentally! although as a group they are compara%le to the group studied in the Thomas A Edison "chool! *here the grouping *as %ased on delin?uent traits A cursory e4amination *as made %y o%serving other pupils in this school in their classes and on the grounds A large percentage of severe facial and dental arch deformities and a very high percentage *ith definite distur%ances in facial gro*th *ere evident These data are presented as applying to a group of individuals characteri6ed %y a distur%ed mentality! to the e4tent that they *ere assigned to special classes for the mentally retarded While the group constituting the school population at )ut*aithe represented the relatively large group of pupils assigned to special classes for %ac/*ard children and did not carry the stigmata of delin?uency carried %y those of the Thomas A Edison "chool! %oth groups had many physical defects in common We are! accordingly! concerned *ith the relationship e4isting among various stages of mental %ac/*ardness! pre>delin?uency and criminality To thro* light on this su%Aect! ( visited our "tate Penitentiary to o%serve the characteristics of facial and dental arch development of the individuals *hose unsocial traits had %rought them to this institution ( visited the dental clinic *ith the director! Dr May! and sa* the mouths of typical mem%ers of that colony as they *ere presented for oral e4amination ( as/ed the director *hat! if any! special features of the oral cavity he had o%served to %e characteristic of this group and

different from those he had o%served outside the institution in his private practice +e stated that he had noted continually that there *as a tendency for the tongue to %e too large for the mouth This is a constant characteristic of another group of mentally inAured! namely! the Mongoloid This institution has a population of appro4imately four thousand individuals A high percentage of them gave mar/ed evidence of inAury in the prenatal period as e4pressed in distur%ances of facial form and the shape of the dental arches (n o%serving over half the population at *or/ or e4ercise! ( did not see one *ith a typically normal facial development (n #ig ,55 *ill %e seen typical e4amples of this group These sho* front and side vie*s Hsee +ootonBs recent %oo/ ,7aI

FI". 1!!. 8riminals. =ere their unsocial traits related directly to incom#lete brain organi*ation associated with #renatal in@uryH

Ne*spaper daily illustrated reports of crimes committed %y young criminals sho* almost continually these evidences of prenatal inAury Note the t*o characters Bird and Ni4on! #ig ,5-

FI". 1! . 'ote the mar%ed lac% of normal facial develo#ment of these notorious young criminals. 'i,on is only 14. $hese are ty#ical sam#les seen fre(uently in the daily #ress.

(t is important to emphasi6e the fact that the distur%ances in the development of the head! face and %rain may have a variety of e4pressions (n the more severe form characteristic of the Mongoloid group! as seen in #ig ,5. the facial inAury is typical and is associated *ith a mental distur%ance *hich! in turn! has %een sho*n to %e associated *ith typical %rain lesions The individuals of that group! ho*ever! do not tend to %e criminals (ndeed! their inAury is too severe As a group they are apt to %e docile! tracta%le and happy (ndeed! in the mentally %ac/*ard and criminal groups in their various stages! *e find facial patterns typical of large num%ers of individuals *e see on the streets! *ho are in school or in %usiness! and entirely capa%le of maintaining a respected and honora%le position in society Accordingly! it is not Austified! and indeed *ould %e entirely unfair! to associate their distur%ed facial and dental arch development *ith traits that *ould %e normally found in the grossly unsocial groups We cannot %y vie*ing the face evaluate the /ind or e4tent of %rain inAury that is associated *ith prenatal malnutrition of that individual (ndeed! these various divergent facial patterns are accepted %y our modern civili6ation as representative of the many varieties or patterns constituting a normal population (t is not until *e see primitive groups living under a controlled natural environment that *e see NatureBs model and design of the human physiognomy

FI". 1!). $his is a ty#ical mongoloid defective. 'ote the mar%ed lac% of develo#ment of the middle third of the face and nose with the u##er arch too small for the lower. Individuals of this ty#e loo% ali%e and act ali%e and all have ty#ical s#eech and behavior defects. $hese are now associated with definite defects in the brain. 'early all are either a first or last child. A large #ercentage are born to mothers over forty years of age.

We are concerned to /no* the percentage in any typical colony of our modern civili6ation that may %e placed in the various classifications of normal! mildly %ac/*ard mentally! severely %ac/*ard mentally! unsocial! delin?uent! criminal! idiots! epileptic and insane Tredgold H5I reports t*o surveys in England and Wales *hich give figures on the proportion of the population that could %e identified *ith definite lesions (t *ould %e fortunate if a survey could %e made in the 3nited "tates that *ould indicate the e4tent of the increase in delin?uents of various types! including rac/eteers and criminals (t *ould %e very helpful if these data could %e related to the degrees of prenatal inAury There are many phases of modern degeneration *hich lend themselves to study from the standpoint of the pro%a%le role of progressive decline in the efficiency of nutrition to the progressive increase in mor%idity! mortality! mental deficiency and delin?uency This is discussed in the ne4t chapter on "oil Depletion! Plant and Animal Deterioration

#rom the point of vie* of this pro%lem the differences %et*een the modern *hite civili6ations and many of the primitive groups is interesting Criminal tendencies in isolated primitives are so slight that no prisons are re?uired ( have referred to the 1oetschental =alley in "*it6erland! *hich! until recently! has %een physically isolated from the process of moderni6ation #or the t*o thousand inha%itants in that valley! there is no prison (n 3ganda! Africa! the &uanda tri%es estimated to num%er t*o and a half millions! had no prisons )%servation of NatureBs normal facial patterns in the primitive racial stoc/s! esta%lishes types *ithin the limits of normality The readers of this te4t %y o%serving the individuals in any given families may see in ho* large a percentage of *hite families the progressive narro*ing and lengthening of the face in the younger mem%ers of the family as compared *ith the older occurs #urther o%servations *ill ena%le one to recogni6e rapidly! even *ithout e4perience and special training in anatomy! these evidences of prenatal inAury ( made a survey in the Ne* England "tates! Cue%ec and Eastern )ntario! %ecause the 3nited "tates death rate from heart disease as reported %y the American +eart Association *as sho*n to %e highest in =ermont and Ne* +ampshire! follo*ed closely %y Massachusetts and Ne* Yor/ ( first visited the Ne* Yor/ "tate +ospital for tu%erculosis patients at &ay%roo/! near "aranac With the assistance of a mem%er of the staff! ( e4amined fifty young men and *omen in the *ards (n that group! only three *ere found *ith normal facial and dental arch development These three individuals *ere mar%le cutters *ho *ere suffering from silicosis The forty>seven other individuals e4amined H2. per centI *ere found to have mar/ed evidence of inAury in the developmental period At the state fair at &utland! =ermont! to *hich residents came from various communities throughout the state! ( *as a%le to count! %y o%serving and recording the individuals *ho passed! that in each ,;; people! three out of four gave evidence of inAury in the developmental period "imilar studies *ere made at the "tate #arm for delin?uent %oys and girls! almost all of *hom had %een %efore the courts , found that a very high percentage! appro4imating ,;; per cent of those o%served! had received inAuries in the prenatal period ( then *ent to Cue%ec and studied groups of school children in the early teens ( o%served groups in *hich a very high percentage gave mar/ed evidence of prenatal inAury This seemed aggravated in districts *here the farms had %een a%andoned! %ecause the land *as not producing as *ell as in the past ( studied (ndians in t*o (ndian &eservations! also! and there again found mar/ed evidence of inAury typical of our moderni6ed communities "imilarly! a limestone district in )ntario *as visited and critical o%servations *ere made of the facial form of the ne* generation! in regions in *hich the

fertility of the soil had %een definitely depleted through e4haustion These again sho*ed evidence of prenatal inAury through faulty nutrition The prisoners in a Aail *ere e4amined! and all of them e4cept t*o ha%itual drun/ards sho*ed mar/ed evidence of prenatal inAury (f space permitted! it *ould %e interesting to include here a discussion and illustrations of the physical characteristics of the rac/eteers and criminals *hose pictures are sho*n in our ne*spapers almost daily (t is rare that a normal face is depicted in this group As an approach to more detailed study of the availa%le information regarding the processes that are involved in the production of facial deformities! it *ill %e helpful to thin/ of the face as constituting the floor of the anterior part of the %rain The pituitary %ody is situated on the underside of the %rain Aust %ac/ of the eyes (t is the governing %ody for the activity of gro*th! and largely controls the functioning of several of the other glands of internal secretion (t is! as it *ere! the master of the ship We are! accordingly! primarily concerned *ith the role that it plays! and the forces *hich control its o*n development and function (ts dependence upon vitamin E has %een demonstrated %y many *or/ers #or e4ample! Dr M M ) Barrie H-I has reported that an inade?uate amount of vitamin E produces mar/ed distur%ance in the gro*th of the offspring of rats +e states@ The changes o%served are similar in several *ays to those produced %y hypophysectomy Hremoval of pituitary glandI Mar/ed degranulation of the anterior pituitary is found in %oth the a%normal young and the adult sterile animals 1ac/ of vitamin E therefore produces a virtual nutritional hypophysectomy in the young rat The *or/ recently done in this field %y Dr +ector Mortimer and his associates in Mc$ill 3niversity! Montreal! has included studies of s/ull development of rats +e has sho*n that the surgical removal of the pituitary %ody at the %ase of the %rain in very young rats produces regularly a certain type of defect in s/ull development This has %een characteri6ed %y a lac/ of development for*ard of the mu66le or face! *ith a narro*ing of the nose and dental arches +e found that %y the addition of e4tracts made from the pituitary glands! *hich he had removed surgically! he entirely prevented the development of these defects! there%y esta%lishing the relation of the inAury to deficiencies of the hormones developed %y that organ Another approach to the pro%lem on *hich he has e4pended much fruitful effort! has %een in connection *ith the study of the s/ulls of individuals *ho are /no*n to have distur%ances in the functioning of the pituitary gland through the interference caused %y

tumors Common illustrations are the cases of acromegaly or giantism By associating these physical changes in %odily form *ith each 4>ray! data o%tained from s/iagraphs! together *ith the history and the nature of the tumor! considera%le information has %een developed Another important series of studies has included the correlation! %y means of the 4>rays! of the s/ulls of individuals suffering from certain types of physical and mental distur%ances! *ith certain a%normalities in the s/ull as sho*n %y the 4>rays By these various means Dr Mortimer has %een a%le to divide the various types of s/ull defects and developmental and gro*th defects into distinct classifications With this yardstic/ he is a%le to classify individuals from their &oentgenograms (t is of interest that in his *or/! in association *ith Dr $ 1evine! Dr A W &o*e and others at the Evans Memorial for Clinical &esearch and Neuro>Endocrine &esearch in Boston! important relationships have %een esta%lished through the e4amination of over three thousand case histories E>ray records of the s/ull are included in the studies They report that independent and previous physiological investigations gave evidence at the time of the e4amination of distur%ed pituitary function Dr MortimerBs e4cellent investigations seem to indicate clearly that facial and dental arch form are directly related to and controlled %y the functioning of the pituitary %ody in the %ase of the %rain Dr Barrie H-I reports that partial deficiency of vitamin E! as sho*n in the case of the female rat! results in the prolongation of gestation *hich may %e continued as long as ten days %eyond the normal period The offspring under these conditions are a%normal #urther! animals deficient in vitamin E! occasionally give %irth to a litter! %ut fail to lactate When *e reali6e that one of the %est sources of vitamin E is *heat germ! most of *hich is removed from *hite flour! usually along *ith four>fifths of the mineral! *e see one cause of the tragedy that is over*helming so many individuals in our modern civili6ation (n many individuals it may %e *ise to reinforce our modern *hite %read and starchy dietary *ith *heat germ! *hich can %e o%tained in pac/age form from the manufacturers of flour As this is put up in cans! all air is displaced *ith an inert gas *hen the cans are sealed While in this *ay o4idation of the em%ryo *hich is very fragile! is prevented! as soon as the seal is %ro/en! o4idation sets in and progresses rapidly! producing a product that is not compara%le to the *heat em%ryo of freshly crac/ed *hole *heat My investigations indicate that Nature has put Aust the right amount of em%ryo in each grain of *heat to accompany that ?uantity of food (f the *hole *heat is prepared and eaten promptly after grinding and e4posing the em%ryo to o4idation! the effect desired %y Nature is ade?uately provided

(t is important to emphasi6e in connection *ith the development of the deformities of the face that other s/eletal deficiencies or a%normalities result from the same distur%ing factors )ne of these is the narro*ing of the entire %ody! *ith a tendency to increase in height This is sho*n in many of the family groups of moderni6ed primitives The effect of this narro*ing of the %ody! *hich in girls results in the %oyish type of figure due to the narro*ing of the hips! introduces an entirely ne* and serious pro%lem in the e4perience of our modern civili6ation *hen confronted *ith the pro%lems of child%irth Among primitive races living in a primitive state child%irth *as a very simple and rapid process! accompanied %y little fear or apprehensionF *hereas! in the moderni6ed descendants! even in the first and second generations of those individuals %orn to parents after they had adopted the foods of modern *hite civili6ations! serious trou%le *as often e4perienced We have %een considering the changes *hich ta/e place in the s/eletal gro*th as a result of the distur%ances in the functioning of the pituitary %ody of the individual after %irth! or of the mother during the prenatal period We are also concerned *ith changes in the soft tissues! particularly the %rain ( have presented data indicating that a very large percentage of mentally %ac/*ard children have distur%ances in facial development The availa%le data also indicate that a large percentage of those *ho are seriously inAured in facial form have some distur%ance in their mental or moral character Whether there is relationship %et*een the processes *hich develop these physical a%normalities in %rain gro*th and mental efficiency! including emotional states and character traits is no* to %e considered An important contri%ution has %een made to this phase of the pro%lem %y Dr Dames Pape6! Professor of Anatomy at Cornell 3niversity! H.I *ho concludes his report@ (s emotion a magic product! or is it a physiologic process *hich depends on an anatomic mechanismK The evidence presented is suggestive of such a mechanism as a unit *ithin the larger architectural mosaic of the %rain &esearch data have %een presented *hich deal *ith the anatomical defects of the %rain of individuals suffering from the typical mental and physical patterns of the so>called Mongolian idiot (n these cases the gyrus cinguli of the %rain *ere found to %e a%sent! *hich indicates the impossi%ility that these individuals function normally either physically or mentally

Modern civili6ation has provided a large group of the defectives /no*n as Mongolian idiots They have very definite characteristics %oth physical and mental Among the former! one of the most universal e4pressions is a vacant stare associated *ith a face that is mar/edly underdeveloped in the middle third! usually accompanied %y narro* nostrils and a narro* upper dental arch )ne of the outstanding characteristics of the group is their ina%ility to develop mentally %eyond three to eight years of age Because of the difficulty of %uilding a character and intelligence level %eyond infancy! these unfortunates are housed largely in state institutions for fee%leminded "ince the physical picture is similar to that *hich occurs in a much less severe form in a large num%er of individuals in our modern civili6ation! it is important that *e study this group in the light of the information that is availa%le *ith regard to their physical! mental and moral characteristics! and in the light of such information as is availa%le regarding their origin The surveys that have %een made reveal the fact that nearly all of them are %orn to mothers more than forty years of age! and apparently at a period of very lo* efficiency in reproductive capacity While most of the discussion and literature stress the importance of the age of the mother! some data are no* availa%le *hich thro* responsi%ility also on the paternal side Gorosi! as reported %y Tredgold in Mental Deficiency! came to the conclusion as a result of the investigation of 5.!;;; unselected individuals that the children of fathers %elo* t*enty or a%ove forty years of age are *ea/er than the children of fathers %et*een these ages Also! the children of mothers over forty years of age are *ea/er than those %orn to mothers %elo* this age Tredgold presents data connecting defective structures in the %rain *ith certain phases of physical %ehavior and mental deficiencies +e ?uotes many authors *hose data correspond *ith his o*n Much of this material relates to accounts of incomplete prenatal development of nerve structures in the %rain We are particularly interested in the origin and the nature of the %rain lesions Penrose! H7I in analy6ing the relative etiologic importance of %irth order and maternal age in Mongolism presents data o%tained from an e4amination of 55. defectives in *hich the total num%er of children in all the families involved *as ,!;,- Accordingly! in these families appro4imately 5; per cent *ere so affected The average num%er of children per family *as five and one>half +e states@ Mongolian im%eciles are very often %orn last in a long family This fact! *hich *as pointed out many years ago %y "huttle*orth! has led clinicians to

%elieve that Mongolism is to some e4tent a product of the e4haustion of maternal reproductive po*ers due to fre?uent child %earing The conclusion is *idely accepted *ith the reservation that the affected child is not necessarily %orn at the end of the family "everal cases are first>%orn! in fact! and it is sometimes stated that the conditions occur more fre?uently in first and last children than in other ordinal positions There is! ho*ever! ample evidence that Mongolian im%eciles have a significantly later %irth ran/ than normal children $ )rdahl H8I has reported on a study of ninety>one cases in *hich he found that fifty>si4 or 8; per cent *ere the last %orn The families averaged five children +e states that 'uterine e4haustion is the most commonly advanced reason for Mongolism ' Madge T Mac/lin H9I says! '(t is usually stated that it HMongolismI occurs more fre?uently in the later pregnancies o*ing either to reproductive e4haustion or to too advanced age of the mother ' We are concerned at this point for evidence that *ill thro* light on the relationship %et*een the functioning of the pituitary %ody in the %ase of the %rain and the development of this type of facial and mental deformity A stri/ing case is that of a %oy si4teen years of age *ho *as a typical Mongolian idiot +e had t*o sisters *ho *ere much older than he +is mother *as a partial invalid *hen he *as %orn late in her life We have no data relative to the details of the children *ho may have %een lost +is father *as living and *ell e4cept for a railroad inAury This %oy at the age of si4teen *as infantile in many of his characteristics and developments The genitals *ere those of a %oy eight years old The facial e4pression *as that of the typical Mongolian idiot By the Binet test he had a mentality of a%out four years &oentgenograms of his hands sho*ed that the epiphyseal %ones had not united +e played on the floor *ith %loc/s and *ith rattles li/e a child +is interest *as in childrenBs activities H#ig ,57 I The outstanding physical characteristic *as his ma4illary arch *hich *as so much smaller than the mandi%ular arch that it *ent entirely inside it (n order to give him a masticating surface! and *ith the hope of helping him %oth physically and mentally! since several cases had greatly %enefited %y such an operation! ( determined to *iden his arch %y moving the ma4illary %ones apart a%out one>half inch The position of his teeth %efore the moving of the %ones is sho*n in #ig ,58 &oentgenograms sho*ing the opening of the median suture *ith increase of pressure are also sho*n in #ig ,58 An important phase of this case *as that the left nostril *as entirely occluded! and pro%a%ly had %een all his life A rhinologist spent half an hour trying to shrin/ the tissue *ith adrenalin and cocain sufficiently to get air or *ater through! and *as not a%le to do so The ?uantity of air that he *as a%le to inhale through his right nostril *as so scant that he continually %reathed *ith his mouth open At

night he *as forced to lie *ith something li/e his coat rolled into a hard ridge and placed under the %ac/ of his nec/ and his head pushed far %ac/ to a position that *ould open his mouth and retain it so! or he *ould a*a/en! strangling %ecause of the closing of his mouth

FI". 1!-. $hese views show #hysical changes in the mongoloid ty#e due to movement of ma,illary bones to stimulate the #ituitary gland in base of brain. Left+ front and side view before+ center+ front and side view in thirty days. 2ight+ front and side view si, months after. Aged si,teen+ infantile before+ adolescent after o#eration. =hile he im#roved mentally he was harmless before and a se, #ervert after o#eration and had to be #laced in an institution.

FI". 1!/. $hese ,&ray #ictures show the #osition of the teeth before o#eration to move ma,illary bonesC and #rogessively+ by the dates shown+ the widening of the u##er arch. In twelve wee%s> time the boy #assed through adolescence. 'ew bone ra#idly filled in the s#ace between the se#arated bones. $he s#ace was retained with a fi,ed bridge carrying two additional teeth. 1is mother was nearly fifty when he was born.

With the movement of the ma4illary %ones laterally! as sho*n progressively in #ig ,58! there *as a very great change in his physical development and mentality +e gre* three inches in a%out four months +is moustache started to gro* immediatelyF and in t*elve *ee/sB time the genitals developed from those of a child to those of a man! and *ith it a sense of modesty +is mental change *as even more mar/ed The space %et*een the ma4illary %ones *as *idened a%out one>half inch in a%out thirty days This lateral pressure on the ma4illary %ones *as accomplished %y rigid attachments to the teeth of the t*o sides of the upper arch The out*ard movement of the ma4illary %ones H*hich form the roof of the mouth and sides of the noseI %y pressure on the temporal %ones produced a tension do*n*ard on the floor of the anterior part of the %rain! thus

stimulating the pituitary gland in the %ase of the %rain (n a fe* *ee/sB time he passed through stages that usually ta/e several years At first! he got %ehind the door to frighten usF later! he put %ent pins on chairs to see us Aump *hen *e sat do*n! and finally he %ecame the cause of a policemanBs coming to the office from *here he *as conducting traffic on the corner %elo* to find *ho it *as s?uirting *ater on him *hen his %ac/ *as turned +e developed a great fondness for calling people over the telephone! *anted to %orro* my automo%ile to ta/e his mother for a drive! and *ith his arm caressingly a%out the shoulders of one of the secretaries! invited her to go *ith him to a dance All this change developed in a%out t*elve *ee/s A most remar/a%le event happened in connection *ith this procedure +e lived in another city! and so! *hile *ith me! stayed in a %oarding house at a little distance from my office in order that he might have fre?uent! and almost constant attention )n his return to his home to*n! his efficiency had increased to such an e4tent that his mother could send him *ith the money to the grocery store *ith the order for the dayBs groceries! and he could %ring %ac/ the right change and could tell *hen it *as correct +e could also come alone to me ninety miles %y railroad and ma/e t*o changes of trains and the various transfers on the street cars of the city *ith accuracy and safety +e *ore an appliance in his mouth to /eep the %ones in position This appliance %ecame dislodgedF the ma4illary %ones settled togetherF immediately! or in a day or t*o! he lapsed into his old condition of lethargy accompanied %y an old trou%le! *hich had fre?uently %een distressing! namely! nausea! this sometimes lasting for t*enty>four hours With the readaptation of the separating appliance and the reconstruction of the retaining appliance! he returned rapidly to his improved condition But a ne* pro%lem had developed We had changed an infant to a potential man *ith the impulses of a man! %ut *ith the mind of a child With the change in his physical condition he %ecame a menace in his community as a se4 pervert +is mother died and his sister married (t %ecame necessary to have him placed in a state institution for defectives During the period he *as in my care! he had learned to read child stories and ne*spaper headings! and had spent much time doing so The changes in his physical appearance are sho*n in #ig ,57! a%ove! front vie*! and %elo*! side vie* The first picture at the left sho*s his appearance %efore the operationF the second! thirty days afterF and the last! si4 months later The opening produced in the upper arch in front of half an inch *as filled %y supplying t*o teeth on a restoration! *hich at the same time held the ma4illary %ones in their ne* position (n si4 months he had

developed *his/ers and moustache The progressive changes in the position of the ma4illary %ones *ith the opening of the median suture are sho*n in #ig ,58! together *ith the mechanical appliance (n the last vie*! the restoration carrying the porcelain teeth to fill the space is sho*n A very important contri%ution to our /no*ledge of the cause of Mongolism has recently %een pu%lished %y Dr Clemens E Benda! H:I Clinical Director of the Wrentham "tate "chool! Wrentham! Massachusetts! in association *ith the +arvard Medical "chool of Boston +e and his group have approached the pro%lem of Mongolism from t*o different anglesF first! as to determine *hether it is accidental! and second! *hether it is a unit of symptoms *hich can %e related to more essential alteration Their studies including careful anatomical studies have %een made on the %asis of an e4amination of ,57 Mongoloids +e states@ "ummari6ing our investigations! the pituitary in mongoloids reveals a peculiar and definite pathology )n the %asis of fourteen cases *e feel Austified in emphasi6ing that in mongolism definite failure of the pituitary development is to %e found Mongolism appears as a hypopituitarism of a specific type! in *hich the a%sence or deficiency of %asophiles seems to %e essential The evidence indicates that this severe type of facial and %rain inAury is related directly to a lo*ered reproductive capacity of the mother associated *ith age! since the maAority are %orn to mothers %eyond forty years of age! and to an inade?uate nutrition of the mother! particularly in vitamin E since this vitamin plays so important a role in the nutrition of the pituitary %ody (mportant ne* data have %een provided in an analysis of %irths in the 3nited "tates in connection *ith the development of the Mongolian group Bleyer H2I has reported a study of 5!:55 cases +e reports that of the total %irths in the 3nited "tates in ,2-.! of ,!;27!2-2! there *ere ,!:55 reported as Mongoloids The average age of the mothers of these individuals *as forty>one years +e reports data indicating that in the age group of mothers forty to forty>four the chances of the development of a Mongoloid *ould %e seventy>five times as high as normal e4pectancy! and in the age forty>five to forty>nine the chances are ,57 times normal e4pectancy (n a group of ,!2.5 Mongoloids! ,!,;; or 79 per cent *ere last children These data are in /eeping *ith those of several other investigators! and emphasi6e the pro%lem of depleted reproductive capacity The interesting pro%lems involved in the %irth of identical t*ins thro* light on the origin of %oth physical and mental characters (t is a matter of great

significance in connection *ith these studies that anomalies *hich *e can associate *ith parental deficient nutrition are reproduced in %oth t*ins (mportant additional light has %een thro*n on this phase %y a family of si4 pairs of fraternal t*ins %orn to the same parents These are reported %y Dr William W $reulich! of Ne* +aven H,;I (t is significant that nine of these individuals Hone of the oldest pair is deceased! and the youngest t*ins are yet %a%es in armsI sho* mar/ed narro*ing of the nostrils and lac/ of development of the middle third of the face! narro*ing of the face and tendency to %e mouth %reathers #urther! the severity of this condition appears to %e progressively more severe in the younger pairs of t*ins! sufficiently gro*n to sho* facial development There is accordingly! evidence here of progressive lo*ering of reproductive efficiency! and the fact that %oth individuals are involved similarly has great significance! since they are fraternal t*ins arising from a single ovum This seems clearly to relate this distur%ance *ith a deficient germ plasm #actors that are reproduced in identical t*ins *ould include %oth hereditary characters and those that are produced %y a distur%ance in environment resulting in an interference *ith normal hereditary processes (n a case of t*ins that are not identical! there is significance in the development of similar deformities *hich are li/ely to %e of ac?uired origin rather than of hereditary origin (n #ig ,59 is seen a pair of t*ins Note that they have similar distur%ance in the development of the dental arches *ith the upper laterals depressed and the cuspids cro*ded out*ard in the arch

FI". 1!3. $hese boys are twins+ not identical. 'ote+ however+ both have same ty#e of deformity of the dental arch+ a##arently due to the same cause.

A very important source of information *hich deals *ith the relation of distur%ances of the physical development of the head and mentality is provided %y a study of the mem%ers of the teen>age group *ho are classed as mentally %ac/*ard (n an e4amination of a Cleveland school in a colored district that has %een set aside largely for %oys and girls *ho are distinctly deficient in their a%ility to learn! it *as disclosed that a very large percentage suffered from

gross facial deformities *hen Audged %y these standards Typical individuals in this group are sho*n in #ig ,5:! one is *hite! lo*er left (t is clear that these %oys *ere all physically inAured in the formative period Their clinical history indicates that the %rain *as involved in this distur%ed development

FI". 1!4. $hese four boys are ty#ical of a grou# of several hundred in a s#ecial school for bac%ward children. ?ractically all showed some evidence of incom#lete facial and dental arch develo#ment. $he range of defects is wide. Blac%s are similarly in@ured as whites. $his is inhibited heredity.

)ne of the pro%lems involved in the development of the group of distur%ances having physical and mental e4pressions! is associated *ith the sensitiveness of the %ody during the period of adolescence Many students of degenerative pro%lems have emphasi6ed various phases of this large pro%lem Burt' commented@ '(t is almost as though crime *ere some contagious disease! to *hich the constitutionally suscepti%le *ere suddenly e4posed at pu%erty! or to *hich pu%erty left them peculiarly prone ' The age of adolescence is also the period of greatest suscepti%ility to dental caries Data derived from chemical studies of the %lood and saliva sho* that in this period of suscepti%ility to dental caries the supplies of minerals and vitamins are inade?uate to meet NatureBs demands! and the system %orro*s minerals from the s/eleton to maintain vital processes 1ichtenstein and Bro*n H,5I report data *hich reveal

that educational ?uotients! li/e intelligence ?uotients! fall *ith increase in age during the years of developing pu%erty They sho* that the educational ?uotient at nine years of age for the group studied *as ,;;F at eleven years of age! :2F at t*elve years! :-F and at thirteen years! 9. The changes in facial and dental arch form! *hich ( have descri%ed at length in this volume! develop in this age period also! not as a result of faulty nutrition of the individual %ut as the result of distortions in the architectural design in the very early part of the formative period Apparently! they are directly related to ?ualities in the germ plasm of one or %oth parents! *hich result from nutritional defects in the parent %efore the conception too/ place! or deficient nutrition of the mother in the early part of the formative period Case records sho* that the first signs of delin?uency generally ma/e their appearance during these years The age reported most fre?uently *as that of thirteen )ne e4pression of the rate of the progressive degeneration that is ta/ing place in the 3nited "tates is the increase in delin?uency and crime in young people %et*een t*elve and t*enty years of age! as *ell as in crime in general Edgar +oover! Director of the Bureau of (nvestigation! has recently pu%lished data sho*ing comparative figures for ,2-8 and ,2-9! during *hich time crimes in the 3nited "tates increased from ,!---!758 to ,!.,7!:,8! an increase of si4 per cent This increase is occurring in spite of the rapid development of social organi6ations for improving the environment Preventive measures among the unsocial group! *ho pass through the stages of predelin?uency and crime! have %een almost entirely confined to improvement in the social surroundings of the gro*ing youth While! no dou%t! individuals *ith a lo* factor of safety are less li/ely to develop serious criminal tendencies under favora%le environments! such factors as constitute a first>conditioning force! i e ! inAury of the germ plasm! and deficient nutrition in the developmental period are not corrected %y these efforts These ne* data relating to the nature of the underlying causes strongly emphasi6e the need for %eginning much earlier (ndeed! the preparation for the ne4t generation should %egin early in the life of the preceding generation Many investigators have emphasi6ed the sensitiveness of the nervous system to distur%ances in the formative period Considera%le data have %een presented indicating that the tissues of the nervous system are the most easily affected of all the structures of the %ody The e4tent of the inAuries to the nervous system vary through a *ide range

+arris in his chapter on 'Congenital A%normalities of the "/eleton' in Blac/erBs H,-I 'Chances of Mor%id (nheritance' has presented data indicating the sensitive period at *hich the ovum is most li/ely to %e inAured@ #e* normal human em%ryos have %een su%Aected to careful study The vast maAority of human em%ryos e4amined have %een a%normal! and it is their a%normality *hich has led to their a%ortion %et*een the si4th and thirteenth *ee/s of em%ryonic life! a critical period associated *ith the development of the placenta! during *hich the death rate is pro%a%ly in the neigh%orhood of at least ,7 per cent (n tracing the development of the human em%ryo! he tells *hy the gro*th process is very different from that of the development of em%ryos of lo*er forms +e states regarding deformed ova@ ')va that survive the eighth *ee/ tend to live on to term! and are %orn as monsters ' ( have referred previously to a personal communication from Professor "hute! of the 3niversity of Western )ntario! *hich states that he had %een impressed *ith the high percentage of deformities in a%orted fetuses This seems to %e NatureBs method of eliminating defective individuals +arris says further@ (t is sometimes suggested that threatened a%ortions in early pregnancy should not %e treated %y rest and ?uiet! as it is ?uite possi%le that the uterus is attempting to rid itself of a pathological ovum *hich might %ecome a monster in the future The availa%le data emphasi6e strongly that a very small percentage of the total gross deformities ever develop to menace society +arris ?uotes Mall@ H,.I +e estimated from the records of ,;;!;;; pregnancies that there *ere :;!795 normal %irths! ,,!987 a%ortions of normal em%ryos and early monsters! and 8,7 monsters %orn at term Thus at term , child in ,-5 is %orn *ith some anatomical defect #or each such case appearing at term! ,5 others died and *ere a%orted during pregnancy These data deal *ith gross defects involving physical deficiencies in the infant and indicate that the defects that are produced in the formative period! *hich are less severe than the a%ove! are not recogni6a%le at %irth and may not %e until long after*ards According to +arris! 'During the fourth *ee/ of em%ryonic life the head! %rain and spinal cord are most suscepti%le to adverse conditions ' +e traces the sensitive areas of the various structures through the various *ee/s in the em%ryonic history The deformities of the face among the primitive races *hich ( have illustrated e4tensively fre?uently are not revealed

until the eruption of the permanent dentition and the development of the adult features While it is true that many children sho* deformity in facial development even in %a%yhood and childhood! those individuals are usually much more seriously inAured *hen the adult face is developed Bloom H,7I has presented the anatomical and histological characteristics of a defective %orn to a mother fifty>one years of age! *hose general health *as reported as good The infantBs facial pattern *as mar/edly divergent from normal and practically no %rain tissues had %een formed This e4pression of an e4treme inAury *as entirely %eyond that *ith *hich *e are concerned in the study of the mental and the moral cripples *ho constitute an increasing part of our society This is presented to emphasi6e NatureBs ine4ora%le re?uirement that each parent shall %e individually physically fit for the responsi%ility of producing the ne4t generation "everal primitive races studied have reali6ed this responsi%ility There are some phases of modern physical degeneration in *hich most of us ta/e part *ith remar/a%le complacency We *ould consider it a great misfortune and disgrace to %urn up the furniture in our homes to provide *armth! if fuel *ere availa%le for the collection This is precisely *hat *e are doing *ith our s/eletons %y a process of %orro*ing! simply %ecause *e fail to provide ne* %ody repairing material each day in the food You are all familiar *ith the tragic misfortune that overta/es so many elderly people through the accident of a %ro/en hip or other fractured %one "tatistics sho* that appro4imately 7; per cent of fractured hips occurring in people %eyond 87 years of age never unite We loo/ upon this as one of the inevita%le conse?uences of advancing age (n Chapter ,7 ( have referred to the small %oy *hose leg *as %ro/en *hen he fell in a convulsion *hile *al/ing across the /itchen floor That %one did not %rea/ %ecause the %lo* *as hard %ut %ecause the minerals had %een %orro*ed from the inside %y the %lood stream in order to maintain an ade?uate amount of the minerals! chiefly calcium and phosphorus in the %lood and %ody fluids +e had %een %orro*ing from his s/eleton for months %ecause due to a lac/ of vitamins he could not a%sor% even the minerals that *ere present in the inade?uate food that he *as eating The calcium and the phosphorus of the mil/ *ere in the s/immed mil/ that he *as using %ut he needed the activators of the %utter>fat in order to use the minerals "imply replacing *hite %read *ith these activators and the normal minerals and vitamins of *heat immediately chec/ed the convulsions We have many other e4pressions of this %orro*ing process Much of *hat *e have thought of as so>called pyorrhea in *hich the %one is progressively

lost from around the teeth thus allo*ing them to loosen! constitutes one of the most common phases of the %orro*ing process This tissue *ith its lo*ered defense rapidly %ecomes infected and *e thin/ of the process largely in terms of that infection A part of the local process includes the deposit of so>called calculus and tartar a%out the teeth These contain to4ic su%stances *hich greatly irritate the flesh starting an inflammatory reaction Many primitive peoples not only retain all of their teeth! many of them to an old age! %ut also have a healthy flesh supporting these teeth This has occurred in spite of the fact that the primitives have not had dentists to remove the deposits and no means for doing so for themselves Note particularly the teeth of the Es/imos The teeth are often *orn nearly to the gum line and yet the gum tissue has not receded Many of these primitive groups *ere practically free from the affection *hich *e have included in the general term of pyorrhea or gingivitis Pyorrhea in the light of our ne*er /no*ledge is largely a nutritional pro%lem While nutrition alone often *ill not %e ade?uate for correcting it! *hen esta%lished practically no treatment *ill %e completely ade?uate *ithout reinforcing the nutrition in so far as deficient nutrition has %een a contri%uting factor Nutrition plus the fre?uent removal of deposits! plus suita%le medication *ill chec/ and prevent pyorrhea %ut not correct the damage that has already %een done The elements that are chiefly needed in our nutrition are those that ( have outlined as %eing particularly a%undant in the menus as used %y several of the primitive races These are discussed in detail in Chapter ,7 Another important aspect of this pro%lem of %orro*ing has to do *ith the progressive shrin/ing of the s/eleton as evidenced %y the shortening of the stature ( have measured many individuals *ho have lost from t*o to si4 inches in height in a decade or t*o ( have seen a fe* individuals *ho have lost as much as ten inches of their height %y this process of %orro*ing from the s/eleton )ur %odies need a certain amount of fresh minerals every day *ith *hich to manufacture %lood The days that these minerals are not provided in the foods they *ill %e ta/en from our storage depots! the s/eleton A particularly tragic phase of this pro%lem of %orro*ing from the %one is seen in gro*ing girls and is chiefly due to their am%ition to avoid enlargement of their %odies to /eep do*n their *eight The girls deprive themselves of %ody %uilding material at a time *hen their %odies are gro*ing and are re?uiring considera%le ne* mineral #orming %one has a prior claim on minerals! *hich is sufficiently commanding to induce the individual to %orro* from %ones that are already formed to provide for the necessary lengthening and gro*th By this process many of the %ones of the %ody are softened! particularly the %ones

of the spine Curvatures develop! one of the e4pressions of *hich may %e round or stooped shoulders Among primitive races this type of girl! so commonly seen in our modern civili6ation! is a%sent Pro%a%ly not one of these girls has ever suspected the suffering and sorro* that is %eing stored up for future life as a result of this %ad management at a critical time in her development #ig ,-. illustrates one of the tragedies of this %orro*ing process Practically all of these physical evidences of degeneration can %e prevented and fortunately many of them can %e relieved in large part *ith an ade?uate nutrition Even ununited fractures often can %e induced to unite %y an ade?uate reinforcement of the nutrition This is true not only for young people %ut for elderly people as *ell (n addition to the pro%lems gro*ing out of physical inAuries through lac/ of development %efore %irth! *hich e4press themselves as facial and other deformities! there is increasing need for concern for physical handicaps entailed in underdevelopment of the hips The difficulty encountered at child%irth in our modern civili6ation has %een emphasi6ed %y Dr Gathleen =aughan H,8I of 1ondon (n her %oo/! '"afe Child%irth!' she states that faults of development more than race modify pelvic shape (n the #ore*ord to her %oo/! Dr +o*ard A Gelly! Professor Emeritus of $ynaecological "urgery! Dohns +op/ins 3niversity! says@ Dr =aughan presents such an array of facts and data that the %oo/ must impress every reader (t is of vital importance that her conclusions %e considered! for in my opinion our methods of %ringing up our girls and the ha%its of our *omen *ith many of the customs of Bcivili6edB life must %e radically readAusted This important *or/ should %e made availa%le for reference in the school li%raries of the 3nited "tates #urther data from it are presented in Chapter 5, The great contrast in discomfort and length of time of the la%or of modern mothers is to %e contrasted *ith ease of child%irth among primitive mothers Many *or/ers among the primitive races have emphasi6ed the vigorous health and e4cellence of the infant at %irth We have here! therefore! emphasis on the need in the interest of the infant that the mother shall have an easy and short la%or Both of these factors are directly influenced %y the vitamin content of the motherBs %ody as supplied %y her nutrition and also %y the physical development of her %ody if her mother at the time of gestation and prior to conception had ade?uate vitamins in her food to insure perfect germ cells

The sensitivity of the %rain to inAury resulting from medication given the mother has %een emphasi6ed %y Dr #rederic "chrei%er of Detroit (n his paper %efore the American Medical Association meeting in "an #rancisco! Dune! ,2-:! he *as ?uoted as saying H,9I that the analysis sho*ed that 95 per cent of the children had sho*n difficulty in %reathing at the time of %irth or in the first fe* days follo*ing %irth +e concluded! therefore! that this difficulty in %reathing *as the cause of the %rain damage Difficulty in %reathing *ould lead to a shortage of o4ygen An insufficient supply of o4ygen in the %lood stream *ould have serious effects upon the tissues of the %rain (n this connection! he cited evidence found in post>mortem e4aminations that deficiency of o4ygen caused microscopic changes in the %rain E>ray photographs of some of the children e4amined %y Dr "chrei%er sho*ed various degrees of %rain atrophy The contri%ution of Dr "chrei%er also emphasi6es strongly the suscepti%ility of the %rain tissue to inAuries *hich may handicap the individual throughout life )eferences
,

5
. 7 8

9 : 2

1A(&D! D The tail that *ags the nation "ev, of "evs#, 25@..! ,2-7 T&ED$)1D! A # Mental Deficiency HAmentiaI Ed 7 Ne* Yor/! William Wood! ,252 BA&&(E! M M ) Nutritional anterior pituitary deficiency ,io$hem# .# (n press PAPE<! D A proposed mechanism of emotion Ar$h# e!r# and Psy$hiat#, -:@9,-! ,2-9 PEN&)"E! 1 " Maternal age in Mongolism Pro$# "oy# So$# Lond#, ,,7@ .-,! ,2-. )&DA+1! $ Birth ran/ of Mongolians@ Mongolism! definite form of mental deficiency! found more fre?uently in the later %irth ran/s .# Hered#, ,:@.52! ,259 MACG1(N! M T Primogeniture and developmental anomalies H!man ,iol#, ,@-:5! ,252 BENDA! A E "tudies in the endocrine pathology of mongoloid deficiency Pro$# Am# A# Ment# 'efi$ien$y, .-@,7 ,! ,2-: B1EYE&! A (diocy>>the role of advancing maternal age Pro$# Am# Assn# Ment# 'efi$#, 8,@,;

,; $&E31(C+! W W The %irth of si4 pairs of fraternal t*ins to the same

parents .#A#M#A#, ,,;@772! ,2-: ,, B3&T! C 1 The Young Delin?uent 1ondon! 3niversity of 1ondon Press! ,257 ,5 1(C+TEN"TE(N! M and B&)WN! A W (ntelligence and achievement of children in a delin?uency area .# .!venile "esear$h, 55@,! ,2-: ,- B1ACGE&! C P Chances of Mor%id (nheritance Baltimore! Wood! ,2-.! chapter ,: ,. MA11! # P )n the fre?uency of locali6ed anomalies in the human em%ryos and infants at %irth Am# .# Anat#, 55@.2! ,2,9 ,7 B1))M! D D A%normalities encountered in dissection of the head and nec/ of an anencephalic monster ,8@558! ,2-9 ,7a +))T)N! E A Crime and the Man Cam%ridge! +arvard 3niversity Press! ,2-2 ,8 =A3$+AN! G "afe Child%irth Baltimore! Win Wood! ,2-9 ,9 "C+&E(BE&! # Brain Damage at Child%irth Cleveland Press! Dune 5-! ,2-: Chapter 2/ !oil depletion and plant and animal deterioration T+E data availa%le on the su%Aect of soil depletion and animal deterioration are so voluminous that it *ould re?uire a volume to present them ade?uately When *e reali6e the ?uantities of many of the minerals *hich must enter into the composition of the %odies of human %eings and other animals! *e appreciate the difficulty of providing in pasture and agricultural soils a concentration of these minerals sufficient to supply the needs for plant gro*th and food production (f *e thin/ of gro*ing plants and grasses in terms of average soil tilled to a depth of seven inches! *e are dealing *ith a total of appro4imately t*o million pounds of soil per acre! of *hich t*o thousand pounds *ill %e phosphorus in its various chemical forms! some of *hich *ill not %e readily availa%le for plants (f one>half of this phosphorus *ere present in an availa%le form! there *ould %e enough for only one hundred poor crops! utili6ing ten pounds to the acre for the seed aloneF or for forty good crops! ta/ing t*enty>five pounds per acre! assuming that the seed *ere to %e removed from that land and not replaced A si4ty>%ushel crop of *heat or corn per acre ta/es t*enty>five to t*enty>eight pounds of phosphorus in the seed The soil is depleted of calcium similarly! though that mineral is not usually present in such limited amounts nor so rapidly ta/en a*ay as is phosphorus The leaves and stems of rapidly gro*ing young plants and grasses are rich in calcium and

phosphorus As the plants ripen the phosphorus is transported in large amounts to the seed *hile most of the calcium remains in the leaves A large part of the commerce of the *orld is concerned *ith the transportation of chemical elements as foods! chief of *hich are calcium and phosphorus Whether the product of the soil is ultimately used as *heat for %read! mil/ and meat for foods! or *ool and hides for clothing! every pound of these products that is shipped represents a depletion of soil for pasturage or for grain production (f *e thin/ of one hundred good crops constituting the limit of capacity of the %est soils! and one>fourth of that for a great deal of the acreage of the tilla%le soil! *e are pro%a%ly over>generous This pro%lem of depletion may seem to many people unimportant! either %ecause there has %een no consciousness that depletion has %een ta/ing place! or %ecause they %elieve that replenishment is a simple matter (n correspondence *ith government officials in practically every state of the 3nited "tates ( find that during the last fifty years there has %een a reduction in capacity of the soil for productivity in many districts! amounting to from 57 to 7; per cent ( am informed also that it *ould cost appro4imately fifty dollars per acre to replenish the supply of phosphorus Many people reali6e that farms they /ne* in their childhood have ceased to %e productive %ecause they have 'run out ' The movement of population to cities and to*ns is! in part! the result of the call of the social center and in part a conse?uence of the need of forsa/ing depleted soil While there are many things that influence the movement from the farms! there is much to %e learned from the government census reports *hich deal directly *ith farm acreage and values (f *e relate the levels of life of human and domestic animals to the pro%lem of soil depletion! *e find t*o important groups of data #irst! there are those *hich relate to specific land areas! some small and some very largeF and second! those *hich relate to civili6ations and groups! %oth large and small that have passed out of e4istence or are rapidly deteriorating A study of the s/eletons of the past and present often discloses a progressive %rea/do*n #or e4ample! *e may mention the important anthropological findings of Professor +ooton of +arvard! *ho! in his e4aminations of various pue%los of the Western Plains! especially at the Pecos Pue%lo *here the progressive %urials have %een uncovered! has %rought to light the calendar of a civili6ation e4tending over a thousand years These findings sho* that there has %een over the period of years a progressive increase in s/eletal deformities! including arthritis and

dental caries! together *ith a reduction in stature! suggesting a direct relationship to progressive depletion of the soil (n a recent maga6ine article! ( have presented data H,I comparing the mineral content of different pasture grasses! and relating these to deficiencies in cattle 3nfortunately! space does not permit revie*ing these data here in detail They sho* that calcium varied from ; ,9 per cent for a dry pasture grass in Ari6ona to , 2 per cent in a Pennsylvania pasturage plant! to 5 per cent in a British Colum%ia pasturage plant! a range of over ten fold "imilarly! phosphorus *as sho*n to vary from ; ;- per cent to , : per cent! a range of si4ty fold Neither pasture animals nor human %eings can eat a sufficient amount of lo* mineral plant food to provide the total mineral re?uirements of ordinary meta%olism (n cases of overload! such as pregnancy and lactation in adults! and rapid gro*th in children! the demand is increased greatly #or e4ample! a high>mil/> production co* from southern Te4as on a certain lo* mineral pasture *ill run %ehind her normal re?uirements a%out 8; grams of phosphorus and ,8; grams of potassium per day (n that district large num%ers of cattle *ere una%le at the time to maintain their o*n %odies! let alone reproduce or provide mil/ Many cattle in the district developed loin disease (t *as found that moving them to another plot of ground *here the soil *as not depleted provided recovery A%out thirty>seven %illion dollars! or appro4imately .; per cent of the cash income of salaries and *ages of the people in the 3nited "tates! is used for the purchase of foods When *e add to this the e4penditure of energy %y the people living on the land! it represents a total! pro%a%ly e4ceeding fifty %illion dollars a year that is spent for the chemicals that are provided in the foods! a large amount of *hich! perhaps 7; per cent! *ill have %een e4pended for calcium and phosphorus! perhaps 57 per cent for other chemicals! and 57 per cent for special vitamin or activator carrying foods )f this enormous transportation of minerals from the soil an e4ceedingly small proportion gets %ac/ to the tilla%le land in this country )rr H5I states that 'Consumption in the 3nited Gingdom of live stoc/ products mostly derived from grass lands has %een estimated at a%out four hundred million pounds sterling per annum Hnearly t0o billion dollarsI ' This includes dairy products! meats and hides Never in the history of the *orld has there %een such a large scale depletion of the soil %y transportation a*ay from the tilled and pasturage areas "ic/ness in the 3nited "tates has %een calculated to cost nearly half as much as food! and is increasing An important discovery has %een made *ith regard to the feeding of dairy cattle and other live stoc/@ the nutritive value of young grass! *hen in a state of rapid gro*th! carries not only a very large ?uantity of minerals! %ut also

digesti%le proteins in amounts that are appro4imately e?uivalent to those provided %y the concentrated cereal cattle foods! such as linseed ca/e (t is o%served also that not only do the mil/ products of such co*s remain at a high level *hile the co*s are on the rapidly gro*ing young grass! particularly a rapidly gro*ing young *heat grass or young rye grass! %ut the animals themselves are in %etter physical condition than *hen on grain concentrates #urther! that calves fed on the mil/ of those co*s gro* much more rapidly than they do *hen the co*s are on other fodder and have a much higher resistance to disease $rass! to provide these nutritional factors! must %e gro*n on a very rich! *ell>%alanced soil A young plant! of necessity! produces a rapid depletion of soil Minerals and other chemicals are removed and therefore there is need for ade?uate replacement (n Chapter ,: ( have reported investigations made %y Professors Meigs and Converse at the Beltsville E4perimental "tation! in *hich they have sho*n that feeding cattle on a grade of dried hay that *as lo* in chlorophyll resulted in the development of dead or %lind calves! and further that *hen the mil/ of these co*s *as fed to three normal calves they died in fifty>seven! si4ty>t*o and seventy>one days respectively These calves had %een fed on *hole mil/ until t*enty days of age They sho* that the main deficiency in this ration *as vitamin A "ince mammals re?uire mil/ in infancy and since it is the most efficient single food /no*n! ( have made a special study of mil/ and its products The role of the vitamins and other activating su%stances in foods is ?uite as important and essential as that of minerals These activating su%stances! in general! can %e divided into t*o groups! those that are *ater>solu%le and those that are fat>solu%le! the former %eing much more readily o%tained in most communities! than the latter "ince the fat>solu%le and also the *ater>solu%le vitamins are essential for mineral utili6ation and particularly since the fat> solu%le activators are so fre?uently found to %e inade?uately supplied in diet and are usually more difficult to o%tain! a special effort has %een made to determine the level of these in dairy products in many different places for different seasons of the year To accomplish this! ( have o%tained each year since ,259 samples of cream and %utter! mostly %utter! for analysis for their activator content The *or/ has rapidly e4tended so that for the eleventh year *e are receiving no* H,2-2I samples from several hundred places distri%uted throughout the *orld! usually once or t*ice a month throughout the year Methods used for these studies are %oth %iologic and chemical These data are used in connection *ith mor%idity and mortality statistics for the same districts

The progressive changing of the levels of life is sho*n %y the mor%idity and mortality statistics of the various areas of the 3nited "tates and Canada The American +eart Association pu%lishes! from time to time! very important data relative to the num%er of deaths from heart disease in the various states of the 3nion (t is of interest to note that the highest mortality levels that are o%tained are found in those states! in general! that have %een longest occupied %y modern civili6ations! namely! the Atlantic "tates! the Ne* England "tates! the $reat 1a/es "tates and the Pacific "tates Their data pu%lished in their %oo/let Pt+eart Disease Mortality "tatistics' and %ased on the 3nited "tates &egistration area reveal that the death rate per ,;;!;;; population *as ,5- in ,2;; The data sent me in Novem%er ,2-9 from the 3nited "tates Census Bureau! Department of Commerce! in Washington! report the death rate from heart per ,;;!;;; for ,2-. as 5-2 2! in other *ords an increase of :8 2 per cent in thirty>four years #igures provided %y the Bureau of Census for England and Wales sho* the death rate per ,;;!;;; to %e 582 -F and for "cotland! 5-5 While the average figure for the 3nited "tates &egistration area of 55. deaths per ,;;!;;; seems very high! it is e4ceedingly important to note that the Ne* England "tates *ere much higher! leading the entire country Massachusetts reported -;9 -F Ne* +ampshire! -5- ,F =ermont! -,; :F Ne* Yor/! -;5 ,F Maine! 529 7 The rate of increase in the decade of ,25, to ,2-; *as 7, - per cent for Dela*areF 75 per cent for Connecticut! 7, per cent for Pennsylvania! 72 . per cent for Missouri! 8; ; per cent for WashingtonF 77 per cent for WisconsinF 8. per cent for 1ouisianaF 9, per cent for #loridaF 8- per cent for "outh CarolinaF :, per cent for MontanaF 8, per cent for Gentuc/yF and 7, 2 per cent for North Carolina "uch rates of increase as these are cause for alarm "ir Arnold Theiler! *ho spent a ?uarter of a decade studying the pro%lems of nutritional deficiency diseases among pasture animals in "outh Africa! has discussed at length the reduction of phosphorus in availa%le ?uantities for plant development as constituting! %y far! the most important mineral deficiency +e reported data o%tained from many countries through the *orld! indicating that the deterioration of cattle and sheep can %e directly traced to an inade?uate amount of phosphorus in the soil +e states! in discussing the relation of this pro%lem to the conditions as they o%tain in Australia! that@ H-I Amongst the Australian data the figures sho*ing depletion of phosphorus as a result of sale of products off the farm *ithout ade?uate replacement %y manuring! are interesting Thus &ichardson estimates that it *ould ta/e t*o million tons of superphosphate to replace the phosphorus removed in the form of mil/! mutton and *ool (n the 'ranching stage' of the development of a

country the fact is often forgotten that the %alance of Nature is fre?uently distur%ed to the detriment of generations to come (t is important to /eep in mind that mor%idity and mortality data for many diseases follo* a relatively regular course from year to year! *ith large increases in the late *inter and spring and a mar/ed decrease in summer and early autumn The rise and fall of the level of mor%idity *ith the changing season produces curves that are e4ceedingly regular for the same place from year to year The distri%ution! ho*ever! is distinctly different for different latitudes and altitudes (t is further of special importance to note that the curves for the "outhern +emisphere! *ith its opposite seasons! are in reverse of those of the Northern +emisphere! and have very similar levels for the same seasonal periods ( have o%tained the figures for the levels of mor%idity for several diseases in several countries! including the 3nited "tates and Canada ( find that the distri%ution of the rise and fall in mor%idity and mortality does not follo* the sunshine curve %ut does follo* the curve of vegeta%le gro*th Accordingly! ( have made studies %y dividing the 3nited "tates and Canada into si4teen districts! four from East to West and four from North to "outh ( have plotted %y months the levels of mortality for heart disease and pneumonia in these various districts! from figures o%tained from the governments of these t*o countries "imilarly! ( have plotted curves for the vitamin content found in %utter and cream samples o%tained from these si4teen districts When these are arranged in accordance *ith the levels %y months they are found! in each case! to %e opposite to the mortality from heart disease and pneumonia (t is also important to note that *hile these curves sho* a higher midsummer level of vitamins in dairy products in the northern tier of districts! the period of high level is shorter than in the more southern division T*o pea/s tend to appear in the summer cycle of curves for the vitamins! one representing the spring period of active gro*th and the other! the fall period These pea/s are closer together in the north than in the south A particularly important phase of this study is the finding of a lo*er level of vitamins throughout the year in those districts *hich correspond *ith the areas of the 3nited "tates and Canada that have %een longest settled! and conse?uently most depleted %y agriculture A similar study has %een made %ased on the data pu%lished in a report %y Tisdall! Bro*n and Gelley! H.I of Toronto Their figures for childrenBs diseases *hich included chic/en po4! measles! nephritis! scarlet fever! hemorrhage of ne*%orn! tetany and retropharyngeal a%scess *ere arranged according to the incidence for each month All of these diseases sho* a relatively high incidence during #e%ruary and March! rising in Decem%er and Danuary! falling during April and May!

reaching a very lo* level in midsummer and then ma/ing a rapid increase during the autumn These are opposite to the vitamin levels found in the dairy products of )ntario for the same months (n Chapter -! ( discussed data o%tained during t*o summers in the 1oetschental and other "*iss valleys The 1oetschental =alley has %een isolated from contact *ith surrounding civili6ations %y its uni?ue physical environment #or t*elve hundred years during *hich time a *ritten history of the valley has %een /ept! the people have maintained a high level of physical e4cellence providing practically all their food! shelter and clothing from the products raised in the valley Cattle and goats provided mil/! mil/ products and meat The stoc/ *as carefully sheltered during the inclement *eather and great care *as used to carry %ac/ to the soil all of the enrichment This! of course! is a process that is efficiently carried out in many parts of the *orld today (n this manner e4tensive depletion of the minerals re?uired for food for animals and human %eings may %e prevented Their practice is in stri/ing contrast to that in many of the agricultural districts of the 3nited "tates in *hich the minerals are systematically shipped from the land to the cities! there to %e dissipated to the ocean through the se*erage system Among many primitive races there is some attempt to preserve the fertility of the soil #or e4ample! in Africa! many of the tri%es that depend in part on agriculture! cleared off only a fe* acres in the heart of a forest and cropped this land for a limited num%er of years! usually less than ten $reat care *as ta/en to prevent the loss of the humus %oth through drenching rains and *ind erosion The decaying vegetation and lighter soil that might %e dislodged %y the *ater *ere caught in the entanglement of roots and shru%%ery surrounding the agricultural patch The surrounding trees protect the soil from *ind erosion Care *as ta/en not to form gullies! furro*s and grooves that could carry currents of *ater and thus float a*ay the valua%le humus from the soil This again is in contrast to conditions in other parts of the *orld! particularly in the 3nited "tates "ears H7I has stated that 'Bare ground left %y the plo* *ill have as much soil *ashed off in ten years as the un%ro/en prairie *ill lose in four thousand Even so! soil in the prairie *ill %e forming as fast as! or faster than it is lost ' (n NatureBs program! minerals are loaned temporarily to the plants and animals and their return to the soil is essential To ?uote again from "ears What is lent %y earth has %een used %y countless generations of plants and animals no* dead and *ill %e re?uired %y countless others in the future (n the case of an element such as phosphorus! so limited is the supply that if it *ere not constantly %eing returned to the soil! a single century *ould %e sufficient to produce a disastrous reduction in the amount of life

The history of preceding civili6ations and cultures of man/ind indicate the im%alances that have developed *hen minerals have %een permanently transferred from the soil There are only a fe* localities in the *orld *here great civili6ations have continued to e4ist through long periods and these have very distinct characteristics (t re?uired only a fe* centuries! and in some profligated systems a fe* decades to produce so serious a mineral depletion of the soil that progressive plant and animal deterioration resulted (n such instances! regular and ade?uate replenishment *as not ta/ing place The replenishment may %e made! as in the case of the prairie *ith its plant and animal life! through a replacement in the soil of %orro*ed minerals! a program carried out efficiently %y a fe* intelligent civili6ations The %alance of the cultures have largely failed at this point Another procedure for the replenishing of the depleted soils is %y the annual spring overflo* of great *ater systems *hich float enrichment from the highlands of the *atersheds to the lo*er plains of the great *ater*ays This is illustrated %y the history of the Nile *hich has carried its generous %lan/et of fertili6ing humus and rich soil from the high interior of Africa north*ard over its long course through "udan and Egypt to the Mediterranean! and thus made it possi%le for the %orders of the Nile to sustain a population of greater density than that of either China or (ndia The salvation of Egypt has %een the fact that the source of the Nile has %een %eyond the reach of moderni6ing influences that could destroy NatureBs vast stores of these replenishing soil products Where human %eings have deforested vast mountainsides at the sources of the great *ater*ays! this *hole pro%lem has %een changed A similar situation has occurred in China +er t*o great rivers! the Yangt6e and the Yello* &iver! having their sources in the isolated vastness of the +imalayas in Ti%et! have through the centuries provided the replenishment needed for supporting the vast population of the plains of these great *ater*ays Together *ith this natural replenishment the Chinese have %een e4ceedingly efficient in returning to the soil the minerals %orro*ed %y the plant and animal life Their efficiency as agriculturists has e4ceeded that of the residents of most parts of the populated *orld The story in Europe and America has %een vastly different in many districts The %eds of roots of trees and grasses that hold the moisture and induce precipitation have %een rudely %ro/en up An important function of the plant and tree roots is the entanglement of dead plant life =egetation holds %ac/ moisture at the time of melting sno*s and rainy seasons so efficiently that disastrous floods are prevented and a continuing flo* of *ater maintained over

an e4tended period 3nder the pressure of population more and more of the highlands have %een denuded for agricultureF the forests have often %een ruthlessly %urned do*n! fre?uently *ith the destruction of very valua%le tim%er The ashes from these great conflagrations provided fertili6er for a fe* good crops! %ut these chemicals *ere dissipated rapidly in the s*ift flo* of the *ater in *hich they *ere solu%le! *ith the result that vast areas that Nature had ta/en millenniums to forest have %een denuded and the soil *ashed a*ay in a fe* decades These mountainsides have %ecome a great menace instead of a great storehouse of plant food material for the plains country of the streams 1oss of tim%er *hich *as needed greatly for commerce and manufacture has %een another disastrous result The heavy rains of the spring no* find little impediment and rush madly to*ard the lo*er levels to carry *ith them not the rich vegeta%le matter of the previous era! %ut clay and roc/s *hich in a mighty rush spread over the vast plains of the lo*lands This material is not good soil *ith *hich to replenish and fertili6e the river %ottoms )n the contrary! it often covers the plains country *ith a layer of silt many feet deep ma/ing it impossi%le to utili6e the fertile soil underneath We have only to loo/ over the departed civili6ations of historic times to see the *rec/age and devastation caused %y these processes The rise and fall in succession of such cultures as those of $reece! &ome! North Africa! "pain! and many districts of Europe! have follo*ed the pattern *hich *e are carving so rapidly *ith the rise and fall of the moderni6ed culture in the 3nited "tates The complacency *ith *hich the masses of the people as *ell as the politicians vie* our trend is not unli/e the drifting of a merry party in the rapids a%ove a great cataract There seems to %e no appropriate sense of impending doom An outstanding e4ample of our profligate handling of soil and *atersheds may %e seen in our recent e4periences in the Mississippi Basin The )hio &iver draining the *estern slopes of the Allegheny Mountains has gone on rampages almost annually for a decade carrying *ith it great damage to property and loss of life )ther %ranches of the Mississippi! particularly the Missouri! draining the eastern slopes of the &oc/y Mountains have gone out of control so that vast areas are flooded *ith silt There is no* a concerted effort to stem this series of cataclysms %y %uilding dy/es along the great *ater*ays to raise the %an/s and dams in the higher regions of the *atershed to hold %ac/ the floods These artificial la/es %ecome settling pools for the silt and soon lose their efficiency %y %eing filled *ith the de%ris that they are holding %ac/ from the lo*er levels An effort is also %eing made to reforest *hich is purposeful! %ut *hen *e

consider the millenniums of time that Nature has re?uired to %uild the tangle*ood of plant life! shru%%ery and trees over the roc/s and through the gullies to act as great defenses for holding %ac/ the *ater! these modern programs offer very little assurance for early relief Another very destructive force is the *ind When surfaces are denuded either at high or lo* altitudes the *ind starts carving up the soil and starts it on the march across the country We call the demonstrations dust storms When *e travel through our Western "tates! it is not uncommon to see %uildings and trees partially %uried in these rolling dunes of drifting sand When *e *ere traveling across the desert of Peru in ,2-9! *e sa* in many places mountain> li/e dunes rolling slo*ly across the country! fre?uently so completely %loc/ing former traffic routes that long detours *ere necessary When *e *ere flying over eastern Australia in search of groups of primitive a%origines! *e sa* great forests gradually %eing engulfed *ith these marching %illo*s of sand so that most of the trees *ere covered to their tips #e* people *ill reali6e that it is estimated that only a%out .7 per cent of the land surface of the 3nited "tates is no* availa%le for agricultural purposes and gra6ing This includes vast areas that are rapidly approaching the limit of utility (n one of my trips to the Western "tates ( visited a large ranch of some fifty thousand acres ( as/ed the rancher *hether he *as conscious of a depletion in the soil of the ranch in its a%ility to carry pasture cattle +e said that it *as very greatly depleted! that *hereas formerly the co*s on the ranch *ere a%le to produce from ninety>three to ninety>five healthy calves per hundred co*s annually! nearly all of sufficiently high physical ?uality to %e availa%le for reproductive purposes! no* he *as getting only forty to forty>four calves per hundred co*s annually and usually only ten or eleven of these *ere physically fit for reproductive purposes +e stated also that he *as a%le to raise as many calves for restoc/ing the ranch on the plant food produced on the fifty acres to *hich he *as applying a high fertili6ation program as on the rest of the fifty> thousand>acre ranch )f late most of the calves for the ranch had to %e imported from other states (n a city in the vicinity ( in?uired of the director of pu%lic health *hat the death rate *as among their children up to one year of age +e stated that the figures *ere progressively increasing in spite of the fact that they *ere giving free hospitali6ation and free prenatal and postnatal care for all mothers *ho could not afford to pay for the service This death rate had more than dou%led in fifty years ( as/ed ho* he interpreted the increasing mortality rate among

the infants and mothers +is comment *as in effect that they could not e4plain the cause! %ut that they /ne* that the mothers of this last generation *ere far less fit physically for reproduction than their mothers or grandmothers had %een To many uninformed people the ans*er *ill seem simple Those *ho are responsi%le for these programs! recogni6e the difficulty in replenishing the e4hausted minerals and food elements in ade?uate ?uantity ( have %een informed %y the director of the department of agriculture of the state of )hio that it *ould cost fifty dollars per acre to restore the phosphorus alone that has %een e4hausted during the last fifty to one hundred years +e stated that the pro%lem is still further complicated %y the fact that the farmer cannot go to a %an/ and %orro* money to %uy this fertili6er (f! ho*ever! he %uys adAoining acreage to dou%le his o*n! he can then %orro* t*ice as much money as he can on his o*n farm But this is not all of the difficulty &ecent data indicate that if sufficient phosphorus in a form easily availa%le for plant use *ere supplied to the land at once! it *ould /ill the plant lifeF it must %e provided in a form in *hich %y a process of *eathering it is made slo*ly availa%le for plant utili6ation Phosphorus is only one of the minerals that is readily ta/en from the soil )ther minerals also are difficult to provide ( have %een a%le practically to dou%le the *eight and si6e of %eets in five *ee/s %y the addition of a ta%lespoonful of ferric ammonium citrate to each s?uare foot of garden soil An important commentary on soil depletion is provided %y the large num%er of farms that have %een a%andoned in many districts throughout the 3nited "tates The severe industrial depression *hich has thro*n large num%ers of shop and mill *or/ers out of employment! has induced a considera%le num%er of these to return to the land for su%sistence As one drives through farming districts that once *ere very fertile many farms are seen apparently a%andoned insofar as tillage is concerned (n my studies on the relation of the physiognomy of the people of various districts to the soil! ( have found a difference in the facial type of the last generation of young adults *hen compared *ith that of their parents The ne* generation has inherited depleted soil (n many communities three generations of adults are availa%le for study The yardstic/ for these comparisons has %een developed in the preceding chapters (t *ill %e of interest for the readers to apply this yardstic/ to their o*n %rothers and sisters in comparison *ith the parents and particularly their grandparents The most serious pro%lem confronting the coming generations is this nearly unsurmounta%le handicap of

depletion of the ?uality of the foods %ecause of the depletion of the minerals of the soil )eferences
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5
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P&(CE! W A Ne* light on the control of dental caries and the degenerative diseases .# Am# 'ent# Assn#, ,:@,::2! ,2-, )&&! D B The composition of the pasture 1ondon! + M "tationery )ffice E M B ! ,:! ,252 T+E(1E&! A and $&EEN! + Aphosphoris in ruminants !trition Absts# and "ev#, ,@-72! ,2-5 T("DA11! B&)WN and GE11EY The age! se4! and seasonal incidence in children Am# .# 'is# Child#, -2@,8-! ,2-; "EA&"! P B Deserts on the March Norman! 3niversity of )/lahoma Press! ,2-7 Chapter 21 Practical application of primitive wisdom

(# T+E o%servations and deductions presented in the foregoing chapters are e4erting as controlling an influence on individual and national character as seems to %e indicated! the pro%lem of the outloo/ for our modern civili6ation is changed in many important aspects )ne of the most urgent changes in our vie*point should %e to loo/ upon the assortment of physical! mental and moral distortions as due! in considera%le part! to nutritional distur%ances in one or %oth parents *hich modify the development of the child! rather than to accepted factors in the inheritance The evidence indicates that these parental distur%ances of nutritional origin may affect the germ plasm! thus modifying the architecture! or may prevent the mother from %uilding a complete fetal structure! including the %rain (n other *ords! these data indicate that instead of dealing entirely *ith hereditary factors! *e are dealing in part *ith distortions due to inhi%itions of normal hereditary processes This changes the prospects for the offspring of succeeding generations Atavism *ill still have plenty to her credit even if she must give up her claim to distortions of individual characteristics Daco%son H,I has summari6ed the determining factors in individuality and personality *hen he says 'The De/yll>+ydes of our common life are ethnic hy%rids ' Most current interpretations are fatalistic and leave practically no escape from our succession of modern physical! mental and moral cripples Daco%son says of our modern young people@

=ery much of the strange %ehavior of our young people to>day is simply due to their lac/ of ethnical anchorageF they are %e*ildered hy%rids! una%le to %elieve sincerely in anything! and diso*ned %y their o*n ancestral manes To turn these neurotic hy%rids loose in the *orld %y the million! *ith no %ac/ground! no heritage! no code! is as %ad as imposing illegitimacyF their %ehavior! instead of e4pressing easily! naturally and spontaneously a long>used credo! *ill %e determined %y fears and senseless ta%oos +o* can character %e %uilt upon such foundationsK There is a ludicrous as *ell as a pathetic side to the situation presented %y a $ree/ pu66led %y his predominantly $erman children! or %y the $erman *oman una%le to understand her predominantly "panish progeny (t is a foolish case over again of hen hatching duc/lings! of *olf fostering foundlings (f our modern degeneration *ere largely the result of incompati%le racial stoc/s as indicated %y these premises! the outloo/ *ould %e gloomy in the e4treme Those *ho find themselves depressed %y this current interpretation of controlling forces *ould do *ell to recall the e4periments on pigs referred to in Chapters ,9 and ,:! in *hich a large colony all %orn %lind and maimed %ecause of maternal nutritional deficiency>>from deficient vitamin A>>*ere a%le to %eget offspring *ith normal eyes and normal %odies *hen they themselves had normal nutrition Much emphasis has %een placed on the incompati%ility of certain racial %loods According to Daco%son! H,I Aside from the effects of environment! it may safely %e assumed that *hen t*o strains of %lood *ill not mi4 *ell a /ind of 'molecular insult' occurs *hich the %iologists may some day %e a%le to detect %eforehand! Aust as %lood is no* tested and matched for transfusion (t is fortunate that there is a ne* e4planation for the distressing old doctrine *hich holds that geniuses cannot %e %orn unless there is an a%undant crop of defectives (n this connection Daco%son says! The genius tends to %e a product of mi4ed ethnic and nervously peculiar stoc/>>stoc/ so peculiar that it e4hi%its an unusual amount of %adness The human family pays dearly for its geniuses Dust as nature in general is prodigal in *asting individuals for the development of a type! or species! so do *e here find much human *astage apparently for a similar purpose )ne may thin/ of the insane and the defectives as so many individuals *asted in order that a fe* geniuses may %e developed (t *ould seemB that in order to produce one genius there must %e %attalions of criminals! *ea/lings and lunatics Niet6sche must

have had %iologic implications of this sort in mind *hen he spo/e of the masses as merely 'fertili6ers' for the genius This is *hy the genius has %een compared to the lily on the dunghill +e a%sor%s all the energy of his family group! leaving the fertili6ing mass depleted )ur recent data on the primitive races indicate that this theory is not true! since in a single generation various types and degrees of physical! mental or moral crippling may occur in spite of their purity of %lood and all that inheritance could accomplish as a reinforcement through the ages The e4tent to *hich the general pu%lic has ta/en for granted that there is a direct relationship %et*een mental e4cellence and mental deficiency is illustrated %y the commonly heard e4pression 'great *its and fools are near a/in' *hich e4presses tersely the attitude of a modern school of psychiatry This doctrine is not supported %y controlled data from scientifically organi6ed investigations )ne of the principal e4ponents ?uoted is Maudsley *ho stated 'it is not e4aggeration to say that there is hardly ever a man of genius *ho has not insanity or nervous disorder of some form in his family ' Many revie*s of the lives of great men have %een pu%lished in support of this doctrine +aveloc/ Ellis! ho*ever! one of the leading psychologists and psychiatrists of our day! has sho*n that the percentage of cases su%stantiating this doctrine is less than 5 per cent and less than half that proportion found in the population at large! *hich in a tested group he found to %e . 5 per cent East of +arvard in discussing this pro%lem states! after revie*ing the evidence pro and con@ 'Thus it is seen that *here one collates the *or/ of the most competent investigators on the possi%ility of relation %et*een insanity and genius the conclusion is unavoida%le that none e4ists ' Those *ho still %elieve in the old fatalistic doctrines may ans*er the ?uestions *hy the last child is affected seriously much more often than *ould %e e4pected through chanceF or *hy the most severe defectives are %orn after mothers have e4ceeded forty years of ageF and still further *hy our defectives are found chiefly among the later mem%ers of large families These facts are not e4plaina%le %y MendelBs la*s of heredity Professor D C Brash! of the 3niversity of Birmingham! in his monograph H5I discusses the current theories in detail +e emphasi6es the role of heredity as the controlling factor in the origin of divergencies +o*ever! all of the distortions of the face and Aa*s *hich he presents as %eing related to heredity can %e duplicated! as ( have sho*n! in the distur%ances appearing in the first and second generation after primitive racial stoc/s have adopted the foods of our modern civili6ations in displacement of their native foods +e emphasi6es

the importance of an ade?uate diet during the gro*th period of the child! and also the fact that malocclusion is not a direct manifestation of ric/ets +ellman has emphasi6ed the importance of childhood diseases The distur%ances *hich *e are studying here! ho*ever! are not related to these influences T*o of the outstanding advances in la%oratory and clinical approach to this pro%lem of the relation of the structure of the %rain to its function as e4pressed in mentality and %ehavior have %een the *or/ of Tredgold in England! referred to in Chapter ,2! and the 'Waverly &esearches in the Pathology of the #ee%le> Minded!' in Massachusetts Tredgold recogni6es t*o sources of %rain inAury! 'germinal %light' and BBarrestBB and puts particular stress on the former as %eing pathological and not spontaneous! and related to the germ of either or %oth parents due to poisoning of the germ cell The 'arrest' pro%lems have to do *ith intra>uterine environmental distur%ances The Waverly group have made very detailed anatomical studies! %oth gross and microscopic! of %rains of mental defectives and related these data to the clinical characteristics of the individuals %oth mental and physical *hen living They have reported in detail t*o groups of studies of ten individuals each (n their summary of the second group they state@ H-I The provisional conclusions dra*n from the second series and the com%ined first and second series are much in agreement *ith the original conclusions dra*n from the first series *hich *ere as follo*s@ #irst that measura%le %rain can %e correlated *ith testa%le mind in the lo* and high orders *ith fairly positive results That is the small simple %rains represented the lo* intellects or idiots and the most comple4 %rain patterns corresponded to the high grade! moronic and su%normal types of fee%le>mindedness The lessons from the primitive races demonstrate certain procedures that should %e adopted for chec/ing the progressive degeneration of our moderni6ed cultures (f! as no* seems indicated! mal>development *ith its production of physical! mental and moral cripples is the result of forces that could have %een reduced or prevented! %y *hat program shall *e proceed to accomplish this reduction or preventionK ( have presumed in this discussion that the primitive races are a%le to provide us *ith valua%le information (n the first place! the primitive peoples have carried out programs that *ill produce physically e4cellent %a%ies This they have achieved %y a system of carefully planned nutritional programs for mothers>to>%e (t is important to note that they %egin this process of special feeding long %efore conception ta/es place! not leaving it! as is so generally

done until after the mother>to>%e /no*s she is pregnant (n some instances special foods are given the fathers>to>%e! as *ell as the mothers>to>%e Those groups of primitive racial stoc/s *ho live %y the sea and have access to animal life from the sea! have depended largely upon certain types of animal life and animal products "pecifically! the Es/imos! the people of the "outh "ea (slands! the residents of the islands north of Australia! the $aelics in the )uter +e%rides! and the coastal Peruvian (ndians have depended upon these products for their reinforcement #ish eggs have %een used as part of this program in all of these groups The cattle tri%es of Africa! the "*iss in isolated high Alpine valleys! and the tri%es living in the higher altitudes of Asia! including northern (ndia! have depended upon a very high ?uality of dairy products Among the primitive Masai in certain districts of Africa! the girls *ere re?uired to *ait for marriage until the time of the year *hen the co*s *ere on the rapidly gro*ing young grass and to use the mil/ from these co*s for a certain num%er of months %efore they could %e married (n several agricultural tri%es in Africa the girls *ere fed on special foods for si4 months %efore marriage The need for this type of program is a%undantly %orne out %y recent e4perimental *or/ on animals! such as ( have reported in Chapters ,9! ,: and ,2 Another important feature of the control of e4cellence of child life among the primitive races has %een the systematic spacing of children %y control of pregnancies The interval %et*een children ranged from t*o and a half to four years #or most of the tri%es in Africa this *as accomplished %y the plural>*ife system The *ife *ith the youngest child *as protected The original Maori culture of Ne* <ealand accomplished the same end %y %irth control and definite planning (n one of the #iAi (sland tri%es the minimum spacing *as four years These practices are in strong contrast *ith either the hapha6ard! entirely unorgani6ed programs of individuals in much of our modern civili6ation! or the organi6ed over>cro*ding of pregnancies also current The ?uestion arises immediately@ *hat can %e done in the light of the data that ( have presented in this volume to improve the condition of our modern civili6ationK A first re?uisite and perhaps %y far the most important is that of providing information indicating *hy our present hapha6ard or over>cro*ded programs of pregnancies are entirely inade?uate This should include! particularly! the education of the highschool>age groups! %oth girls and %oys (n the matter of instruction of %oys and girls it is of interest that several of the primitive races have very definite programs (n some! child%irth clinics supervised %y the mid*ife are held for the gro*ing girls With several of these

tri%es! ho*ever! the ease *ith *hich child%irth is accomplished is so great that it is loo/ed upon as ?uite an insignificant e4perience Among the ancient Peruvians! particularly the Chimu culture! definite programs *ere carried out for teaching the various procedures in industry! home>%uilding and home management This *as accomplished %y reproducing in pottery form! as on practical *ater Augs! the various incidents to %e demonstrated The matter of child%irth *as reproduced in detail in pottery form so that it *as common /no*ledge for all young people from earliest o%servation to the time the practical pro%lems arose Many of the pro%lems related directly *ere similarly illustrated in pottery forms (t is not sufficient that information shall %e availa%le through maternal health clinics to young married couples (f pigs need several months of special feeding in order that the mothers>to>%e may %e prepared for ade?uate carrying for*ard of all of the inheritance factors in a high state of perfection! surely human mothers>to>%e deserve as much consideration (t is sho*n that it is not ade?uate that sufficient vitamin A %e present to give the appearance of good health (f highly efficient reproduction is to %e accomplished there must %e a greater ?uantity than this There is no good reason *hy *e! *ith our modern system of transportation! cannot provide an ade?uate ?uantity of the special foods for preparing *omen for pregnancy ?uite as efficiently as the primitive races *ho often had to go long distances *ithout other transportation than human carriers The primitive care of a ne*%orn infant has %een a matter of severe criticism %y modernists especially those *ho have gone among them to enlighten them in modern *ays of child rearing (t is common practice among many primitive tri%es to *rap the ne*%orn infant in an a%sor%ent moss! *hich is changed daily A ne*%orn infant! ho*ever! does not %egin having regular all over %aths for a fe* *ee/s after %irth While this method is orthodo4 among the primitives it is greatly deplored as a grossly cruel and igno%le treatment %y most moderns Dr William #orest Patric/ of Portland! )regon *as deeply concerned over the regularly occurring rash that develops on ne*%orn infants shortly after they are first *ashed and groomed +e had a suspicion that Nature had a *ay of ta/ing care of this (n ,2-, he left the original oily varnish on several %a%ies for t*o *ee/s *ithout the ordinary *ashing and greasing +e found them completely free from the s/in irritation and infection *hich accompanies modern treatment This method *as adopted %y the Multanomah County +ospital of )regon *hich no* reports that in ,!2,8 cases of un*ashed! unanointed %a%ies only t*o cases of pyodermia occurred They record that each day the clothing *as changed and %uttoc/s *ashed *ith *arm *ater Beyond this the infants *ere not handled Dr Patric/ states that *ithin t*elve hours after %irth %y

NatureBs method the infantBs s/in is clear! and NatureBs protective film has entirely disappeared (n my o%servations of the infantBs care among primitive races ( have %een continually impressed *ith the great infre?uency *ith *hich *e ever hear a primitive child cry or e4press any discomfort from the treatment it receives )f course! *hen hungry they ma/e their *ants /no*n The primitive mother is usually very prompt! if possi%le! to feed her child Among the important applications that can %e made of the *isdom of the primitive races is one related to methods for the prevention of those physical defects *hich occur in the formative period and *hich result in physical! mental and moral crippling When ( visited the native #iAian Museum at "uva! ( found the director *ell>informed *ith regard to the practices of the natives in the matter of producing healthy normal children +e provided me *ith a shell of a species of spider cra% *hich the natives use for feeding the mothers so that the children *ill %e physically e4cellent and %right mentally! clearly indicating that they *ere conscious that the motherBs food influenced %oth the physical and mental capacity of the child The care *ith *hich e4pectant mothers *ere treated *as uni?ue in many of the Pacific (slands #or e4ample! in one group *e *ere informed that the mother told the chief immediately *hen she %ecame pregnant The chief called a feast in cele%ration and in honor of the ne* mem%er that *ould come to Aoin their colony At this feast the mem%ers of the colony pledged themselves to adopt the child if its o*n parents should die At this feast the chief appointed one or t*o young men to %e responsi%le for going to the sea from day to day to secure the special sea foods that e4pectant mothers need to nourish the child &ecent studies on the vitamin content of cra%s have sho*n that they are among the richest sources availa%le We have then for modern mothers the message from these primitives to use the sea foods li%erally! %oth during the preparatory period in anticipation of pregnancy and during that entire period (n #ig ,52 *ill %e seen a *oman of one of the #iAi (slands *ho had gone several miles to the sea to get this particular type of lo%ster>cra% *hich she %elieved! and *hich her tri%al custom had demonstrated! *as particularly efficient for producing a highly perfect infant

FI". 1!9. $his Fi@i woman has come a long distance to gather s#ecial foods needed for the #roduction of a healthy child. $hese and many #rimitive #eo#le have understood the necessity for s#ecial foods before marriage+ during gestation+ during the nursing #eriod and for rebuilding before the ne,t #regnancy.

#or the (ndians of the far North this reinforcement *as accomplished %y supplying special feedings of organs of animals Among the (ndians in the moose country near the Arctic circle a larger percentage of the children *ere %orn in Dune than in any other month This *as accomplished! ( *as told! %y %oth parents eating li%erally of the thyroid glands of the male moose as they came do*n from the high mountain areas for the mating season! at *hich time the large protu%erances carrying the thyroids under the throat *ere greatly enlarged Among the Es/imos ( found fish eggs *ere eaten %y the child%earing *omen! and the milt of the male salmon %y the fathers for the purpose of reinforcing reproductive efficiency

The coastal (ndians in Peru ate the so>called angelote egg! an organ of the male fish of an ovoviviparous species These organs *ere used %y the fathers> to>%e and the fish eggs %y the mothers>to>%e (n Africa ( found many tri%es gathering certain plants from s*amps and marshes and streams! particularly the *ater hyacinth These plants *ere dried and %urned for their ashes *hich *ere put into the foods of mothers and gro*ing children A species of *ater hyacinth is sho*n in #ig ,-; The *oman sho*n in #ig ,-;! *ith an enormous goiter! had come do*n from a nine>thousand>foot level in the mountains a%ove 1a/e Ed*ard +ere all the drin/ing *ater *as sno* *ater *hich did not carry iodine "he had come do*n from the high area to the si4thousand>foot level to gather the *ater hyacinth and other plants to o%tain the ashes from these and other iodine carrying plants to carry %ac/ to her children to prevent! as she e4plained! the formation of '%ig nec/!' such as she had The people living at the si4>thousand>foot level also use the ashes of these plants

FI". 1 <. $his African woman with goiter has come down from the 9<<< foot level in the mountains in Belgian 8ongo near the source of the 'ile to a /<<< foot level to gather s#ecial #lants for burning to carry the ashes u# to her family to #revent goiter in her children. 2ight+ a 'ile #lant+ a water hyacinth burned for its ashes.

Among many of the tri%es in Africa there *ere not only special nutritional programs for the *omen %efore pregnancy! %ut also during the gestation period! and again during the nursing period As an illustration of the remar/a%le *isdom of these primitive tri%es! ( found them using for the nursing period t*o cereals *ith unusual properties )ne! *as a red millet *hich *as not only high in carotin %ut had a calcium content of five to ten times that of most other cereals They used also for nursing mothers in several tri%es in Africa! a cereal called %y them linga>linga This proved to %e

the same cereal under the name of ?uinua that the (ndians of Peru use li%erally! particularly the nursing mothers The %otanical name is ?uinoa This cereal has the remar/a%le property of %eing not only rich in minerals! %ut a po*erful stimulant to the flo* of mil/ ( have found no record of the use of similar cereals among either the English or American peoples (n Chapter ,.! ( presented data indicating that the Peruvians! *ho *ere descendants of the old Chimu culture on the coast of Peru! used fish eggs li%erally during the developmental period of girls in order that they might perfect their physical preparation for the later responsi%ility of motherhood These fish eggs *ere an important part of the nutrition of the *omen during their reproductive period They *ere availa%le %oth at the coast mar/et of Peru and as dried fish eggs in the highland mar/ets! *hence they *ere o%tained %y the *omen in the high "ierras to reinforce their fertility and efficiency for child%earing A chemical analysis of the dried fish eggs that ( %rought to my la%oratory from Alas/a as *ell as of samples %rought from other places has revealed them to %e a very rich source of %ody>%uilding minerals and vitamins +ere again! ( have found no record of their use in our modern civili6ation for reinforcing physical development and maternal efficiency for reproduction As ( have noted in Chapter ,7 special nutrition *as provided for the fathers %y tri%es in the Ama6on Aungle! as *ell as %y the coastal tri%es Professor Drummond! a British %io>chemist! in discussing the ?uestion of the modern decline in fertility! %efore the &oyal "ociety of Medicine H.I suggested that the decline in the %irth rate in European countries! during the last fifty years! *as due! largely! to the change in national diets *hich resulted from the removal of vitamins B and E from grains *hen the em%ryo or germ *as removed in the milling process +e called attention to the fact that the decline in the %irth rate corresponded directly *ith the time *hen the change *as made in the milling process so that refined flour *as made availa%le instead of the entire grain product )f the many pro%lems on *hich the e4perience of the primitive races can thro* light! pro%a%ly none is more pressing than practical procedures for improving child life "ince this has %een sho*n to %e largely dependent upon the architectural design! as determined %y the health of the parental germ cells and %y the prenatal environment of the child! the program that is to %e successful must %egin early enough to o%viate these various distur%ing forces The normal determining factors that are of hereditary origin may %e interrupted in a given generation %ut need not %ecome fi4ed characteristics in the future generations This ?uestion of parental nutrition! accordingly! constitutes a

fundamental determining factor in the health and physical perfection of the offspring )ne of the fre?uent pro%lems %rought to my attention has to do *ith the responsi%ility of young men and *omen in the matter of the danger of transmitting their personal deformities to their offspring Many! indeed! *ith great reluctance and sense of personal loss decline marriage %ecause of this fear! a fear gro*ing out of the current teaching that their children *ill %e mar/ed as they have %een )n the presumption that all mentally crippled individuals *ill %e in danger of transmitting these ?ualities to their offspring there is a strong movement continually in operation to*ard segregating such individuals or incapacitating them %y sterili6ation "everal primitive racial stoc/s have produced large populations *ithout criminals and defectives %y means of an ade?uate nutritional program *hich provided normal development and function May it not %e that even our defectives! *hen they have resulted from poisoning of germ cells or interference *ith an ade?uate normal intrauterine environment! may %e a%le to %uild a society *ith a high incidence of perfection! that *ill progressively return to*ard NatureBs ideal of human %eings *ith normal physical! mental and moral ?ualitiesK Because of its interpretation of the individualBs responsi%ility for his mental and moral ?ualities! society has not only underta/en to protect itself from the acts of so>called unsocial individuals %ut has proceeded to treat them as though they *ere responsi%le for the inAury that society has done to them Does it not seem inevita%le that this apparently false attitude *ill change if it %e demonstrated that they are the result of a program of inade?uate nutrition for the parents As *e have seen! the children %orn in many of the families of primitive racial stoc/s after the parents have adopted our moderni6ed dietary! may have mar/ed changes in the facial and dental arch forms (n our moderni6ed *hite civili6ation this change occurs so fre?uently that in a considera%le percentage of the families there is seen a progressive narro*ing of the dental arches in the succeeding children of the same family "ince the position of the permanent teeth *hich erupt at from seven to t*elve years of age! can %e determined %y 4> rays early in child life! this procedure provides an opportunity to anticipate deformities that *ill ma/e their appearance *ith the eruption of the permanent teeth (n #ig ,-,! may %e seen the 4>rays of the upper arches of three children Even under conditions causing the permanent teeth to develop irregularly the deciduous dental arch *ill not sho* the deformity that *ill %e e4pressed later

in the permanent dental arch The a%normal placement of the developing permanent teeth! ho*ever! *ill sho* the deformity that is later to %e produced in the face even though the deciduous arch is normal in design Both deciduous and permanent teeth can %e seen at the same time (n #ig ,-, it *ill %e seen that there is a progressive deformity revealed in the position of the permanent teeth in these three children HMost severe in the youngest I This narro*ing of the curve made %y the permanent teeth is a condition characteristic of a large num%er of individuals! occurring in at least 57 per cent of the families throughout the 3nited "tatesF in some districts the percentage *ill reach 7; to 97 per cent

FI". 1 1. I&rays of teeth of three children in one family show in the teeth and u##er arch a #rogressive in@ury in the younger children as indicated by the #rogressive narrowing of the #lacement of the tooth buds of the u##er #ermanent teeth. 'ote the narrowing curve of the arch.

Another stri/ing illustration of this progressive inAury in the younger mem%ers of the family! detected early %y the 4>rays! is sho*n in #ig ,-5 Note the %readth of the arch of the permanent teeth of the oldest child Hto the leftI! and the mar/ed narro*ing of the arch of the t*o younger children Hto the rightI

FI". 1 !. $hese ,&rays illustrate the #rogressive in@ury in the two younger children in this family. 'ote the #rogressive narrowing of the #ermanent arch illustrated by the la##ing of the laterals over the centrals in the youngest+ and decreasing distance between the cus#ids.

While the application of orthodontic procedures for the improve> ment of the facial form and arrangement of the teeth *ill ma/e a vast improvement in facial

e4pression! that procedure *ill not modify distur%ances in other parts of the %ody! such as the a%normal underdevelopment of the hips and pelvic %ones (f an improvement in nutrition for the mothers>to>%e is ade?uately provided in accordance *ith the procedures of the primitives! it should %e possi%le to prevent this progressive lo*ering of the capacity of our modern *omen to produce physically fit children #ig ,-- is another illustration The oldest child! ten years of age! is sho*n at the upper left "he has a mar/ed underdevelopment of the *idth of the face and dental arches The nostrils are a%normally narro* and she tends to %e a mouth %reather "he is very nervous and is %ecoming stooped (n the lo*er left photograph! is sho*n an 4>ray of the narro*ed upper arch At the right is sho*n her younger sister! si4 years of age (t *ill %e seen that the proportions of her face are much more normal and that she %reathes *ith complete ease through her nose "he has none of the nervous trou%le of her older sister (n the 4>rays! %elo*! at the right! it *ill %e seen that her permanent arch! as indicated %y the positions of the permanent teeth! although not so far advanced as that of her sister! has good design The history of these pregnancies is of interest The duration of la%or for the first child *as fifty>three hours and for the second three hours #ollo*ing the %irth of the first child the mother *as a partial invalid for several months #ollo*ing that of the second child the e4perience of child%irth made %ut slight impression on the strength and health of the mother During the first pregnancy no special effort *as made to reinforce the nutrition of the mother During the second pregnancy the selection of foods *as made on the %asis of nutrition of the successful primitives This included the use of mil/! green vegeta%les! sea foods! organs of animals and the reinforcement of the fat> solu%le vitamins %y very high vitamin %utter and high vitamin natural cod liver oil (t is a usual e4perience that the difficulties of la%or are greatly decreased and the strength and vitality of the child enhanced *here the mother has ade?uately reinforced nutrition along these lines during the formative period of the child

FI". 1 . In this family the first child to the left was most in@ured in the formative #eriod as shown in the form of the face and dental arches above and ,&rays below. $he first child re(uired fifty&three hours of labor and the second three hours+ #receded by s#ecial nutrition of the mother.

The pro%lem of maternal responsi%ility *ith regard to the physical capacity of their offspring to reproduce a healthy ne* generation comprises one of the most serious pro%lems confronting modern degenerating society (n a previous chapter ( have discussed the difficulty that 6oological garden directors have had in rearing mem%ers of the cat family in captivity (t has %een a very general e4perience until the modern system of feeding animal organs *as instituted! that unless the mothers>to>%e had themselves %een %orn in the Aungle the lac/ of development of the pelvic arch *ould fre?uently prevent normal %irth of their young (n the Cleveland <oo a very valua%le tigress! that had %een %orn in captivity! found it impossi%le to give %irth to her young Although a Caesarian operation *as performed! she lost her life The young also died )ne of the veterinaries told me that the pelvic arch *as entirely too small to allo* the young to pass through the %irth canal "tudies of the facial %ones of this animal sho*ed mar/ed a%normality in development The result of distur%ance in the gro*th of the %ones of the head and of the development of general %ody design is ?uite regularly a narro*ing of the entire %ody! and often there is a definite lengthening "tatistics have %een pu%lished relative to the increase in the height of girls in colleges during the last fe*

decades This is pro%a%ly a %ad rather than a good sign as actually it is an e4pression of this change in the shape of the %ody ( am informed %y gynecologists that narro*ing of the pelvic arch is one of the factors that is contri%uting to the increased difficulties that are encountered in child%irth %y our modern generation A typical case illustrating the relationship %et*een the lac/ of pelvic development and deformity of the face! is presented in #ig ,-. This girl presented a very mar/ed underdevelopment of the lo*er third of the face *hich produced the appcarance of protrusion of her upper teeth so that it *as ?uite difficult or impossi%le for her to cover them *ith her lips An operation to improve her appearance consisted in removing the first %icuspid on each side a%ove and then moving the %one carrying the anterior teeth %ac/*ard *ith appliances! the *idth of the t*o removed teeth This changed the relationship of the teeth as sho*n in the t*o upper vie*s in #ig ,-. The operation greatly improved her facial appearance and she lost the inferiority comple4 *hich had prevented her from mingling *ith young people When she *ent to the hospital for her first child! there *as special concern %ecause of her *ea/ heart! and every effort *as made to o%tain a normal %irth rather than one %y Caesarian section This proved impossi%le and the Caesarian operation *as done $reat difficulty *as e4perienced in saving the life of the mother and child +er %oyish figure! of *hich she had %een so proud! and *hich had %een a part of her serious deformity! during her formative period had nearly resulted in her undoing "he nursed her %a%y for some time %ut the overdraft of reproduction on her frail %ody *as so great that she aged rapidly! her %ac/ *ea/ened and she stooped for*ard as sho*n in #ig ,-.! lo*er right (n the vie* at the lo*er left! it *ill %e seen that the teeth remained in their ne* position A point to /eep in mind is that her physical deficiency *as pro%a%ly directly caused %y an inade?uate nutrition of her mother during the intrauterine development and prior to conception (t is! of course! possi%le that the father also contri%uted a poisoned germ cell that constituted a distur%ance in the architectural design of the offspring (n this connection! it is important to have in mind the tragic influence of a program of deli%erate starvation of mothers>to>%e in order that the %ones of the %a%y may %e soft and thus provide an easy %irth "ome literature has %een pu%lished indicating the foods that *ould %e efficient in accomplishing this This means almost certain *rec/age or handicapping of the childBs life

FI". 1 ). $his girl suffered with a serious deformity of her face. She also had very contracted #elvic arch. $he facial deformity was im#roved as shown. She nearly lost her life with the birth of her first baby which was removed by 8aesarian o#eration. 'ote her badly deformed bac% from the overload of re#roduction.

(nformation from many sources may suggest that the e4pectant mother needs more calcium and more vitamin D "he may go to the pharmacy *ith a prescription or on her o*n initiative o%tain calcium ta%lets and so>called vitamin D as a synthetic preparation We are concerned here *ith data *hich *ill thro* light on the comparative value of the treatment the modern mother *ill thus give herself *ith that that the primitive mother *ould provide Dr Wayne Brehm *ho is associated *ith t*o Colum%us! )hio! hospitals has recently pu%lished the results H7I of a study of the effect of the treatment received in 7.; o%stetrical cases divided into si4 groups of ninety individuals each! on the %asis on *hich their nutrition *as reinforced in order to study the comparative effects of the different treatments The reinforcement of the diet consisted in $roup , of ta/ing calcium and synthetic vitamin D as viosterolF $roup 5! calcium aloneF $roup -! viosterol aloneF $roup .! calcium and cod liver oilF $roup 7! cod liver oil alone and $roup 8! no reinforcement #or those receiving the calcium and viosterol there *as e4tensive calcification in the placentae! mar/ed closure of the fontanelle Hthe normal opening in the top of

the infant s/ullI and mar/ed calcification in the /idneys #or those receiving calcium alone there *as no placental calcification! slight closure of the fontanelle and no calcification of the /idneys $roup - receiving viosterol had moderate to mar/ed placental calcification! moderate closure of the fontanelle and no calcification of the /idneys Those receiving cod liver oil alone had very slight placental calcification! slight fontanelle closure and no calcification in the /idneys Those receiving no reinforcement had very slight placental calcification! normal fontanelle closures and no calcification of the /idneys The effect on the mother *as a prolonging of la%or in $roup , and at %irth the fetal heads *ere less moulded not %eing a%le to adAust their shape to the shape of the %irth tu%e These infants had a general appearance of ossification or postmaturity This strongly emphasi6es the great desira%ility of using NatureBs natural foods instead of modern synthetic su%stitutes (t is a matter of great importance that the most serious distur%ances in reproduction and child%irth are occurring in the most civili6ed parts of the *orld (n Chapter ,2 ( have referred to the important *or/ of Dr Gathleen =aughan entitled '"afe Child%irth ' "he has not only had *ide e4perience among several tri%es in (ndia and in the British +ospitals %ut has collected a large ?uantity of information regarding the e4perience of many races throughout the *orld +er data strongly emphasi6e the necessity that the gro*ing girl shall %e allo*ed to have an active outdoor life not only until the completion of the %uilding of her %ody at a%out fourteen years of age! %ut through the child>%earing period (n practically all countries a restricted sedentary indoor life greatly increases the complications associated *ith child%irth "he ?uotes Whitridge Williams to the effect that@ 'At the onset of pregnancy the HmalesI are ,57 to ,;; HfemalesI! and he adds that se4 is determined in the germ cells! primarily or immediately after their union! and is immuta%le %y the time segmentation of the ovum %egins ' Not*ithstanding this advantage! prenatal and infant mortality reduces the proportion of %oys to a level %elo* that of girls Dr =aughan in her reference to the data on the annual report of the chief medical officer! the Minister of +ealth! states as follo*s@ )ur infant mortality returns sho* that over half the num%er of infants dying %efore they are a year old die %efore they have lived a month Hand 8!9.. of them %efore they are t*enty>four hours oldI! strongly suggesting that their vitality *as impaired %y the process of %irth The figures of those *ho did not survive one month are 5;!;8;! and of these more than half are males# So 0e lose over ten tho!sand boys every year !nder a month old6 HPu%lic +ealth &eport! No 77! BritishI +ear *hat Dr Peter McGinley has to say on the su%Aect 'The death rate of infants in the period immediately su%se?uent to %irth

is nine times as high as that *hich occurs later in the first years of life ' +e sho*s ho* the difficulty e4perienced %y the mothers during parturition leads to the death of infants at and Aust after %irth! and says in this connection! '(nfant deaths under a month are significantly associated *ith the death rates of mothers in child%earing ' +e ?uotes Netherland statistics sho*ing that of still%irths due to difficulty during %irth! male still%irths predominate! and says! 'These figures might %e ta/en in support of the vie* that the greater si6e of the male head is a cause of some greater difficulty in la%our than there is *ith a female %irth ' +ere! indeed! in civili6ed child%irth is the la%oratory *here the se4 of the population is finally determined>the actual %irths of %oys and girls are nearly e?ual in num%er! %ut the small ones slip throughF the larger children are the ones *ho are /illed during %irth! or so damaged that life is heavily handicapped! and *e are left *ith an enormous surplus female population This destruction of male infants! *hich goes on day %y day and year %y year! puts the conse?uences of the $reat War into the shade )ur surplus female population Hno* reaching over one and a half million in e4cess of the maleI is directly due to it We have no need of PharaohBs mid*ives to /ill our %oys off at %irth HE4odus i ,8I Civili6ation does it unaided! for all civili6ed races as they pass their 6enith and are on the do*ngrade have eventually had to face the same pro%lem! the outnum%ering of men %y *omen! and most of them have met it as the East does to>day %y female infanticide A more intelligent policy *ould %e to prevent the males dying at %irth We see that difficult child%irth leads to a high maternal mortality! %ut it is also the cause of a high infant mortality falling most heavily upon the male infants! and it is also responsi%le for the production of mental defectives in ever>increasing num%ers Dr =aughanBs *or/ places emphasis on the necessity that the human %ody %e properly %uilt! especially that of the mother>to>%e "he sho*s clearly that the shape of the pelvis is determined %y the method of life and the nutrition (n all primitive tri%es living an outdoor life child%irth is easy and la%or is of short duration "he sho*s that this is associated *ith a round pelvis and that the distortion of the pelvis to a flattened or /idney shape! even to a small degree! greatly reduces the capacity and therefore the ease *ith *hich the infant head may pass through the %irth canal (n Dr =aughanBs *ide e4perience she has o%served t*o *ays %y *hich a rough estimate of the pelvic shape and capacity may %e anticipated@ first! %y the gait of the individual! %ecause the angle of the hips is determined %y the shape of the pelvisF and second! %y the teeth and Aa*s "he has recogni6ed an association %et*een facial and dental arch deformities and deformed pelvis

During my investigations in eastern Australia ( *as informed that the %irth rate among the *hites had declined over a large area and to such an e4tent that many families had no children and many *omen could produce only one child The diets used in that district *ere very largely refined *hite>flour products! sugar! polished rice! vegeta%le fats! canned goods and a limited amount of meat The alarm regarding the declining %irth rate in Australia has recently %een a matter of discussion %y the Ne* "outh Wales legislature as indicated %y an Associated Press dispatch from "ydney! Australia! dated August ,! ,2-:@ 'A Bstor/ der%yB *ith s*eepsta/es pri6es *as proposed in the Ne* "outh Wales 1egislature today to %oost AustraliaBs falling %irth rate ' A report Aust received from the Bureau of +ome Economics! Department of Agriculture! Washington! presents figures for the average amount of the various foods used in different income groups in different parts of the 3nited "tates These sho*ed that in general a%out one>third of the income up to L57;; *as spent for food per familyF further! that the total flour e?uivalent ranged from ; -2 to ; 7; pound per capita per day These ?uantities *ill furnish a%out :52 to ,;8- calories per day! per capita (t *ill %e seen at once that this provides a large num%er of the calories re?uired for gro*ing children and sedentary adults per day With this num%er of calories derived from refined flour products there is no ade?uate provision for a normal amount of such %ody>%uilding materials as minerals and vitamins These have %een removed! largely! in the milling process! and are largely denied to our modern civili6ation insofar as the cereal foods are concerned This includes vitamin E! so essential for the functioning of the pituitary gland! the master governor of the %ody )ne of the most important lessons *e may learn from the primitive cultures is the detail of their procedures for preventing dental caries "ince ( have devoted an entire chapter HChapter ,8I to this ( *ill ma/e only a %rief comment here "imply stated! the practical application of the primitive *isdom for accomplishing this *ould involve returning to the use of natural foods *hich provide the entire assortment of %ody%uilding and repairing food factors This means the recognition of the fact that all forms of animal life are the product of the food environments that have produced them Therefore! *e cannot distort and ro% the foods *ithout serious inAury Nature has put these foods up in pac/ages containing the com%inations of minerals and other factors that are essential for nourishing the various organs "ome of the simpler animal forms are a%le to synthesi6e in their %odies some of the food elements *hich *e humans also re?uire! %ut cannot create ourselves )ur modern process of ro%%ing the natural foods for convenience or gain completely th*arts NatureBs inviola%le program ( have sho*n ho* the ro%%ing of the *heat in the ma/ing

of *hite flour reduced the minerals and other chemicals in the grains! so as to ma/e them sources of energy *ithout normal %ody>%uilding and repairing ?ualities )ur appetites have %een distorted so that hunger appeals only for energy *ith no conscious need for %ody>%uilding and repairing chemicals A first re?uisite for the control of tooth decay is to have provided an ade?uate inta/e of the %ody>%uilding and repairing factors %y the time the hunger appeal for energy has %een satisfied A sufficient variety of foods must %e used to supply the %odyBs demand for those elements *hich it needs in large ?uantities! that is! calcium and phosphorus! and the other elements *hich it needs in smaller ?uantities! though Aust as imperatively )ne of the serious human deficiencies is the ina%ility to synthesi6e certain of the activators *hich include the /no*n vitamins This ma/es necessary the reinforcement of the nutrition *ith definite amounts of special foods to supply these organic catalysts! especially the fat>solu%le activators! including the /no*n vitamins! *hich are particularly difficult to provide in ade?uate ?uantities ( have sho*n that the primitive races studied *ere dependent upon one of three sources for some of these fat>solu%le factors! namely! sea foods! organs of animals or dairy products These are all of animal origin ( have indicated in Chapter ,8 the nutritional programs that have proved in clinical testing ade?uate for providing the %ody *ith nutrition that *ill not only prevent tooth decay! %ut chec/ it *hen it is active The stress periods of life! namely! active gro*th in children and motherhood! do not constitute overloads among most of the primitive races %ecause the factor of safety provided %y them in the selection of foods is sufficiently high to protect them against all stresses ( have indicated the type of nutrition that is especially needed for these stress periods in our modern civili6ation Also! that it is not necessary to adopt the foods of any particular racial stoc/! %ut only to ma/e our nutrition ade?uate in all its nutritive factors to the primitive nutritions Tooth decay is not only unnecessary! %ut an indication of our divergence from NatureBs fundamental la*s of life and health H"ee Chapter ,8 for primitive menus I The responsi%ility of our modern processed foods of commerce as contri%uting factors in the cause of tooth decay is stri/ingly demonstrated %y the rapid development of tooth decay among the gro*ing children on the Pacific (slands during the time trader ships made calls for dried copra *hen its price *as high for several months This *as paid for in 2; per cent *hite flour and refined sugar and not over ,; per cent in cloth and clothing When the price of copra reduced from L.;; a ton to L. a ton! the trader ships stopped calling and tooth decay stopped *hen the people *ent %ac/ to their native diet ( sa* many such individuals *ith teeth *ith open cavities in *hich the tooth decay had ceased to %e active

(n underta/ing to ma/e practical application of primitive *isdom to our modern pro%lems! the field is so %road that only a limited num%er of items may %e included (t is important to emphasi6e the difference %et*een the procedures used in the preparation of %oys and girls for life in many of the primitive groups! and in our modern social organi6ation #e* people *ill reali6e the remar/a%le training given the primitive children! *ith the fathers and mothers as tutors To illustrate! among the (ndians of the far North in Canada near the Arctic Circle! the girls rather than the %oys select a companion for life This is done *ith the help of her parents Before a %oy is considered *orthy of consideration he must demonstrate that he can %uild the *inter ca%in! provide the fire*ood for maintaining the home of the parents! and all of the provisions of *ild game! during the trial period of several *ee/s After an ade?uate demonstration of %ravery as *ell as of s/ill! in *hich the %oy must /ill a gri66ly %ear! he is accepted into the home for a period of trial marriage The girl has the privilege of ma/ing her choice %y trial! %ut *hen the choice is made there is complete faithfulness on the part of %oth $irls are prepared for lifeBs duties %y %eing taught to ma/e clothing! prepare food! care for children and assist in the maintenance of the home ( have seldom! if ever! seen such happy people as these forest (ndians of the far North (n Chapter ,;! in discussing the Australian A%origines! ( have similarly descri%ed the preparation of %oys for the responsi%ility of manhood No modern college graduate has to *in his spurs under more e4acting e4aminations and tests than do those %oys (n Africa several specialties call for special training The medicine men spend several years under the training of a tutor Each %oy must provide a specified num%er of cattle per year *hich are eaten %y the group Pro%a%ly the most indeli%le impression that is left %y my investigations among primitive races! is that *hich came from e4amining ,!598 s/ulls of the people *ho had %een %uried hundreds of years ago along the Pacific Coast of Peru and in the high Andean Plateau! *ithout finding a single s/ull *ith the typical mar/ed narro*ing of the face and dental arches! that afflicts a considera%le proportion not only of the residents in moderni6ed districts in Peru! %ut in most of the 3nited "tates and many communities of Europe today ( /no* of no pro%lem so important to our modern civili6ation as the finding of the reason for this! and the elimination of the cause of error Perhaps fe* *ill recogni6e the significance of this important point This may %e the reason *hy the prospect is not encouraging

)ne of the important lessons *e should learn from the primitive races is that of the need for maintaining a %alance %e*een soil productivity! plant gro*th and human %a%ies Even in a country *ith so lo* a fertility as o%tains in the greater part of Australia! the A%origines for a very long period *ere a%le to maintain this %alance Their system of %irth control *as very efficient and e4acting A survey made %y a committee appointed %y the 1eague of Nations indicates the need per capita of appro4imately one>half acre of land for *heat! t*o acres for dairy products! and ten acres for %eef producing pasture for the supply of meat When *e reali6e that )hio has %een occupied %y our modern civili6ation for only one hundred fifty years and that it is estimated that during that time appro4imately half of the topsoil has %een lost through *ater and *ind erosion *e reali6e that NatureBs accumulated vegeta%le enrichment has %een greatly reduced in this area *ithin a short time from this one source alone (n Chapter 5; ( have sho*n that there is only enough phosphorus in the top seven inches of agricultural land for appro4imately fifty crops of high>yield *heat or one hundred crops of moderate>yield )ther grains ma/e similar drafts upon the land ( have given data indicating a relationship %et*een progressive soil depletion and progressive increase in heart disease (t is apparent that the present and past one or t*o generations have ta/en more than their share of the minerals that *ere availa%le in the soil in most of the 3nited "tates! and have done so *ithout returning them Thus! they have handicapped! to a serious e4tent! the succeeding generations! since it is so difficult to replenish the minerals! and since it is practically impossi%le to accumulate another layer of topsoil! in less than a period of many hundreds of years This constitutes! accordingly! one of the serious dilemmas! since human %eings are dependent upon soil for their animal and plant foods! for %ody> %uilding The minerals are in turn dependent upon the nutritive factors in the soil for esta%lishing their ?uality The vitamin and protein content of plants has %een sho*n to %e directly related to availa%ility of soil minerals and other nutriments A program that does not include maintaining this %alance %et*een population and soil productivity must inevita%ly lead to disastrous degeneration )ver>population means strife and *ars The history of the rise and fall of many of the past civili6ations has recorded a progressive rise! *hile civili6ations *ere using the accumulated nutrition in the topsoil! forest! shru%%ery and grass! follo*ed %y a progressive decline! *hile the same civili6ations *ere reaping the results of the destruction of these essential ultimate sources of life Their cycle of rise and degeneration are stri/ingly duplicated in our present American culture

=arious therapeutic measures in use today have come to us from primitive peoples )ne of the greatest scourges of the *orld is malaria fever Every*here it has %een fought successfully *ith ?uinine (ndeed! many parts of the *orld *ould not have %een tenanta%le for *hites *ithout it Yet fe* people reali6e that ?uinine *as the gift of the ancient Peruvian (ndians (n Chapter ,7 ( presented data regarding the treatment used %y several primitive races for preventing and correcting serious distur%ances in the digestive tract This consisted in the use of clay or aluminum silicate *hich modern science has learned has the important ?uality of %eing a%le to adsor% and thus collect to4ic su%stances and other products (mportant ne* light is no* thro*n on the pro%a%le role of this su%stance in the primitive diet and its possi%le application in our modern pro%lems of sensiti6ation reactions or allergies (n the first volume of my *or/ on 'Dental (nfections!' ( presented data relating to4ic sensiti6ation reactions to dental infections These *ere sho*n in %oth animals and human %eings ( discussed the relation of these reactions to histamine and emphasi6ed their similarity to the effect produced %y inocculation *ith histamine An important ne* chapter has recently %een added to this pro%lem %y the *or/ of Dr C # Code for *hich he has received an a*ard %y the American Association for the Advancement of "cience +e reported his findings %efore the Association meeting at &ichmond! =irginia! in Decem%er! ,2-: Dr Code has apparently discovered that histamine is the actual product responsi%le for the symptoms of the various allergies (ts e4cess accumulation in the %lood is the actual cause of the symptoms *hether e4pressed as asthma! hay fever or s/in eruptions such as produced %y pollens! various foods! dust and other sensiti6ing agents +e has sho*n that the eosinophils! a type of *hite %lood cell! are the source of e4cess histamine in the %lood (t is accordingly indicated that the primitive treatment %y the use of /aolin! aluminum silicate! as an adsor%ent *as used directly for controlling such symptoms (t is no* further indicated that this treatment can %e helpful for the prevention of modern allergies Previous investigations have sho*n that histamine is produced in the alimentary tract as a putrefaction product of proteins %y the action of certain micro>organisms of the colon group Modern science %oasts the discovery of vitamin C! lac/ of *hich too/ its toll of thousands of the *hite mariners through hundreds of years *ith scurvy The first recorded cure of that disease *as made %y the (ndians in Canada *hen the British soldiers *ere dying in large num%ers The (ndians taught them to use a tea made from the steeped tips of the shoots of the spruce When ( *as among the (ndians of the far north ( as/ed a chief *hy the (ndians did not get scurvy +e then proceeded! as ( have related in Chapter ,7! to e4plain to me ho* the

(ndians prevented scurvy %y the use of special organs in the animals While it is true that *e have come to associate the a%sence of vitamin C as the causative factor in scurvy! *e do not /no* ho* many other affections may %e due to its a%sence in ade?uate ?uantity in our foods Almost *ee/ly! ne* diseases are %eing associated *ith vitamin deficiencies in our modern dietaries )ne of our modern tendencies is to select the foods *e li/e! particularly those that satisfy our hunger *ithout our having to eat much! and! another is to thin/ in terms of the fe* /no*n vitamins and their effects The primitive tendency seems to have %een to provide an ade?uate factor of safety for all emergencies %y the selection of a sufficient variety and ?uantity of the various natural foods to prevent entirely most of our modern affections Their success demonstrates that their program is superior to ours An important advance in modern international relationships provides for e4change of professorships and! thus! interchanges of *isdom We have sho*n a most lauda%le and sympathetic interest in carrying our culture to the remnants of these primitive races Would it not %e fortunate to accept in e4change lessons from their inherited /no*ledgeK (t may %e not only our greatest opportunity! %ut our %est hope for stemming the tide of our progressive %rea/do*n and also for our return to harmony *ith NatureBs la*s! since life in its fullness is Nature o%eyed As ( have soAourned among mem%ers of primitive racial stoc/s in several parts of the *orld! ( have %een deeply impressed *ith their fine personalities! and strong characters ( have never felt the slightest fear in %eing among themF ( have never found that my trust in them *as misplaced As soon as they had learned that ( *as visiting them in their interest! their /indness and devotion *as very remar/a%le #undamentally they are spiritual and have a devout reverence for an all>po*erful! all>pervading po*er *hich not only protects and provides for them! %ut accepts them as a part of that great encompassing soul if they o%ey NatureBs la*s Ernest Thompson "eton has %eautifully e4pressed the spirit of the (ndian in the opening paragraph of his little %oo/ 'The $ospel of the &ed Man'@ The culture and civili6ation of the White man are essentially materialF his measure of success is! '+o* much property have ( ac?uired for myselfK' The culture of the &ed man is fundamentally spiritualF his measure of success is! '+o* much service have ( rendered to my peopleK' The civili6ation of the White man is a failureF it is visi%ly crum%ling around us (t has failed at every crucial test No one *ho measures things %y results can ?uestion this fundamental statement

The faith of the primitive in the all>pervading po*er of *hich he is a part includes a %elief in immortality +e lives in communion *ith the great unseen "pirit! of *hich he is a part! al*ays in humility and reverence Eli6a%eth )dell in the follo*ing lines seems to e4press the spirit of the primitives! #lat outstretched upon a mound )f earth ( lieF ( press my ear Against its surface and ( hear #ar off and deep! the measured sound )f heart that %eats *ithin the ground And *ith it pounds in harmony The s*ift! familiar heart in me They pulse as one! together s*ell! Together fallF ( cannot tell My sound from earthBs! for ( am part )f rhythmic! universal heart )eferences , DAC)B")N! A C $enius H"ome &evaluationsI Ne* Yor/! $reen%urg! ,258 5 B&A"+! D C The etiology of irregularity and malocclusion of the teeth 'ental ,oard of United /ingdom, 1ondon! ,2-; - Waverly researches in the pathology of the fee%le>minded H&esearch series! cases E( to EEI Mem# Am# A$ad# Arts 7 S$i#, ,.@,-,! ,25, . D&3MM)ND! D C The Medical Aspects of Decline of Population .#A#M#A#, ,,;@2;:! ,2-: 7 B&E+M! W Potential dangers of viosterol during pregnancy *ith o%servations of calcification of placentae 2hio S# M# .#, --@22;! ,2-9