Nutrition and Physical Degeneration Weston A.Price cała książka po angielsku

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Chapter 9

ISOLATED AND MODERNIZED AFRICAN TRIBES

AFRICA has been the last of the large continents to be invaded and explored by our modern civilization. It has one of the largest native populations still living in accordance with inherited traditions. Accordingly, it provides a particularly favorable field for studying primitive racial stocks.

This study of primitive racial stocks, with the exception of some Indian groups, has been largely concerned with people living under physical conditions quite different from those which obtain in the central area of a large continent.

Sea foods are within reach of the inhabitants of islands and coastal. regions regardless of latitude. The inhabitants of the interior of a continent, however, have not access to liberal supplies of various forms of animal life of the sea. It was important, therefore, in the interest of the inhabitants of the United States, Canada, Europe, and other large continental interiors, to study primitive people living under environments similar to theirs. Africa is one of the few countries that can provide both 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 tribes with superb physiques and much accumulated wisdom. We are concerned to know how they have accomplished this, and whether they or any other people can survive in that environment after adopting the formulas of our modern civilizations. Considering that the most universal scourge of modern civilization is dental caries, though it is only one of its many degenerative processes, it is important that we study these people to note how they have solved the major problems of living in so severe and disciplining an environment as provided in Africa.

This was done during the summer of 1935. Our route took us through the Red Sea and down the Indian Ocean to enter the African continent at Mombasa below the equator and then across Kenya and Uganda into Eastern Belgian Congo, and thence about 4,000 miles down the long stretch of the Nile through Sudan to the modernized civilization of Egypt. This journey covered most of the country around Ethiopia and gave us contact with several of the most primitive racial stocks of that country. These people are accordingly the neighbors of the Abyssinians or Ethiopians. Since the various tribes speak different languages and are under different governments, it was necessary to organize our safari in connection with the local government officials in the different districts.


During these journeys in Africa which covered about 6,000 miles, we came in contact with about thirty different tribes. Special attention was given to the foods, samples of which were obtained for chemical analysis. Over 2,500 negatives were made and developed in the field. If any one impression of our experiences were to be selected as particularly vivid, it would be the contrast between the health and ruggedness of the primitives in general and that of the foreigners who have entered their country. That their superior ruggedness was not racial became evident when through contact with modern civilizations degenerative processes developed. Very few of the many Europeans with whom we came in contact had lived in central Africa for as much as two years without serious illness or distinct evidence of physical stress. That the cause was not the severity of the climate, but something related to the methods of living, was soon apparent. In all the districts it was recognized and expected that the foreigners must plan to spend a portion of every few years or every year outside that environment if they would keep well. Children born in that country to Europeans were generally expected to spend several of their growing years in Europe or America if they would build even relatively normal bodies.

One exacting condition of the environment that we encountered was the constant exposure to disease. Dysentery epidemics were so severe and frequent that we scarcely allowed ourselves to eat any food that had not been cooked or that we had not peeled ourselves. In general, it was necessary to boil all drinking water. We dared not allow our bare feet to touch a floor of the ground for fear of jiggers which burrow into the skin of the feet. Scarcely ever when below 6,000 feet were we safe after sundown to step from behind mosquito netting or to go out without thorough protection against the malaria pests. These malaria mosquitoes which include many varieties are largely night feeders. They were thought to come out soon after sundown. We were advised that the most dangerous places for becoming infected were the public eating houses, since the mosquitoes hide under the tables and attack the diner's ankles if they are not adequately protected. We rigidly followed the precaution of providing adequate protection against these pests. Disease-carrying ticks were so abundant in the grass and shrubbery that we had to be on guard constantly to remove them from our clothing before they buried themselves in our flesh. They were often carriers of very severe fevers. We had to be most careful not to touch the hides with which the natives protected their bodies from the cold at night and from the sun in the daytime without thorough sterilization following any contact. There was grave danger from the lice that infected the hair of the hides. We dared not enter several districts because of the dreaded tsetse fly and the sleeping sickness it carries. One wonders at the apparent health of the natives until he learns of the unique immunity they have developed and which is largely transmitted to the offspring. In several districts we were told that practically every living native had had typhus fever and was immune, though the lice from their bodies could transmit the disease. One also wonders why people with such resistance to disease are not able to combat the degenerative diseases of modern civilization. When they adopt modern civilization they then become susceptible to several of our modern degenerative processes, including tooth decay.

Dr. Anderson who is in charge of a splendid government hospital in Kenya, assured me that in several years of service among the primitive people of that district he had observed that they did not suffer from appendicitis, gall bladder trouble, cystitis and duodenal ulcer. Malignancy was also very rare among the primitives.

It is of great significance that we studied six tribes in which there appeared to be not a single tooth attacked by dental caries nor a single malformed dental arch. Several other tribes were found with nearly complete immunity to dental caries. In thirteen tribes we did not meet a single individual with irregular teeth. Where the members of these same tribes had adopted modern civilization many cases of tooth decay were found. In the next generation following the adoption of the European dietaries dental arch deformities frequently developed.

We are concerned to know something of the origin of these people including the Ethiopians and to what extent racial ancestry has protected them. If we refer to an ethnographic map of African races we find there is evidence of a great movement northward from South Africa. These people had some things in common with the Melanesians and Polynesians of the South Pacific whom we studied the year previously. Their language carries some words of similar meaning. While there are many tribes existing today, it is of significance that they each possess some identifying characteristics of language, dress and food habits. Another great racial movement has apparently moved southward from Northern Africa. These tribes are of Hamitic origin and include Nilotic tribes and Abyssinians. The Nilotic tribes have a distinct physical pattern and mode of life. These great racial movements have met in the Upper Nile region of Eastern Africa near the equator, and have swayed back and forth with successive obliteration or absorption of those tribes that were least sturdy. The negro race occupied an area across Africa from the West to Central Africa. They were exposed to the aggression and oppression of these two great racial movements, resulting often in intermingling in various proportions of racial bloods. The Semitic race, chiefly Arabs, occupied Arabia and a great area in Northern Africa.

In this bird's eye view we are observing changes that have been in progress during many hundreds or thousands of years. The Arabs have been the principal slave dealers working in from the east coast of Africa. They have maintained their individuality without much blending except on the coast. They have not become an important part of the native stock of the interior. These primitive native stocks can be largely identified on the basis of their habits and methods of living. The Nilotic tribes have been chiefly herders of cattle and goats and have lived primarily on dairy products, including milk and blood, with some meat, and with a varying percentage of vegetable foods. It was most interesting to observe that in every instance these cattle people dominated the surrounding tribes. They were characterized by superb physical development, great bravery and a mental acumen that made it possible for them to dominate because of their superior intelligence. Among these Nilotic tribes the Masai forced their way farthest south and occupy a position between two of the great Bantu tribes, the Kikuyu and the Wakamba. Both of these latter tribes are primarily agricultural people.

Masai Tribe. The Masai are tall and strong. Fig. 39 shows a typical belle, also a Masai man who is much taller than our six-foot guide. It is interesting to study the methods of living and observe the accumulated wisdom of the Masai. They are reported to have known for over two hundred years that malaria was carried by mosquitoes, and further they have practiced exposing the members of their tribes who had been infected with syphilis by the Arabs to malaria to prevent the serious injuries resulting from the spirochetal infection. Yet modern medicine boasts of being the discoverers of this great principle of using malaria to prevent or relieve syphilitic infections of the spinal cord and brain.

FIG 39 These members of the Masai tribe illustrate the splendid nutrition provided by their diet of cattle products namely: meat, milk and blood. The chief beside our guide is well over six feet. This Masai belle wears the customary decorations of coils of copper wire bracelets and anklets which largely constitute the attire of the girls.

I saw the native Masai operating on their cattle with skill and knowledge. The Masai have no currency and all their transactions are made with cows or goats. A valuable cow was not eating properly, and I observed them taking a thorn out of the inside of her mouth. The surgical operation was done with a knife of their own making and tempered by pounding. The wound was treated by rubbing it with the ashes of a plant that acted as a very powerful styptic. Their knowledge of veterinary science is quite remarkable. I saw them treating a young cow that had failed to conceive. They apparently knew the cause and proceeded to treat her as modern veterinaries might do in order to overcome her difficulties. For their food throughout the centuries they have depended very largely on milk, meat and blood, reinforced with vegetables and fruits. They milk the cows daily and bleed the steers at regular intervals by a unique process. In Fig. 40 we see a native Masai with his bow and arrow, the latter tipped with a sharp knife which is guarded by a shoulder to determine the depth to which the arrow may enter the vein. If the animal is sufficiently tame, the blood is drawn while it is standing. If the animal is frightened it is quickly hobbled, as shown below. In this figure the stream of blood may be seen spurting from the jugular vein into a gourd which holds about a gallon. A torque is placed around the neck before the puncture is made. The animals did not even flinch when struck by the arrow, the operation is done so quickly and skillfully. When sufficient blood was drawn, the torque was removed and the blood immediately stopped flowing. A styptic made of ashes referred to above was used. This serves also to protect the wound from infection. The blood is defibrinated by whipping in the gourd. The fibrin is fried or cooked much as bacon or meat would be prepared. The defibrinated blood is used raw just as the milk is, except in smaller quantities. When available, each growing child receives a day's ration of blood as does each pregnant or lactating woman. Formerly, the warriors used this food exclusively. These three sources, milk, blood and meat provide them with liberal supplies of body-building minerals and the special vitamins, both fat-soluble and water soluble. Their estimate of a desirable dairy stock is based on quality not quantity. They judge the value of a cow for keeping in their herd by the length of time it takes her calf to stand on its feet and run after it is born, which is only a very few minutes. This is in striking contrast with the practice of our modern dairymen who are chiefly concerned with the quantity of milk and quantity of butter fat rather than with its value as a source of special factors for nutrition. Many of the calves of the modern high-production cows of civilized countries are not able to stand for many hours after birth, frequently twenty-four. This ability to stand is very important in a country infested with predatory animals; such as lions, leopards, hyenas, jackals and vultures.

FIG. 40. An important source of fat soluble vitamins during the drought period is the blood of the steers which is drawn about every thirty days. Above shows the lance tipped arrow being shot into the neck vein. If the animal is wild it is hobbled as shown below where the stream of blood is seen spurting into the gourd. The flow ceases when the compress is removed.

This reminded me of my experience in Alaska in studying the reindeer of the Eskimos. I was told that a reindeer calf could be dropped in a foot of snow and almost immediately it could run with such speed that the predatory animals, including wolves, could not catch it. And, moreover, that these fawns would go almost immediately after their birth with a herd on a stampede and never be knocked down.

The problem of combating the predatory animals, particularly the lions, calls for greater skill and bravery than is required by other tribes in Africa. The lions live on the large grazing animals, particularly the cattle, from which they select the strongest. In driving over the veldt we frequently saw one or two men or boys guarding an entire herd with only their spears. Their skill in killing a lion with a spear is one of the most superb of human achievements. I was interested to learn that they much prefer their locally made spears to those that are manufactured outside and brought in, because of their certainty that they will not break, will withstand straightening regardless of how much they are bent and because due to the process of manufacture will take a very sharp edge.

On one occasion, after we had been kept awake much of the night by the roaring of the lions and neighing of the zebras that were being attacked by the lions, we visited a Masai manyata nearby in the morning to learn that when they let their cattle and goats out of the corral of acacia thorns, three or four spearsmen went ahead in search of the lions that might be waiting to ambush the cattle. They apparently did not have the slightest fear. The lions evidentally had made a kill nearby. This the natives determined by the number of coyotes.

The heart and courage of these people has been largely broken by the action of the government in taking away their shields in order to prevent them pillaging the surrounding native tribes as formerly. They depended upon their shields to protect them from the arrows of the other tribes. The efforts to make agriculturists of these Masai people are not promising.

In a typical manyata the chief has several wives. Each one has a separate dwelling. Timber and shrubbery are so scarce in this vicinity that the dwellings are built of clay mixed with cow dung which is plastered over a framework of twigs. Many chiefs are over six feet in height.

The Masai live in a very extensive game preserve in which hundreds of thousands of grazing animals enjoy an existence protected from man since even the natives are not allowed to kill the animals as formerly. They seemed to be preserved for the numerous lions which occasionally become very bold since they have an abundance of food and no enemies. Recently the local government authorities found it necessary to shoot off eighty of the lions in a particular district because of their aggressiveness.

In the Masai tribe, a study of 2,516 teeth in eighty-eight individuals distributed through several widely separated manyatas showed only four individuals with caries. These had a total of ten carious teeth, or only 0.4 per cent of the teeth attacked by tooth decay.

Kikuyu Tribe, Kianzbu, Kenya. In contrast with the Masai, the Kikuyu tribe, which inhabits a district to the west and north of the Masai, are characterized by being primarily an agricultural people. Their chief articles of diet are sweet potatoes, corn, beans, and some bananas, millet, and Kafir corn, a variety of Indian millet. The women use special diets during gestation and lactation. The girls in this tribe, as in several others, are placed on a special diet for six months prior to marriage. They nurse their children for three harvests and precede each pregnancy with special feeding.

The Kikuyus are not as tall as the Masai and physically they are much less rugged. Like many of the central African tribes, they remove some lower incisors at the time these permanent teeth erupt. This custom is reported to have been established for the purpose of feeding the individuals in case of lock-jaw. One of the striking tribal customs is the making of large perforations in the ears in which they carry many metal ornaments. A typical Kikuyu woman is shown in Fig. 41 (upper right). Typical Kikuyu men are also shown in Fig. 41. Note their fine teeth and dental arches.

FIG. 41. The development of the faces and dental arches in many African tribes is superb. The girl at the upper right is wearing several earrings in the lobe of each ear. The Wakamba tribe points the teeth as shown below. This does not cause tooth decay while they live on their native food.

A study of 1,041 teeth in thirty-three individuals showed fifty-seven teeth with caries, or 5.5 per cent. These were 36.4 per cent of the individuals affected.

Much of the territory occupied by the Kikuyu tribes was formerly forest. Their practice has been to burn down a section of forest in order to get new lands for planting. As soon as the virgin fertility is exhausted, which is usually in three to five years, they burn down another section of forest. By this process they have largely denuded their section of Kenya of its timber. This has resulted in a great waste of building material. There are few stands of native forest within easy reach of transportation.

Wakamba Tribe, Kenya. The Wakamba tribe point their teeth as shown in Fig. 41. They occupy the territory to the east of the Masai, who in past centuries have driven themselves as a wedge between the Kikuyu and the Wakamba tribes. The Masai until checked carried on a relentless warfare, consisting largely of raids, in which they slaughtered the men and carried off the women and children and drove away the cattle or goats. The Wakambas are intellectually superior to the Kikuyus and have distinct artistic skill in the carving of art objects. They are mechanical and like machinery. Many of them have important positions in the shops of the Kenya and Uganda railway.

An examination of 1,112 teeth of thirty-seven individuals showed sixty-nine teeth with caries, or 6.2 per cent. Twenty-one and six-tenths per cent of the individuals studied had dental caries.

Jalou Tribe, Kenya. This tribe occupies the territory along Lake Victoria and Kisumu Bay. They are one of the most intelligent and physically excellent native tribes. They were studied in two groups, one at Maseno, and the other at Ogado.

The group studied at the Maseno school were boys ranging from about ten years to twenty-two, totaling about 190 in all. The principal of the school presented the boys in military formation for inspection. Through him as interpreter I asked that all boys who had ever had toothache hold up their hands, and nineteen did so. Of the nineteen only one individual was found to have caries; two of his teeth were involved, which, out of 546 teeth for these individuals, gives 0.4 per cent of the teeth with caries.

In the Ogada Mission a study of 258 teeth for ten individuals revealed no teeth affected with dental caries.

Jeannes School, Kenya. This school is located at Kabete. It is an institution where young married couples are trained in domestic science, agriculture, and similar subjects.

In 388 teeth of thirteen individuals, thirty-one teeth were found to have been attacked by dental caries, or 7.9 per cent. These were in six individuals.

Pumwani Mission School, Kenya. This is a native suburb of Nairobi, and there the people have come under the influence of recent European contact.

In an examination of 588 teeth of twenty-one individuals twenty-six teeth had caries, or 4.4 per cent.

C. M. S. School, Nukuru, Kenya. The children of this school belong to several tribes, chiefly Jalou. In a study of 312 teeth of eleven individuals, only one tooth was found to have been attacked by tooth decay, or 0.3 per cent.

Chewya at Kisurnu, Kenya. The natives of this district belong to the Maragoli tribe. They are very strong and physically well developed. They live within easy reach of Lake Victoria from which they obtain large quantities of fish which constitutes an important part of their diet, together with cereals and sweet potatoes.

A study of 552 teeth of nineteen individuals revealed only one tooth with dental caries, or 0.2 per cent.

Muhima Tribe or Anchola, Uganda. This tribe resides in southern Uganda. They, like the Masai, are primarily a cattle raising people and live on milk, blood and meat. The district in which they live is to the east of Lake Edward and the Mountains of the Moon. They constitute one of the very primitive and undisturbed groups. While the Masai raise chiefly the hump-backed cattle, the herds of this Muhima or Anchola tribe are characterized by their large wide-spread horns. Like the Masai, they are tall and courageous. They defend their herds and their families from lions and leopards with their primitive spears. Like the other primitive cattle people, they dominate the adjoining tribes.

In a study of 1,040 teeth of thirty-seven individuals, not a single tooth was found with dental caries. This tribe makes their huts of grass and sticks.

Watusi Tribe. This is a very interesting tribe living on the east of Lake Kivu, one of the headwaters of the West Nile in Ruanda which is a Belgian Protectorate. They are tall and athletic. Their faces differ markedly from those of other tribes, and they boast a very noble inheritance. According to legend, a Roman military expedition penetrated into central Africa at the time of Anthony and Cleopatra. A phalanx remained, refusing to return with the expedition. They took wives from the native tribes and passed laws that thereafter no marriage could take place outside their group. They have magnificent physiques. Many stand over six feet without shoes.

Several of the tribes neighboring Ethiopia are agriculturists and grow corn, beans, millet, sweet potatoes, bananas, Kafir corn, and other grains, as their chief articles of food. Physically they are not as well built as either the tribes using dairy products liberally or those using fish from the fresh water lakes and streams. They have been dominated because they possess less courage and resourcefulness.

The Government of Kenya has for several years sponsored an athletic contest among the various tribes, the test being one of strength for which they use a tug-of-war. One particular tribe has carried off the trophy repeatedly. This tribe resides on the east coast of Lake Victoria and lives very largely on fish. The members are powerful athletes and wonderful swimmers. They are said not to have been conquered in warfare when they could take the warfare to the water. One of their methods is to swim under water to the enemy's fleet and scuttle their boats. They fight with spears under water with marvelous skill. Their physiques are magnificent. In a group of 190 boys who had been gathered into a government school near the east coast of Lake Victoria only one boy was found with dental caries, and two of his teeth had been affected. The people dry the fish which are carried far inland.

Uganda which lies to the north and west of Lake Victoria and west of Kenya, is high and although on the equator, has an equitable climate with an abundance of native foods. Two crops per year are produced, and many varieties of bananas grow wild. The Buganda Tribe, Uganda, is the chief tribe of this region. Uganda has been called the Garden of Eden of Africa because of its abundance of plant foods, chiefly bananas and sweet potatoes, and because of its abundance of fresh water fish and animal life. The natives are thrifty and mentally superior to those of most other districts. They have a king and a native parliament which the British Government recognizes and entrusts with local administrative affairs. A typical group was studied in a mission at Masaka. An examination of 664 teeth of twenty-one individuals revealed only three teeth with caries, or 0.4 per cent.

West Nile Laborers from the Belgian Congo. The West Nile Laborers studied at Masaka represent a very strong and dependable group. They come from districts north of Lake Albert in Belgian Congo. They are much sought for in industrial enterprises and are often moved in groups for a considerable distance.

A study of 984 teeth of thirty-one individuals revealed that only three teeth had ever been attacked by tooth decay, or 0.3 per cent. Only one individual had dental caries.

As one travels down the West Nile and later along the western border of Ethiopia many unique tribes are met. A typical negroid type of the upper Nile region is shown in Fig. 42. Members of these tribes wear little or no clothing. They have splendid physiques and high immunity to dental caries.

FIG. 42. The reward of obeying nature's laws of nutrition is illustrated in this west Nile tribe in Belgian Congo. Note the breadth of the dental arches and the finely proportioned features. Their bodies are as well built as their heads. Exceedingly few teeth have been attacked by dental caries while on their native foods.

After the confluence of the White Nile and West Nile, the former draining Lake Victoria and the Uganda lakes through Uganda, and the latter, Lakes Kivu, Edwards and Albert and eastern Belgian Congo, the volume of water moving northward is very large. A unique obstruction to navigation has developed due to the fact that the Nile runs underground for a considerable distance. In this district vegetation is rank and prolific, including large quantities of water plants which form islands that are often attached temporarily to the shore. The water carries large quantities of alluvia which furnish an abundance of nutriment to the floating plant life. Accordingly, in many of these floating islands a large quantity of soil is enmeshed in the plant roots. At some period in the past the river became bridged across in upper Sudan near its southern border. With the progressive addition of new material a large natural bridge has been raised on which trees are now growing, and across which are elephant trails. This and a series of rapids require a detour of over a hundred miles.

The elephants are so plentiful in this district that both in Uganda and Sudan the governments have been required to send in special hunters to reduce the herds. In one district in Uganda two hundred were said to have been slaughtered. They are very destructive to banana plantations. They break the banana trees over or pull them up by the roots and eat the succulent heart as well as the fruits. In a night a herd may destroy an entire plantation. The only people in the districts who are permitted to kill the elephants without license are the pygmies. They are also the only ones not required to pay a head tax. There are many tribes of them in the great forest area in Belgian Congo and Uganda. Their skill with spears is remarkable and they are able to kill an elephant while the animal remains unaware of his danger. It takes them one to two days to hamstring an elephant by working stealthily from behind, always keeping out of the elephant's sight. Although an elephant can scent a human for a long distance, these pygmies can disguise themselves so completely that the elephant is unaware of their presence. After disabling him by cutting the tendons of both hind legs, they attack him openly and, while one attracts his attention, the other slowly but progressively hacks off his trunk. In this manner he bleeds to death. They are particularly fond of elephant meat and a slaughter means a great feast. While we were in one of the pygmy colonies two of them brought in the tusks of an elephant they had just killed. We had the rare opportunity of witnessing the celebration in the colony, which included the special reproduction in pantomime of the attack and method of killing the elephant. The pygmy mother of these two men is shown in Fig. 43 (lower half). It will be noticed that she is a full head shorter than Mrs. Price, who is five feet three inches tall. This rugged, though small, woman is the mother of five grown men, two of whom are shown in Fig. 43 with the tusks of the elephant. Note their homemade spears. As marksmen with bows and arrows and as trappers, these pygmies have wonderful skill. Their arrows are tipped with iron of their own manufacture and have receptacles for carrying drugs which they extract from plants. These drugs temporarily paralyze the animals. For animals which they wish to destroy the arrows carry a poison which rapidly produces death. The home life of the pygmies in the forest is often filled with danger. Just before our arrival two babies had been carried off by a leopard. This stealthy night prowler is one of the most difficult animals to combat and probably has been one of the reasons the pygmies build cabins in the trees. Ordinarily their homes are built on the ground in a little clearing in the big forest. They consist of low shelters covered with banana leaves and other plants, built over a frame work. The native missionary dispensed our gift of salt which is one of their most prized gifts. They put on a dance for us.

FIG. 43. The Pygmies of Belgian Congo are expert hunters. The two young men in the center above have slain single handed the large bull elephant whose tusks they are holding. The spears used are shown. They are two of five grown sons of the pygmy mother standing next to Mrs. Price in the lower picture. Their teeth are excellent and their knowledge of foods unique.

Pygmies, Ituru Forest, Belgian Congo. These people are said to have originally lived in the trees and they were exceedingly shy and difficult to contact. We were taken to several of their villages in the heart of the dense Ituru forest. We found them very well disposed through the confidence that has been established by the mission workers. Their shyness, however, together with the difficulty of making them understand through two transfers of languages, made an examination of their teeth very difficult.

A study of 352 teeth of twelve individuals revealed eight teeth had been attacked by tooth decay, or 2.2 per cent.

The native tribes of Africa have depended to a great extent on fresh water fish from the numerous lakes and rivers for certain of their essential food factors. After being dried in the sun these fish are carried long distances into the interior. The Nile perch grows frequently to a weight of 150 pounds. The natives of Africa know that certain insects are very rich in special food values at certain seasons, also that their eggs are valuable foods. A fly that hatches in enormous quantities in Lake Victoria is gathered and used fresh and dried for storage. They also use ant eggs and ants.

Nyankunde Mission, Iruinu, Belgian Congo. This group is made up of members of the Bahema, Babira, Alur and Balendu tribes. We will consider the representatives of these different tribes collectively since they live largely on a common dietary consisting chiefly of cereals. Only the Bahemas of this group have small herds of cattle. Some of the others have a few goats. This district is located southwest of Lake Albert.

A study of 6,461 teeth of 217 individuals revealed 390 teeth with dental caries, or 6 per cent. Thirty-eight and seven-tenths per cent of the individuals suffered from dental caries.

Bogora Mission, Belgian Congo. This mission is located west of Lake Albert and includes members of the Bahema and Balendu tribes. While the Bahema tribe originally lived very largely on cattle products, milk, blood and meat, in this district, the herds were small and they were using a considerable quantity of cereals, chiefly corn and beans, some sweet potatoes and bananas. These latter were the chief foods of the other tribes, in addition to goats' milk.

An examination of 2,196 teeth of seventy-seven individuals revealed 160 teeth with caries, or 7.2 per cent. Fifty-three per cent of the individuals had caries.

Kasenyi Port, Lake Albert, Belgian Congo. These natives were members of several tribes surrounding this district who were for the most part temporary residents as laborers. The people had been living largely on a cereal diet and now during their temporary residence at the port had had fish.

An examination of 1,940 teeth of sixty-three individuals revealed 120 teeth with dental caries, or 6.1 per cent of the teeth. Fifty and eighttenths per cent of the individuals had dental caries.

Wanande Tribe, Belgian Congo. This tribe is located at Lubero in Belgian Congo. Their diet consists largely of bananas, sweet potatoes, cereals and goats' milk.

In an examination of 368 teeth of thirteen individuals, there were eight teeth with caries, or 2.2 per cent. Fifteen and four-tenths per cent of the individuals were affected.

Baitu Tribe, Nyunge, Ruanda, Belgian Protectorate. This district lies south of Uganda and east of Belgian Congo proper, northwest of Tanganyika. It lies just east of Lake Kivu. When we learn that Lake Kivu was only discovered in 1894, even though it is one of the important sources of the Nile waters, we realize the primitiveness of the people of this and adjoining districts. This group lives largely on dairy products from cattle and goats, together with sweet potatoes, cereals and bananas.

In a study of 364 teeth of thirteen individuals, not a single tooth was found to have been attacked by dental caries.

Native Hotel Staff at Goina, Belgian Congo. This group consisted of the inside and outside servants of a tourist hotel on Lake Kivu.

An examination of 320 teeth of ten individuals revealed twenty teeth with caries, or 6.3 per cent. It is significant that all of these carious teeth were in the mouth of one individual, the cook. The others all boarded themselves and lived on native diets. The cook used European foods.

Where the members of the African tribes had attached themselves to coffee plantations aad were provided with the imported foods of white flour, sugar, polished rice and canned goods, tooth decay became rampant. This is typically illustrated in Fig. 44.

FIG. 44. Wherever the Africans have aidopted the foods of modern commerce, dental caries was active, thus destroying large numbers of the teeth and causing great suffering. The cases shown here are typical of workers on plantations which largely use imported foods.

Anglo-Egyptian Sudan has an area approximately one-third that of the United States. It is traversed throughout its length from south to north by the Nile. There are several tribes living along this great waterway, which are of special interest now owing to their close proximity to Ethiopia. There are wonderful hunters and warriors among them. In hunting they use their long-bladed spears almost entirely. The shores of the Nile for nearly a thousand miles in this district are lined with papyrus and other water plants to a depth of from several hundred yards to a few miles. Back of this area the land rises and provides excellent pasturage for the grazing cattle. These tribes, therefore, use milk, blood and meat from cattle and large quantities of animal life from the Nile River. Some of the tribes are very tall, particularly the Neurs. The women are often six feet or over, and the men seven feet, some of them reaching seven and a half feet in height. I was particularly interested in their food habits both because of their high immunity to dental caries which approximated one hundred per cent, and because of their physical development. I learned that they have a belief which to them is their religion, namely, that every man and woman has a soul which resides in the liver and that a man's character and physical growth depend upon how well he feeds that soul by eating the livers of animals. The liver is so sacred that it may not be touched by human hands. It is accordingly always handled with their spear or saber, or with specially prepared forked sticks. It is eaten both raw and cooked.

Many of these tribes, like the Neurs, wear no clothing and decorate their bodies with various designs, some of them representing strings of beads produced by putting foreign substances under the skin in definite order. They have maintained a particularly bitter warfare against the Arab slave dealers who have come across from the Red Sea coast to carry off the women and children. In isolated districts even to this day they are suspicious of foreigners. We were told that in one district adjoining Ethiopia all light skinned people are in danger and cannot safely enter that territory without a military escort.

Terraizeka, Upper Nile, Sudan. These people are tall and live largely on fish and other animal life. This part of Sudan consists of many districts of great marshland called the sudd. It is covered with rank papyrus to the height of fifteen to thirty feet. This jungle of rank marsh growth swarms with a wide variety of animal life, large and small.

An examination of 548 teeth of eighteen individuals revealed that not a single tooth had been attacked by dental caries, or 100 per cent immunity.

Neurs, Malakal, Sudan. The Neurs at Malakal on the Nile River are a unique tribe because of their remarkable stature. Many of the women are six feet tall and the men range from six feet to seven and a half feet in height. Their food consists very largely of animal life of the Nile, dairy products, milk and blood from the herds.

A study of 1,268 teeth of thirty-nine individuals revealed only six teeth with dental caries, or 0.5 per cent. Only three individuals had caries, or 7.7 per cent.

Dinkas, Jebelein, Sudan. This tribe lives on the Nile. Its members are not as tall as the Neurs. They are physically better proportioned and have greater strength. They use fish from the Nile and cereals for their diet. They decorate their bodies profusely with scars.

An examination of 592 teeth of twenty-two individuals revealed only one tooth with caries, or 0.2 per cent.

Arab Schools at Khartoum and Omdurman, Sudan. The Arabs are the chief occupants of the territory of Northern Sudan. Omdurman on the west bank of the White Nile opposite Khartoum is the largest purely Arab city in the world. It has been but slightly influenced by modern civilization. Khartoum, on the contrary, just across the river from Omdurman and the capital of Anglo-Egyptian Sudan, has districts which are typically modern. These include the government offices and administration organization. The Arab section of Khartoum has been definitely influenced by contact with the Europeans. This makes possible a comparative study of similar groups in the two cities-modernized Khartoum and primitive Omdurman.

A study of 1,284 teeth of fifty-two individuals in an Arab school at Khartoum revealed that 59 teeth or 4.7 per cent had been attacked by dental caries, or 44.2 per cent of the individuals studied.

In Omdurman a study of 744 teeth in thirty-one individuals, revealed only nine teeth that had been attacked by tooth decay, or 1.2 per cent. In this group only two or 6.4 per cent of the individuals had dental caries.

The groups examined were selected with the assistance of the government officials and consisted of the higher grade pupils in two advanced native schools, one in Khartoum and one in Omdurman.

It is of interest that of the two boys in the Arab school at Omdurman with dental caries one was the son of a rich merchant and used liberally sweets and European foods.

Native Hospital, Khartoum, Sudan. The individuals studied in this institution were from quite remote areas distributed through Sudan. Some had traveled many days on camels to obtain the help that the hospital provided.

A study of 288 teeth of ten individuals revealed that thirteen had been attacked by tooth decay, or 4.5 per cent.

Ikhlas School, Cairo, Egypt. This is a native school in which the individuals are comparable in many respects to those in the native schools at Khartoum and Omdurman. Their nutrition is highly modernized by living in a modern city.

A study of 2,092 teeth of eighty-five individuals revealed that 353 teeth or 12.1 per cent had been attacked by tooth decay. Seventy-five per cent of the individuals of this group had dental caries.

The total number of teeth examined in the preceding groups was 28,438. Of this number, 1,346 were found with dental caries or 4.7 per cent. This represents a total of 1,002 individuals examined, of whom 300 had one or more carious teeth, or had lost teeth by caries, making 29.9 per cent of the individuals with dental caries. Of this total number of individuals studied in twenty-seven groups, there were several groups with practically complete immunity to dental caries, while other groups had relatively high incidence of that disease.

Facial and Dental Arch Deformities. The purpose of these studies has included the obtaining of data which will throw light also on the etiology of deformities of the dental arches and face, including irregularity of position of the teeth.

A marked variation of the incidence of irregularities was found in the different tribes. This variation could be directly associated with the nutrition rather than with the tribal pattern. The lowest percentage of irregularity occurred in the tribes living very largely on dairy products and marine life. For example, among the Masai living on milk, blood and meat, only 3.4 per cent had irregularities. Among the Kikuyu and Wakamba, 18.2 and 18.9 per cent respectively had irregularities. These peap!e were largely agriculturists living primarily on vegetable foods. In the native Arab school at Omdurman, among the pupils living almost entirely according to the native customs of selection and preparation of foods, 6.4 per cent had irregularities, while in the native school at modernized Khartoum 17 per cent had irregularities. In the Ikhlas school at Cairo, under modern influence, 16.5 per cent had irregularities. In the native hospital at Khartoum, 70 per cent had irregularities. In the Pygmy group 33.3 per cent had irregularities, and among the grain eaters of the west Nile, 25.5 per cent had irregularities. The Jeannes School had 46.1 per cent and the Ogada mission 30 per cent.

While the primitive racial stocks of Africa developed normal facial and dental arch forms when on their native foods, several characteristic types of deformity frequently developed in the children of the modernized groups. One of the simplest forms, and one which corresponds with a very common deformity pattern in the United States, involves the dropping inward of the laterals with narrowing of the upper arch making the incisors appear abnormally prominent and crowding the cuspids outside the line of the arch. Typical illustrations of this are shown in Fig. 45. Where the nutritional deficiency is very severe, as at Mombasa on the coast, more severe changes in facial form are found.

FIG. 45. In the new generations, born after the parents had adopted typical modernized diets of Europeans, there was a marked change in the facial and dental arch forms of the adolescent children. Note the narrowing of the nostrils and dental arches and the crowding of the teeth in these four typical young men.

Among the deformity patterns a lack of development forward of the middle third of the face or of the lower third of the face often appeared in the more highly modernized groups. An illustration of the former is seen in Fig. 46 (upper left), and of the latter in Fig. 46 (lower left and right). In the girl at the upper left, the upper arch tends to go inside the lower arch all around. This girl is of the first generation, in a mission in Nairobi, following the adoption of the modernized foods by the parents.

FIG. 46. Disturbed nature may present a variety nf deformity patterns. In the upper left the upper arch is much too small for the lower and nearly goes inside it. The upper right is narrowed with crowding of the teeth. Both lower cases demonstrate an underdevelopment of the mandible of the lower jaw.

A more extreme and severe type of facial change involves an abnormal narrowing with marked distortion of both upper and lower arches. This is shown typically in Fig. 47.

FIG. 47. As in our civilization, even the first generation, after the adoption of modernized foods may show gross deformities. Note the extreme protrusion of the upper teeth with shortening of the lower jaw in the upper pictures and the marked narrowing with lengthening of the face in the lower views. The injury is not limited to the visible structures.

These extreme deformities often produce facial expressions that are suggestive of the faces of some of the monkeys. This is illustrated by the three boys shown with the monkey in Fig. 48.

FIG. 48. A very frequent injury apearing in the offspring after the adoption of less efficient foods often involves a marked depression of the middle third of the face as illustrated in the three boys in this view. Note the comparison with the chimpanzee face.

The Arabs in several districts use camels' milk extensively. It is nutritious, and in much of the desert country constitutes the mainstay of the nomads for months at a time. The primitive Arabs studied had fine dental arches with very little deformity. Even the horses ridden by the Arab chiefs in moving their camel herds across the desert are often dependent, sometimes for as long as three months, upon the milk of the camels for their nutrition. Typical Arab faces and a camel caravan at rest are shown in Fig. 49. The primitive Arab girls have splendidly developed faces and fine dental arches. Their natural beauty, however, is rapidly lost with modernization, as illustrated in Fig. 50.

FIG. 49. In the hot desert countries of Asia and Africa camel's milk is an important item of human nutrition. The teeth of the Arahs, as illustrated helow, are excellent. Large areas could not maintain human life without the camel and its milk.

FIG. 50. Both girls and boys in the modernized colonies in Cairo showed typical deformity patterns in faces and dental arches. The health of these groups is not comparable to that of those living on the native dietaries. Reproductive efficiency in these generations is greatly reduced.

Dr. Hrdlicka has called attention to the occasional development in several racial stocks of individuals who travel on all fours instead of upright. I saw several individuals of this type in Africa scooting around about as rapidly as the dogs. They were, accordingly, difficult to photograph. Two are shown in Fig. 51.

FIG. 51. These two native African children scooted around on all fours so swiftly that it was difficult to take their pictures. We did not see them stand up. They behaved very much like tame chimpanzees.

While slavery of the old form no longer exists in the so-called civilized countries, in its new form it is a most tragic reality for many of the people. Taxes and the new order of living make many demands. For many of these primitive tribes a new suit of clothes could formerly be had every day with no more trouble than cutting a new banana leaf. With the new order they are requested to cover their bodies with clothing. Cloth of all kinds including the poorest cotton has to be imported. They must pay an excessive charge due to the long transportation cost for the imported goods, a charge which often exceeds the original cost in the European or American markets by several fold. In order to pay their head tax they are frequently required to carry such products as can be used by the government officials, chiefly foods, over long distances and for part of each year. These foods are often those which not only the adults, but particularly the growing children sorely need for providing body growth and repair. This naturally has produced a current of acute unrest and a chafing under the foreign domination.

As we encircled Ethiopia we found the natives not only aware of what was going on in that border country, but deeply concerned regarding the outcome. From their temper and sympathetic attitude for the oppressed Ethiopians, it would not be surprising if sympathizers pass over the border into that country to support their crushed neighbors. The problem is accordingly very much larger than the interest of some particular foreign power. It deals directly with the future course of events and the attitude of the African natives in general toward foreign domination. The native African is not only chafing under the taxation by foreign overlords, but is conscious that his race becomes blighted when met by our modern civilization. I found them well aware of the fact that those of their tribes who had adopted European methods of living and foods not only developed rampant tooth decay, but other degenerative processes.

In one of the most efficiently organized mission schools that we found in Africa, the principal asked me to help them solve a serious problem. He said there was no single question asked them so often by the native boys in their school as why it is that those families that have grown up in the mission or government schools were physically not so strong as those families who had never been in contact with the mission or government schools. These young men were thinking. I was even asked several times by them whether or not I thought that the native Africans must go the way of the Red Indians of America.

The happiness of the people in their homes and community life is everywhere very striking. A mining prospector who had spent two decades studying the mineral deposits of Uganda was quoted to me as stating that if he could have the heaven of his choice in which to spend all eternity it would be to live in Uganda as the natives of Uganda had lived before modern civilization came to it.

While inter-tribal warfare has largely ceased, a new scourge is upon them, namely the scourge which comes with modern civilization. As in the primitive racial stocks previously studied and reported, we found that modernizing forces were often associated with a very marked increase of the death rate over the birth rate. In some districts in Africa a marked degeneration is taking place. Geoffrey Gorer in his book, "Africa Dances," (1) which was written after making studies in West Africa, discusses this problem at length.

He quotes figures given by Marcel Sauvage (2) in his article on French Equatorial Africa: "'In 1911 French Equatorial Africa had twenty million negro inhabitants; in 1921 there were seven and a half million; in 1931 there were two and a half million.'"

He states regarding the quotation: "These figures were given in a responsible French conservative paper and have not been denied." Major Browne, a high official of the British Government Administrative Department of Kenya, with long experience, states in the closing paragraph of his book entitled, "The Vanishing Tribes of Kenya," (3) the following:

It must also be remembered that the "blessings of civilization" are not in practice by any means as obvious as some simple-minded folk would like to believe. It can be said with fair accuracy that among the tribes with which we have been dealing there is, in their uncontaminated society, no pauperism, no paid prostitution, very little serious drunkenness, and on the whole astonishingly little crime; while practically everyone has enough to eat, sufficient clothing, and an adequate dwelling, according to the primitive native standard. Of what civilized community can as much be said?

Civilizations have been rising and falling not only through all the period of recorded history, but long before as evidenced by archeological findings. If we think of Nature's calendar as one in which centuries are days and civilizations are years, the part current events are playing in the history of a great continent like Africa may be mere incidents.

This much we do know that throughout the world some remnants of several primitive racial stocks have persisted to this day even in very exacting environments and only by such could they have been protected.

In my studies of these several racial stocks I find that it is not accident but accumulated wisdom regarding foods that lies behind their physical excellence and freedom from our modern degenerative processes, and, further, that on various sides of our world the primitive people know many of the things that are essential for life-things that our modern civilizations apparently do not know. These are the fundamental truths of life that have put them in harmony with Nature through obeying her nutritional laws. Whence this wisdom? Was there in the distant past a world civilization that was better attuned to Nature's laws and have these remnants retained that knowledge? If this is not the explanation, it must be that these various primitive racial stocks have been able through a superior skill in interpreting cause and effect, to determine for themselves what foods in their environment are best for producing human bodies with a maximum 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 0 to less than 1 per cent of the teeth affected for many of the tribes. Where modernized, however, the incidence increased to 12.1 per cent.

In the matter of facial deformity thirteen tribes out of twenty-seven studied presented so high a standard of excellence that not a single individual in the group was found with deformed dental arches.

Their nutrition varied according to their location, but always provided an adequate quantity of body-building and repairing material, even though much effort was required to obtain some of the essential food factors. Many tribes practiced feeding girls special foods for an extended period before marriage. Spacing of children was provided by a system of plural wives.

REFERENCES

GORER, G. Africa Dances. N. Y., Knopf, 1935.
SAUVAGE, M. Les secrets de l'Afrique Noire. Intransigeant, July-Aug., 1934.
BROWNE, G. The Vanishing Tribes of Kenya. London, Seeley Service, 1925.

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Chapter 10

ISOLATED AND MODERNIZED AUSTRALIAN ABORIGINES

OUR problem of throwing light upon the cause of the physical breakdown of our modern civilization, with special consideration of tooth decay and facial deformity, requires a critical examination of individuals living in as wide a range of physical conditions as may be possible. This requires that the Aborigines of Australia be included in this examination of human reactions to physical environments. These were studied in 1936.

In selecting the individuals in the various groups special effort was made to include children between the ages of ten and sixteen years in order to have an opportunity to observe and record the condition of the dental arches after the permanent teeth had erupted. This was necessary because the deciduous dentition or first set of teeth may be in normal position in the arches with a correct relationship between the arches, and the permanent dentition show marked irregularity. The shape of the dental arches of the infant at birth and the teeth that are to take their place in the arches have considerable of their calcification at birth. The development of the adult face, however, does not occur until the permanent teeth have erupted. The general shape or pattern is largely influenced by 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 Aborigines constitute one of the most unique primitive races that have come out of the past into our modern times and they are probably the oldest living race. We are particularly concerned with those qualities that have made possible their survival and cultural development.

The Aborigines are of special interest because they have come out of a very distant past and are associated with animal life which is unique in being characterized as a living museum preserved from the dawn of animal life on the earth. Many of the animal species that are abundant in Australia are found only in fossil form on other continents. The evidence indicates that they crossed on a land bridge which connected Australia with Asia. After the bridge was submerged the animals persisted in that protected island continent which never has known 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 two of the many forms found in Australia. These are the opossum of the marsupial family and the sloth. One of the most curious animals living on the earth today, or that has left its remains in the petrified skeletons of early periods of the earth's history, is the duckbill platypus. It has the unique distinction of having the characteristics of several animal species. It lays eggs like a bird and hatches them with the heat of its body in its pouch. It has webbed, five-toed feet, like the water birds, a bill like a duck and hair and tail like a beaver. The typical marsupial pouch for carrying its young, is another characteristic of this strange animal. Like other mammals it provides milk for its young. Its milk is similar in chemical constituents to that of other mammals. Most rudimentary in form are the mammary glands of the platypus. The young, when hatched in the pouch, nuzzle the lining membrane of the pouch and the milk exudes through minute openings. There is no nipple. The animal lives chiefly in the water. Its home is built above the water level on the bank, but the entrance to it is underneath the water. They are exceedingly playful creatures, apparently more at home in the water than on land. They live on both animal life and plant food found under the water. They seem to be related to an early era of differentiation of animal species.


The Aborigines are credited with having the most primitive type of skeletal development of any race living today. The eyes are very deep set, the brows very prominent giving them an expression that identifies them as a distinct racial type. See Fig. 52. Professor Weidenreich has shown that they resemble in this regard the recently discovered ancient Peking man. While they are still in the Stone Age stage in their arts and crafts, they have developed further in some respects than has any other ancient race. Their skill in tracking and outwitting the fleet and very cunning animal life of their land is so remarkable that they have been accredited with a sixth sense. They have been able to build good bodies and maintain them in excellent condition in a country in which the plant life, and consequently the lower animal life can be maintained at only a very low level because of the absence of rain. Over half of Australia has less than ten inches of rain a year. It is significant that the natives have maintained a vigorous existence in districts in which the white population which expelled them is unable to continue to live. Among the white race there, the death rate approaches or exceeds the birth rate.

FIG. 52. The Aborigines of Australia are recognized to be the oldest living race of mankind. Note the prominent eyebrows and deep set eyes. The man at the upper right is holding his spears and wamara, or spear thrower. They are very fond of decorations on their bodies. Little baldness was seen even in the very old.

They have developed a device for throwing spears, which makes them more deadly than any in the world. I witnessed a group of the present-day natives throwing their spears at a target which consisted of a banana stalk much smaller than a man's body. They threw the spears from a distance which I estimated to be seventy-five yards. About thirty spears were thrown and several pierced the banana stalk and the others were stuck in the ground close around it. This was accomplished by means of a wamara or throwing stick approximately as long as the arm, with a strong hand grip at one end and a device on the other end for engaging in a depression in the butt of the spear. This was thrown by poising the spear about the level of the shoulder, the spear supported by the fingers of the hand which swung the throwing stick. The latter extended back over the shoulder. The impact of their spears has often been demonstrated to be sufficient to completely penetrate a man's body. Their method of tempering wood for the points of the spears was such that the spearheads offered great resistance. A throwing stick is shown in Fig. 52 (upper right).

These natives decorate their bodies with paints for dances and sports. They know the habits of all of the animals and insects so well that they are able to reproduce the calls of the animals and thus decoy them into traps. Some of the water birds maintain sentinels at lookout points to guard those in the water. The Aborigines are able to decoy these birds by most ingenious methods. They travel with their bodies disguised by grass and shrubbery and enter the water with a headgear made from feathers of one of the birds. Once in the water, they then maneuver in a manner similar to that of the birds and go among the flock of wild ducks or swans. Working entirely under water, they draw the birds under one by one and take load after load to shore without raising the suspicion of the flock. When working among the kangaroos they are so skilled in preparing movable blinds that they can kill many in a grazing wild pack without alarming the rest, always striking when the animal is grazing. Their skill at fishing probably exceeds that of any other race. They are so highly trained in the knowledge of the habits of the fish and the type of movement that the fish transmits to the water and to the reeds in the water, that one of their important contests between tribes is to see how many fish can be struck in succession with a spear, the fish never being seen, their only information as to its whereabouts being the change in the surface of the water and movement of grasses that are growing in the water as the fish moves. The fish are started by the umpire's striking the water. The experts bring up a fish six times out of eight. These fishing contests are held along the banks of lakes and rivers where the water 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 being done with stone axes. The canoe offers an exceedingly treacherous platform from which a standing man must throw his spear. For some of the contests the canoe carries a paddler, but in the most exacting contests the spear man must manage his own flat-bottomed canoe.

The skill of the Aborigines in tracking is so phenomenal that practically every large modern town or city in Australia has one or more of these men on its police staff today to track criminals. For weeks, they carry the detailed information about the characteristics of the prisoner's foot across the desert, and when they come across the man s foot print they recognize it among all others in the same path. Every leaf that is turned over or grain of sand on bare rocks has meaning for them.

Their social organization is such that almost every person who had been in intimate contact with them, testified that they had never known any of the Aborigines to be guilty of the theft of anything. Even where partly modernized, as they are in the large government reservations they are trustworthy. A nurse in an emergency hospital told me that she continually left her money, jewelry and other objects of personal property freely exposed and available where many of the hundreds of primitives passing could pick them up, and that she had never known them to take anything. The other nurses had had the same experience.

Every boy and girl among these Aborigines must pass many examinations. Their early schooling includes the tracking of small animals and insects. The small boys begin throwing spears almost as soon as they can stand up straight. No young man can even witness a meeting of the council, let alone become a member of it, until he has passed three supreme tests of manhood. First, he is tested for his ability to withstand hunger without complaint. The test for this is to go on a march for two or three days over the hot desert and assist in preparing the meals of roast kangaroo and other choice foods and not partake of any himself. He must not complain. If he becomes too weak, he is given a small portion. There are tests for fear in which he is placed under the most trying ordeals without knowing that it is part of his examination, and he must demonstrate that he will accept death rather than flee. No member of their society would be allowed to continue to live with the tribe if he had defied the ideals of the group. Immorality is cause for immediate death.

The growing boys among the Aborigines are taught deference and esteem for their elders in many impressive ways. A boy may not kill or capture a slow moving animal. That is left for the older men, whom he must call. He must limit his hunting primarily to the fast fleeing and canny kangaroos and wallabies, whom even a man on horseback cannot outdistance. Racketeers and such unsocial beings could not exist in this type of civilization.

Marriages are arranged according to very distinct tribal patterns and every girl is provided with a husband at a time decided by the council. Their code of ethics is built around the conception of a powerful Supreme Force that is related to the sun. They believe that there is an after-existence in which the myriads of stars represent the spirits of the Aborigines that lived before. The boys and girls are taught the names of the great characters that make up the different constellations. These were individuals who had conquered 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, which is that life consists in serving others as one would wish to be served. The seven stars of Pleiades were seven beautiful maidens that had surpassed most other girls in their devotion and service in the interest of their tribe. It is most remarkable how closely this concept is related to the classical myth regarding the seven daughters of Atlas and the nymph, Pleione.

A part of a young men's examination to determine his ability to withstand pain and his power 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 with his badge of attainment. It consists of the boy's lying on his back and allowing the appointed operator to knock out one of his front upper teeth. This is done by putting a peg against the tooth and hitting it a series of sharp blows with a stone. He must endure this without flinching. We saw scores that carried this diploma. Prior to this, other very severe tests of physical endurance had been successfully completed.

The marvelous vision of these primitive people is illustrated by the fact that they can see many stars that our race cannot see. In this connection it is authoritatively recorded regarding the Maori of New Zealand that they can see the satellites of Jupiter which are only visible to the white man's eye with the aid of telescopes. These people prove that they can see the satellites by telling the man at the telescope when the eclipse of one of the stars occurs. It is said of these primitive Aborigines of Australia that they can see animals moving at a distance of a mile which ordinary white people can not see at all.

While these evidences of superior physical development command our most profound admiration, their ability to build superb bodies and maintain them in excellent condition in so difficult an environment commands our genuine respect. It is a supreme test of human efficiency. It is doubtful if many places in the world can demonstrate so great a contrast in physical development and perfection of body as that which exists between the primitive Aborigines of Australia who have been the sole arbiters of their fate, and those Aborigines who have been under the influence of the white man. The white man has deprived them of their original habitats and is now feeding them in reservations while using them as laborers in modern industrial pursuits. This contrast between the primitive Aborigines as they still exist in isolated communities in Australia and the modern members of the clans is not, however, much greater than that between these excellent primitives and the whites, near whom they are living.

In my comparative study of primitive races in different parts of the world, of modernized members of their groups and of whites who have displaced them, as well as in my study of our typical modern social organization, I have seldom, if ever, found whites suffering so tragically from evidence of physical degeneration, as expressed in tooth decay and change in facial form, as are the whites of eastern Australia. This has occurred on the very best of the land that these primitives formerly occupied and becomes at once a monument to the wisdom of the primitive Aborigines and a signboard of warning to the modern civilization that has supplanted them. Their superb physical excellence is demonstrated in every isolated group in the primitive stocks with which we came in contact. For tribes that have lived along the coast and had access to the sea foods, their stature was large and well formed.

When living in the Bush they are largely without clothing. Where they are congregated in the reservations they are required to wear clothing. It is important to note in these people the splendid proportions of the faces, all of which are broad, with the dental arches wide and well contoured. This is Nature's normal form for all humans and is shown in Figs. 53 and 54 (upper right). The person in Fig. 53 (upper left) is a woman.

FIG. 53. No other primitive race seems to deserve so much credit for skill in obeying nature's laws as these primitive Aborigines because of the perpetual drought hazards of much of the land they live in. Half of Australia has less than ten inches of rain per year. Note the magnificent dental arches and beautiful teeth of these primitives. Tooth decay was almost unknown in many districts.

FIG. 54. Wherever the primitive Aborigines have been placed in reservations and fed on the white man's foods of commerce dental caries has become rampant. This destroys their beauty, prevents mastication, and provides infection for seriously injuring their bodies. Note the contrast between the primitive woman in the upper right and the three modernized women.

Various factors in the changed environment were studied critically. Samples of foods were gathered for chemical analysis; and the changes in the modern diet from that which was characteristic of the primitives were studied. When the teeth of the primitives and the teeth found in the skulls that had been assembled in the museums were examined, it was found that dental caries or tooth decay was exceedingly rare among the isolated groups. Those individuals, however, who had adopted the foods of the white man suffered extremely from tooth decay as did the whites. Where they had no opportunity to get native food to combine with the white man's food their condition was desperate and extreme. This is readily disclosed in Fig. 54. Note contrast with upper right. It is quite impossible to imagine the suffering that these people were compelled to endure due to abscessing teeth resulting from rampant tooth decay. As we had found in some of the modernized islands of the Pacific, we discovered that here, too, discouragement and a longing for death had taken the place of a joy in living in many. Few souls in the world have experienced this discouragement and this longing to a greater degree.

One of the most important phases of our special quest was to get information that would throw light on the degeneration of the facial pattern that occurs so often in our modern civilization. This has its expression in the narrowing and lengthening of the face and the development of crooked teeth. It is most remarkable and should be one of the most challenging facts that can come to our modern civilization that such primitive races as the Aborigines of Australia, have reproduced for generation after generation through many centuries-no one knows for how many thousands of years-without the development of a conspicuous number of irregularities of the dental arches. Yet, in the next generation after these people adopt the foods of the white man, a large percentage of the children developed irregularities of the dental arches with conspicuous facial deformities. The deformity patterns are similar to those seen in white civilizations. Typical illustrations of this will be seen in Figs. 55 and 56. Severe deformities of the face were frequently seen in the modernized groups, as evidenced in Fig. 57.

FIG. 55. It is remarkable that regardless of race or color the new generations born after the adoption by primitives of deficient foods develop in general the same facial and dental arch deformities and skeletal defects. Note the characteristic narrowing of the dental arches and crowding of the teeth of this modernized generation of Aborigines and their similarity to the facial patterns of modern whites.

FIG. 56. The disturbance in facial growth is often so serious as to make normal breathing through the nose very difficult. This is primarily due to faulty development of the maxillary bones.

FIG. 57. Deformity patterns produced in the modernized Aborigines of Australia by white men's food. Note the undershot mandible, upper left, the pinched nostrils and facial deformity of all four.

The data obtained from a study of the native Australians who are located in a reservation near Sydney, at LeParouse, revealed that among the Aborigines 47.5 per cent of the teeth had been attacked by dental caries, and 40 per cent of the individuals had abnormal dental arches. For the women of this group, 81.3 per cent of all the teeth had been attacked by dental caries, and for the men, 60.4 per cent, and for the children, 16.5 per cent. In this group 100 per cent of the individuals were affected by dental caries.

Palm Island is a government reservation situated in the ocean about fifty miles from the mainland, off the east coast of Australia, about two-thirds of the way up the coast. It was reached by a government launch. Included in the population of this reservation are a large number of adults who have been moved from various districts on the mainland of Central and Eastern Australia and many children who were born either before or after their parents were moved to this reservation. The food available on the Island is almost entirely that provided by the government. Of ninety-eight individuals examined and measured, 53.1 per cent of them had dental caries. For the group as a whole, 8.9 per cent of all of the teeth were affected; for the women, 21.2 per cent; for the men, 14.2 per cent; and for the children, 5.8 per cent. Fifty per cent of the children had deformed dental arches, which occurred in only 11 per cent of the adults.

Cape Bedford is situated about three-fourths of the way up the east coast and is so isolated that it was necessary for us to use a special aeroplane to reach it. Landing was made on the beach. This group of people is under the management of a German Lutheran missionary. They are dependent almost entirely on the food provided by the mission and the government. The official in charge had spent fifty years in devoted service to these native people. We found him exceedingly sad because of the very rapid breakdown that was in progress among the natives in his care. The dental caries for the group of eighty-three individuals studied was 12.4 per cent of their 2,176 teeth examined. For the women, this amounted to 37.2 per cent of the teeth; for the men, 8.4 per cent; and for the children, 6.1 per cent. Of the eighty-three individuals, 48.1 per cent had been affected by dental caries. Many of the adults in this group had been born on plantations under the influence of the modern nutrition, and many of the children had been born in the mission. For the adults, 46 per cent had abnormally formed dental arches, and for the children, 41.6 per cent. We were advised that deaths occurred very frequently from tuberculosis. This reservation does not provide the natives with natural hunting grounds capable of providing the people with animal life for food. The coast for some distance inland is a series of sand dunes which are slowly being transferred over the vegetation by wind, completely smothering it. While the coast is well supplied with a variety of deep-water fish the natives have practically no equipment for obtaining them, a condition which restricts them very largely to the use of the imported foods supplied by the officials.

Our next stop, using the special aeroplane, was at Lockhart River, which is about four-fifths of the way up the east coast of Australia. Here again we were able to land on the beach near a large group of primitive Aborigines. 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 York Peninsula, is still so primitive that there has been very little encroachment by the white population. It will be remembered that in this area there are no roads, the country being a primitive wilderness. Of fifty-eight individuals examined, their 1,784 teeth revealed that only 4.3 per cent had been attacked by dental caries. For the women, this amounted to 3.4 per cent; for the men, 6.1 per cent; and for the children, 3.2 per cent. Some of these men had at some time worked on cattle ranches for the white men. Of the children, only 6.3 per cent had abnormal dental arches, and of the adults, 8.7 per cent. In this group, therefore, 91.4 per cent of all ages had reproduced the typical racial pattern as compared with 56 per cent of the group at Cape Bedford, 62 per cent of the group at Palm Island, and 60 per cent at LeParouse. At Lockhart River, 32.7 per cent of the individuals had dental caries.

A reservation called Cowall Creek on the west side of York Peninsula situated on the Gulf of Carpenteria, was reached by flying our special plane to Horn Island in the Torres Strait north of Australia and proceeding from there by boat to Thursday Island, and on, by boat, to Cowall Creek. In this reservation thirty-five individuals were studied and found to be in a very pathetic condition. We were told that deaths occurred frequently. Of the 976 teeth examined, 24.6 per cent had been attacked by tooth decay. For the women, this amounted to 60.7 per cent; for the men, 30.4 per cent; and for the children, 8.9 per cent. Forty-nine and six-tenths per cent of the individuals studied had abnormal dental arches. Of the children 66.6 per cent had deformed dental arches, and 9 per cent of the adults. Many of these adults had been raised in the bush. Of the individuals studied, 68.6 per cent had had dental caries. One can scarcely visualize, without observing 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 by the government, while they are conscious that if they could return to their normal habits of life they would regain their health and again enjoy life. Many individuals were seen with abscessing teeth. One girl with a fistula exuding pus on the outside of her face is shown in Fig. 58 (upper right). In their native life where they could get the foods that keep them well and preserve their teeth, they had no need for dentists. Now they have need, but have no dentists. It is easy to chide and blame the officials who provide them with the modernized foods under which they are breaking, but it must be remembered that practically all modern civilizations are more or less in the same plight themselves.

FIG. 58. Aborigines in Australia living on a reservation. The boy at the upper left has suppurating tubercular axillary glands. The girl at the upper right has pus running to the outside of her face from an abscessed tooth. The boy whose legs are shown at the lower left has a badly deformed body from malnutrition. The girl at the lower right has tubercular glands of the neck.

An opportunity was provided for examining a group of the native Aborigines of Australia who made up the crew of eighteen for a pearl-fishing boat. Of this group, 5.7 per cent of their 554 teeth had been attacked by tooth decay. These individuals could be readily divided into two groups; namely, those who had been raised in the Bush and those who had been raised in missions. For the thirteen raised in the Bush, not a single tooth of their 364 teeth had ever been attacked by tooth decay and not a single individual had deformed dental arches. In contrast with this, of the five raised in the mission, 19.3 per cent of their 140 teeth had been attacked by tooth decay and 40 per cent of these individuals had abnormal dental arches.

The cook on the government boat was an aboriginal Australian from Northern Australia. He had been trained on a military craft as a dietitian. Nearly all his teeth were lost. It is of interest that while the native Aborigines had relatively perfect teeth, this man who was a trained dietitian for the whites had lost nearly all his teeth from tooth decay and pyorrhea.

In the group of Aborigines so far reported, there were many who had come from the interior districts of Australia and many who had always lived near the coast. These two types of districts provided quite different types of foods. Those near the coast were able to obtain animal life from the sea, including fish, dugong or sea cow, a great variety of shell fish, and some sea plants. Those from the interior districts could not obtain animal life of the sea, but did obtain animal life of the land which was eaten with their plant foods in each case. It was quite important to reach a group of Aborigines who had always lived inland and who were on a reservation inland. This contact was made with the group at a government reservation called Cherbourg. A typical group of individuals was examined. Of forty-five individuals with 1,236 teeth, 42.5 per cent of the teeth had been attacked by tooth decay. For the women, this constituted 43.7 per cent; for the men, 64.6 per cent; and for the children, 5.6 per cent. Of all of the individuals here examined 64.5 per cent had dental caries. It is of interest that many of these men had worked on white men's cattle ranches. While the adults showed 11.7 per cent to have deformed dental arches, this rose to 50 per cent for the children of the group. We were informed that in all of these groups tuberculosis was taking a very heavy toll. In Fig. 58, upper left, will be seen a boy with a superating tubercular gland of the axilla; at the right, a girl with a fistula draining pus onto the outside of the face from an abscessed tooth; below, deformed legs and a girl with tubercular glands of the neck.

A reservation situated on the coast where sea foods were available might be expected to make available a particular type of nutrition through sea foods. The individuals in a reservation for the Aborigines at Tweed Heads, which is so situated, were studied. Of the twenty-seven individuals examined, 89 per cent had dental caries. Of their 774 teeth, 39.7 per cent had been attacked by dental caries. For the women, this amounted to 62.5 per cent; for the men, 70.9 per cent; and for the children, 20.8 per cent. Most of these children had been born in this environment while their parents were being fed, largely, the foods provided by the government and mission. In this group, 83.4 per cent of the children had deformed dental arches, and 33.3 per cent of the adults.

An interesting incident was brought to my attention in one of the Australian reservations where the food was practically all supplied by the government. I was told by the director in charge, and in further detail by the other officials, that a number of native babies had become ill while nursing from their mothers. Some had died. By changing the nutrition to a condensed whole milk product, the babies recovered. When placed back on their mother's breast food they again became ill. The problem was: Why was not their mothers' milk adequate? I was later told by the director of a condition that had developed in the pen of the reservation's hogs which were kept to use up the scraps and garbage from the reservation's kitchens. He reported that one after another the hogs went down with a type of paralysis and could not get up. The symptoms were suggestively like vitamin A deficiency in both the babies and the hogs, and indicated the treatment.

The rapid degeneration of the Australian Aborigines after the adoption of the government's modern foods provides a demonstration that should be infinitely more convincing than animal experimentation. It should be a matter not only of concern but deep alarm that human beings can degenerate physically so rapidly by the use of a certain type of nutrition, particularly the dietary products used so generally by modern civilization.

The child life among the Aborigines of Australia proved to be exceedingly interesting. Children develop independence very young and learn very early to take care of themselves. Mothers are very affectionate and show great concern when their children are not thriving. Two typical mothers with their children are shown in Fig. 59. These children, as suggested in the picture, were keenly interested in everything that I did, but were not alarmed or frightened.

FIG. 59. Typical Aborigine mothers with their children.

The wonderful wisdom of these primitive people was attested by the principal of the public school at Palm Island. A mother died and her nursing infant was taken care of by its maternal grandmother, who had not recently given birth to a child. She proceeded to carry out the primitive formula for providing breast food by artificial means. Her method was to make an ointment of the fresh bodies of an insect which made its nest in the leaves of a certain tree. This she rubbed on her breast and in a short time produced milk liberally for this foster child. I was shown the type of insect, photographed its nest and the colony inside when the nest was opened. The people who vouched for this circumstance declared that they had seen the entire procedure and knew the facts to be as stated. They further stated that this was common knowledge among the Aborigines.

Another important source of information regarding the Aborigines of Australia was provided by a study of the skeletal material and skulls in the museums at Sydney and Canberra, particularly the former. I do not know the number of skulls that are available there for study, but it is very large. I examined many and found them remarkably uniform in design and quality. The dental arches were splendidly formed. The teeth were in excellent condition with exceedingly little dental caries. A characteristic of these skulls was the evidence of a shortage of material for those that had been transferred to a museum from the interior arid plains country. Those skulls, however, that had come from coastal areas where sea foods were available, show much more massive dimensions of the general pattern. In Fig. 60 will be seen typical skulls showing the normal dental arches and general design of the head. It is of interest to note the very heavy orbital ridges which characterize this race.

FIG. 60. The buried skulls throughout Australia provide a dependable record of their physical excellence and splendid facial and dental arch forms. In the lower pictures are shown the skull dome of a typical Australian Aborigine for comparison with that of the recently discovered Peking man who possibly lived a million years ago.

I have previously referred to a report by Professor Weidenreich regarding the resemblance of the Australian native's skulls to those of the recently discovered Peking man in the caves of China. In Fig. 60 are two views for comparison. The skull at the left is that of an Australian primitive photographed in a museum in Sydney, and an outline of the Peking skull is shown at the right. Professor Weidenreich has emphasized the observations that when three skulls are put in series, namely, the Australian primitive, the Peking skull and a chimpanzee skull, the Peking skull appears to be about half way between the two in design and developmental order. The Australian primitive's skull is higher in the crown, showing much greater brain capacity. The supra-orbital depressions are less deep in the Peking than in the chimpanzee, and still less deep in the Australian primitive. The supra-orbital ridges which produce the prominent eyebrows are less pronounced in the Australian primitive than in the Peking man, and still more prominent in the chimpanzee. The prominent supra-orbital ridges of the chimpanzee face are shown in Fig. 48.

The age of the Peking skulls has been 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 be part of the first race of mankind. It is a matter of concern that if a scale were extended a mile long and the decades represented by inches, there would apparently be more degeneration in the last few inches than in the preceding mile. This gives some idea of the virulence of the blight contributed by our modern civilization.

The foods available for these people are exceedingly limited in variety and quantity, due to the absence of rains, and unfertility of the soil. For plant foods they used roots, stems, leaves, berries and seeds of grasses and a native pea eaten with tissues of large and small animals. The large animals available are the kangaroo and wallaby. Among the small animals they have a variety of rodents, insects, beetles and grubs, and wherever available various forms of animal life from the rivers and oceans. Birds and birds' eggs are used where available. They are able to balance their rations to provide the requisites for splendid body building and body repair. In several parts of Australia, which originally supported a large population of the primitives, none are left except a few score in reservations. These also are rapidly disappearing. Their fertility has been so greatly reduced that the death rate far exceeds the birth rate.

This group provides evidence of exceptional efficiency in obeying the laws of Nature through thousands of years, even in a parched land that is exceedingly inhospitable because of the scant plant foods for either men or animals. While the Aborigines are credited with being the oldest race on the face of the earth today, they are dying out with great rapidity wherever they have changed their native nutrition to that of the modern white civilization. For them this is not a matter of choice, but rather of necessity, since in a large part of Australia the few that are left are crowded into reservations where they have little or no access to native foods and are compelled to live on the foods provided for them by our white civilization. They demonstrate in a tragic way the inadequacy of the white man's dietary programs.

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Chapter 11

ISOLATED AND MODERNIZED TORRES
STRAIT ISLANDERS

IN STUDYING the relationship between nutrition and physical characteristics, it is important to make observations at the point of contact with civilization where as few factors as possible in the environment have been modified by that contact. My previous studies have shown that wherever groups of people were utilizing sea foods abundantly in connection with land plants including roots, greens and fruits, they enjoyed fine physical development with uniform reproduction of the racial pattern and a very high immunity to dental caries. For this particular study we wished to select a racial group living on islands in tropical or subtropical climate, whose ancestral stocks differed from those previously observed, and which was located at points of contact with modern civilization. A high level of excellence might be expected among the groups who were in process of being modernized but were still utilizing the native foods.

For this study the inhabitants of islands north of Australia were chosen in order to record the effect on the Asiatic and Malay stocks at the points of contact of the north with the south and of the east with the west. In the Torres Strait there are a number of fertile islands supporting populations of from several hundred to a few thousand individuals each. These groups are in an area of the sea that is well stocked with sea animal life, and during the past they have been sufficiently isolated to provide protection. The racial stocks have retained their identities and include Papuans, New Guineans, Mobuiags, Arakuns, Kendals and Yonkas. The splendid dental arches of these groups will be seen in the various illustrations. Many of the girls are quite prepossessing, as may be seen in Fig. 61.

FIG. 61. The inhabitants of the islands north of Australia have splendidly built bodies with fine facial and dental arch form.

With the valuable assistance of the officials of the Australian Government we were able to make investigations on several islands in the Torres Strait. The local administrator provided us with a government boat and personal introductions to the local chief and local representatives of the government. We were accompanied by the administrator and by the general manager of the government stores. These stores have been located on the various islands, and the profit derived from them is used for administrative expenses of the government. They provide modern clothing in addition to foods, chiefly white flour, polished rice, canned goods, and sugar. Studies were made on the various islands in the order in which the stores had been installed on them. It is important to have in mind the nature of these islands. Some are of volcanic origin and have rugged interiors with deep bays; others are of coral origin. All are in a zone that is abundantly supplied with sea animal life, this being the scene of the richest pearl fishing industry in the world.

Badu Island had had the store for the longest period, namely twenty-three years. Of the 586 teeth of twenty individuals examined, 20.6 per cent had been attacked by tooth decay. Of the individuals examined 95 per cent had dental caries. Unfortunately, our stay at this island was accompanied by a torrential downpour which made it very difficult for us to carry forward our investigations. Had we been able to examine the mothers the figures doubtless would have been much higher. The children were examined at the school and showed 18.8 per cent of the teeth to have been attacked by tooth decay. The men examined showed 21.9 per cent. Figures given me by Dr. Gibson, who had been taken by the government to the island to make extractions, showed that he found as high as 60 per cent of the teeth had been attacked by tooth decay. For the children of this group, 33.3 per cent had abnormal dental arches, whereas only 9.1 per cent of the adults' arches were abnormally formed.

On York Island, 1,876 teeth of sixty-five individuals showed that 12.7 per cent had been attacked by tooth decay. For the women, this was 20.2 per cent; for the men, 12.1 per cent; and for the children, 7 per cent. For the children, 47.1 per cent had abnormal dental arches; for the adults, 27 per cent were affected. The individuals on this island had been in contact with the pearl fisheries industry for several years. Several of the men had been working on the fishing boat. Of the sixtyfive individuals examined, 67.6 per cent had dental caries.

On Darnley Island, thirty-three individuals showed that of their 900 teeth 5.7 per cent had been attacked by tooth decay. The store had been established on this island recently. For the women, 16.6 per cent of the teeth had been attacked; for the men, 6.3 per cent; and for the children, 4.1 per cent. On this island, 29.6 per cent of the children showed abnormal dental arches, and 14.3 per cent of the adults. Of the whole group, 46.1 per cent had been attacked by dental caries.

On Murray Island where a store had recently been established, of the 1,074 teeth examined for 39 individuals, only 0.7 per cent of the teeth had been attacked by tooth decay. For the women, this amounted to 2 per cent; for the men, 1.7 per cent; and for the children, 0.26 per cent. Only 12.8 per cent of the group had dental caries. It is significant that the natives were conscious of a danger from the presence on the island of a store providing imported foods. This had been so serious a problem that there was a question whether it would be safe for us to land, since on the last visit of the government officials, blood was almost shed because of the opposition of the natives to the government s program. The result of our examination indicates that dental caries on these islands shows an incidence which has an apparent direct relationship to the length of time government stores have been established there. The immunity to dental caries on this island is nearly 100 per cent. Of the adults, 14.3 per cent had abnormal dental arches, and of the children, 34.4 per cent.

Thursday Island is the location of the administrative center for the group. Although it is the best sheltered harbor and affords protection for small boats in the Torres Strait, it was not originally inhabited by the natives. They considered it unfit for habitation because the soil was so poor that it could not provide the proper plant foods to be eaten with the sea foods which are abundant about all of the islands. Nearly all of the whites inhabiting the islands of this district live on this island. They are the families of the administrative officers and of merchants who are engaged in the pearl industry. Owing to the infertility of the soil, practically all of the food has to be shipped in except the little that the whites obtain from the sea. On the island there were many native families, with children attending the native school, while their fathers worked in the pearling fleets. Thirty individuals in three fleets were examined, and of their 960 teeth only thirty-five had been attacked by dental caries, or 3.6 per cent. Of these thirty individuals, five, or 16.3 per cent had abnormal dental arches. The men who had teeth attacked by dental caries informed me that this had happened after they had engaged on the pearling vessels and began to use the foods provided there. In the native school on Thursday Island twenty-three children were examined. They were living in homes in which a considerable part of the food was purchased at the company stores. The incidence of tooth decay was 12.2 per cent of their 664 teeth. Many of these Thursday Island children had been born since their parents had begun using the commercial foods provided to the islanders. Among twenty-three individuals, 43.5 per cent had abnormal dental arches.

While these investigations were planned and carried out primarily to obtain data on the condition of the native races in contact with modern white civilization, wherever possible, data were obtained on the whites also. In a school for whites on Thursday Island, fifty children were examined with regard to their dental arches, but an embarrassing situation was encountered with regard to the sensitiveness of the whites in the matter of having their children examined for dental caries. Figures were obtained for the facial development which reveal that, out of the fifty children examined, 64 per cent had irregularities of facial and dental arch development. In the upper half of Fig. 62, will be seen a group of children photographed in the native school, and in the lower a group of white girls photographed at the white school. The difference in their facial development is readily seen. The son of the white teacher (Fig. 66, left) had marked under development of his face. The white population lived largely on canned food.

FIG. 62. School children from the two groups on Thursday Island. Note the beautifully proportioned faces of the natives, and the pinched nostrils and marked disturbance in proportions of the faces of the whites. The dental arches of the natives are broad, while many of the whites have very crowded teeth. The parents and children of the natives used native foods while the parents and children of the whites used the modern imported foods of commerce.

Hammond Island adloins Thursday Island sufficiently close by to be easily reached in small boats. Accordingly, the people of this island have access to the stores of the white settlement on Thursday Island. Unlike Thursday Island, Hammond Island is quite fertile. Of twenty-seven individuals, all of native stock, 16.5 per cent of their 732 teeth had been attacked by dental caries, and 40 per cent of the individuals showed some deformity of the dental arches. After examining the children at the mission school, I inquired whether there were not families on the island that were living entirely isolated from contact with modern influences. I was taken to the far side of the island to an isolated family. This family had continued to live on their own resources. They were raising vegetables including bananas, pumpkins, and pawpaws. In the cases of the three girls in the family, one with a child five months of age, only six of their eighty-four teeth had been attacked by tooth decay, or 7.1 per cent, as compared with 16.5 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 shown in Fig. 63. We inquired about the mother and were told that she was out fishing, notwithstanding the fact that the sea was quite rough. While we were there, she came in with two fish (Fig. 63). Here was one of the principal secrets of their happiness and success in life. The Catholic priest who had charge of the mission on this island told me that this family practically never asked for assistance of any kind, and was always in a position to help others. They were happy and well nourished. It is important to note that the progressive degeneration in facial form which occurred in many of the families on the other islands was not found in this family.

FIG. 63. These pictures tell an interesting story. The grandmother shown in the lower right knew the importance of sea food for her children and grandchildren and did the fishing herself. Note the beautiful teeth and well formed faces of her daughters.

The incidence of dental caries ranged from 20.6 per cent of all of the teeth examined for the various age groups on Badu Island to 0.7 per cent, on Murray Island. A group of individuals from this island will be seen in Fig. 64. Note the remarkable width 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 wish that their people were not required to purchase food from the government store. The island is situated on the Barrier Reef and has an abundant supply of small fish. The swarms of fish are often so dense that the natives throw a spear with several prongs into the school of fish and when the spear is drawn back, there are several fish on it. This condition provides abundant food for sharks many of which could be seen surrounding the schools of small fish. Encircling the group, they dashed in, mouths open and gorged themselves with the mass of fish from the water. It seemed quite remarkable that the people were willing to go into the water to spear the fish within the zone frequently approached by the sharks, but I was told by the natives that when the fish are so abundant the sharks never attack human beings. One of the natives rowed me in his canoe to a point where I could photograph the sharks at close range. To show his disdain for the shark, 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 was immediately thrown out by the shark, which had not been frightened sufficiently to make it leave the scene of action. The sharks in my pictures were swimming so close to the shore that the upper part of the tail was forced out of the water, also the back fin, in order to clear the bottom. It was a great revelation to watch the movement of the tail. Instead of swinging it from side to side like other fish, with which I was familiar, the shark would rotate its tail half or three quarters of a turn in a motion like that of a propeller of a boat, then reverse the motion for the return trip. By a sudden increase of speed in this motion, the shark could dart ahead at a rapid rate, corral the small fish by encircling them, and finally make a dash through the school with its mouth open. Hundreds of the small fish, in order to escape, dart out of the water into the air. This exposes them to the birds, a flock of which follows the sharks when they are feeding on the fish. The birds dive down at the time they see the shark making his raid and catch the small fish as they dart out of the water. It is by the birds of prey that the native fishermen from their lookout locate the schools of fish. While there is a difference of opinion as to whether some species of shark will attack human beings, we saw one pearl diver who bore enormous scars received from the jaws of a shark.

FIG. 64. Natives on the islands of the Great Barrier Reef. The dental arches here teach a high degree of excellence.

The procedure on one island is to snare the sharks by calling them by means of special sounds made by clapping together two large half shells on the surface of the water. This attracts the shark, and then the men one at a time go into the water with a sharp stick with which they guard themselves against attack. A noose made of rope of coconut fiber is slipped over the shark's head and over the back fin. It is then allowed to tire out and is brought to shore. It was not unusual in a good season for the shark fishers to bring in three or four in a night's fishing. The strength of the native swimmers is almost beyond belief. The pearling boats are frequently in great danger of being dashed to pieces on a coral reef, since in those waters gales of fifty miles an hour are frequent. We experienced some such gales. On one occasion, when a pearling boat was wrecked some distance from an exposed rock, one strong swimmer rescued and helped two dozen of the crew to the rock, and was himself rescued after being in the water continuously for thirty-two hours. The pearling boats feed their crew largely on commercial provisions. When the men have been continuously on the boats for one or two years, or often when they have been at sea using this food for six months, they have rampant tooth decay. When the cavities approach or reach the pulp chambers the pain produced in the teeth by the high pressure in deep water produces such agony that they often have to give up pearling.

Physical characteristics of all these residents of the Torres Strait Islands, regardless of their tribal group, were, sturdy development throughout their bodies, broad dental arches, and for all of those who had always lived only on their native food, a close proximity to one hundred per cent immunity to dental caries. These men are natural mariners. They do not hesitate to make long trips even in rough seas in their homemade crafts. They have an uncanny skill in determining the location of invisible coral reefs. They relate the height of the swell as it rolls over the reef to particular color tones in the water, all of which were too vague for me to see even when they were pointed out.

Among the inhabitants of the Torres Strait Islands, almost all individuals who had been born before the foods of modern civilization had become available were found to have dental arches normal in form. In many families, however, living on islands where a store had been established for some time, and on Thursday Island where imported foods had been available for several decades, many individuals were found who had been born since the use of imported foods. They had gross deformities of the dental arches. This fact is illustrated in Fig. 65 in which typical depression of the laterals and narrowing of the upper arch and abnormal prominence of the cuspids due to the lack of space for the normal eruption may be seen. The facial deformity in two white boys is seen in Fig. 66. Rampant tooth decay in white children is shown in Fig. 67.

FIG. 65. The contrast between the primitive and modernized natives in facial and dental arch form is as striking here as elsewhere. These young natives were born to parents who had adopted our modern foods of commerce. Note the narrowed faces and dental arches with pinched nostrils and crowding of the teeth. Their magnificent heredity could not protect them.

FIG. 66. These children are from the white colony on Thursday Island. Note the pinched nostrils and deformed dental arches with crowding of the teeth. The boy at the left is a mouth breather.

FIG. 67. As everywhere these whites prefer the modernized foods and pay the penalty in rampant tooth decay. They are in pathetic contrast with the superb unspoiled natives. They are within reach of some of the best foods to be found anywhere in the world and yet do not use them; a typical characteristic of modern whites.

We are particularly concerned with data that will throw light on the nature of the forces responsible for the production of these deformities. Since they do not appear to their full extent until the eruption of the permanent teeth as part of the development of the adult, it is easy for the abnormality to be ascribed to the period of child growth. As a result, it has been related to faulty breathing habits, thumb sucking, posture, or sleeping habits, of the child.

It would be difficult to find a more happy and contented people than the primitives in the Torres Strait Islands as they lived without contact with modern civilization. Indeed, they seem to resent very acutely the modern intrusion. They not only have nearly perfect bodies, but an associated personality and character of a high degree of excellence. One is continually impressed with happiness, peace and health while in their congenial presence.

These people are not lazy, but they do not struggle over hard to obtain 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.

In their native state they have exceedingly little disease. Dr. J. R. Nimmo, the government physician in charge of the supervision of this group, told me in his thirteen years with them he had not seen a single case of malignancy, and had seen only one that he had suspected might be malignancy among the entire four thousand native population. He stated that during this same period he had operated several dozen malignancies for the white population, which numbers about three hundred. He reported that among the primitive stock other affections requiring surgical interference were rare.

The environment of the Torres Strait Islanders provides a very liberal supply of sea foods and fertile islands on which an adequate quantity of tropical plants are readily grown. Taro, bananas, papaya, and plums are all grown abundantly. The sea foods include large and small fish in great abundance, dugong, and a great variety of shellfish. These foods have developed for them remarkable physiques with practically complete immunity to dental caries. Wherever they have adopted the white man's foods, however, they suffer the typical expressions of degeneration, such as, loss of immunity to dental caries; and in the succeeding generations there is a marked change in facial and dental arch form with marked lowering of resistance to disease.

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Chapter 12

ISOLATED AND MODERNIZED NEW ZEALAND MAORI

BECAUSE of the fine reputation of the racial stock in its primitive condition, it was with particular interest that studies were made in New Zealand. Pickerill (1) has made a very extensive study of the New Zealand Maori, both by examination of the skulls and by examination of the relatively primitive living Maori. He states:

In an examination of 250 Maori skulls--all from an uncivilized age--I found carious teeth present in only two skulls or 0.76 per cent. By taking the average of Mummery's and my own investigations, the incidence of caries in the Maori is found to be 1.2 per cent in a total of 326 skulls. This is lower even than the Esquimaux, and shows the Maori to have been the most immune race to caries, for which statistics are available.

Comparing these figures with those applicable to the present time, we find that the descendants of the Britons and Anglo-Saxons are afflicted with dental caries to the extent of 86 per cent to 98 per cent; and after examining fifty Maori school children living under European conditions entirely, I found that 95 per cent of them had decayed teeth.

It will be noted that the basis of computation in the above is percentage of individuals with caries. I am using in addition to these figures the percentage of teeth attacked by dental caries. Expressed in percentage of teeth affected the figure for Pickerill's group would be 0.05 or 1 in 2,000 teeth.

We were deeply indebted to the government officials in New Zealand for their invaluable assistance. In anticipation of making these studies I had been in correspondence with the officials for over two years. When we arrived at Auckland, New Zealand, on our way to Australia, our ship was in port for one day. We were met by Colonel Saunders, Director of Oral Hygiene in the New Zealand Department of Public Health who had been sent from the capitol at Wellington to offer assistance. A personal representative of the Government was sent as guide, and transportation to the various Maori settlements in which we wished to make our studies was provided.


New Zealand is setting a standard for the world in the care of growing children as well as in many other health problems. A large percentage of the schools in New Zealand are provided with dental service. A specially trained woman was in charge of the work in each school under Colonel Saunders' supervision. The operations performed by these young women on children far exceeded in quality the average that I have seen by dentists in America. Their plan gives dental care to children twelve years of age and under, provided the parents express a wish that their children receive that care. The service was being extended rapidly to all communities. Since my return, I have learned that the work is being organized to provide for every community of New Zealand. The art of the Maori gives evidence of their great ability and skill in sculpturing. Boys and girls do beautiful carving and weaving. All native buildings and structures are embellished with carvings often in fine detail.

It was most gratifying to find neat and well-appointed dental office buildings for both natives and whites, located beside a large number of the public schools throughout New Zealand. In many communities two or three schools were served by the same operator. Children were either brought to the central dental infirmary or provision was made for an operating room in the vicinity of each school. The operator went from district to district. A typical dental infirmary is shown in Fig. 68, with Colonel Saunders and one of his efficient women operators in the foreground. I had suggested that I should be glad to have observers from the Department of Health accompany us or arrange to be present at convenient places to observe the conditions and to note my interpretations of them. From two to five such observers were generally present, including the official representative of the department. The planning of the itinerary was very greatly assisted by a Maori member of Parliament, Mr. Aparana Ngata.

FIG. 68. The New Zealand government provides nearly universal free dental service for the children, regardless of color, to the age of twelve years. This is a typical dental clinic maintained in connection with the school system. They are operated by trained dental hygienists. The director of the system, Colonel Saunders, is seen in the picture.

Although New Zealand is a new country with a relatively small population, there being approximately only a million and a half individuals, the building of highways has rapidly been extended to include all modernized sections. In order to reach the most remote groups it was often necessary to go beyond the zone of public improvements and follow quite primitive trails. Fortunately this was possible because it was the dry season. Even then many streams had to be forded, which would have been quite impossible at other seasons of the year. We were able to average approximately a hundred miles of travel per day for eighteen days, visiting twenty-five districts and making examinations of native Maori families and children in native schools, representing various stages of modernization. This included a few white schools and tubercular sanitariums.

Since over 95 per cent of the New Zealanders are to be found in the North Island, our investigations were limited to this island. Our itinerary started at Wellington at the south end of the North Island and progressed northward in such a way as to reach both the principal centers of native population who were modernized and those who were more isolated. This latter group, however, was a small part of the total native population. Detailed examinations including measurements and photographic records were made in twenty-two groups consisting chiefly of the older children in public schools. In the examination of 535 individuals in these twenty-two school districts their 15,332 teeth revealed that 3,420 had been attacked by dental caries or 22.3 per cent. In the most modernized groups 31 to 50 per cent had dental caries. In the most isolated group only 2 per cent of the teeth had been attacked by dental caries. The incidence of deformity of dental arches in the modernized groups ranged from 40 to 100 per cent. In many districts members of the older generations revealed 100 per cent normally formed dental arches. The children of these individuals, however, showed a much higher percentage of deformed dental arches.

These data are in striking contrast with the condition of the teeth and dental arches of the skulls of the Maori before contact with the white man and the reports of examinations by early scientists who made contact with the primitive Maori before he was modernized. These reports revealed only one tooth in 2000 teeth attacked by dental caries with practically 100 per cent normally formed dental arches.

My investigations were made in the following places in the North Island. The Pukerora Tubercular Sanatorium provided forty native Maori for studies. These were largely young men and women and being in a modern institution they were receiving the modern foods of the whites of New Zealand. Their modernization was demonstrated not only by the high incidence of dental caries but also by the fact that 90 per cent of the adults and 100 per cent of the children had abnormalities of the dental arches.

The Hukarera College for Maori girls is at Napier. These girls were largely from modernized native homes and were now living in a modern institution. Their modernization was expressed in the high percentage of dental caries and their deformed dental arches.

At the Nuhaka school an opportunity was provided through the assistance of the government officials to study the parents of many of the children. Tooth decay was wide-spread among the women and active among both the men and children.

The Mahia Peninsula provided one of the more isolated groups which showed a marked difference between the older generation and the new. These people had good access to sea foods and those still using these abundantly had much the best teeth. A group of the children who had been born and raised in this district and who had lived largely on the native foods had only 1.7 per cent of their teeth attacked by dental caries.

The other places studied were Raukokore, Tekaha, Rautoki, Rotarua, Tehoro, Waiomio, Teahuahu, Kaikohe, Whakarara, Mautauri Bay, Ahipara, Manukau, Rawena, Ellerslie, Queen Victoria School at Auckland and Waipawa.

New Zealand has become justly famous for its scenery. The South Island has been frequently termed the Southern Alps because of its snow-capped mountains and glaciers. Of the 70,000 members of the Maori race living in the two islands, about 2000 are on the South Island and the balance on the North Island. While snow is present on many of the mountains of the North Island in the winter season, only a few of the higher peaks are snow capped during the summer. Most of the shoreline of the seacoast of the South Island is very rugged, with glaciers descending almost to the sea. The coastline of the North Island is broken and in places is quite rugged. The approach to the Mahia Peninsula is along a rocky coast skirting the bay. The most important industries of New Zealand are dairy products, and sheep raising for wool.

The reputation of the Maori people for splendid physiques has placed them on a pedestal of perfection. Much of this has been lost in modernization. However, through the assistance of the government, I was able to see many excellent physical specimens. In Fig. 69 will be seen four typical Maori who retained much of the tribal excellence. Note their fine dental arches. A young Maori man who stands about six feet four inches and weighs 230 pounds was examined. The Maori men have great physical endurance and good minds. Many fine lawyers and government executives are Maori. The breakdown of these people comes when they depart from their native foods to the foods of modern civilization, foods consisting largely of white flour, sweetened goods, syrup and canned goods. The effect is similar to that experienced by other races after using foods of modern civilization. Typical illustrations of tooth decay are shown in Fig. 70. In some individuals still in their teens half of the teeth were decayed. The tooth decay among the whites of New Zealand and Australia was severe. This is illustrated in Fig. 71. Particularly striking is the similarity between the deformities of the dental arches which occur in the Maori people who were born after their parents adopted the modern foods, and those of the whites. This is well illustrated in Fig. 72 for Maori boys. In my studies among other modernized primitive racial stocks, there was a very high incidence of facial deformity, which approached one hundred per cent among individuals in tuberculosis sanatoria. This condition obtained also in New Zealand.

FIG. 69. Since the discovery of New Zealand the primitive natives, the Mann, have had the reputation of having the finest teeth and finest bodies of any race in the world. These faces are typical. Only about one tooth per thousand teeth had been attacked by tooth decay before they came under the influence of the white man.

FIG. 70. With the advent of the white man in New Zealand tooth decay has become rampant. The suffering from dental caries and abscessed teeth is very great in the most modernized Maori. The boy at the lower left has a deep scar in his upper lip from an accident.

FIG. 71. Whereas the original primitive Maori had reportedly the finest teeth in the world, the whites now in New Zealand are claimed to have the poorest teeth in the world. These individuals are typical. An analysis of the two types of food reveals the reason.

FIG. 72. In striking contrast with the beautiful faces of the primitive Maori those born since the adoption of deficient modernized foods are grossly deformed. Note the marked underdevelopment of the facial bones, one of the results being narrowing of the dental arches with crowding of the teeth and an underdevelopment of the air passages. We have wrongly assigned these distorted forms to mixture of racial bloods.

Through the kindness of the director of the Maori Museum at Auckland, I was able to examine many Maori skulls. Two views are shown in Fig. 73. The skulls belong in the pre-Columbian period. Note the splendid design of the face and dental arches and high perfection of the teeth.

FIG. 73. The large collections of skulls of the ancient Mann of New Zealand attest to their superb physical development and to the excellence of their dental arches.

One 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 abandonment of the native foods and the substitution of foods of modern civilization. This is discussed in later chapters.

It was particularly instructive to observe the diligence with which some of the isolated Maori near the coast sought out certain types of food in accordance with the tradition and accumulated wisdom of their tribes. As among the various archipelagos and island dwellers of the Pacific, great emphasis was placed upon shell fish. Much effort was made to obtain these in large quantities. In Fig. 74 (lower), will be seen two boys who have been gathering sea clams found abundantly on these shores. Much of the fishing is done when the tide is out. Some groups used large quantities of the species called abalone on the West Coast of America and paua in New Zealand. In Fig. 74 (upper), a man, his wife and child are shown. The father is holding an abalone; the little girl is holding a mollusk found only in New Zealand, the toharoa; the mother is holding a plate of edible kelp which these people use abundantly, as do many sea bordering races. Maori boys enjoy a species of grubs which they seek with great eagerness and prize highly. The primitive Maori use large quantities of fern root which grows abundantly and is very nutritious.

FIG. 74. Native Maori demonstrating some of the accessory essentials obtained from the sea. These include certain sea weeds and an assortment of shell fish. It is much easier for the moderns to exchange their labor for the palate tickling devitalized foods of commerce than to obtain the native foods of land and sea.

Probably few primitive races have developed calisthenics and systematic physical exercise to so high a point as the primitive Maori. On arising early in the morning, the chief of the village starts singing a song which is accompanied by a rhythmic dance. This is taken up not only by the members of his household, but by all in the adjoining households until the entire village is swaying in unison to the same tempo. This has a remarkably beneficial effect in not only developing deep breathing, but in developing the muscles of the body, particularly those of the abdomen, with the result that these people maintain excellent figures to old age.

Sir Arbuthnot Lane (2) said of this practice the following:

As to daily exercise, it is shown here that every person capable of movement can benefit by it, and I am certain that the only natural and really beneficial system of exercise is that developed through long ages by the New Zealand Maori and their race-brothers in other lands.

The practical application of their wisdom is discussed in Chapter 21.

The Maori race developed a knowledge of Nature's laws and adopted a system of living in harmony with those laws to so high a degree that they were able to build what was reported by early scientists to be the most physically perfect race living on the face of the earth. They accomplished this largely through diet and a system of social organization designed to provide a high degree of perfection in their offspring. To do this they utilized foods from the sea very liberally. The fact that they were able to maintain an immunity to dental caries so high that only one tooth in two thousand had been attacked by tooth decay (which is probably as high a degree of immunity as that of any contemporary race) is a strong argument in favor of their plan of life.

REFERENCES

PICKERILL, H. P. The Prevention of Dental Caries and Oral Sepsis. Philadelphia, White, 1914.
LANE, A. Preface to Maori Symbolism by Ettie A. Rout. London, Paul Trench, Trubner, 1926.


Key to Route Followed in Peru
1. Panama 10. Huaura 19. San Rosa
2. Buenaventura 11. Chimbote 20. Cuzco
3. Manta 12. Santa Island 21. Calca
4. Guayaquil 13. Chiclayo 22. Manchu Piccu
5. Talara 14. Eten 23. Huancayo
6. Trujillo 15. Huaraz 24. Oroya
7. Callao 16. Arequipa 25. Perene
8. Lima 17. Lake Titicaca
9. Huacho 18. Juallanca

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Chapter 13

ANCIENT CIVILIZATIONS OF PERU

IN THE foregoing field studies among primitive races we have been dealing chiefly with living groups. Since the West Coast of South America has been the home of several ancient cultures, it is important that they be included with the living remnants of primitive racial stocks, in order to note the contributions that they may make to the problem of modern degeneration. The relationship between the Andes Mountain Range and the coast and the sea currents is such that there has been created a zone, ranging from forty to one hundred miles in width between the coast and the mountains, which for a distance of over a thousand miles is completely arid. The air currents drifting westward across South America from the Atlantic carry an abundance of moisture. When they strike the eastern foothills of the Andes they are projected upward into a region of constant cold which causes the moisture to be precipitated as rain on the eastern slopes, and as snow on the eastern Cordillera Range. Hence the name of the eastern range is the White Cordillera, and that of the western range, which receives little of this rain, is the Black Cordillera. Between these two ranges is a great plain, which in the rainy season is well watered. The great civilizations of the past have always utilized water from the melting snow through irrigation ditches with the result that a vast acreage was put to agricultural uses.

The Humboldt Current which sweeps northward from the southern ice fields and carries its chilly water almost to the equator has influenced the development of the West Coast of South America. The effect of the current on the climate is generally noticeable. One of the conspicuous results is the presence of a cloud bank which hovers over the coastal area at an altitude of from one thousand to three thousand feet above sea level for several months of the year. Back from the coast these clouds rest on the land and constitute a nearly constant fog for extended periods. When one passes inland from the coast up the mountains he moves from a zone which in winter is clammy and chilly, into the fog zone, and then suddenly out of it into clear sky and brilliant sunlight. It is of interest that the capital, Lima, is so situated that it suffers from this unhappy cloud and fog situation. When Pizarro sent a commission to search out a location for his capital city the natives commented on the fact that he was selecting a very undesirable location. Either on the coast or farther inland than Lima the climate is much more favorable, and these were the locations in which the ancient civilizations have left some very elaborate foundations of fortresses and extended residential areas. The great expanse of desert extending from the coast to the mountains, with its great moving sand dunes and with scarcely a sign of green life, is one of the least hospitable environments that any culture could choose. Notwithstanding this, the entire coast is a succession of ancient burial mounds in which it is estimated that there are fifteen million mummies in an excellent state of preservation. The few hundred thousand that have been disturbed by grave robbers in search of gold and silver, have been left bleaching on the sands. Where had these people come from and why were they buried here? The answer is to be found in the fact that probably few locations in the world provided such an inexhaustible supply of food for producing a good culture as did this area. The lack of present appreciation of this fact is evidenced by the absence of flourishing modern communities, notwithstanding the almost continuous chain of ancient walls, fortresses, habitations, and irrigation systems to be found along this coast. The Humboldt Current coming from the ice fields of the Antarctic carries with it a prodigious quantity of the chemical food elements that are most effective in the production of a vast population of fish. Probably no place in the world provides as great an area teeming with marine life. The ancient cultures appreciated the value of these sea foods and utilized them to the full. They realized also that certain land plants should be eaten with the sea foods. Accordingly, they constructed great aqueducts used in transporting the water, sometimes a hundred miles, for the purpose of irrigating river bottoms which had been collecting the alluvial soil from the Andes through past ages. These river beds are to be found from twenty to fifty miles apart and many of them are entirely dry except in the rainy season in the high Andes. In the river bottoms these ancient cultures grew large quantities of corn, beans, squash, and other plants. These plant foods were gathered, stored, and eaten with sea foods. The people on the coast had direct communication with the people in the high plateaus. It is of more than passing interest that some twenty-one of our modern food plants apparently came from Peru.

Where there is such a quantity of animal life in the sea in the form of fish one would expect to find the predatory animals that live on fish. One group of these attack the fish from the air and they constitute the great flock of guanayes, piqueros and pelicans. For a thousand miles along the coast, these fish-eating birds are to be seen in great winding queues going to and fro between the fishing grounds and their nesting places. At other times they may be seen in great clouds, beyond computation in number, fishing over an area of many square miles. On one island I was told by the caretaker that twenty-four million birds had their nests there. We passed through a flock of the birds fishing, which the caretaker estimated to contain between four and five million birds. On one island I found it impossible to step anywhere, off the path, without treading on birds' nests. It is of interest that a product of these birds has constituted one of the greatest sources of wealth in the past for Peru, namely, the guano, which is the droppings of the birds left on the islands along the coast where they have their nests. Through the centuries these deposits have reached to a depth of 100 feet in places. When it is realized that only one-fifth of the droppings are placed on the islands, it immediately raises the great question as to the quantity of fish consumed by these birds. As high as seventy-five fish have been found in the digestive tract of a single bird. The quantity of fish consumed per day by the birds nesting on this one island has been estimated to be greater than the entire catch of fish off the New England coast per day.

In addition to the birds, a vast number of sea lions and seals live on the fish. The sea lions have a rookery in the vicinity of Santa Island, which was estimated to contain over a million. These enormous animals devour great quantities of fish. It would be difficult to estimate how far the fish destroyed by this one group of sea lions would go toward providing excellent nutrition for the entire population of the United States. The guano, consisting of the partially digested animal life of the sea, constitutes what is probably the best known fertilizer in the world. It is thirty-three times as efficient as the best barnyard manure. At one time it was sent in shiploads to Europe and the United States, but now the Peruvian Government is retaining nearly all of it for local use. They have locked the barn door after the horse was stolen, figuratively speaking, since the accumulation of ages had been carried off by shiploads to other countries before its export was checked. At the present time all islands are under guard and the birds are protected. They are coming back into many of the islands from which they had been driven and are re-nesting. Birds are given two or three years of undisturbed life for producing deposits. These are then carefully removed from the surface of the islands and the birds are allowed to remain undisturbed for another period.

A very important and fortunate phase of the culture of the primitive races of the coast has been their method of burial. Bodies are carefully wrapped in many layers of raiment often beautifully spun. With the mummies articles of special interest and value are usually buried. Implements used by the individuals in their lifetime were also put in the grave. With a fisherman there were placed his nets and fishing tackle. Almost always, jars containing foods to supply him on his journey in the transition to a future life were left in the tomb. In some of the cultures the various domestic and industrial scenes were reproduced in pottery. These disclosed a great variety of foods which are familiar to us today. Even the designs of their habitations were reproduced in pottery. Similarly their methods of performing surgical operations, in which they were very skillful, were depicted. Fortunately, the different cultures had quite different types of pottery as well as quite different types of clothing. This makes it possible to identify various groups and indicate the boundaries of their habitations.

Their engineering feats disclosed skill in planning fortresses. Their forts were probably impregnable from assault in that day. The materials used for building their temples, abodes, and fortifications differ somewhat in various locations. Throughout the greater extent of the coast of Peru, the walls of buildings were made of adobe often many feet thick and sometimes sixty feet high. They had walled cities protected by inner and outer lines of fortifications. It is particularly significant that the hardest metals that they are known to have had were copper and bronze. Silver and gold were quite plentiful. Their surgical instruments were flints and the operations that they were able to perform with these instruments were very remarkable. An important instrument in warfare consisted of a club with a star on the end made of copper or stone. With this the opponent's skull was crushed in. One of the amazing features in the various collections of skulls is the large number that show the results of surgical operations. These operations were apparently done for the purpose of saving the life of the individual. The procedure was to remove a section of bone in the center of the depressed area and raise the depressed edges surrounding that area. The fact that a large number of these show abundant evidence of healing and repair clearly indicates that the individual lived for an extended period following the operation. In some cases, the opening is apparently entirely closed in with new bone. Some of these trepanning operations removed a quantity of bone over an area large enough for a human hand to pass through. A group of these operated skulls are shown in Fig. 75. The owner of the one on the lower row, left, probably died following the operation, as there is no evidence of repair. The others show good healing, which in some is very extensive. A study of these trephined skulls reveals that 62 per cent lived for months or years. In Fig. 75 (lower right), is seen a skull which shows a large operation. A part of the surgical procedure was to place a plate of gold over the opening in the skull for protection. One of these is shown in the upper half of Fig. 76. Below is shown the healed scar after removal of the gold plate.

FIG. 75. Trephined skulls of the ancient peoples of Peru. Their war weapons were designed to produce skull fractures. Their surgeons trephined the skulls, thus removing the depressed area. The large percentage of operated skulls showing extensive healing indicates a large percentage lived for months and years afterwards. Their surgical flesh cutting knives were made of copper and bronze, the bone cutting of mounted crystals. They used cocoa leaves (cocaine) as a sedative as the natives do today.

FIG. 76. These ancient surgeons placed a gold plate over the skull opening beneath the scalp to protect the brain. Above, two views are shown of a skull with a gold plate in position and below the same skull with the gold plate removed. Note that the skull opening is nearly healed in. To the right below an extensive operation is shown.

The skill of the surgeons in amputations is illustrated by the pottery reproductions of amputated parts. One of these, for example, shows a man with an amputated foot holding the stump of his leg with one hand while putting on a sock over the end of the stump with the other hand. The technic of amputation is shown in pottery form in Fig. 77. A serious disease of the foot is suggested, requiring amputation of the leg, high up. Note how the thigh bone was cut so as to provide a fleshcovered stump. Below in Fig. 77 is shown a healed oblique fracture with good adaptation.

FIG. 77. The skill of the ancient surgeons in plastic and bone surgery is illustrated in the pottery jar above. In order to provide flesh for a pad over the amputated bone stump the flesh is cut lower than the bone by pushing the flesh up at the time the bone is cut. In the lower view good healing is shown of a difficult oblique fracture.

When the Spaniards arrived to carry forward the conquest of Peru they found the entire coastal area and upper plateaus under the control of a culture organized under the Inca rulers. Prior to the domination of that culture, which had its origin in the high plateau country, several other cultures had developed along the coast in succeeding eras of domination. In northern Peru the Chimus developed a great culture that extended over a long period of time. Their capital city was at Chan Chan, inland from the present coastal port of Saliverry and near Trujillo. 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 were not arid desert but well supplied with rain. That this was not so is clearly evidenced by the fact that the walls were built of stucco made by mixing water with the available sand and rubble either in continuous molds or in blocks that were built into the fort. Since these blocks were only sun-dried they had very little resistance to rain. In this rainless desert land they have continued to stand through many centuries, many of them probably through several thousand years. There has been a vast change in the walls of the ruined city of Chan Chan within a decade and a half.

In 1925 this district was visited by a heavy downpour of rain which apparently exceeded any precipitation, not only through historic times, but for many centuries preceding. Temples, courtyards and military defenses which were in splendid preservation before that downpour were reduced to a mere semblance of their former structure. Clearly these great cities and their defenses could not have been built of this material in the period when downpours were even occasional, let alone frequent.

It was, of course, the wealth of the ancient cultures that spurred on the conquistadors. It is very difficult to estimate the per capita quantity of gold available in those early cultures. That gold and silver were abundant is evidenced by the extensive use that was made of these metals for covering the walls of rooms and decorating public buildings with massive plates, sometimes entirely encircling a building and the walls of its various rooms. A considerable quantity of gold and silver has been taken from the burial mounds. One burial mound is reported to have yielded between six and seven million dollars worth of gold. So great has been the activity of the grave robbers that the Peruvian Government has placed a ban on this enterprise though for a period it was allowed on condition that a stated percentage was given to the Government.

One of the principal characteristics of the Chimu culture of the coastal area of northern Peru is shown in the type of pottery they produced. All articles were realistic in design. The pots show hunting scenes, fishing and domestic scenes, as illustrated above. They were very skillful in reproducing features in nearly natural size. Many thousands of these portrait jars have been taken from the mounds of this district. The local museum in the vicinity of Chan Chan, under the skillful direction of Mr. Larco Herrera at Chiclyan was reported to contain over twenty thousand jars and specimens taken from the mounds.

To the south of the domain of the Chimu culture, a very strong culture was built up with very different characteristics known as the Naska. While many of their habits of life, including their methods of providing food, were similar to those of the Chimu culture, they were unique in the designs of their pottery, which were characterized by being allegorical. They used elaborate color designs and fantastic patterns. Very little is known as yet of the meaning of much that they have left. While sundials of ancient design and build have been found in many parts of Peru, it is not known to what extent they developed a knowledge of astronomy. The pilot of the plane that flew us from Lima to Arequipa took us over some very strange architectural designs of geometrical patterns which he had discovered and which he suggested had not been reported upon nor interpreted. I 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 which indicate the use of competent engineering equipment and a high knowledge of surveying.

One of the principal purposes of my trip to Peru was to study the effect of the Humboldt Current, with its supply of human food, on the ancient cultures which were buried along the coast. In other parts of the world, where Nature had provided the sea with an abundance of sea life which was being utilized by native races, I found quite routinely excellent physical development with typical broad, well-developed facial forms and dental arches with normal contours. In each of these groups, the people have reproduced quite closely the racial type in practically all members of the group. I have emphasized with illustrations this fact in connection with the Melanesians and Polynesians on eight archipelagos of the Pacific Ocean, the Malay races on the islands north of Australia, the Aborigines of Australia along the east coast; also the Gaelics in the Outer Hebrides, and the Eskimos of Alaska.

The activity of grave robbers in the ancient burial mounds has left skeletons strewn helter skelter where many of them have been weathering, probably for years. While many of these had apparently been deliberately smashed, large numbers were intact, and in a good state of preservation. Some of the ancient cemeteries apparently extended over areas covering a square mile; and as far as the eye could see the white bleaching bones, particularly the skulls, dotted the landscape. Since there were several distinct cultures, I endeavored to make a cross section study of a number of these burial grounds in order that a fair average of specimens might be obtained. The skulls were handled by me, personally, and large numbers of them were photographed. As I have mentioned, it was the ancient custom when making the burials to inter objects that were of special interest to the individuals, including the implements with which he had worked. Fishermen's skulls are shown in Fig. 78 with their nets. It will be noted that all these arches are broad and wide, that the third molars are well formed and almost always well developed, and in good masticating position. Notwithstanding the long period of interment the fabrics buried with these people were often in a remarkably good state of preservation. Even the hair was well preserved. A characteristic of the method of preparation for burial involved placing over the teeth a preparation that was held in position by a strip of cloth which cemented the teeth quite firmly to this strip with the result that when the mummy cases were torn open the removal of this bandage removed the straight rooted teeth, and therefore large numbers of the skulls that were bleaching on the sandy wastes were without the straight rooted teeth. Of course, these would readily tumble out at the slightest jar, after the mummified tissues had decomposed from exposure. The teeth lost in this way would include practically all of the upper and lower incisors, some of the bicuspids and third molars.

FIG. 78. The two skulls in the upper photograph apparently belonged to fishermen of the Chimu culture as evidenced by the flattened back of the head. Note the splendidly formed dental arches. In an examination of one thousand two hundred and seventy-six skulls in succession I did not find one with the typical deformities of our moderns.

Since our study was primarily concerned with the shape of the dental arches and facial form, these characteristics could be studied and recorded with the straight rooted teeth removed. Fortunately, there are some excellent collections of skulls in museums in Peru, with the skulls in position where they can be readily studied for the shape of the dental arches. When we have in mind that from 25 to 75 per cent of individuals in various communities in the United States have a distinct irregularity in the development of the dental arches and facial form, the cause and significance of which constitutes one of the important problems of this study, the striking contrast found in these Peruvian skulls will be seen to constitute a challenge for our modern civilizations. In a study of 1,276 skulls of these ancient Peruvians, I did not find a single skull with significant deformity of the dental arches.

Since these investigations have apparently established the fact that this problem is related directly to nutrition, and chiefly to nutrition in the formative period, and, as we shall see, to a very early part of the formative period, we have here evidence of a system of living that is very closely in accord with Nature's fundamental laws of reproduction. Several studies have been made dealing with the incidence of dental caries or tooth decay among these ancient cultures. The author of "Bird Islands of Peru" (1) states that in his examination of fifty mummies in succession he found only four with a tooth with dental caries. This again is in striking contrast to our modernized communities in which from 95 to 100 per cent of all the members of a community group suffer from dental caries. I have shown in connection with the Indians of the western coast of Canada that in six highly modernized communities where the Indians were using white man's foods, 40 per cent of all the teeth had been attacked by dental caries. A similar high percentage was found in the Indians now living in Florida. The ancient burials in southern Florida revealed apparent, complete immunity. These were pre-Columbian burials.

The skill of the primitive cultures of Peru in engineering as evidenced by the irrigation systems has always been a subject of amazement to modern engineers. I visited in a valley fifteen miles from the Santa River an ancient aqueduct which was said to be a hundred miles long. Our guide informed me that he had walked in it for thirty-five miles. With its even grades, overflows and auxiliary channels for distribution, its adaptation to the area to be watered, and the skill with which it was cut through rock shoulders and its retaining walls built, it constitutes a monument to engineering ability. Modern engineers have estimated that this aqueduct could deliver sixty million cubic feet of water a day. In Fig. 79 will be seen a section where it has been carried through a rock cutting and beyond will be seen a retaining wall used to carry the flume along the sheer face of a rock. The modern inhabitants of this community have carried away this retaining wall for use in the foundations of their huts. Below, in Fig. 79, will be seen a district of many hundreds of acres, possibly a thousand, where the fields are laid out just as they were left hundreds of years ago when the primitive people were driven from this habitat. All this valley needs is water.

FIG. 79. The ancient civilizations of Peru had skilled engineers. In the upper view is seen one of the ancient aqueducts still intact for thirty-five miles which modern scientists estimate was capable of delivering sixty million cubic feet of water per day. They had no hardened tools or blasting powder, yet they cut this channel through boulders and rocks. Below is seen a valley covering thousands of acres once made fertile by irrigation but now an arid desert.

In order to reach the burial places it was necessary to drive many hundreds of miles over the arid desert inland from the coast. We were exceedingly fortunate in having as our interpreter and guide Dr. Albert Giesecke, who for fourteen years was the Chancellor of Cuzco University. With his excellent knowledge of the country and its languages, with the credentials which gave us entry to the secluded places, together with the kindness and helpfulness of the Peruvian Government officials in almost all localities, we were able to obtain much valuable information. In an estimate of this culture not only their arts, but their scientific skill should be included.

Since the primary object of this quest was to learn of the efficiency of these primitive people in the art of living in harmony with Nature's laws and their methods for accomplishing this, it was desirable to find, if possible, some living descendants of these people to gain from them the information that had been handed down. We were told that there were a few villages in an isolated section of the coast in northern Peru where the inhabitants claimed descent from the ancient Chimu cultures of that area. This group was characterized by a flattening of the skull at the back which classified them as short heads and is readily identified. We were very fortunate in having the assistance of Commander Daniel Matto of the Peruvian Army. He was able to utilize the police facilities for locating typical old residents who could tell us much of the story of their race and its recent history as it had been handed down by word of mouth. In Fig. 80 will be seen one of these nonagenarians. He told us of incidents that had been related to him by his great-greatgrandfather and by the old people of that area, of the coming of Pizarro four hundred years ago. The height of this man can be judged as he is seen standing beside Mrs. Price, who is five feet three. His head is shown both front and side view, revealing the flattened surface at the back. An ancient skull with typical flattening is also shown. Fortunately these people are living very closely in accordance with the customs of their ancestors. They are fisherfolk, with a hardihood and skill that is in striking contrast with the lethargy of the modernized groups. Their fine physical development, the breadth of their dental arches and the regularity of their facial features are in striking contrast to the characteristics noted among individuals in the modernized colonies. In Fig. 81 will be seen typical members of these colonies.

FIG. 80. The ancient Chimus flattened the back of the head, as shown in the lower left, by placing the infant on a board. A descendant of the Chimus is shown in the upper left with Mrs. Price, and in front and side views at the right. Note that the back of his head is similarly flattened.

FIG. 81. Some descendants of the ancient Chimu culture are still living in a few fishing villages in the north of Peru. They live, as did their ancestors, largely on the sea food. Typical faces of this native stock are shown in this photograph. Note the breadth of the dental arches and full development of the facial bones.

The skill with which these men manage their fishing boats is inspiring. Even though the surf was rolling in great combers they did not hesitate to go out in either their small crafts carrying one individual or in their large sailboats carrying a dozen men. The abundance of the fish in this district is demonstrated by the large catch that each succeeding boat brought to shore.

At the time the Spanish Conquistadors arrived in Peru one of the most unique of the ancient cultures held sway over both the mountain plateaus and the coastal plains from Santiago of Chile northward to Quito, Equador, a distance of about 1200 miles. This culture took its name from the ruling emperors called Incas. The capital of their, great kingdom was Cuzco, a city located between the East and West Cordillera Ranges of the Andes. These parallel ranges are from fifty to two hundred miles apart. Between them is situated a great plateau ranging from 10,000 to 13,000 feet above the sea. The mountain ranges are snow-capped and include in Peru alone fifty peaks that are over 18,000 feet in altitude, ranging up to 22,185 feet in Mount Huascaran. Only Mount Aconcagua in Chile is higher. It is 23,075 feet--the highest mountain in the Americas. The air drift is across South America from east to west, carrying vast quantities of water received by evaporation from the Atlantic Ocean. This moisture is precipitated rapidly when the clouds are forced into the chill of the higher Andes. In the rainy season the great plateau area is frequently well watered, though not in sufficient quantity to meet the needs of agriculture for much of the territory. In the past the precipitation has been supplemented by vast irrigation projects using the water from the melting snows. It is estimated that the population ruled over by the reigning Incas at the time of the coming of the Spaniards reached five millions.

It is probable that few, if any, of the ancient or modern cultures of the world have ever attained a more highly perfected organization of society than had this Inca culture. The ruling Inca was a benevolent despot, and according to history unique in that he practiced most diligently all of the laws he promulgated for his people. There was no poverty, want or crime. Every man, woman and child was specifically provided with all necessities. The entire amount of tillable land was divided so that every man, woman and child had his assigned parcel. Everyone worked as assigned by the proper official. While it is not appropriate here to go into details, it is important that we have a bird's eye view of this great culture for which I will quote a paragraph from Agnes Rothery's "South America, The West Coast and The East." (2)

The people who erected this temple lived in order and health, under the most successful communism the world has ever seen. Their land was divided into three portions--one portion for the Inca, one for the Sun, and one for the people, with seventy square meters for every boy and thirty-five for every girl. The live stock and implements were similarly apportioned and the land was ploughed, planted, and the crops gathered in strict rotation. First the fields of the Sun were cultivated, and then the land of the aged, the sick, widows, and orphans was tended; then the lands of the people, neighbors assisting one another; and last of all the lands of the Inca, with songs of praise and joy, because this was the service of their King. To every living soul was given his tasks, according to his physical and mental capacities. He was prevented from overwork, prohibited from idleness, cared for in illness and old age. Children were taken by the Government when they were five and trained to the profession where they were most needed. There was no hunger, no crime in the whole empire.

The Inca held his kingly office over the docile, industrious, and contented mass not only through his royal blood, but through his wisdom and kindness in caring for and guiding his subjects, his bravery in war, and his statesmanship at home. Although he set an example to his subjects by following every law which he promulgated (astonishing idea to our modern lawmakers!), he lived, as became his rank, in luxury. In his garden were rows of corn moulded from pure gold with leaves of pure silver, and a tassel of spun silver, as fine as silk, moving in the air. Llamas and alpacas, life-sized and cunningly fashioned from the same metal, stood upon his lawns, as they did in the courts of the Temple of the Sun.

Cuzco, the capital, is reported to have housed about two hundred thousand people at the time of the Spanish Conquest. It is situated on a branch of the Urabamba River in a beautiful valley surrounded by fertile mountain sides and towering snow-capped pinnacles. The Urabamba River drains a large area of the plateau lying to the south of Cuzco and has cut a magnificent gorge through the southern range of the Andes where it passes from the plateau to the eastern watershed and thence to the Amazon. A little to the south of Cuzco the eastern and the western ranges of mountains approach and combine in a cluster of magnificent pinnacles and intervening valleys and gorges, that are to be equalled by no mountain scenery in the world. Today, almost all travel from the Andean Plateau north of this region, as well as from all areas along the coast, must proceed to the coast, thence down the coast by boat to the port of Mollendo which is often dangerous or impossible of approach because of the heavy seas. The journey is made by train up through Arequipa and over the western Cordillera Range of the Andes into the plateau country and from there northward to Cuzco. So great is this natural barrier that the detour requires many days, and the crossing of several divides ranging from fourteen to sixteen thousand feet above the sea. This was not necessary for the Incas who had built roads and suspension bridges through these mountains from Cuzco to all parts of the great empire. It is in this mountain vastness that the Inca rulers had constructed their most superb fortresses. While the early Spanish conquerors of the country knew that the nobility had great defenses to which they might retreat, the location of the fortresses was not known. Their greatest fortress was discovered and excavated by Professor C. W. Bingham of Yale, under the auspices of Yale University and the American Museum of Natural History. This fortress and retreat is now world famous as Macchu Piccu, and probably represents the highest development of engineering, ancient and in some respects modern, on the American continent.

We are particularly concerned with the type of men that were capable of such great achievement, since they were required to carry forward their great undertakings without the use of iron or the wheel. While the great Inca culture dominated the Sierras and the coast for several centuries prior to the coming of the Spanish, and while they had their seat of government and vast agricultural enterprises in the high Sierras, it is of special interest that many of the most magnificent monuments remaining today in stone were not constructed by the Inca culture, but by the Tauhuanocan culture which preceded the Inca. The Incas were a part of the Quechu linguistic stock, while the Tauhuanocans were a part of the Aymara linguistic stock. The Incas had their capital in the high plateau country about the center of Peru. The earlier Tauhuanocan culture centered in southern Peru near Lake Titicaca where their most magnificent structures are to be found today. One of the largest single stones to be moved and put into the building of a great temple in the history of the world is to be found near Lake Titicaca. According to engineers, there is no quarry known in an easily reached locality where such a stone could be quarried. It is conjectured that it was brought two hundred miles over mountainous country. It is important to note that many magnificent structures, evidently belonging to this ancient Tauhaunocan culture, are found distributed through the Andean Plateau from Bolivia to Equador. Their masonry was characterized by the fitting together of large stones faced so perfectly that in many of the walls it was difficult to find a crevice which had enough space to allow the passage of the point of my pen knife, notwithstanding that these stones were many-sided with some of them fifteen to twenty feet in length. In Figure 82 above will be seen a section of wall of the great fortress Sacsahuaman overlooking Cuzco. Modern engineers seem unable to provide a satisfactory answer as to how these people were able to cut these stones with the limited facilities available, nor is it explained how they were able to transport and hoist some of their enormous monoliths. The walls and fortress of Macchu Piccu, as well as the residences and temples, were built of white granite which apparently was taken from quarries in the bank of the river Urabamba, two thousand feet below the fortress. Without modern hoisting machinery, how did they raise those mammoth stones? In Fig. 82 below is shown a typical section of wall. One stone shown has twelve faces and twelve angles, all fitting accurately its boundary stones. It is as though the stones were plastic and pressed into a mould.

FIG. 82. The primitive peoples of the Andean Sierra built wonderful fortresses and temples of cut stones which are assembled without mortar and cut to interlock. The central stone, above, is estimated to weigh one hundred and forty thousand pounds. Below the largest stone has twelve faces and twelve angles.

The country is rugged. Over it passes the highest standard-gage railroad in the world,--about 16,000 feet above sea level. The banks of this river are protected for long distances by ancient stone retaining walls. The native Indians live and herd their flocks of llamas and alpacas up near the snow line, largely between 15,000 and 18,000 feet. The Incas and their descendants now occupying the high Sierras in the Andes have been thrifty agriculturists. They turn the soil with a very narrow, long, slender bladed spade which they force into the ground, and with which they pry the ground up in chunks. They then break up the chunks. These spades were originally made of copper which they mined themselves. Cuzco is the archeological capital of South America, but its glory is in the ancient fortresses and temples, rather than in the modern structures. As one passes through the streets, he will note that in many instances the foundations and parts of the walls of many of the modern Spanish cathedrals and public buildings are of old Inca construction, of fine stone work surmounted by cheap rubble work and mortar superstructure. Whereas the original Cuzco had running water and an excellent sanitation system, modern Cuzco has deplorable sanitary conditions. The following is quoted from the West Coast Leader, published in Lima, dated July 20, 1937: "Of a total 3,600 houses in the city of Cuzco 900 are without water or drainage; 2,400 are without light (windows) and 1,080 completely lack any sanitary systems. It is not surprising, therefore, that in some years the death rate exceeds the birth rate.

We are particularly concerned in studying these people to know the sources of their great capacity for developing art, engineering, government and social organization. Can such a magnificent culture be brought about unless founded on a superb physical development resulting from purely biologic forces?

Earthquakes are very frequent in the Andes. We experienced several while in Peru. One of these opened up a cave in the mountainside in the Urabamba Valley near which we were making studies. The cave had just been explored and a number of ancient burials found. I was able to examine a number of skulls from this cave which apparently represented a pre-Spanish period. The date of the burials could not be determined. The skulls were interpreted as belonging to an early Indian period. In Fig. 83 may be seen two typical skulls. Note the broad sweep of the dental arches and freedom from tooth decay. The third molars (wisdom teeth) are well developed and in normal position for mastication. These are typical of the entire group found in this burial place. It is very evident that these individuals were provided with an adequate nutrition throughout the formative and growth periods, as well as during their adult life. This is significant because of the limited variety of foods easily obtainable for the people in the high plateau country of the Andes.

FIG. 83. Typical skulls of High Sierra Indians from a recently opened burial cave. Note the breadth of the dental arches provided by excellent development of the bones of the head.

The ancient Peruvians of both the coastal area and high plateau country had developed superb physical bodies in each of the several cultures. This development had been brought about in spite of the bad conditions prevailing with arid desert land extending from the coast to the mountains, and in spite of the severe climate of the high Sierras. The people utilized the wide variety of animal life from the sea in conjunction with the excellent plant foods grown in the river basins with the aid of irrigation. Over twenty of our common plants had their origin in ancient Peru. In the high Sierras, their animal foods were largely limited to the llama, alpaca and wild animals. Each household, however, maintained a colony of guinea pigs. Owing to the difficulty of boiling in the high altitudes, they found it necessary to roast their cereals and meats. Their vegetable foods included potatoes, which were preserved in powder form by freezing and drying and pulverizing. Corn and several varieties of beans and quinua were their principal cereals. The latter is a small seed of very high nutritive value.

REFERENCES

MURPHY, R. C. Bird Islands of Peru. New York, Putnam, 1925.
ROTHERY, A. South America, The West Coast and the East. New York, Houghton, Muffin, 1930.

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Chapter 14

ISOLATED AND MODERNIZED PERUVIAN INDIANS

IN ORDER to understand the living descendants of the ancient residents of the high Andes it is essential that we know their environment. Their climate is cold at night the year around. While during the winter the snow is deep in the high mountains, there is very little on the plateau, since Peru is near the equator extending from 5 to 16 degrees south latitude. The sunshine is bright and warm even in winter. Consequently 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 belong to the camel species, as does the vicuna. The llama is the Indians' beast of burden in the Andes. Only the males are used. The animals are very docile and respond with gentleness when treated with kindness. One continually marvels at the ease with which the Indian guides his loaded caravan with soft words or motions, never with harshness. The llama has many unique features as a beast of burden. It forages as it moves along and consequently must be driven very slowly. Each animal will carry a burden not exceeding a hundred pounds, and if more is placed on its back it will immediately lie down until the extra burden is removed. The llama has broad doubletoed feet like the camel which make it very sure-footed. It requires no shoeing and exceedingly little care. It can thrive, however, only in the high altitudes. The wool 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 wool of fine quality. Accustomed as this animal is to the severe cold and the high altitudes, as well as to the rain and sun, its fleece is both durable and warm. It is used extensively throughout the world for suits for aviators. The native colors vary from white to bluish tints and from light to very dark browns. It accordingly provides very stable colors for weaving directly into ponchos and native apparel. The vicuna is a much smaller animal than either the llama or alpaca. It has one of the most highly prized coats of fur produced anywhere in the world. This animal has never been domesticated; vast herds have lived wild on the high slopes of the Andes mountains. The demand for vicuna fur became so great that a million and a half of these animals were slain in one year to obtain their fur pelts. The result is that the Peruvian Government has now completely forbidden their destruction. The garments of the ruling class of the Incas were made of the vicuna wool.

One of the important objectives of my trip to Peru was to find and study, if possible, some descendants of these Andean stocks. Fortunately, large numbers of the Aymara linguistic stock, the descendants of the Tauhuanocan culture, are still residing in southern Peru and Bolivia where they are said to retain the essentials of their ancient methods of living. They constitute the principal native populations in the vicinity of Lake Titicaca and the high mountain plateaus of southern Peru and northern Bolivia. I have always encountered difficulty in persuading the native peoples to allow themselves to be photographed in their primitive costumes. They are usually willing to be photographed provided one will wait for them to put on some modern garment.

I am reminded of an experience on one of the South Sea Islands where there was need for roads, but no money with which to build them. Laws were passed by the chiefs that anyone approaching a highway in native garb where he might be seen by a foreigner was subject to arrest and to payment of a fine which had to be worked out as labor in building roads. Of course, on that island no one would allow himself to be photographed without some modern clothing. One boy presented himself wearing a single garment, a man's full dress vest, which had evidently reached the island in a missionary barrel.

The hats in the pictures in Fig. 84 are of native design and manufacture. They are made of fur and are like our modern derbies in construction.

FIG. 84. Descendants of the Tauhuanocans who were the most famous ancient workers in stone. They live in the high Sierras of southern Peru and northern Bolivia. They belong to the Aymara linguistic division. They make fur felt hats and are skilled agriculturists.

It is important to note the roundness of the features of the Aymaras, the wide development of the nostrils for air intake and the breadth of the dental arches. Many of them had been transported several hundreds of miles to a coffee plantation because of their adeptness and skill in sorting imperfect coffee beans from the run. As I watched them I found it difficult to move my eyes fast enough to follow their fingers and pick out from the moving run the undesired or imperfectly formed kernels. This revealed a superb development of coordination. The wisdom of these Aymaras is discussed in Chapter 21.

I was very anxious to study the Incas in different parts of the high Andes, particularly some of the original type in the vicinity of Cuzco, their ancient capital. Throughout the Andean Plateau, the Indians from the higher elevations bring down their wares on market days to exchange with Indians from other localities, as well as to meet and visit with their friends. They are very industrious and one seldom sees a woman, either shepherding the stock or carrying a burden, who is not busily engaged in spinning wool. While their wool is obtained in part from sheep that have been imported, a great deal of it is obtained from the alpacas which, like the llamas, are raised in the high altitudes where the Indians always prefer to live. I was fortunate in making contact with several groups of Indians in high altitudes through the kindness of the prefects. A group of Indians from the high mountains of the Urabamba Valley near Cuzco is shown in Fig. 85. An examination of this group of twenty-five revealed the fact that not one tooth had been attacked by dental caries and that, at all ages, the teeth normally due were present.

FIG. 85. The Quichua Indians living in the high Andes are descendants of the Incas. They live at high elevations, up to 18,000 feet, where they raise herds of llamas and alpacas. They weave their own garments and have great physical endurance. They can carry over 200 pounds all day at high altitudes in the manner shown at the lower right.

In Fig. 85, lower right, may be seen a typical Indian of the Andes carrying a heavy load. The Indians of this region are able to carry all day two hundred to three hundred pounds, and to do this day after day. At several of the ports, these mountain Indians have been brought down to the coast to load and unload coffee and freight from the ships. Their strength is phenomenal.

In approaching the study of the descendants of the Inca culture, it is important to keep in mind a little of their history and persecution under the Spanish rule. To this day they are bitter against the white man for the treachery that has been meted out to them on many occasions. Their leader was seized under treachery. The agreement to free him, if the designated rooms were filled with gold as high as a man could reach, was broken and their chief killed after the gold was obtained. It is recorded that some six million of them died in the mines under forced labor and poor foods under the lash of their Spanish oppressors. In many places they still keep themselves aloof by staying in the high mountains of the Andes with their flocks of llamas and alpacas. They come down only for trading. As in the past, they still weave their own garments. Indeed, they provide practically all of their necessities from the local environment. Their capacity for enduring cold is wonderful. They can sleep comfortably through the freezing nights with their ponchos wrapped about their heads and with their legs and feet bare. They wear two types of head cover, one inside the other. Several individuals are seen in Fig. 85. Many of them have faces that show strong character and personality.

The women of this district wear felt hats which can be turned up or down according to the weather. Fine examples of weaving were worn by the women.

In Fig. 86 will be seen two young men who had just come down from the high mountains to a government school. The one in the lower photograph is still wearing his native costume. The one in the upper has discarded his native costume for white man's trousers. Note the fine development of his chest, the splendid facial development and fine teeth and dental arches. It is important to keep in mind that these people are living in a rarified atmosphere and that, because of the high altitude, they need greater lung capacity and stronger hearts than do the people living at sea level. The ratio of oxygen content is reduced about half at 10,000 feet.

FIG. 86. The chest development, of necessity, must have large lung capacity for living in the rare atmosphere of the high Andes. The boy shown above has a magnificent physique, including facial and dental arch development. Below is seen the typical clothing worn up among the snows. Even in frosty weather they are bare below the knees.

The broad dental arches of these Indians are shown in Fig. 87. Note the extensive wear of the teeth at the upper left. Much of the food is eaten cold and dry as parched corn and beans. Such rough foods as these wear the teeth down.

FIG. 87. The superb facial and dental arch development of these high Andean Indians is shown above. The man at the upper left was said to be very old yet he climbs the mountains up into the snows herding the llamas and alpacas. The teeth have a very high state of perfection. Long and vigorous use has worn the teeth of the old people.

Market days which usually occur on Sunday present an interesting scene. The Indians travel long distances with their wares for exchange. They have no currency and exchanges are made by bargaining.

Where these Indians have become modernized, the new generation shows typical changes in facial and dental arch form as reported for the other groups. There is also a marked character reaction which will be discussed in detail in Chapter 19. In Fig. 88 are shown four typical modification patterns due to the influence of modernization after the foods of the white man have displaced the native dietary.

FIG. 88. The modernization of the Sierra Indians through the introduction of foods of modern commerce has produced a sad wreckage in physique and often character. The boy at the upper left is a mouth breather because his nostrils are too small to carry sufficient air. The girl at the upper right has a badly underdeveloped chin and pinched nostrils. Both boys below have badly narrowed arches with crowding teeth.

An important item in the life of the Andean Indians is the satisfaction they get from chewing cocoa leaves from which is made our modern cocaine. In order to extract the alkaloid they chew with these leaves the ash produced by the burning of a particular plant. This drug is chewed as tobacco, one large quid will last for several hours. Practically every Indian carries in a little pouch a quantity of these leaves in dried form. The effect of this drug is to increase their capacity for endurance. It makes them unconscious of hunger and fatigue. Through our interpreter we frequently asked them regarding the comfort or nourishment they obtained from the leaves and were told that they often preferred these leaves to food when they were on a journey and carrying heavy loads. I was informed that they can increase the quantity of the drug used to a point at which they are quite unconcious of pain and able to endure injuries without suffering, and operations without discomfort. Since packets of these leaves were found in the burials near the coast, it is clear that the drugs were used throughout Peru in early times. It is also of interest that several of the skulls taken from the cave in the high Andes, were found with trephine operations in the skulls similar to those found in the burials along the coast.

The physical perfection and development of the present and past Andean population has been accomplished in spite of the difficulty of building and maintaining good bodily structure at the high altitude where dairy products have not been and are not at present a large part of the nutritional program. In this regard the ancient and contemporary peoples of the Andes differ radically from the present and past groups of people who live in the high valleys of Switzerland and Tibet where milk is plentiful. The cow, sheep, horse and pig have been imported into the high Andean countries during the last four hundred years since the Spanish Conquests, but they have not acclimatized easily. The earlier cultures were of course, dependent upon the llama, alpaca, wild deer, birds and guinea pig for animal foods. While there have been vast burial mounds built and preserved in the coastal regions where the absence of rain and the dry sand have added materially to their preservation, the rainy seasons have established very different conditions for skeletal preservation in the high altitudes. Nevertheless, a large number of skeletons in good state of preservation have been recovered.

The high Andean plateau extends throughout the length of Peru between the mountain chains. The present Indian stock was studied in four different places in the high plateau country, the farthest north being Huaras. In this area we were materially assisted by the governor of the province who very kindly sent messengers and brought down Indian families from high altitudes to the police headquarters at Huaras. This place is at an elevation of about 11,000 feet. We had an opportunity to study also many who had come from the higher altitudes to the markets to sell their wares. Huaras lies in a fertile valley that has been in contact with modern civilization for many decades. This vicinity, therefore, provided a wide range in classes of people, from Indians who are isolated to those who are living in highly modernized groups. In addition to the opportunity for studying the older people there were opportunities for studying adolescents in the two high schools, one for girls and one for boys. Some were pure-bloods who had been highly isolated in their formative and childhood periods. The mixed-bloods had been considerably modernized. There were some whites. I was told by the prefect and others who were well informed that there was quite a distinct difference between the Indians who were living in the high northern Cordillera, the western Andean range called the Black Mountains, and those living in the eastern range or White Mountains. The latter were physically much better built and were least modernized. Typical low immunity to caries and changes in facial and dental arch form were found in these modernized groups.

Another important area in which the native Indians were studied was Chiclayo. This district is unique in large part because of the influence of the modern civilization at Lima with which it is connected by the railroad. The native market here is very large and occupies about a mile of the main street of the town, through which no traffic except pedestrian traffic can pass while the market is in session. The town has been under the influence of the Spanish since the time of the Conquest. It has many colonial buildings and a large cathedral. It has not, however, accommodations for the influx of tourists who come out of curiosity for the purchase of Indian wares. With the aid of the prefect, even though no public accommodations were available, we were made very comfortable in the soldiers' barracks. As the Indians came down from the mountains to display and sell their wares, they were brought to us at the barracks. Since this district has been in quite intimate contact with the nutrition of the modernized capital, we found here many individuals showing typical degeneration of the teeth and dental arches.

The adaptation of racial characteristics to the environment in which they have developed is very strikingly illustrated in the Indian cultures of the Amazon jungle district. We were very fortunate in being able to make studies of some groups living at present as did their ancestors through countless centuries in the Amazon basin. We were greatly pleased and impressed with the splendid physiques and fine personalities of many of the individuals of the groups.

The abundance of rain, the fertility of the soil and the warm climate make plant growth most luxuriant on the eastern slopes of the Andes. It is of interest that in passing from the capital, Lima, across the desert stretch between the ocean and the mountains and then up the wall of the Andes to an altitude of sixteen thousand feet and then down to the plateau at about twelve thousand feet and up again over the eastern range and down into the Amazon basin, one has passed through the tropics, temperate zone and sub-arctic zones with varieties of plant life corresponding to each. A distance of a few hundred yards will often divide the limits of particular birds and flowers. When one reaches the foothills of the Andes on the eastern side, he is in a region of rushing streams teeming with fish, a region of tropical fruits and vegetables. It is in this setting that some of the finest Indians we have seen were enjoying life in its fullness. The type of shelter is very simple, indeed, consisting as it does of a framework covered with banana and palm leaves. We were privileged to meet by special arrangement about thirty of this tribe who had been brought from some distance by the officials of the Perene Colony, owned and operated by the Peruvian Corporation. In Fig. 89 will be seen the chief and one of the noble women of his retinue. They understood that they would have their pictures taken and came dressed in royal regalia. Typical countenances are seen in Figs. 90 and 91. These people have very kind faces with broad dental arches, and a high sense of humor. They decorated their faces especially for their photograph. In the entire group associated with this chief I did not find a single tooth that had been attacked by dental caries. The fine dental arches are illustrated in Figs. 90 and 91. Many of these young men had really noble countenances, such as would rate them as leaders in modern science and culture.

FIG. 89. Jungle Indians from the Amazon. This is the chief of a tribe who came prepared to have their pictures taken in their tribal regalia. Note the splendid features of both and the noble carriage of the woman.

FIG. 90. The facial and dental arch development of the jungle Indians was superb and the teeth were excellent and free from dental caries. Note the complete development of the dental arches and nostrils.

FIG. 91. The excellence of skeletal development of the jungle Indians as expressed in the faces and dental arches, is illustrated in these views. Their foods were selected from the animal life of the streams and the bush together with native plants.

In another tribe, however, of the same racial stock, efforts to modernize had been in operation for some time by a mission. The food of this latter group had been distinctly affected by their contact with the modern group. By reducing the animal foods, the change in physical efficiency, and appearance of tooth decay, is most marked. In Fig. 92 above will be seen typical cases of rampant tooth decay with extensive loss of the teeth. In Fig. 92 below are shown two of the first generation following the adoption of the modernized type of diet in this group. Note the narrowing of the faces with crowding of the teeth. Note the deformed dental arches.

FIG. 92. At the point of contact of these jungle Indians with modernization where it included a change from their native diet tooth decay became rampant as shown. A marked change in facial form occurred accompanied by crowding of the teeth in the new generation.

The native foods of these Amazon Jungle Indians included the liberal use of fish which are very abundant in both the Amazon and its branches, particularly in the foothill streams; animal life from the forest and thickets; bird life, including many water fowl and their eggs; plants and fruits. They use very large quantities of yucca which is a starchy root quite similar to our potato in chemical content. This is not the yucca of North America.

The Peruvian Indians, in the highlands and in the eastern watershed of the Andes, and also in the Amazon Basin, have built superb bodies with high immunity to dental caries and with splendidly developed facial and dental arch forms while living on the native foods in accordance with their accumulated wisdom. Whenever they have adopted the foods of modern civilization and have displaced their own nutrition, dental caries has been found to be wide-spread; and in the succeeding generations following the adoption of modern foods, a change in facial and dental arch forms has developed. The modernized foods which displaced their native foods were the typical white man's dietary of refined-flour products, sugar, sweetened foods, canned goods, and polished rice.

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Chapter 15

CHARACTERISTICS OF PRIMITIVE AND
MODERNIZED DIETARIES

IF PRIMITIVE races have been more efficient than modernized groups in the matter of preventing degenerative processes, physical, mental and moral, it is only because they have been more efficient in complying with Nature's laws. We have two procedures that we can use for evaluating their programs: first, the interpretation of their data in terms of our modern knowledge; and second, the clinical application of their procedures to our modern social problems. Specifically, since the greater success of the primitives in meeting Nature's laws has been based primarily on dietary procedures, it becomes desirable first, to evaluatetheir dietary programs on the basis of known biologic requirements for comparison with the foods of our modern civilization; and second, to test their primitive nutritional programs by applying their equivalents to our modern families.

The advance in our knowledge of body-building and body-repairing materials from a biochemical standpoint makes it possible even with our limited knowledge of organic catalysts, to draw comparisons between the primitive and modernized dietaries. If we use the generally accepted minimal and optimal quantities of the various minerals and vitamins required, as indicated by Sherman, (1) we shall have at once a yardstick for evaluating the primitive dietaries.

Of the eighteen elements of which the human body is composed, all of which are presumably essential, several are needed in very small quantities. A few are required in liberal quantities. The normal adult needs to receive from the foods eaten one-half to one gram of calcium or lime per day. Few people receive more than one-half of the minerals present in the food. The requirements of phosphorus are approximately twice this amount. Of iron we need from one-seventh to one-third of a gram per day. Smaller amounts than these are required of several other elements. In order to utilize these minerals, and to build and maintain the functions of various organs, definite quantities of various organic catalysts which act as activating substances are needed. These include the known and unknown vitamins.

Unlike some experimental animals human beings have not the ability to create some special chemical substances (not elements) such as vitamins within their bodies. Several animals have this capacity. For example, scurvy, which is due to a lack of vitamin C, cannot be produced readily in rats because rats can manufacture vitamin C. Similarly, rickets cannot be produced easily in guinea pigs, because they can synthesize vitamin D. The absence of vitamin D and adequate minerals produces rickets in young human beings. Neither rickets nor scurvy can be produced readily in dogs because of the dogs' capacity to synthesize both vitamins C and D. We are not so fortunate. Similarly, the absence of vitamin B (B1) produces in birds and man severe nervous system reactions, such as beri-beri. These symptoms are often less pronounced, or quite different, in other animals.

From our knowledge of the dietaries used by the various primitive racial stocks we can calculate the approximate amounts of the minerals and vitamins provided by those dietaries, for comparison with the amounts provided by modernized foods. Our problem is simplified by the fact that the food of the white man in various parts of the world being built from a few fundamental food factors, has certain quite constant characteristics. Hence the displacing diets are similar for the several modernized groups herewith considered.

As a further approach to our problem, it is important to keep in mind that, in general, the wild animal life has largely escaped many of the degenerative processes which affect modern white peoples. We ascribe this to animal instinct in the matter of food selection. It is possible that man has lost through disuse some of the normal faculty for consciously recognizing body requirements. In other words, the only hunger of which we now are conscious is a hunger for energy to keep us warm and to supply power. In general, we stop eating when an adequate amount of energy has been provided, whether or not the body building and repairing materials have been included in the food. The heat and energy factor in our foods is measured in calories. In planning an adequate diet, a proper ratio between body building and energy units must be maintained. It is important to keep in mind that while the amount of body-building and repairing material required is similar for different individuals of the same age and weight, it is markedly different for two individuals, one of whom is leading a sedentary, and the other, an active life. Similarly, there is a great difference between the amount of body-building and repairing material required by a growing child or an expectant mother and an average adult.

There are certain characteristics of the various dietaries of the primitive races, which are universally present when that dietary program is associated with a high immunity to disease and freedom from deformities. In general, these are the foods that provide adequate sources of body-building and body-repairing material. The use by primitives, of foods relatively low in calories has resulted in forcing them to eat large quantities of these foods, in order to provide the heat and energy requirements of the body. The primitives have obtained, often with great difficulty, foods that are scarce but rich in certain elements. In these rare foods were elements which the body requires in small quantities, including minerals such as iodine, copper, manganese and special vitamins. In connection with the vitamins it should be kept in mind that our knowledge of these unique organic catalysts is limited. The medical profession and the public at large think of vitamin D as consisting of just one chemical factor, whereas, investigations are revealing continually new and additional factors. A recent review (2) describes in considerable detail eight distinct factors in vitamin D and refers to information indicating that there may be at least twelve. Clearly, it is not possible to undertake to provide an adequate nutrition simply by reinforcing the diet with a few synthetic products which are known to represent certain of these nutritional factors. By the mass of the people at large, as well as by members 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 which appear to be successful in controlling dental caries and deformities may be divided into three groups based upon the sources from which they derive the minerals and fat-soluble activators. I do not use the term vitamins exclusively because as yet little is known about the whole group of organic catalysts, although we have considerable knowledge of the limited number which are designated by the first half dozen letters of the alphabet. Most lay people and members of the medical and dental professions assume that the six or eight vitamins constitute practically all that are needed in an adequate nutrition. These organic activators can be divided into two main groups, water-soluble and fat-soluble. An essential characteristic of the successful dietary programs of primitive races has been found to relate to a liberal source of the fat-soluble activator group.

When we discuss the successful dietary programs of the various groups from the standpoint of their ability to control tooth decay and prevent deformity we find that for the people in the high and isolated Alpine valleys their nutrition is dependent largely on entire rye bread and dairy products with meat about once a week and various vegetables, fresh in the summer season and stored for the winter season. An analysis in my laboratory of the dairy products obtained from the Loetschental Valley in Switzerland through a series of years has shown the vitamin content to be much higher than the average throughout the world for similar foods during the same seasons. The milk in these high valleys is produced from green pasturage and stored green hay of exceptionally high chlorophyll content. The milk and the rye bread provided minerals abundantly.

The diet of the people in the Outer Hebrides which proved adequate for maintaining a high immunity to dental caries and preventing deformity consisted chiefly of oat products and sea foods including the wide variety of fish available there. This diet included generally no dairy products since the pasture was not adequate for maintaining cattle. Oat grain was the only cereal that could be matured satisfactorily in that climate. Some green foods were available in the summer and some vegetables were grown and stored for winter. This diet, which included a liberal supply of fish, included also the use of livers of fish. One important fish dish was baked cod's head that had been stuffed with oat meal and chopped cods' livers. This was an important inclusion in the diets of the growing children. The oats and fish, including livers, provided minerals and vitamins adequate for an excellent racial stock with high immunity to tooth decay.

For the Eskimos of Alaska the native diet consisted of a liberal use of organs and other special tissues of the large animal life of the sea, as well as of fish. The latter were dried in large quantities in the summer and stored for winter use. The fish were also eaten frozen. Seal oil was used freely as an adjunct to this diet and seal meat was specially prized and was usually available. Caribou meat was sometimes available. The organs were used. Their fruits were limited largely to a few berries including cranberries, available in the summer and stored for winter use. Several plant foods were gathered in the summer and stored in fat or frozen for winter use. A ground nut that was gathered by the Tundra mice and stored in caches was used by the Eskimos as a vegetable. Stems of certain water grasses, water plants and bulbs were occasionally used. The bulk of their diet, however, was fish and large animal life of the sea from which they selected certain organs and tissues with great care and wisdom. These included the inner layer of skin of one of the whale species, which has recently been shown to be very rich in vitamin C. Fish eggs were dried in season. They were used liberally as food for the growing children and were recognized as important for growth and reproduction. This successful nutrition provided ample amounts of fat-soluble activators and minerals from sea animal life.

For the Indians living inside the Rocky Mountain Range in the far North of Canada, the successful nutrition for nine months of the year was largely limited to wild game, chiefly moose and caribou. During the summer months the Indians were able to use growing plants. During the winter some use was made of bark and buds of trees. I found the Indians putting great emphasis upon the eating of the organs of the animals, including the wall of parts of the digestive tract. Much of the muscle meat of the animals was fed to the dogs. It is important that skeletons are rarely found where large game animals have been slaughtered by the Indians of the North. The skeletal remains are found as piles of finely broken bone chips or splinters that have been cracked up to obtain as much as possible of the marrow and nutritive qualities of the bones. These Indians obtain their fat-soluble 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 bone marrow, both as a substitute for milk and as a special dietary ration.

In the various archipelagos of the South Pacific and in the islands north of Australia, the natives depended greatly on shell fish and various scale fish from adjacent seas. These were eaten with an assortment of plant roots and fruits, raw and cooked. Taro was an important factor in the nutrition of most of these groups. It is the root of a species of lily similar to "elephant ears" used for garden decorations in America because of its large leaves. In several of the islands the tender young leaves of this plant were eaten with coconut cream baked in the leaf of the tia plant. In the Hawaiian group of islands the taro plant is cooked and dried and pounded into powder and then mixed with water and allowed to ferment for twenty-four hours, more or less, in accordance with the stiffness of the product desired. This is called poi. Its use in this form was comparable in efficiency with its use on other archipelagos as a boiled root served much as we use potatoes. For these South Sea Islanders fat-soluble vitamins and many of the minerals were supplied by the shell-fish and other animal life from the sea.

The native tribes in eastern and central Africa, used large quantities of sweet potatoes, beans, and some cereals. Where they were living sufficiently near fresh water streams and lakes, large quantities of fish were eaten. Goats or cattle or both were domesticated by many tribes. Other tribes used wild animal life quite liberally. Some very unique and special sources of vitamins were used by some of these tribes. For example, in certain seasons of the year great swarms of a large winged insect develop in Lake Victoria and other lakes. These often accumulated on the shores to a depth of many inches. They were gathered, dried and preserved to be used in puddings which are highly prized by the natives and are well spoken of by the missionaries. Another insect source of vitamins used frequently by the natives is the ant which is collected from great ant hills that in many districts grow to heights of ten feet or more. In the mating season the ants develop wings and come out of the ant hills in great quantities and go into the air for the mating process. These expeditions are frequently made during or following a rain. The natives have developed procedures for inducing these ants to come out by covering over the opening with bushes to give the effect of clouds and then pounding on the ground to give an imitation of rain. We were told by the missionaries that one of the great luxuries was an ant pie but unfortunately they were not able to supply us with this delicacy. Parts of Africa like many other districts are often plagued by vast swarms of locusts. These are gathered in large quantities, to be cooked 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 maize, beans, linga linga, millet, and Kaffir corn, cooked or roasted. Most of these were ground just before cooking.

Among the Aborigines of Australia we found that those living near the sea were using animal life from that source liberally, together with the native plants and animals of the land. They have not cultivated the land plants during their primitive life. In the interior, they use freely the wild animal life, particularly wallaby, kangaroo, small animals and rodents. All of the edible parts, including the walls of the viscera and internal organs are eaten.

The native Maori in New Zealand, used large quantities of foods from the sea, wherever these were available. Even in the inland food depots, mutton birds were still available in large quantities. These birds were captured just before they left the nests. They developed in the rockeries about the coast, chiefly on the extreme southern coast of the South Island. At this stage, the flesh is very tender and very fat from the gorging that has been provided by their parent. The value of this food for the treatment of tuberculosis was being heralded quite widely in both Australia and New Zealand. In the primitive state of the islands large quantities of land birds were available and because of the fertility of the soil and favorable climate, vegetables and fruits grew abundantly in the wild. Large quantities of fern root were used. Where groups of the Maori race were found isolated sufficiently from contact with modern civilization and its foods to be dependent largely on the native foods, they selected with precision certain shell-fish because of their unique nutritive value.

A splendid illustration of the primitive Maori instinct or wisdom regarding the value of sea foods was shown in an experience we had while making examinations in a native school on the east coast of the North Islands. I was impressed with the fact that the children in the school gave very little evidence of having active dental caries. I asked the teacher what the children brought from their homes to eat at their midday lunch, since most of them had to come too great a distance to return at noon. I was told that they brought no lunch but that when school was dismissed at noon the children rushed for the beach where, while part of the group prepared bonfires, the others stripped and dived into the sea, and brought up a large species of lobster. The lobsters were promptly roasted on the coals and devoured with great relish. Other sea foods are pictured in Fig. 74.

The native diet of the tribes living in the islands north of Australia consisted of liberal quantities of sea foods. These were eaten with a variety of plant roots and greens, together with fruits which grew abundantly in that favorable climate. Few places in the world have so favorable a quantity of food for sea-animal life as these waters which provide the richest pearl fisheries in the world. This is evidence of the enormous quantity of shell-fish that develop there. Here, as off the east coast of Australia, are to be found some of the largest shell-fish of the world. It was a common occurrence to see these shells being used by natives for such purposes as water storage and for bath tubs of a size approximately that of a wash tub. Australia and New Zealand are near enough to the Antarctic ice cap to have their shores bathed with currents coming from the ice fields, currents which abound in food for sea animals. The great barrier reef off the east coast of Australia extends north to within a few leagues of New Guinea. Murray Island is near the north end of this barrier. The fish in the water at times form such a dense mass that they can be scooped into the boats directly from the sea. Fishermen wading out in the surf and throwing their spears into the schools of fish usually impale one or several.

The incidence of tooth decay on this island was less than one per cent of all of the teeth examined. Another important sea food in these waters was dugong, referred to as sea cow in northern waters. This animal is very highly prized but is becoming scarce. We found its meat very much like lamb. It lives on the vegetation of the sea floor in shallow water. As we flew over the bays of Eastern Australia going northward in search of colonies of native Aborigines, we could see these sea animals pasturing in the clear water among the ocean plants.

During these investigations of primitive races, I have been impressed with the superior quality of the human stock developed by Nature wherever a liberal source of sea foods existed. These zones of abundant marine life were largely in the wake of the ocean currents drifting from the ice fields of the poles. The Humboldt Current is probably the most liberal carrier of marine life of any of the ocean currents. It leaves the ice field of the Antarctic and bathes the west coast of South America from its southern tip nearly to the equator, where the coast line changes direction and the Humboldt Current is deflected out into the ocean. It meets here a warm current coming down from the coast of Central America, Panama and Columbia. If the superb physiques that Nature has established among the Maori of New Zealand, the Malays of the Islands north of Australia, the Gaelics of the Outer Hebrides and the natives on several of the archipelagos of the Pacific, owe their superior physical development to sea foods, we should expect to find that the tribes which have had contact with the great Humboldt Current food would also have superb physiques. Unfortunately, very little has been known of the ancient cultures that have developed along the coast of Chile and Peru. It has been reported that of all the Indian tribes of South America, those in Patagonia were the most stalwart. While the west coast of Peru is bathed by the Humboldt Current with its nearly inexhaustible supply of human nutrition, the lands bordering that shore are among the most desolate deserts of the world. The zone between the Andes Mountains and the coast for approximately a thousand miles is utterly barren, consisting of moving sand dunes and jagged promontories. Practically the only break in this waterless, treeless desert is to be found in the few ribbons of water that trickle down from the melting snows of the Andes Coastal Range. This coast has no rainy seasons. Any vegetation grown, now or in the past thousands of years, has had to be watered from the limited supply afforded by these rivers which seem so insignificant when compared with the vastness of the territory. These river bottoms contain the alluvial deposits from the Andes and are very rich when watered. It has been only by means of gigantic engineering undertakings that the water from these rivers has been carried through great irrigation ditches, sometimes fifty to a hundred miles long for the purpose of making it possible to utilize these river bottom lands for agriculture.

In many of the primitive tribes living by the sea we found emphasis on the value of fish eggs and on some animal forms for insuring a high physical development of growing children, particularly of girls, and a high perfection of offspring through a reinforcement of the mother's nutrition. It is also important to note that in several of the primitive tribes studied there has been a consciousness that not only the mother should have special nutrition, but also the father. In this group very great value was placed upon a product obtained from a sea form known locally as the angelote or angel fish, which in classification is between a skate and a shark. The young of the angelota are born alive, ready for free swimming and capable of foraging for themselves immediately at birth. Twenty to thirty young are born in one litter. The eggs of the female before fertilization are about one inch in diameter, slightly oval but nearly spherical. They are used as food by all, but the special food product for men is a pair of glands obtained from the male. These glands weigh up to a pound each, when they are dried. They have a recognized value among the natives for treating cases of tuberculosis, especially for controlling lung hemorrhages. The sea foods were used in conjunction with the land plants and fruits raised by means of irrigation in the river valleys. Together these foods provided adequate nutrition for maintaining high physical excellence.

In Chapter 13 I have discussed the probable order of these ancient cultures and the possible extent of their duration. Very little is known of their origin. Evidence has recently been discovered in Panama indicating that both the wealth and the culture of Peru were carried northward by maritime conquerors 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 saw the development of many magnificent cultures through past ages, the highlands of Peru also have left much evidence of superior attainments and wisdom. The two great Indian linguistic groups of the Andean highlands of today are the Aymara of Southern Peru and Bolivia and the Quichus of central and northern Peru. The Aymara are credited with being the descendants of the Tauhuanocan culture which preceded the Incan culture in the highlands. The Quichu are credited with being the descendants of the Incan culture which had its zenith just prior to the coming of the Spaniards. In Chapter 14 I have shown photographs of these racial stocks as they are found today in the Andean Sierras. It may be possible that in former times the vast mountain ranges provided large herds of grazing wild animals of the deer family. Because of the vastness of the population and the extent to which all available land surfaces were utilized for agriculture, it does not seem possible that wild animal life could have been an adequate source of nutrition. The members of the camel family, the llamas, alpacas, and vicunas were utilized for food. Of these the first two were used to considerable extent as they are today. When it is recognized that in the Sierra the available water is largely that provided to the streams from the melting snows and from rains in the rainy season, it will be realized that these sources of fresh water could not provide the liberal quantity of iodine essential for human growth and development. It was, accordingly, a matter of great interest to discover that these Indians used regularly dried fish eggs from the sea. Commerce in these dried foods is carried on today as it no doubt has been for centuries. When I inquired of them why they used this material they explained that it was necessary to maintain the fertility of their women. I was informed also that every exchange depot and market carried these dried fish eggs so that they were always available. Another sea product of very great importance, and one which was universally available was dried kelp. Upon inquiry I learned that the Indians used it so that they would not get "big necks" like the whites. The kelp provided a very rich source of iodine as well as of copper, which is very important to them in the utilization of iron for building an exceptionally efficient quality of blood for carrying oxygen liberally at those high altitudes. An important part of their dietary consists today as in the past of potatoes which are gathered and frozen, dried and powdered, and preserved in the powdered form. This powder is used in soups with llama meat and other products. Since the vitamin D group of activators is absent from nearly all plant products but must be synthesized in animal bodies from the plant foods, where it is largely stored in organs, an adequate source had to be provided. The Indians of the highlands of Peru maintained colonies of guinea pigs which were used in their stews. The ancient burials also show that the guinea pig was a common source of food since mummified bodies of this animal were found. This is significant since of all the animals that are used for experimental work the guinea pig is probably the most efficient in synthesizing vitamin D from plant foods. They are very hardy. They live on a great variety of green plant foods and twigs and are very prolific. They apparently played a very important part in the physical excellence of the ancient cultures.

It is unfortunate that as the white man has come into contact with the primitives in various parts of the world he has failed to appreciate the accumulated wisdom of the primitive racial stocks. Much valuable wisdom has been lost by this means. I have referred to the skill of the Indians in preventing scurvy and to the many drugs that we use which the white man has learned of from the primitives.

In this connection the Indians of British Columbia, who have been so efficient in preventing scurvy, have a plant product for the prevention and cure of diabetes. This has recently become known to the white man through the experience of a patient who was brought into the hospital at Prince Rupert, British Columbia, as reported in the Canadian Medical Journal, July 1938. Prince Rupert is near the boundary between British Columbia and Alaska on the coast. The patient came to that hospital for an operation and suddenly showed signs of diabetes, which required treatment with large doses of insulin. Dr. Richard Geddes Large asked him regarding the history of his affection and what he had been taking. He was told that for several years he had been using an Indian preparation which was a hot water infusion of a root of devil's-club which is a spiny, prickly shrub. This medicine was in common use by the British Columbia Indians. The material was obtained and used in this hospital for the treatment of diabetes and was found to be quite as efficient as insulin and had the great advantage that it would be taken by mouth whereas the insulin which is destroyed in the stomach by the process of digestion must be injected. They could see very little difference in the efficiency of this preparation whether taken internally or used hypodermically. This promises to be a great boon to a large group of individuals suffering from diabetes. It is also probable that its use will prevent the development of diabetes and since the Indians used it for other affections it may also become a very important adjunct in modern preventive medicine.

One of the sources that I have found to be helpful in studying primitive races is an investigation of knapsacks. I have asked for the privilege of seeing what is carried in their knapsacks. I found dried fish eggs and dried kelp in the knapsacks in the high Andes. It is also of interest that among this group in the Andes, among those in central Africa, and among the Aborigines of Australia, each knapsack contained a ball of clay, a little of which was dissolved in water. Into this they dipped their morsels of food while eating. Their explanation was to prevent "sick stomach." This is the medicine that is used by the native in these countries for combating dysentery and food infections. It is the treatment that was given me when I developed dysentery infection in central Africa while making studies there. The English doctor in Nairobi whom I called in said he would give me the native treatment of a suspension of clay. It proved very effective. An illustration of the way in which modern science is siowiy adopting practices that have been long in use among primitive races, is to be found in the recent extensive use that is made of clay (kaolin) in our modern medicine. This is illustrated in the following: (3)

In the course of an expedition to Lake Titicaca, South America, financed by the Percy Slade Trustees in which one of us (H.P.M.) took part, an interesting observation was made in regard to the diet of the Quetchus Indians on the Capachica Peninsula near Puno. These people are almost certainly descendants of the Incas and at the present time live very primitively. They exist largely on a vegetable diet of which potatoes form an important part. Immediately, before being eaten, the potatoes are dipped into an aqueous suspension of clay, a procedure which is said to prevent "souring of the stomach."

We have examined this clay and found it to consist of kaolin containing a trace of organic material, possibly coumarin, and presumably a decomposition product of the grass from underneath which the clay is dug. The local name for the clay is Chacco, and the Indians distinguish between good and bad qualities. This dietetic procedure is universal among the Indians of the Puno district, and is probably of very ancient origin.

Such a practice by a primitive people would appear rather remarkable in view of the comparatively recent introduction of kaolin into modern medicine as a protective agent for the gastric and intestinal mucosa and as a remedy for bacterial infections of the gut.

It is of interest that both the British and American Pharmacopeias have added kaolin to their list during the last two decades.

The Indians of the past buried, with their dead, foods to carry them on their journey. From an examination of these one learns that in many respects the Indians living in the high Sierras are living today very much as their ancestors did during past centuries. Items of importance now and in the past are parched corn and parched beans which are nibbled as the people walk along carrying their heavy burdens. Today these are the only foods eaten on many long journeys. We found the parched beans pleasant to taste and very satisfying when we were hungry.

The Indians of the Amazon Basin have had a history very different from either those of the high Sierras of the Andes or those of the coastal region. The fact that vast areas of the Amazon Basin have not only never been surveyed, but never even penetrated, indicates the nature of the isolation of these groups. Very little progress has been made in the effort to conquer or modernize these Indians. A few explorers have made expeditions into parts of the interior and have reported the characteristics of the plant and animal life, as well as of the native races. Our sole contact was with the tribe which came to the coffee plantation to assist in the gathering and the harvest of the coffee beans. In Chapter 14 I have described these people in considerable detail. Since the Amazon Basin has vast quantities of rain as well as abundant streams from the eastern watershed of the Andes, the tribes live largely in tropical jungles where there is an abundance of water. They are expert, accordingly, in the use of river crafts and in fishing for the various types of marine life. Unlike the Indians of the high Andes or of the coast regions they are not agriculturists. They live on wild native foods almost entirely. They are expert with the blow gun, with the bow and arrow and in snaring with both nets and loops. They use very large quantities of a tuber root called yucca which has many qualities similar to the roots of the edible variety of the lily family. This plant is boiled and eaten much as are potatoes. They use also large quantities of fish from the streams, birds and small animals of the land, together with the native fruits including bananas. Their dietary provides a very liberal supply of minerals and vitamins together with an adequate quantity of carbohydrates, fats and proteins.

In evaluating the nutritive value of the dietary programs of primitive races and our modernized cultures, it is important that we have a yardstick adequately adjusted to make computation in terms of specific body needs for building good bodies and maintaining them in good health. The advance in modern chemistry has gone far toward making this possible.

The problem of estimating the mineral and activator contents, in other words the body-building and repairing qualities of the displacing foods used by the various primitive races, is similar in many respects to estimating these qualities in the foods used in our modern white civilizations, except that modern commerce has transported usually only the foods that will keep well. These include chiefly white flour, sugar, polished rice, vegetable fats and canned goods.

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Very important data for typical American dietaries are now available provided by the Bureau of Home Economics, United States Department of Agriculture, and also by the Bureau of Labor Statistics, United States Department of Labor. These surveys provide a basis of estimating the nutrition of various income groups both with regard to the type of foods selected in our American communities and the quantities of each type used, together with the chemical content of these foods expressed quantitatively. Those who wish to have detailed reports are referred to the bulletins of the above departments. In my clinical studies of the mineral constituents of individuals, affected with dental caries and other disturbances of physical deficiency, I find a wide range of variation in the calcium, phosphorus and fat-soluble activator content of the dietaries used, although in general the calorie content is adequate. This latter factor is controlled by appetite. These computations reveal that the individuals studied have a calcium intake ranging from 0.3 to 0.5 grams; and a phosphorus intake of from 0.3 to 0.6 grams. The minimum adult requirements as provided by such an authority as Sherman, whose figures are used by the United States Department of Labor, are for the average adult 0.68 of a gram of calcium and 1.32 grams of phosphorus per day. It can be seen readily that the amounts given above are far short of the minimum even if individuals absorbed from the foods all of the minerals present. A question arises at this point as to the efficiency of the human body in removing all of the minerals from the ingested foods. Extensive laboratory determinations have shown that most people cannot absorb more than half of the calcium and phosphorus from the foods eaten. The amounts utilized depend directly on the presence of other substances, particularly fat-soluble vitamins. It is at this point probably that the greatest breakdown in our modern diet takes place, namely, in the ingestion and utilization of adequate amounts of the special activating substances, including the vitamins needed for rendering the minerals in the food available to the human system. A recent report by the Council on Foods of the American Medical (4) Association makes this comment on spinach:

Spinach may be regarded as a rich source of vitamin A and as a contributor of vitamin C, iron and roughage to the diet. It is therefore a valuable food. (But) the iron is not well utilized by infants . . . (and) 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 utilize it. Data have been published showing that children absorb very little of the calcium or phosphorus in spinach before six years of age. Adult individuals vary in the efficiency with which they absorb minerals and other chemicals essential for mineral utilization. It is possible to starve for minerals that are abundant in the foods eaten because they cannot be utilized without an adequate quantity of the fat-soluble activators.

FIG. 93. This figure shows the rapid healing of a fractured femur of a boy four and onehalf years of age suffering from convulsions due to malnutrition. His fracture occurred when he fell in a convulsion. There was no healing in sixty days. After reinforcing his nutrition with butter vitamins the healing at the right occurred in thirty days. Whole milk replaced skim milk and a whole wheat gruel made from freshly ground whole wheat replaced white bread.

This is illustrated in the following case. A minister in an industrial section of our city, during the period of severe depression, telephoned me stating that he had just been called to baptize a dying child. The child was not dead although almost constantly in convulsions. He thought the condition was probably nutritional and asked if he could bring the boy to the office immediately. The boy was badly emaciated, had rampant tooth decay, one leg in a cast, a very bad bronchial cough and was in and out of convulsions in rapid succession. His convulsions had been getting worse progressively during the past eight months. His leg had been fractured two or three months previously while walking across the room when he fell in one of his convulsions. No healing had occurred. His diet consisted of white bread and skimmed milk. For mending the fracture the boy needed minerals, calcium, phosphorus and magnesium. His convulsions were due to a low calcium content of the blood. All of these were in the skimmed milk for the butter-fat removed in the cream contains no calcium nor phosphorus, except traces. The program provided was a change from the white flour bread to wheat gruel made from freshly ground wheat and the substitution of whole milk for skimmed milk, with the addition of about a teaspoonful of a very high vitamin butter with each feeding. He was given this meal that evening when he returned to his home. He slept all night without a convulsion. He was fed the same food five times the next day and did not have a convulsion. He proceeded rapidly to regain his health without recurrence of his convulsions. In a month the fracture was united. Two views of the fracture are shown in Fig. 93, one before and one after the treatment. Six weeks after this nutritional program was started the preacher called at the home to see how the boy was getting along. His mother stated that the boy was playing about the doorstep, but they could not see him. She called but received no answer. Presently they spied him where he had climbed up the downspout of the house to the second story. On being scolded by his mother, he ran and jumped over the garden fence, thus demonstrating that he was pretty much of a normal boy. This boy's imperative need, that was not provided in white bread and skimmed milk, was the presence of the vitamins and other activators that are in whole milk but not in skimmed milk, and in whole wheat, freshly ground, but not in white flour. He was restored to health by the simple process of having Nature's natural foods restored to him.

This problem of borrowing from the skeleton in times of stress may soften the bones so that they will be badly distorted. This is frequently seen as bow legs. An illustration of an extreme condition of bone softening by this process is shown in Fig. 94, lower section, which is the skeleton of a monkey that was a house pet. It became very fond of sweets and was fed on white bread, sweetened jams, etc., as it ate at the same table with its mistress. Note that the bones became so soft that the pull of the muscles distorted them into all sorts of curves. Naturally its body and legs were seriously distorted. In this condition my patient, whom I was serving professionally, asked me for advice regarding her monkey's deformed legs and distorted body. I suggested an improved nutrition and provided fat-soluble vitamins consisting of a mixture of a high vitamin butter oil and high vitamin cod liver oil with the result that minerals were deposited on the borders of the vertebrae and joints and on the surfaces of the bones as shown in the illustration. This of course, could not correct the deformity and the animal was chloroformed.

FIG. 94. This boy, age 5, had suffered for two and one-half years from inflammatory rheumatism, arthritis and heart involvement. Upper left shows limit of movement of neck, left wrist, swollen knees and ankles. The middle upper view shows the change in six months after improvement of his nutrition, and at right his change in one year. Below is shown the grossly demineralized and deformed skeleton of a pet monkey being fed on sweets and pastries.

The necessity that the foods selected and used shall provide an adequate quantity of fat-soluble activators (including the known fatsoluble vitamins) is so imperative and is so important in preventing a part of our modern degeneration that I shall illustrate its need with another practical case.

A mother asked my assistance in planning the nutritional program for her boy. She reported that he was five years of age and that he had been in bed in hospitals with rheumatic fever, arthritis and an acute heart involvement most of the time for the past two and a half years. She had been told that her boy would not recover, so severe were the complications. As is so generally the case with rheumatic fever and endocarditis, this boy was suffering from severe tooth decay. In this connection the American Heart Association has reported that 75 per cent of heart involvements begin before ten years of age. My studies have shown that in about 95 per cent of these cases there is active tooth decay. The important change that I made in this boy's dietary program was the removal of the white flour products and in their stead the use of freshly cracked or ground wheat and oats used with whole milk to which was added a small amount of specially high vitamin butter produced by cows pasturing on green wheat. Small doses of a high-vitamin, natural cod liver oil were also added. At this time the boy was so badly crippled with arthritis, in his swollen knees, wrists, and rigid spine, that he was bedfast and cried by the hour. With the improvement in his nutrition which was the only change made in his care, his acute pain rapidly subsided, his appetite greatly improved, he slept soundly and gained rapidly in weight. In the first view, to the left, in Fig. 94, the boy is shown sitting on the edge of the bed at the end of the first month on this program. His joints were still badly swollen and his spine so rigid that he could not rotate his head farther than shown in the picture. In the center view he is shown about six months later, and in the third view, one year later. This occurred six years ago. As I write this a letter has been received from the boy's mother. She reports that he is taller and heavier than the average, has a good appetite and sleeps well.

In the newer light regarding the cause of rheumatic fever, or inflammatory rheumatism (discussed in Chapter 21) there appear to be three underlying causes: a general lowered defense against infection in which the fat-soluble vitamins play a very important part; minute hemorrhages in joint tissues as part of the expression of deficiency of vitamin C, a scurvy symptom, and a source of infecting bacteria such as streptococcus. This could be provided by his infected teeth. These typical expressions of modern degeneration could not occur in most of the primitive races studied because of the high factor of safety in the minerals and vitamins of their nutrition. It is important to emphasize the changes that were made in our modern dietary program to make this boy's nutrition adequate for recovery. Sugars and sweets and white flour products were eliminated as far as possible. Freshly ground cereals were used for breads and gruels. Bone marrow was included in stews. Liver and a liberal supply of whole milk, green vegetables and fruits were provided. In addition, he was provided with a butter that was very high in vitamins having been produced by cows fed on a rapidly growing green grass. The best source for this is a pasturage of wheat and rye grass. All green grass in a state of rapid growth is good, although wheat and rye grass are the best found. Unless hay is carefully dried so as to retain its chlorophyll, which is a precursor of vitamin A, the cow cannot synthesize the fat-soluble vitamins.

These two practical cases illustrate the fundamental necessity that there shall not only be an adequate quantity of body-building minerals present, but also that there shall be an adequate quantity of fat-soluble vitamins. Of course, water-soluble vitamins are also essential. While I have reduced the diets of the various primitive races studied to definite quantities of mineral and calorie content, these data are so voluminous that it will not be appropriate to include them here. It will be more informative to discuss the ratios of both body-building and repairing material in the several primitive dietaries, in comparison with the displacing foods adopted from our modern civilization. The amount of food eaten by an individual is controlled primarily by the hunger factor which for our modernized groups apparently relates only to need for heat and energy. The dietaries adopted have all been built on the basis of the heat and energy requirements of the body for the groups living in the several districts and under their modes of life. These have been calculated for the principal foods eaten by the various groups. The figures will be published in detail in a more technical report. There are two simple ways in which these comparisons can be made. One is in terms of normal body requirements; and the other in terms of the ratio between the mineral and the vitamin content of the native foods and the displacing foods. If we use as a basis the ability of individuals to remove half of the minerals present even though their bodies need more than this, we will be more generous than the average individual's capacity will justify. This will require that we double the amount, as specified for minimum body use by the United States Department of Labor, Bureau of Labor Statistics, in their Bulletin R 409, that is, for calcium 0.68 grams; for phosphorus 1.32 grams; for iron 0.015 grams. The figures that will be used, therefore, are for twice the above amounts: 1.36 grams of calcium; 2.64 grams of phosphorus; 0.030 grams of iron.

Few people who have not been in contact with experimental data on metabolism can appreciate how little of the minerals in the food are retained in the body by large numbers of individuals who are in need of these very chemicals. We have seen that infants cannot absorb calcium from spinach. If we are to provide nutrition that will include an adequate excess as a factor of safety for overloads, and for such periods as those of rapid growth (for children), pregnancy, lactation and sickness, we must provide the excess to the extent of about twice the requirements of normal adults. It will therefore, be necessary for an adequate nutrition to contain approximately four times the minimum requirements of the average adult if all stress periods are to be passed safely.

It is of interest that the diets of the primitive groups which have shown 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 requirements; whereas the displacing nutrition of commerce, consisting largely of white-flour products, sugar, polished rice, jams, canned goods, and vegetable fats have invariably failed to provide even the minimum requirements. In other words the foods of the native Eskimos contained 5.4 times as much calcium as the displacing foods of the white man, five times as much phosphorus, 1.5 times as much iron, 7.9 times as much magnesium, 1.8 times as much copper, 49.0 times as much iodine, and at least ten times that number of fat-soluble vitamins. For the Indians of the far North of Canada, the native foods provided 5.8 times as much calcium, 5.8 times as much phosphorus, 2.7 times as much iron, 4.3 times as much magnesium, 1.5 times as much copper, 8.8 times as much iodine, and at least a ten fold increase in fat-soluble activators. For brevity, we will apply the figures to calcium, phosphorus, magnesium, iron and fat-soluble activators in order. The ratio in the Swiss native diets to that in the displacing diet was for calcium, 3.7 fold; for phosphorus, 2.2 fold; for magnesium, 2.5 fold; for iron, 3.1 fold; and for the fat-soluble activators, at least ten fold. For the Gaelics in the Outer Hebrides, the native foods provided 2.1 times as much calcium, 2.3 times as much phosphorus, 1.3 times as much magnesium, and 1.0 times as much iron; and the fat-soluble activators were increased at least ten fold. For the Aborigines of Australia, living along the eastern coast where they have access to sea foods the ratio of minerals in the native diet to those in the displacing modernized foods was, for calcium, 4.6 fold; for phosphorus, 6.2 fold; for magnesium, 17 fold; and for iron 50.6 fold; while for the fatsoluble activators, it was at least ten fold. The native diet of the New Zealand Maori provided an increase in the native foods over the displacing foods of the modernized whites of 6.2 fold for calcium, 6.9 fold for phosphorus, 23.4 fold for magnesium, 58.3 fold for iron; and the fatsoluble activators were increased at least ten fold. The native diet of the Melanesians provided similarly an increase over the provision made in the modernized foods which displaced them of 5.7 fold for calcium, 6.4 fold for phosphorus, 26.4 fold for magnesium, and 22.4 fold for iron; while the fat-soluble activators were 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 5.6 fold for calcium, 7.2 fold for phosphorus, 28.5 fold for magnesium, 18.6 fold for iron; and the fat-soluble activators were increased at least ten fold. The coastal Indians of Peru provided through their native primitive diets for an increase in provision over that of the displacing modernized diet of 6.6 fold for calcium, 5.5 fold for phosphorus, 13.6 fold for magnesium, 5.1 fold for iron; and an excess of ten fold was provided for fat-soluble vitamins. For the Indians of the Andean Mountains of Peru, the native foods provided an increase over the provision of the displacing modern foods of S fold for calcium, 5.5 fold for phosphorus, 13.3 fold for magnesium, 29.3 fold for iron; and an excess of at least ten fold was provided for fat-soluble vitamins. For the cattle tribes in the interior of Africa, the primitive foods provided an increase over the provision of the displacing modernized foods of 7.5 fold for calcium, 8.2 fold for phosphorus, 19.1 fold for magnesium, 16.6 fold for iron and at least ten fold for fat-soluble activators. For the agricultural tribes in Central Africa the native diet provided an increase over the provision of the displacing modern diet of 3.5 fold for calcium, 4.1 fold for phosphorus, 5.4 fold for magnesium, 16.6 fold for iron and ten fold for fat-soluble activators. All the above primitive diets provided also a large increase in the water-soluble vitamins over the number provided in the displacing modern diets.

FIG. 95. Effect of different wheat products on rats. Left: whole wheat. Center: white flour. Right: bran and middlings mixture. The graphs record actual amount of indicated minerals present, as milligrams per cent. Only the rats on the whole wheat developed normally without tooth decay. Those on white flour had tooth decay, were underweight, had skin infections and were irritable. They did not reproduce. The third group were undersize. The balance of the ration was the same for all.

From the data presented in the preceding chapters and in this comparison of the primitive and modernized dietaries it is obvious that there is great need that the grains eaten shall contain all the minerals and vitamins which Nature has provided that they carry. Important data might be presented to illustrate this phase in a practical way. In Fig. 95 will be seen three rats all of which received the same diet, except for the type of bread. The first rat (at the left) received whole-wheat products freshly ground, the center one received a white flour product and the third (at the right) a bran and middlings product. The amounts of each ash, of calcium as the oxide, and of phosphorus as the pentoxide; and the amounts of iron and copper present in the diet of each group are shown by the height of the columns beneath the rats. Clinically it will be seen that there is a marked difference in the physical development Qf these rats. Several rats of the same age were in each cage. The feeding was started after weaning at about twenty-three days of age. The rat at the left was on the entire grain product. It was 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 be picked up by the ear or tail without danger of their biting. The rats represented by the one in the center cage using white flour were markedly undersized. Their hair came out in large patches and they had very ugly dispositions, so ugly that they threatened to spring through the cage wall at us when we came to look at them. These rats had tooth decay and they were not able to reproduce. The rats in the next cage (illustrated by the rat to the right) which were on the bran and middlings mixture did not show tooth decay, but were considerably undersized, and they lacked energy. The flour and middlings for the rats in cages two and three were purchased from the miller and hence were not freshly ground. The wheat given to the first group was obtained whole and ground while fresh in a hand mill. It is of interest that notwithstanding 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 been due in large part to the fact that the material was not freshly ground, and as a result they could not obtain a normal vitamin content from the embryo of the grain due to its oxidation. This is further indicated by the fact that the rats in this group did not reproduce, probably due in considerable part to a lack of vitamins B and E which were lost by oxidation of the embryo or germ fat.

There is a misapprehension with regard to the possibility that humans may obtain enough of the vitamin D group of activators from our modern plant foods or from sunshine. This is due to the belief viosterol or similar products by other names, derived by exposing ergosterol to ultraviolet light, offer all of the nutritional factors involved in the vitamin D group. I have emphasized that there are known to be at least eight D factors that have been definitely isolated and twelve that have been reported as partially isolated.

Coffin has recently reported relative to the lack of vitamin D in common foods as follows: (5)

A representative list of common foods was carefully tested, by approved technique, for their vitamin D content.
With the remote possibility of egg yolks, butter, cream, liver and fish it is manifestly impossible to obtain any amount of vitamin D worthy of mention from common foods.
Vegetables do not contain vitamin D.
It will be noted that vitamin D, which the human does not readily synthesize in adequate amounts, must be provided by foods of animal tissues or animal products. As yet I have not found a single group of primitive racial stock which was building and maintaining excellent bodies by living entirely on plant foods. I have found in many parts of the world most devout representatives of modern ethical systems advocating the restriction of foods to the vegetable products. In every instance where the groups involved had been long under this teaching, I found evidence of degeneration in the form of dental caries, and in the new generation in the form of abnormal dental arches to an extent very much higher than in the primitive groups who were not under this influence.

Many illustrations might be presented showing the special wisdom of the primitives in the matter of reinforcing their nutrition with protective foods.

Few people will realize how reluctant members of the primitive races are, in general, to disclose secrets of their race. The need for this is comparable to the need for secrecy regarding modern war devices.

The Indians of the Yukon have long known the cure for scurvy and history makes an important contribution to their wisdom in treating this disease. It is of interest that W. N. Kemp (6) of Vancouver states:

The earliest recorded successful treatment of scurvy occurred in Canada in 1535 when Jacques Cartier, on the advice of a friendly Indian, gave his scurvyprostrated men a decoction of young green succulent 'shoots' from the spruce trees with successful results. These happy effects apparently were not appreciated in Europe, for scurvy continued to be endemic.

Since that time untold thousands of mariners and white land dwellers have died with this dreaded disease.

Shortly before our arrival in Northern Canada a white prospector had died of scurvy. Beside him was his white man's packet of canned foods. Any Indian man or woman, boy or girl, could have told him how to save his life by eating animal organs or the buds of trees.

Another illustration of the wisdom of the native Indians of that far north country came to me through two prospectors whom we rescued and brought out with us just before the fall freeze-up. They had gone into the district, which at that time was still uncharted and unsurveyed, to prospect for precious metals and radium. They were both doctors of engineering and science, and had been sent with very elaborate equipment from one of the large national mining corporations. Owing to the inaccessibility of the region, they adopted a plan for reaching it quickly. They had flown across the two ranges of mountains from Alaska and when they arrived at the inside range, i.e., the Rocky Mountain Range, they found the altitude so high that their plane could not fly over the range, and, as a result, they were brought down on a little lake outside. The plane then returned but was unable to reach the outside world because of shortage of fuel. The pilot had to leave it on a waterway and trudge over the mountains to civilization. The two prospectors undertook to carry their equipment and provisions over the Rocky Mountain Range into the interior district where they were to prospect. They found the distance across the plateau to be about one hundred miles and the elevation ranging up to nine thousand feet. While they had provisions and equipment to stay two years they found it would take all of this time to carry their provisions and instruments across this plateau. They accordingly abandoned everything, and rather than remain in the country with very uncertain facilities and prospects for obtaining food and shelter, made a forced march to the Liard River with the hope that some expedition might be in that territory. One of the men told me the following tragic story. While they were crossing the high plateau he nearly went blind with so violent a pain in his eyes that he feared he would go insane. It was not snow blindness, for they were equipped with glasses. It was xeropthalmia, due to lack of vitamin A. One day he almost ran into a mother grizzly bear and her two cubs. Fortunately, they did not attack him but moved off. He sat down on a stone and wept in despair of ever seeing his family again. As he sat there holding his throbbing head, he heard a voice and looked up. It was an old Indian who had been tracking that grizzly bear. He recognized this prospector's plight and while neither could understand the language of the other, the Indian after making an examination of his eyes, took him by the hand and led him to a stream that was coursing its way down the mountain. Here as the prospector sat waiting the Indian built a trap of stones across the stream. He then went upstream and waded down splashing as he came and thus drove the trout into the trap. He threw the fish out on the bank and told the prospector to eat the flesh of the head and the tissues back of the eyes, including the eyes, with the result that in a few hours his pain had largely subsided. In one day his sight was rapidly returning, and in two days his eyes were nearly normal. He told me with profound emotion and gratitude that that Indian had certainly saved his life.

Now modern science knows that one of the richest sources of vitamin A in the entire animal body is that of the tissues back of the eyes including the retina of the eye.

In Chapter 18 I refer to the work of Wald on studies of vitamin A tissues. He states that extracts of eye tissue (retina, pigment, epithelium, and choroid) show the characteristic vitamin A absorption band and that they are potent in curing vitamin A deficient rats. He shows also that the concentration of vitamin A is constant for different mammals.

I have been impressed to find that primitive racial stocks in various parts of the world are familiar with the fact that eyes constitute an invaluable adjunct for nutrition. Even the one time cannibals of the Fiji Islands, and the hereditary king of the Fiji Islands, told me in detail of the practices with regard to the use of eyes as an adjunct 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, I learned to enjoy greatly fish head soup made from certain selected tissues. After the fish had been cleaned the heads were split and the eyes left in.

The space of the entire book might be used for discussing the nutritional wisdom of the various primitive races. It is a pity that so much of their wisdom has been lost through lack of appreciation by the whites who early made contact with them.

REFERENCES

SHERMAN, H. C. Chemistry of Foods and Nutrition. New York, Macmillan, 1933.
BILLS, C. E. New Forms and Sources of Vitamin D. J.A.M.A., 108:12, 1937, Nutrition Abstracts and Reviews, 1938.
LAWSON, A. and MOON, H. P. A clay adjunct to potato dietary. Nature, 141: 40, 1938.
Report Council on Foods. Nutritional value of spinach. J.A.M.A., 109:1907, 1937.
COFFIN, J. Lack of vitamin D in common foods. J. Am. Dietet. A., 11:119, 1935.
KEMP, W. N. The sources of clinical importance of the vitamins. Bull. Vancouver Med. A., Dec., 1937.

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Chapter 16

PRIMITIVE CONTROL OF DENTAL CARIES

THE essential differences in the diets of the primitive races and those of the modernized groups have been discussed in the preceding chapter. We are concerned now with discovering whether the use of foods, which are equivalent in body-building and repairing material to those used by the primitives will, when provided to our affected modernized groups, prevent tooth decay or check it when it is active.

There are two approaches to this problem of the control of tooth decay by nutritional means. One is by the presentation of clinical results and the other by the consideration of the characteristics of those nutritional programs which have been successful in producing a high immunity to tooth decay.

We may divide the primitive racial stocks into groups, classified according to the physical environment in which they are living and the manner in which the environment largely controls their available foods. It is significant that I have as yet found no group that was building and maintaining good bodies exclusively on plant foods. A number of groups are endeavoring to do so with marked evidence of failure. The variety of animal foods available has varied widely in some groups, and been limited among others.

In the preceding chapter we have seen that the successful dietaries included in addition to a liberal source of minerals, carbohydrates, fats, proteins, and water-soluble vitamins, a source of fat-soluble vitamins.

Vitamin D is not found in plants, but must be sought in an animal food. The dietaries of the efficient primitive racial stocks may be divided into groups on this basis: in the first place those obtaining their fatsoluble activators, which include the known fat-soluble vitamins, from efficient dairy products. This includes the Swiss in the high Alps, the Arabs (using camel's milk), and the Asiatic races (using milk of sheep and musk ox). In the second place there are those using liberally the organs of animals, and the eggs of birds, wild and domesticated. These include the Indians of the far North, the buffalo hunting Plains Indians and the Andean tribes. In the third place there are those using liberally animal life of the sea. These include Pacific Islanders and coastal tribes throughout the world. In the fourth place there are those using small animals and insects. These include the Australian Aborigines in the interior, and the African tribes in the interior.

Many of the above groups use foods from two or more sources. Each of the groups has provided an adequate quantity of body-building material from both animal and plant tissues. It does not matter what the source of minerals and vitamins may be so long as the supply is adequate. In our modern life, the location of a group will determine the most efficient and most convenient source for obtaining the essential foods. Clearly, for those near the coast, the sea may be most convenient, while for those in the interior or in the far North, dairy products or the organs of animals may be the only available source. It would be fortunate indeed, if our problems were as simple as this statement might indicate. We have, however, in the first place, the need for a strength of character and will power such as will make us use the things our bodies require rather than only the foods we like. Another problem arises from the fact that our modern sedentary lives call for so little energy that many people will not eat enough even of a good food to provide for both growth and repair, since hunger appeals are for energy only, the source of heat and power, and not for body-building minerals and other chemicals. Still another problem confronts us, i.e., the sources of fatsoluble activators indicated above, namely: dairy products, organs of animals and sea foods, may vary through a wide range in their content of the fat-soluble activators or vitamins, depending upon the nutrition available for the animals. Cows fed on third grade hay, too low in carotene, not only cannot produce strong calves but their milk will not keep healthy calves alive. (Chapter 18.)

The League of Nations' Committee on Nutrition has estimated the amount of pasture land required per capita to provide adequate milk and meat. Owing to the density of population and cost of land near large cities, it is not possible to provide an adequate acreage for dairy cattle. This results in stall feeding of shipped fodder. Only those cows can be kept in a herd whose production of milk and butter fat can pay in volume for their keep. Unfortunately milk may have a high cream line or butter fat content and still be low in essential fat-soluble vitamins. This constitutes an exceedingly important phase of our modern problem. Butter ships best when hard and this quality can be largely controlled by the fodder given to the cattle and hence becomes an important factor in the wholesale butter industry. Since 1927, I have been analyzing samples of dairy products, chiefly butter, from several parts of the world for their vitamin content. These samples are received every two to four weeks from the same places, usually for several years. They all show a seasonal rise and fall in vitamin content. The high level is always associated with the use of rapidly growing young plant food. This tide in plant life, fluctuating with the seasons, controlled the migration of the buffalo southward in the autumn and winter and northward in the spring. They moved at the rate of about twelve miles per day, travelling with the sun in order to provide the highest-vitamin milk for the young calves born in the south. No doubt these tides in nutrition control also the migration of birds. By far the most efficient plant food that I have found for producing the high-vitamin content in milk is rapidly growing young wheat and rye grass. Oat and barley grass are also excellent. In my clinical work small additions of this high-vitamin butter to otherwise satisfactory diets regularly checks tooth decay when active and at the same time improves vitality and general health.

Similarly the value of eggs for providing fat-soluble vitamins depends directly upon the food eaten by the fowl. The fertility of the eggs also is a direct measure of the vitamin content, including vitamin E.

Since the sea foods are, as a group, so valuable a source of the fatsoluble activators, they have been found to be efficient throughout the world not only for controlling tooth decay, but for producing a human stock of high vitality. Unfortunately the cost of transportation in the fresh state often constitutes a factor limiting distribution. Many of the primitive races preserved the food value, including vitamins, very efficiently by drying the fish. While our modern system of canning prevents decomposition, it does not efficiently preserve some of the fatsoluble activators, particularly vitamin A.

Since the organs, particularly the livers of animals, are storage depots of the vitamins an important source of some of the fat-soluble activators can be provided by extracting the fat of the livers and shipping it as liver oils. Modern methods of processing have greatly improved the quality of these oils. There are some factors, however, which can be provided to great advantage for humans from dairy products of high efficiency.

I have shown in the preceding chapter the quantities of several of the minerals that are essential in suitable chemical form to maintain an adult in good health and make possible tissue repair. The dietaries of the various primitive groups have all been shown to have a mineral content several times higher than that which obtains in the inadequate food eaten by modernized primitives and the people of our modernized cultures.

Modern commerce has deliberately robbed some of nature's foods of much of their body-building material while retaining the hunger satisfying energy factors. For example, in the production of refined white flour approximately eighty per cent or four-fifths of the phosphorus and calcium content are usually removed, together with the vitamins and minerals provided in the embryo or germ. The evidence indicates that a very important factor in the lowering of reproductive efficiency of womanhood is directly related to the removal of vitamin E in the processing of wheat. The germ of wheat is our most readily available source of that vitamin. Its role as a nutritive factor for the pituitary gland in the base of the brain, which largely controls growth and organ function, apparently is important in determining the production of mental types. Similarly the removal of vitamin B with the embryo of the wheat, together with its oxidation after processing, results in depletion of body-building activators.

Refined white sugar carries only negligible traces of body-building and repairing material. It satisfies hunger by providing heat and energy besides having a pleasant flavor. The heat and energy producing factors in our food that are not burned up are usually stored as fat. In the preceding chapter we have seen that approximately half of the foods provided in our modern dietaries furnish little or no body-building or repairing material and supply no vitamins. Approximately 25 per cent of the heat and energy of the American people is supplied by sugar alone which goes far in thwarting Nature's orderly processes of life. This per capita use is unfortunately on the increase. Therefore we must begin by radically reducing the foods that are so deceptive, and often injurious in overloading the system. Even this much change in our modern nutrition will raise the factor of safety sufficiently to check tooth decay in a large percentage of people. It will not, however, be adequate for most children in whom the additional demands of rapid growth must be satisfied. I have found the highest incidence of tooth decay in the high school and boarding school girls, and the next in the boarding school boys. These groups suffer even more than the childbearing mothers.

In discussing the technical aspects later I shall consider the defensive factors in the saliva as controlled by the nutrition through the blood stream, and also the role of oral prophylaxis.

It is appropriate at this point to note some characteristics of a decaying tooth. The process of tooth decay never starts from within but always from without and is most likely to start at the contact points between the teeth or in the pits and grooves, especially when these are incompletely formed. Teeth never have caries while they are covered with flesh but decay most easily soon after eruption, when conditions are unfavorable. If 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 substance by acids produced by bacteria. 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 quantity and activity. The dental profession has been waiting for decades for this question to be solved before taking active steps to prevent the whole process. The primitive approach has been to provide a program that will keep the teeth well, that is, prevention of dental caries by adequate food combinations. I have just stated that teeth harden after eruption if the saliva is normal. This occurs by a process of mineralization much like the process by which petrified wood is produced.

The tooth is made up of four structures. The first is the pulp within, which carries blood vessels and nerves. This structure is surrounded in both the root and crown by the dentine or tooth bone which is nourished from within. The dentine of the root is covered by cementum which receives nourishment from the membrane which attaches the root to the jaw bone. The dentine of the crown or exposed part of the tooth is covered with enamel. Tooth decay proceeds slowly through the enamel and often rapidly in the dentine, always following the minute channels toward the pulp, which may become infected before the decay actually reaches the pulp to expose it; nearly always the decay infects the pulp when it destroys the dentine covering it. When a tooth has a deep cavity of decay, the decalcified dentine has about the density of rotten wood. With an adequate improvement in nutrition, tooth decay will generally be checked provided two conditions are present: in the first place, there must be enough improvement in the quality of the saliva; and in the second, the saliva must have free access to the cavity. Of course, if the decay is removed and a filling placed in the cavity, the bacteria will be mechanically shut out. One of the most severe tests of a nutritional program, accordingly, is the test of its power to check tooth decay completely, even without fillings. There are, however, two further tests of the sufficiency of improvement of the chemical content of the saliva. If it has been sufficiently improved, bacterial growth will not only be inhibited, but the leathery decayed dentine will become mineralized from the saliva by a process similar to petrification. Note that this mineralized dentine is not vital, nor does it increase in volume and fill the cavity. When scraped with a steel instrument it frequently takes on a density like very hard wood and occasionally takes even a glassy surface. When such a tooth is placed in silver nitrate, the chemical does not penetrate this demineralized dentine, though it does rapidly penetrate the decayed dentine of a tooth extracted when decay is active. This process is illustrated in Fig. 96 which shows two deciduous teeth extracted from the same child, one before, and the other a few months after improving the nutrition. These deciduous molars were replaced by the bicuspids of the second dentition. The tooth at the left had deep caries and was removed before the treatment was begun. Note that the silver nitrate has blackened the tissue to the depth of the decay. The tooth at the right was removed about three months after the nutrition was changed. Note that the decayed dentine is so dense that the silver nitrate has not penetrated deeply and discolored it.

FIG. 96. A, illustrates the permeability of decayed dentin to silver nitrate. B, illustrates the decreased permeability of decayed dentin to silver nitrate due to mineralization, after saliva has been improved by correcting the nutrition.

There is still another test that demonstrates Nature's protective mechanisms. Ordinarily, when the pulp of a tooth is exposed by dental caries, the pulp becomes not only infected, but dies opening up a highway of infection direct from the infected mouth to the inside of the fort at the end of the root. One expression of this is a dental abscess, the existence of which is usually unknown to the individual for sometime and the infecting germs pass more or less freely throughout the body by way of the blood stream and lymph channels. This infection may start the degeneration of organs and tissues of other parts of the body.

Among some of the primitive races, whose nutritional programs provided a very high factor of safety, even though the teeth were worn down to the gum line and into what was formerly the pulp chamber, the pulp was not exposed. Nature had built a protecting zone, not in the cavity of the tooth in this case, but within the pulp chamber. This entirely blocked off a threatened exposure and kept the walls of the fort sealed against bacteria. This process does not occur in many instances in people of our modern civilization. Pulp chambers that are opened by wear provide exposed pulp which becomes infected with subsequent abscess formation. If a reinforced nutrition as efficient as that of many of the primitive races, is adopted, the pulp tissue will seal up the opening made by decalcification of the dentine, by building in a new layer of normal dentine which is vital and quite unlike the petrified decay exposed to the saliva, thus completely walling off the impending danger. This is illustrated in Fig. 97 with three cases. At the left are shown x-rays of teeth of three children in one of my experimental clinics in a poor district in Cleveland. The pulp chambers and pulp tissues of the root canals are shown as dark streaks in the center of the tooth. The very large cavities which had decalcified the tooth to the pulp chamber are shown as large dark areas in the crown. Temporary fillings had to be placed because of pain produced by the pressure of food on the pulp below the decayed dentine. After the nutrition was improved, the tissues of the pulp built in secondary dentine thus reincasing itself in a closed chamber. This process is shown in each of the three cases presented in Fig. 97, in the views to the right.

FIG. 97. Three cases that illustrate how nature can close an exposure of the pulp due to dental caries by building a protecting wall within the pulp chamber when the nutrition is adequately improved.

Under the stress of the industrial depression the family dietary of the children shown in Fig. 97 was very deficient. They were brought to a mission where we fed them one reinforced meal at noon for six days a week. The home meals were not changed nor the home care of the teeth. The preliminary studies of each child included complete x-rays of all of the teeth, a chemical analysis of the saliva, a careful plotting of the position, size and depth of all cavities, a record of the height, and weight, and a record of school grades, including grades in deportment. These checks were repeated every four to six weeks for the period of the test, usually three to five months. It is important to note that the home nutrition which had been responsible for the tooth decay was exceedingly low in body building and repairing material, while temporarily satisfying the appetite. It usually consisted of highly sweetened strong coffee and white bread, vegetable fat, pancakes made of white flour and eaten with syrup, and doughnuts fried in vegetable fat.

The nutrition provided these children in this one meal included the following foods. About four ounces of tomato juice or orange juice and a teaspoonful of a mixture of equal parts of a very high vitamin natural cod liver oil and an especially high vitamin butter was given at the beginning of the meal. They then received a bowl containing approximately a pint of a very rich vegetable and meat stew, made largely from bone marrow and fine cuts of tender meat: the meat was usually broiled separately to retain its juice and then chopped very fine and added to the bone marrow meat soup which always contained finely chopped vegetables and plenty of very yellow carrots; for the next course they had cooked fruit, with very little sweetening, and rolls made from freshly ground whole wheat, which were spread with the high-vitamin butter. The wheat for the rolls was ground fresh every day in a motor driven coffee mill. Each child was also given two glasses of fresh whole milk. The menu was varied from day to day by substituting for the meat stew, fish chowder or organs of animals. From time to time, there was placed in a two quart jar a helping similar to that eaten by the children. This was brought to my laboratory for chemical analysis, which analysis showed that these meals provided approximately 1.48 grams of calcium and 1.28 grams of phosphorus in a single helping of each course. Since many of the children doubled up on the course, their intake of these minerals was much higher. I have shown in the preceding chapter that the accepted figures for the requirements of the body for calcium and phosphorus are 0.68 grams of calcium and 1.32 grams of phosphorus. It is obvious that this one meal a day plus the other two meals at home provided a real factor of safety. Clinically this program completely controlled the dental caries of each member of the group.

The chemical analysis of the saliva (1, 2) revealed a marked improvement which progressively increased. At the beginning of the test the average for the group showed a very low factor of safety, so low that we should expect tooth decay to be active. In six weeks the average changed to a condition which we should expect would be accompanied by a cessation of tooth decay. The saliva factor of safety continued to improve for five months at which time the special program was discontinued for the summer.

Several incidents of special interest occurred. Two different teachers came to me to inquire what had been done to make a particular child change from one of the poorest in the class in capacity to learn to one of the best. Dental caries is only one of the many expressions of our modern deficient nutritions.

I have referred to the importance of a high vitamin butter for providing the fat-soluble activators to make possible the utilization of the minerals in the foods. In this connection, it is of interest that butter constitutes the principal source of these essential factors for many primitive groups throughout the world. In the high mountain and plateau district in northern India, and in Tibet, the inhabitants depend largely upon butter made from the milk of the musk ox and the sheep for these activators. The butter is eaten mixed with roasted cereals, is used in tea, and in a porridge made of tea, butter and roasted grains. In Sudan Egypt, I found considerable traffic in high vitamin butter which came from the higher lands a few miles from the Nile Basin. This was being exchanged for and used with varieties of millet grown in other districts. This butter, at the temperature of that area, which ranged from 90° to 110° Fahrenheit, was, of course, always in liquid form. Its brilliant orange color testified to the splendid pasture of the dairy animals. The people in Sudan, including the Arabs, had exceptionally fine teeth with exceedingly little tooth decay (Chapter 9). The most physically perfect people in northern India are probably the Pathans who live on dairy products largely in the form of soured curd, together with wheat and vegetables. The people are very tall and are free of tooth decay.

Probably every housewife is familiar with the low melting quality of the butter produced in early summer when the cows have been put on the green pastures. This is particularly true of butter that has the grassy flavor and the deep yellow to orange color. This butter is usually several times as high in fat-soluble activators including vitamins A and D as butter produced from stall fed cattle or cattle on poorer pasturage. In Chapter 15, I have explained why this butter is not favorable for shipping and why dairymen so frequently give the cows a ration that will produce less of these qualities. One of the principal foods used for accomplishing this is made of cotton seed meal and cereals.

There are many illustrations of the low efficiency of this type of fodder for providing vitamins essential for dairy products. In one of the recent severe droughts in the Mississippi Valley several thousand cattle were shipped to Ohio for water and green pasture as a means of saving their lives. They were fed enroute on concentrates said to consist of cotton seed meal and grain. Professor Oscar Erf of the Department of Dairying of Ohio State University has given me the following detailed information:

With reference to the cattle from the south-western and central-northern states of the drought area which were brought into Ohio in the fall of 1935 on a 600 acre farm north of Delaware, will say that I had the privilege of viewing some of these cattle previous to the time that they were brought to Ohio in 1935. Because of the extreme drought period and the hot sun, it was rare to see green grass on the prairies. The sedges were nearly all dried up. The tumbleweed was about the only thing that was available for the cattle in some instances. The corn was dried up and very little green was in evidence. In the particular location that I was in we found the cattle suffering terribly. Many had infected eyes.

There were a good many deaths on the plains which were literally dried up. Sometimes there was even a small amount of decomposition after death. In the fall, those that survived on the plains, were loaded up and driven to the corrals, loaded into cars and sent east. Only the good ones were loaded and even a large number of these passed out in transit.

I was informed that the crop of grass the year before was very scant. Consequently, a large number of calves were born with weak eyes and these were the early ones to pass out on the plains. The low vitality of the individuals which I considered was due to the lack of vitamin A or the green grass factors was the cause of the serious infection, however their being secondary to the primary cause.

The first train load of the twenty-eight hundred cattle that were brought to this ranch were fed on green corn stalks. There was a nine acre patch of corn in this area. The fences were taken down one afternoon at 3 o'clock and by 9 o'clock there was no evidence of stubbles or roots. This had all been eaten in a very short space of time. We had quite a time getting hays and green stuff which we demanded because of its carotin content and its green grass factor. There was not enough grass available in the beginning so we had to buy about 400 tons of hay a day to keep the animals fed. They got no grain of any kind because it was a question of bringing the cattle to a more or less normal condition with no intention of fattening the animals.

After they had made arrangements for feeding operations and made feed racks in sufficient numbers, we went over the herd to estimate the numbers that were blind and had sore eyes, which I assume from past experience, was due to a vitamin A deficiency. As near as we can estimate, nearly 8 12 animals were affected (29 per cent). There were 157 calves born and approximately 50 per cent were deformed and not normal. We did not get the complete figures but they probably ranged a little higher than that. The worst infected cows were calves and animals that were 18 to 20 months old. I could not get the story of these individuals but they must have been in the area of dry grass for 2 years. There was a slight improvement in those that were not seriously infected after they were fed here. They improved decidedly in October and November and were practically all slaughtered before the middle of December.

The milk of these vitamin deficient cows would not properly nourish either their calves or human beings.

Many children have tooth decay even while using whole milk, in part because the milk is too low in vitamin content, due to the inadequacy of the food given the cows. The means for improving this condition have been discussed in Chapter 15.

Some of the current theories of the chemistry of tooth decay place the responsibility on the local condition in the mouth as affected by the contributing factors provided by sugars and starches which enhance the growth of acid producing organisms. A phase of this has been closely related to the slogan that a clean tooth cannot decay. Among the difficulties in applying this interpretation is the physical impossibility of keeping teeth bacteriologically clean in the environment of the mouth. Another difficulty is the fact that many primitive races have their teeth smeared with starchy foods almost constantly and make no effort whatsoever to clean their teeth. In spite of this they have no tooth decay. In many of the primitive groups that I have studied the process of modernization includes teaching oral hygiene and prophylaxis. Yet, even with the addition of this important adjunct to health, they have in most cases lost their immunity to tooth decay and dental caries has become active. This will be seen in many of the illustrations of the primitive races in the preceding chapters. Of course everyone should clean his teeth, even the primitives, in the interest of and out of consideration for others.

In my clinical work I have sought for extreme cases of active tooth decay in order to test the primitive wisdom. Many of these cases have been furnished by members of the dental profession in other cities and states. By the simple procedure of studying the nutrition of the individual, obtaining a sample of saliva for analysis, seeing x-rays of the individual's teeth and supporting bone, and getting a history of the systemic overloads, I have been able to outline a nutritional program which, in well above 90 per cent of the cases has controlled the dental caries. Improvement in the condition of the teeth has been confirmed by later x-rays and reports by the patients' dentists. In a few cases where I had contact with the patients only through correspondence the cooperation was not adequate for accomplishing complete improvement. While it is true that there is a marked difference in the susceptibility of different individuals to dental caries, even those who would ordinarily be classed as highly susceptible, have generally received permanent benefit from the treatment.

These principles of treatment have now been applied to many hundreds of patients as indicated by the fact that over 2,800 chemical analyses of the saliva have been made. The dietary programs that have been recommended have been determined on the basis of a study of the nutrition used by the patient, the data provided by the x-rays, from the saliva analysis and case history. The diets have been found to be deficient in minerals, chiefly phosphorus. Fat-soluble vitamins have been deficient in practically every case of active tooth decay. The foods selected for reinforcing the deficient nutritions have always included additional fatsoluble vitamins and a liberal source of minerals in the form of natural food. Human beings cannot absorb minerals satisfactorily from inorganic chemicals. Great harm is done, in my judgment, by the sale and use of substitutes for natural foods.

One of our greatest difficulties in undertaking to apply the wisdom of the primitives to our modern problems involves a character factor. The Indians of the high Andes were willing to go hundreds of miles to the sea to get kelp and fish eggs for the use of their people. Yet many of our modern people are unwilling to take sufficient trouble to obtain foods that are competent to accomplish the desired results.

Jobbers and middlemen as well as supply depot managers want butter sold in accordance with its label rather than in accordance with its vitamin content. One large distributor whom I asked to cooperate by maintaining a stock of high-vitamin butter to which I could refer people, told me frankly that he wished I would stop telling people about the difference in the vitamins in butter. He did not wish them to think of butter in terms of its vitamin content. Another large concern told me that when I had worked up a sufficiently large market they would become interested in supplying the demand. I counsel people to put in storage some of that butter which has the grassy flavor and which melts easily and is produced when the cows go onto the rapidly growing young grass. Unfortunately, cows that have been on a stable fodder low in carotene and under the stress of gestation often are so depleted in their own body vitamins that it takes them three or four weeks to replenish their own bodies when they get on good pasture. Then the vitamins will appear in liberal quantity in their milk. This has made it necessary for me to assist many patients in obtaining a supply by analyzing butter for its vitamin content and then putting this material in storage and making it available for special cases as needed.

The program that I have found most efficient has been one which includes the use of small quantities of very high vitamin butter mixed in equal parts with a very high vitamin cod liver oil. A simple method of preparing the butter is by melting it and allowing it to cool for twenty-four hours at a temperature of about 70° F., then centrifugalizing it which provides an oil that remains liquid at room temperature. When this butter oil is mixed in equal parts with a very high-vitamin cod liver oil, it produces a product that is more efficient than either alone. It should be used within a couple of weeks of the time it is mixed. It is desirable that this material be made available in various parts of the country. Even the high-vitamin butter produced on the early summer growth of grass put in storage and used during the winter will go far toward solving our great national problem of shortage of fat-soluble vitamins. The quantity of the mixture of butter oil and cod liver oil required is quite small, half a teaspoonful three times a day with meals is sufficient to control wide-spread tooth decay when used with a diet that is low in sugar and starches and high in foods providing the minerals, particularly phosphorus. A teaspoonful a day divided between two or three meals is usually adequate to prevent dental caries and maintain a high immunity; it will also maintain freedom from colds and a high level of health in general. This reinforcement of the fat-soluble vitamins to a menu that is low in starches and sugars, together with the use of bread and cereal grains freshly ground to retain the full content of the embryo or germ, and with milk for growing children and for many adults, and the liberal use of sea foods and organs of animals, produced the result described.

I have previously reported (3) seventeen cases of extensive dental caries. In these patients there were found 237 open cavities of apparently active caries. Most of the individuals were between twelve and twenty years of age and accordingly had twenty-eight permanent teeth each, or a total of 476. It will be noted that if one cavity is allowed per tooth, approximately half of the total number of teeth were affected, or precisely 49.7 per cent of all the teeth had open cavities. This group includes only persons of whom I have been making critical examination every six to twelve months over a three-year period. In practically all cases, Roentgen-ray examinations were made in addition to clinical examinations of the teeth. While these persons have been on the reinforced nutritional program during the winter and spring months of the past three years, only two new cavities have developed in the group, or 0.4 per cent. The length of time during which the cavities previously found had been developing is not known beyond the fact that all of the patients were receiving frequent and thorough dental service, most of them twice a year and many of them more frequently. It is accordingly probable that the cavities found had developed in less than a year. That dental caries was not a new problem with these persons was indicated by the very extensive and numerous dental restorations that had been made in their mouths. It is, therefore, apparent that 250 times as many cavities developed in the period preceding the starting of the nutritional program as in the three years following its adoption. If these data were reduced to a yearly basis, the comparison would show a much wider variation.

In a group of fifty persons, including the above mentioned seventeen, who had been on the special nutritional program for from one to six years, most of them three years or more, only two new cavities developed. Allowing these persons to have an average of twenty-eight teeth per person, or a total of 1,400 teeth, this would represent an incidence of dental caries in a period of three years of 0.14 per cent. In this group of fifty, there are many instructive and striking cases.

For example, H. F. did not have a single cavity from October, 1932, to June, 1933, while taking additional vitamins and high mineral foods. From June, 1933, to May, 1934, while not taking the special vitamins, she developed ten new cavities.

S. K., prior to 1931 had rampant tooth decay with pulps nearly exposed in all first permanent molars. The remaining deciduous teeth had been reduced to shells. She was on the special nutritional program from December, 1931, to June, 1932, during which time caries was completely arrested. She discontinued taking special oil in June, 1932, and did not take it again until October, 1933, during most of which time she was taking viosterol under a physician's prescription to prevent dental caries. She came in October, 1933, with fourteen new cavities. She was immediately placed again on the special program, from October, 1933, to May, 1934. During this period, the dental caries was completely under control. During the time that she was not on the special program, there developed on many of the surfaces of the permanent teeth white patches of decalcifying enamel. Under the reinforced nutritional program, these largely disappeared, and those that did not regain their translucency turned dark.

Among the group of seventeen J. H., sent in from another city, had thirty-eight open cavities in June, 193 1. In addition to active caries, he had quite disturbing heart symptoms, which curtailed his activity, and he also had a marked sense of lassitude and weariness. He has been on the reinforced nutritional program during the fall, winter and spring of each year since that time. During this time, he has not developed a single new cavity. The density of all the teeth has progressively improved as evidenced by Roentgen-ray records. His physical condition has been greatly improved so that he is able to carry on his college activities and heavy outside work to earn money to maintain his college expenses. He is not conscious of a heart limitation. When asked what the principal change was that he had noticed, he said that in addition to not feeling tired, he was more rested with six hours' sleep than formerly with ten hours'.

A. W. had thirty-two new cavities in the two years previous to beginning the special nutritional reinforcement. She continued this regularly during the winter and spring months for three years and has not had a single new cavity since that time.

In a group of children whose mothers had the special nutritional reinforcement during gestation and lactation and who had been provided with the same dietary adjuncts during the winter and spring months of infancy and early childhood, not a single carious cavity has developed. A number of these children are now in public schools. Their physical development is distinctly above that of the average children of their age, as is also their efficiency in school work.

It is important that I emphasize here some dangers that are not usually recognized or properly emphasized in the literature. When fish oils including cod liver oils are given in too large doses to some patients they experience quite definite symptoms of depression. The available evidence indicates that fish oils that have been exposed to the air may develop toxic substances. My work and that of others with experimental animals has demonstrated that paralysis can be produced readily by over-dosing. Serious structural damage can be done to hearts and kidneys. I have reported this in considerable detail. (4) My investigations have shown that when a high vitamin natural cod liver oil is used in conjunction with a high vitamin butter oil the mixture is much more efficient than either alone.4 This makes it possible to use very small doses. Except in the late stages of pregnancy I do not prescribe more than half a teaspoonful with each of three meals a day. This procedure appears to obviate completely the undesirable effects. As stated elsewhere fish oils should be stored in small containers to avoid exposure to the air. Rancid fats and oils destroy vitamins A and E, (5) the former in the stomach. (6)

I am frequently reminded that ancient skulls are often found with extensive dental caries thus disproving that the primitive groups were more free from dental caries than the modern groups. It must be kept in mind that the fundamental laws of Nature have been in operation as long as animals and men have been on the earth. In my investigations among primitive races, I have been concerned particularly with the study of changes that have taken place both in immunity to dental caries and in the environment, including the foods used. It has been important that I find large groups with relatively high immunity to dental caries to be used as controls. There is great need, accordingly, that additional data be provided. Fortunately, this need is being met. There have just come to my desk two interesting reports; one, from Dr. Arne Hoygaard (7) and the other from Dr. P. O. Pedersen. (8) These two distinguished scientists have spent a year in East Greenland among the Eskimos in that very barren and isolated region. The percentage of teeth found attacked by dental caries among the isolated Eskimos of East Greenland is exceedingly low, less than 1 per cent. Where the Eskimos were in contact with modernized store foods at the port, tooth decay was active. The conditions which they have found were apparently not quite so favorable as in the groups I studied in Alaska. The Greenland Eskimos apparently are living in a more difficult environment. The data provided by these investigations are in accord with the data I have obtained among isolated Eskimos and other primitive racial stocks. Eastern Greenland, by international agreement, is administered by the Danish Government and no one is permitted even to visit the coast of Greenland without special permission. This permission is very difficult to obtain. Even Danish citizens are not free to travel there. We are, accordingly, very grateful to Dr. Hoygaard and Dr. Pedersen for their contribution from studies made in that protected field. We shall look forward with interest to their detailed reports.

Unfortunately, the public is very much at sea because of the extravagant claims that are made for many of the products advertised over the radio, in journals, and by door to door solicitation. A dependable and helpful booklet on the vitamin content of foods has been published by the United States Department of Agriculture, Miscellaneous Publications, No. 275. The fact should always be emphasized that foods as Nature makes 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 just appeared in the September number of the New Zealand Dental Journal by H. H. Tocker on behalf of the Hawkes Bay Branch of the New Zealand Dental Association in which he reports the results of the application of my suggestions in the Hukarere School for native Maori girls at Napier. I have reported my studies there in Chapter 12. They used only one part of my suggestions for checking the activity of dental caries. The diet of both their control group and tested group was the same except for one item, i.e., "one heaped teaspoonful twice daily of malt and cod liver oil." In a group of sixty-six native girls the thirty-three with the best teeth were used as a control group. The remaining thirty-three were given the additional fat-soluble vitamins. In six months' time ~resistance of this group was raised by 41.75 per cent" as compared with the control group. The nutrition of the test group was not adequately reinforced to obtain the best results. There was a marked inadequacy of mineral carrying foods in proportion to the energy and heat providing factors in the foods. An adequate quantity of such efficient foods should be as readily available today as before the white men came to New Zealand.

It is important to summarize at this point some of the data that I have developed in other chapters because of their direct relation to the control of dental caries and other degenerative processes. Since human life like other animal life has been developed in Nature's laboratory to fit Nature's natural foods we run a great risk when we undertake to modify seriously these foods. Bakers' so-called whole wheat bread is not comparable to Nature's foods that provide entire wheat and other cereals, because of the factors that have been removed from the wheat either mechanically or by oxidation. This is so large a problem that adequate changes in the available grain foods cannot be made until there 15 sufficient public demand to produce them through the normal channels of supply and demand. It is primarily a problem for our Federal and State governments. Packaged foods containing dry cereals can undergo important changes, even while the material is being processed or while in packages on the shelves. The determinations of the loss of vitamins in packaged foods as reported in 1938 by the Agricultural Experimental Station of Oklahoma Agricultural and Mechanical College, reveal that a material loss occurs in two weeks' time and a very serious loss in one to two months' time in certain stock rations.

An important source of misapprehension is the literature and teachings of fadists. Such, for example, as the misapprehension of many people that they must use only alkaline producing foods and that a great danger is associated with the use of acid producing foods. In the primitive races I have found practically no difference between the acid balance meat diet of the isolated Eskimos of the far north and the less acid vegetable and milk diet of other groups as efficient factors in control of caries. It is important to keep in mind that our bodies have a mechanism for maintaining proper acid and alkali balance in the blood and this varies through only a very narrow limit whether the balance of the total food eaten is acid or alkaline. It is also important to have in mind that there are certain fat-soluble vitamins provided in dairy products in adequate quantity that cannot all be supplied in fish oils. Also that overdosing with cod liver oil and other fish oils can be definitely detrimental. When packages of cod liver oil are purchased from the trade the material should be received in full containers not exposed to air and when opened should be transferred to small units so it is not progressively oxidized during the period of its use.

The excess of calories over body building minerals is exceedingly high in sweets of various kinds regardless of their special branding and the methods of manufacture and storage. There is very little of the body building minerals in maple syrup, cane syrup from sugar or honey. They can all defeat an otherwise efficient dietary. The problem is not so simple as merely cutting down or eliminating sugars and white flour though this is exceedingly important. It is also necessary that adequate mineral and vitamin carrying foods be made available. It is also necessary to realize that many of our important foods for providing vitamins are very low in body building material. For example, one would have to eat nearly a bushel of apples a day or half a bushel of oranges to obtain a liberal factor of safety for providing phosphorus; similarly one would be required to eat nine and one half pounds of carrots or eleven pounds of beets each day to get enough phosphorus for a liberal factor of safety, while this quantity would be provided in one pound of lentils or beans, wheat or oats. I have discussed elsewhere the availability of phosphorus depending upon its chemical form. Since the calories largely determine the satisfying of the appetite and since under ordinary circumstances we stop when we have obtained about two thousand to twenty-five hundred very little of the highly sweetened fruits defeats our nutritional program. We would have to consume daily the contents of thirty-two one pound jars of marmalade, jellies or jams to provide a two gram intake of phosphorus. This quantity would provide 32,500 calories; an amount impossible for the system to take care of.

Milk is one of the best foods for providing minerals but it may be inadequate in several vitamins. Of all of the primitive groups studied those using sea foods abundantly appear to obtain an adequate quantity of minerals particularly phosphorus with the greatest ease, in part because the fat-soluble vitamins provided in the sea foods (by which I mean animal life of the sea) are usually high. This enables a more efficient utilization of the minerals, calcium and phosphorus.

As I study routinely the sample dietaries being used by people suffering from dental caries, usually associated with other disturbances, I find large numbers who are not getting in their food even half the minimum requirements of calcium, phosphorus and magnesium and iron and usually only a fraction of the minimum requirements of the fat-soluble vitamins. These latter have a role which in many respects is like the battery of an automobile which provides the spark for igniting the fuel. Even though the tank is filled with gasoline there is no power without the igniting spark.

There are two programs now available for meeting the dental caries problem. One is to know first in detail all the physical and chemical factors involved and then proceed. The other is to know how to prevent the disease as the primitives have shown and then proceed. The former is largely the practice of the moderns. The latter is the program suggested by these investigations. Available data indicate that the blood and saliva normally carry defensive factors which when present control the growth 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 which 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 known and unknown vitamins particularly the fat-soluble. Clinical data demonstrate that by following the program outlined dental caries can be prevented or controlled when active in practically all individuals. This does not require either permission or prescription but it is the inherent right of every individual. A properly balanced diet is good for the entire body.

REFERENCES

TISDALL, F. F. and KRAMER, B. Methods for the direct quantitative determination of sodium, potassium, calcium, and magnesium. J. Biol. Chem., 48:1, 1921.
KUTTNER, T. and COHEN, H. Micro colorimetric studies. I. A molybdic acid, stannous chloride reagent. J. Biol. Chem., 75: 517, 1927.
PRICE, W. A. Eskimo and Indian field studies in Alaska and Canada. J. Am. Dent. A., 23:417, 1936.
PRICE, W. A. Control of dental caries and some associated degenerative processes through reinforcement of the diet with special activators. J. Am. Dent. A., 19:1339, 1932.
MATTILL, H. A. The oxidative destruction of vitamins A and E. J.A.M.A., 89:1505, 1927.
LEASE, E. J., et al. Destruction of vitamin A by rancid fats. J. Nutrition, 16:571, 1938.
HOYGAARD, A. Some investigations into the physiology and nasology of Eskimos from Angmagsslik in Greenland. Oslo, Dybwad, 1937.
PEDERSEN, P. O. Investigations into dental conditions of about 3000 ancient and modern Greenlanders. Dent. Rec., 58:191, 1938.

[marcin458]

Chapter 17

ONE ORIGIN OF PHYSICAL DEFORMITIES

FACES are classified on the basis of physical characteristics and appearances which identify them as having a common ancestry. The constant reproduction of ancestral patterns constitutes one of the fundamental laws of heredity. We are concerned here with the divergences from the normal course of reproduction.

The precision with which Nature reproduces widely distributed racial stocks demonstrates how deeply seated and controlling are the Mendelian laws. In Fig. 98 may be seen four young men of the Melanesian race born on four different islands. They have never seen each other, yet they look like brothers. Similarly, in Fig. 99 are shown four Polynesian girls. Here again they look so much alike that they might readily be taken for sisters. Yet, they live in four different groups of Polynesian islands; the Hawaiian, the Samoan, the Tahitian, and the Rarotongan.

FIG. 98. These four Melanesian boys born on different islands look like brothers but are not blood relations. They illustrate the role of heredity in reproducing racial type. Heredity, however, can only operate normally when the germ cells have not been injured.

99. These four Polynesian girls live on different islands and are not related though they look like sisters. They record their racial type by undisturbed heredity.

The blending of different racial stocks produces typical characteristics of either or both ancestral patterns. When, however, marked divergences appear without mixing of racial stocks, the result is not due to heredity, but occurs in spite of heredity. In the previous chapters, I have shown that in the modernized groups of various primitive racial stocks, ccrtain individuals developed marked changes in facial and dental arch form from the racial pattern. We are interested to know the nature of the forces responsible for this distortion of the ancestral pattern. In a study of 1,276 skulls of the ancient civilizations of Peru, I did not find one with a typical divergence from normal such as we find in modern whites or in children of primitive racial stocks after the parents have adopted the foods of our modern civilization. It is important that we study this phase in further detail.

In Fig. 100 are shown two Indian fathers and their sons, whom we studied in Peru. The father and son shown above lived at Talara, in a highly modernized Indian colony. The father worked in the oil fields on the coast. This district is an arid desert into which practically all food has to be shipped for the large colony engaged in the oil industry. The father was born while his parents were using the native foods of the coast, including an abundance of sea foods. The son was born to his parents after they had adopted the foods of modern civilization. The father and son shown below, lived in the high Sierras. The father is an Indian descendant of the Incas and was born while his parents were living on the native dietary of the high plateau country, near Cuzco. After the adoption of the modern foods by the parents, the son shown to the right was born. It is important to keep in mind that the marked change in these fathers and sons has occurred in the first generation after the parents have adopted the white man's foods, and has occurred in spite of heredity.

FIG. 100. Disturbed heredity. Above, father a primitive coastal Indian of Peru with normal facial and dental arch development. Son at right presents distortions of both facial and dental arch form. Below, father a primitive Andean Indian with excellent facial and dental arch form. His son at right has not reproduced the racial pattern. Both sons are full blood.

In Fig. 101 above is shown a Wakamba father in central Africa, a man who is working for the railroad company which contributed largely to the food supply for the laborers. The boy shown at the right was born after the parents had adopted the imported foods. In the lower picture, in Fig. 101, is seen a Fiji Islander and his son. The father was born to parents living on the native foods, and his son was born after the adoption of the white man's foods. All these are typical cases of the inhibition of Nature's normal procedure. We have additional data which indicate that our problem is associated with a progressive lowering of reproductive capacity on the part of one or both of the parents.

FIG. 101. Disturbed heredity. Above, the father is a primitive Wakamba of Central Africa. His son at right has not reproduced the tribal pattern. Below, the father presents the typical Fijian primitive facial and dental arch form. His son at right has a narrowed arch and change in facial form. Both sons are full blood.

In photographing the members of modernized families, regardless of racial stocks, we frequently find that changes in facial expression appear in the younger members of the family. This change in facial contour within a family does not occur in the primitive races, while on their native dietary.

In contrast with this we see, in Fig. 102, two sisters and two brothers. In each pair there is a marked change in the facial form of the younger. The arches and the nostrils of the younger child are narrower and there is a marked lack of development in both the middle and lower thirds of the face.

FIG. 102. Disturbed heredity. Quichua Indians. Note the marked change in shape of the face and dental arches of the younger sister at the right. Also of the younger brother at the right. These families demonstrate a lowering of reproductive capacity of the parents with the later born children.

Very striking illustrations of this progressive degeneration in the children of a given family were found among the modernized aborigines of Australia. Two views of brothers are shown in Fig. 103 (upper). The father and mother of these two boys were born in the Bush. They were living, when photographed, in one of the reservations, on the imported modern foods which were provided by the government. This is also illustrated in the lower photograph. Note the marked underdevelopment of the middle third of the face of the girl.

FIG. 103. Disturbed heredity. These children are Australian Aborigines. Note the marked change in facial and dental arch form in the younger child at the right in both families. This is depressed reproductive capacity of the parents.

Striking instances were frequently seen among the modernized Maori of New Zealand. Two sisters presenting two extremes of facial form are shown in the upper section of Fig. 104. The girl to the left is the older. She has the typical tribal pattern which has been completely lost in her younger sister to the right.

FIG. 104. Above, two Maori girls in New Zealand and below, two white girls in Peru. Note the facial change in the girls at the right compared with their older sisters.

If the change in facial form were the result of racial admixture, we should not have the types of deformity patterns that these cases show. Indeed, in the same family we should not find several different deformity patterns. The lack of development downward of the upper anterior incisors and the bone supporting them is illustrated for the younger child, in Fig. 103 lower right. It will be noted that when this girl's molar teeth are in contact her front teeth still miss occluding by a considerable distance.

Members of the white race are affected in a similar manner. In Fig. 104 (lower) are shown two sisters; the younger to the right reveals strikingly the lack of development of the middle and lower third of the face. The fact that this condition so frequently shows a progressively severe injury in the younger members of the family is a matter of great importance in tracing the causative factors. It is important to keep in mind that when the injury shows in the face of the young child it becomes worse when 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.

In the islands north of Australia where contact with modern civilization is just being made, the adult individuals showed a constant reproduction of the tribal pattern, while those born since contact was made, had many divergences from normal. In Fig. 105 will be seen a family of six individuals. Four were born before the modern store was put on that island and two after the parents had come into contact with the influence of the imported foods. It will be seen that the four older brothers show marked uniformity of facial design, and that all have reproduced the tribal pattern. The two younger members show definite change in facial pattern. This is also illustrated in Fig. 106 above, in which the oldest brother was born before the store was put on Badu Island, and the three younger, after the establishment of the store twenty-three years ago.

FIG. 105. Of these six brothers the four older were born on Badu Island before the white man's store was established. The two younger at right below, after. Note change in facial form.

FIG. 106. Above, the brother at the right was born before the store was put on Badu Island, the three younger, after. Note the change in facial form. Below, note that the dental arches are too constricted to provide space for the erupting cuspids. This boy is the one shown at the left in Figure 107.

This problem of progressive degeneration in the younger members of the family is again illustrated by the group shown in Fig. 107. The older girl has reproduced the tribal pattern of the race with normal broad, dental arches. The second girl shows marked narrowing and lengthening of the face. The third child, a boy, shows very marked divergence from the tribal pattern. This group is shown below with their teeth exposed. It will be seen that the oldest girl has broad dental arches typical of Nature's normal design. The second girl has a marked depression laterally in the molar and bicuspid region producing a narrowing of the palate. The third child has in addition to the narrowing of the face a marked deficiency in bone growth so that the cuspids both above and below are forced entirely outside the arch. The total circumference as well as the breadth of the upper arch is so reduced that space is not available for the cuspids. They will be seen imbedded high in the tissue, as illustrated in the lower picture of Fig. 106.

FIG. 107. Natives from islands north of Australia. Above, note the progressive 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 depression of the bicuspids and molars of the next girl and inadequate bone development of the boy's face. These are on an island north of Australia.

Fig. 108 shows three white girl scouts in New Zealand. Note that progressive narrowing of the body including both shoulders and hips has occurred in the younger members of the family. This is also shown in Fig. 107.

FIG. 108. White Girl Scouts, New Zealand. Note the progressive lengthening and narrowing of the face and narrowing of the hips in the younger girl at the left.

It would be remarkable if these disturbances in the physical pattern were limited to the face and dental arches. An illustration of other deficiency injuries is shown in Fig. 109, which shows three children in a modernized Maori family. It will be seen that while the oldest girl has the typical Maori racial pattern of face, there is a marked lack of development of the middle third of the face, with progressive severity of distortion in her two younger brothers. On observing the feet it will be seen that she has splendidly formed feet while the second child has flat feet, and the third child has clubbed feet.

FIG. 109. New Zealand Mann. Note the progressive change in facial form of the two younger boys as compared with their older sister. Then note the progressive change in their feet. Normal feet, flat feet and club feet.

I have found similar examples in several of the modernized primitive racial stocks. The severity of the disturbing factors may be different under different circumstances. Drought, industrial depression, unemployment, and the like, all have their influence. In Fig. 110 will be seen three Maori children of New Zealand; the second child is smaller in stature than the third and gives more evidence of facial injury. While his older sister and younger brother have normal feet, his quite severe disturbance in facial growth is associated with club feet.

FIG. 110. New Zealand Maori. Note the marked undersize of the second child and underdevelopment of the face associated with marked deformity of the feet.

I have one patient who was the seventh of a family of eleven children. All the children in the family have good facial development, except this patient. She was born in the midst of a severe financial depression when the total amount of money available for the food for the family was reduced to a very low level. The other children were born before or after the depression, and were not injured. In addition to this patient's severe facial deformity, she has had some arthritis and a general rheumatic tendency. Her facial injury is marked and is characterized by a lack of development of the middle third.

Deformities of the feet associated with facial deformity have been found in several modernized groups of primitive racial stocks. A typical case among the modernized Indians of Peru is shown in Fig. 111. The face of this boy shows abnormal development with narrowing of the upper arch and displacement of the teeth. This is associated with gross deformity of one foot and shortening of the leg. He lives in the high country. This phase is strikingly illustrated in Fig. 112 where the face is very badly injured and both feet are seriously clubbed. This boy is a Coastal Indian.

FIG. 111. This boy is a modernized Indian in the high Sierra of Peru. Note the disturbed development of the face associated with the deformity of one foot.

FIG. 112. This is a modernized coastal Indian of Ecuador. Note the serious facial and dental arch distortion associated with club feet.

The serious expressions of physical deformities which we found had occurred in several primitive racial stocks, after they have become modernized sufficiently to be using the foods of our modern civilization, are occurring in our modern American families with equal severity and great frequency.

One method for determining the cause of these deformities is through an examination of birth and death certificates to note the recorded data relative to physical deformities. An outstanding contribution to this approach has been made by Dr. D. P. Murphy, of the University of Pennsylvania. In an examination of 130,132 individual death certificates that have been recorded between 1929 and 1933, he found physical deformities recorded in 1,476 cases. Dr. Murphy sent field workers to make a personal study of the family histories by contacting the mothers or grandmothers, of whom they were able to locate 890. From this group he was able to select 405 with sufficiently complete family histories to allow tabulation in a form that would throw light upon the birth rank and other data. His studies strongly emphasize the presence of a period of low reproductive activity. In concluding one of his reports he states: (1)

Miscarriages, stillbirths, and premature births occurred more often than would be expected by chance in the pregnancies immediately preceding and immediately following the pregnancy which resulted in the birth of a defective child, and less often than would be expected by chance in the remaining pregnancies. Miscarriage, stillbirth, and premature birth occurred most often in the pregnancy immediately preceding that of the defective child.

From the above observations, it is concluded that the birth of a congenitally malformed child may be only one expression of a prolonged decrease in functional reproductive activity, the other expressions being miscarriages, stillbirths, and premature births.

It is suggested that the obstetrician has unusual reason to suspect the possible existence of a congenital malformation in the pregnancy which follows immediately after a miscarriage, a stillbirth, or a premature birth.

Shute, of the University of Western Ontario, London, Canada, in a personal communication, states that he has been impressed, in his studies of aborted fetuses, with the large percentage that are malformed. This seems to link the malformations with the causative factors which have resulted in decreased reproductive activity.

In connection with the production of imperfect infants, the period in the formative process at which the injury occurs and also its origin are important. Murphy has thrown important light on this phase in his study of the cause of the defectives in forty families with two or more malformed. (2) He concludes: "Many if not most of the congenital malformations met with in this study resulted from defects in the germ plasm, which were present before fertilization."

Among the important questions that arise is the relative responsibility of the two parents. As an approach to this phase Murphy (2) has made a study which deals with a consecutive series of 884 families in each of which there appeared at least one congenitally malformed child. In forty of these families, there were two or more malformed brothers and sisters. He presents extensive data in tabular form from which he takes examples to illustrate his interpretation. He states under the "Clinical Value of Study" the following:

It is evident from the above data (tables) that there is a strong tendency for congenital malformations to duplicate in siblings that belong to a consecutive series of families. And also that such defects tend to appear rather frequently among their more distant relatives. This duplication of malformations is to be observed in the case of the more serious types of defects, just 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 which affect the germ cells prior to, rather than after, fertilization. The validity of this theory is emphasized by three examples taken from Tables I and II. Family 17 in Table I contained 3 children with pyloric stenosis, two of which were twins. Family 6 in Table II possessed 2 siblings with cleft palate, conceived by the same father, but born to different mothers. Family 8 in Table II contained 2 children both exhibiting an absence of the right half of the diaphragm. It does not seem likely that such sequences of events as these could be the result of any forces that did not operate until after fertilization had taken place. . . .

Since, as has been shown in a previous report, congenital malformations are 24 times more common in siblings of defective children than in the population at large, the present observations should be of added clinical interest.

Summary and Conclusions

A consecutive series of 40 families having 2 or more congenitally malformed children has been studied with respect to the duplication of defects in siblings.
The defect observed in the first malformed child reappeared in a subsequent malformed sibling in about 50 per cent of all cases; the 50 per cent remaining including all other possible defects.
In a second group of 39 consecutive families, in which a malformed child possessed a malformed relative, the malformation in the child and in the relative were identical in about 41 per cent of cases.
In 19 non-consecutive families with 2 or more malformed children, the defect of the first child repeated in a subsequent child in over half of the families.
It is significant that while these important factors are just coming to light in our modernized civilization, the evidence clearly indicates that several so-called primitive races have been conscious of the need for safeguarding motherhood from reproductive overloads which would reduce the capacity for efficient reproduction. For example, G. T. Baden (3) in his book "Among the Ibos of Nigeria" states:

It is not only a matter of disgrace but an actual abomination, for an Ibo woman to bear children at shorter intervals than about three years. . . . The idea of a fixed minimum period between births is based on several sound principles. The belief prevails strongly that it is necessary for this interval to elapse in order to ensure the mother being able to recuperate her strength completely, and thus be in a thoroughly fit condition to bear another child. Should a second child be born within the prescribed period the theory is held that it must inevitably be weak and sickly, and its chances jeopardized.

Similarly, the Indians of Peru, Ecuador and Columbia have been familiar with the necessity of preventing pregnancy overloads of the mother. Whiffen (4) in his book "North-West Amazons" states:

The numbers (of pregnant women) are remarkable in view of the fact that husbands abstain from any intercourse with their wives, not only during pregnancy but also throughout the period of lactation--far more prolonged with them than with Europeans. The result is that two and a half years between each child is the minimum difference of age, and in the majority of cases it is even greater.

It may also be important to note that the Amazon Indians have been conscious of the fact that these matters are related to the nutrition of both parents. Whiffen states that:

These Indians share the belief of many peoples of the lower cultures that the food eaten by the parents--to some degree of both parents--will have a definite influence upon the birth, appearance, or character of the child.

This problem of the consciousness among primitives of the need for spacing children has been emphasized by George Brown (5) in his studies among Melanesians and Polynesians in which he reports relative to the natives on one of the Solomon Islands as follows:

After the birth of a child the husband was not supposed to cohabit with his wife until the child could walk. If a child was weak or sickly, the people would say, speaking of the parents, "Ah, well, they have only themselves to blame."

These new data have a very important bearing on the problems of degeneration in our modern civilization. Since it is true that a racial pattern can be changed in a single generation our modern concept and teaching with regard to the role of heredity must be modified, in its relationship to cause and effect. A deformity arising from intercepted heredity is just as truly biologic as a deformity arising from accumulated impacts as expressed in heredity. Instead of blaming the past generations for the distortions or frailties of our modern generation and thus relieving our own generation of responsibility these new data indicate that the social organization that is creating these divergencies from normal must alone accept the responsibility.

This completely changes some aspects of the theories and practice of modern social education. Instead of planning the care and management of distorted personality as though the lesion were the result of environmental influences upon a normally organized individual, it should be looked upon as a distortion affecting one link in the chain of heredity which is neither the result of the distortions of previous links nor a controlling factor for future links in the chain. The prognosis, in other words, while being bad for the individual is not necessarily bad for his or her descendants.

While many of the individuals who have suffered physical distortions have apparently practically normal brain development we shall see in the following chapter that a certain percentage have so great a disturbance in brain organization that they cannot and should not be considered as individually responsible for their behavior.

It is urgent therefore that the data presented in this chapter be looked upon as an important key to the progressive degeneration that is taking place in many parts of the world under the influence of our so-called modern civilization. It is a matter of profound significance that the most primitive races were originally able to avoid the physical degeneration so general in many communities today. It is also a matter of importance that the primitives recognized not only these dangers but were conscious of and practiced adequate means for preventing them. They had sufficient character to achieve the ends which they deemed essential. Weakness in character may constitute the greatest barrier in the reorganization and conservation of our modern civilization.

Two serious defects from which many individuals in our modernized civilization suffer are impacted teeth and the absence of teeth due to their failure to develop. It is significant that in the arches of the primitive races practically all teeth form and erupt normally, including the third molars. In the modernized primitives and among our modern whites with deformed dental arches many teeth are impacted and often several of the permanent teeth have never formed. The evidence indicates that this, like the facial and dental arch deformities is due to an absence of vitamin A in the diet of the mother during the gestation period or of one or both of the parents prior to conception. The cause is discussed in the next chapter.

REFERENCES

MURPHY, D. P. Reproductive efficiency and malformed children. Surg. Gynec. and Obst., 62:585, 1936.
MURPHY, D. P. The duplication of congenital malformations in brothers and sisters and among other relatives. Surg. Gynec. and Obst., 63:443, 1936.
BADEN, G. T. Among the Ibos of Nigeria. Phila., Lippincott, 1921.
WIFFEN, T. North-West Amazons. N. Y., Duffield, 1915.
BROWN, G. Melanesians and Polynesians. London, Macmillan, 1910.