Ben Goldacre

The Guardian

Saturday August 18 2007

Every now and then something comes along which is so bonkers and so unhinged that it unmoors itself from all cultural anchoring points, and floats off into a baffling universe all of its own. I am a connoisseur of freaky ideas, but nothing prepared me for this gem from the academic journal Medical Hypotheses: an article called “Down subjects and Oriental population share several specific attitudes and characteristics”.

You’d be right to experience a shudder of nervousness at the title alone, since this is an academic journal, from 2007, and not 1866 when John Langdon Down wrote his classic “Observations on the Ethnic Classification of Idiots”. This paper was the first to describe Down syndrome (which Down called “mongolism”) and in it, the author explained that different forms of genetic disorder were, in fact, evolutionary regressions to what he viewed as the less advanced, non-white forms of humanity. He described an Ethiopian form of “idiot”, a mongoloid form, and so on. Looking back, it reads as spectacularly offensive.

Now. People with Down syndrome – who have three copies of chromosome 21, learning difficulties, and other congenital health problems – do indeed look a tiny bit like people from east Asia, to westerners. This is because they have something called an “epicanthic fold”, a piece of skin that joins the upper part of the nose to the inner part of the eyebrow. It makes the eyes almond shaped. You’ll find epicanthic folds on faces from east Asia, south-east Asia, and some west Africans and Native Americans. People with Down syndrome have various other incidental anatomical differences too, if you’re interested, such as a single crease in their palm.

Flash forward to 2007 – I think that’s where we are – to two Italian doctors. They offer their theory that the parallels between Down syndrome and “oriental” people go beyond this fleeting facial similarity. What is the evidence they have amassed? I offer it almost in its totality.

One aspect, they say, is alimentary characteristics. “Down subjects adore having several dishes displayed on the table, and have a propensity for food which is rich in monosodium glutamate.”

I, too, adore having several dishes displayed upon the table. Two doctors, in an academic journal, in 2007, go on: “The tendencies of Down subjects to carry out recreative-rehabilitative activities, such as embroidery, wicker-working, ceramics, book-binding, etc., that is renowned, remind [us of] the Chinese hand-crafts, which need a notable ability, such as Chinese vases, or the use of chopsticks employed for eating by Asiatic populations.”

Perhaps you can think of cultural rather than genetic explanations for these observations. There’s more. “Down persons during waiting periods, when they get tired of standing up straight, crouch, squatting down, reminding us of the ‘squatting’ position … They remain in this position for several minutes and only to rest themselves.” Amazing. “This position is the same taken by the Vietnamese, the Thai, the Cambodian, the Chinese, while they are waiting at a bus stop, for instance, or while they are chatting.”

And that’s not all. “There is another pose taken by Down subjects while they are sitting on a chair: they sit with their legs crossed while they are eating, writing, watching TV, as the Oriental peoples do.”

To me, and I may be wrong, this article is so fantastical and so thoughtlessly crass that it’s impossible to experience anything like outrage. But this is a proper academic journal, published by Elsevier, with a respectable “impact factor” – a measure of how frequently a journal is cited – of 1.299. I contacted the editor. He told me this paper was a very short, discursive and preliminary communication, floating a general idea for discussion and debate, and that taking scientific ideas out of their context could be misleading. I hope I am not misleading anybody. I contacted Elsevier, the journal publisher: they will consider making the article free to access, so that anyone can read it for themselves, and reach their own conclusion. I’ll let you know… [see below]

· Please send your bad science to bad.science@guardian.co.uk

[Ooh, in case you’re wondering why I wrote about this, it’s a setup for something more interesting, and related, next week, assuming nothing topical comes in. And also because it is a fantastic paper.]

And here is the paper.

dx.doi.org/10.1016/j.mehy.2006.12.043