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Title: Nutrition and Physical Degeneration Author: Weston A. Price * A Project Gutenberg of Australia eBook * eBook No.: 0200251h.html Language: English Date first posted: 2002 Date most recently updated: April 2012 Project Gutenberg of Australia eBooks are created from printed editions which are in the public domain in Australia, unless a copyright notice is included. We do NOT keep any eBooks in compliance with a particular paper edition. Copyright laws are changing all over the world. Be sure to check the copyright laws for your country before downloading or redistributing this file. This eBook is made available at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg of Australia License which may be viewed online at http://gutenberg.net.au/licence.html To contact Project Gutenberg of Australia go to http://gutenberg.net.au

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TABLE OF CONTENTS

Nutrition and



Physical Degeneration



A Comparison of Primitive and Modern Diets

and Their Effects



BY



WESTON A. PRICE, MS., D.D.S., F.A.G.D.

Member Research Commission, American Dental Association

Member American Association of Physical Anthropologists

Author, "Dental Infections, Oral and Systemic"



WITH 134 FIGURES







TO THAT KINDRED SOUL



My Wife



who has assisted me so greatly

on these difficult expeditions,

this book is lovingly dedicated.









TABLE OF CONTENTS

PREFACE



T HE gracious reception given to my several reports of field studies among primitive racial groups and the many requests for copies of those brief reports and for further data, together with the need for providing interpretations and applications of the data, have induced me to consolidate my investigations. There have also been many requests from my patients and from members of the medical and dental professions for concise statements as to what I have found that would be useful as preventive procedures. In addition I have been conscious of an opportunity for helpfulness to the members of the various primitive races that I have studied and who are so rapidly declining in health and numbers at their point of contact with our modern civilization. Since they have so much accumulated wisdom that is passing with them, it has seemed important that the elements in the modern contacts that are so destructive to them should be discovered and removed.

There has been a deep sense of obligation to the officials of many countries for the great kindness and assistance that they have so cheerfully given by providing the opportunity for these investigations. The list of these individuals is much too long to mention them all by name. One of the joys of my work has been the privilege of knowing the magnificent characters that are at the outposts earnestly striving to better the welfare of the natives whom they are ministering to, but who are distraught with the recognition that under the modernization program the natives decline in health and become afflicted by our modern types of degenerative diseases. It would be fortunate if each of these field workers could be provided with a copy of this report which they have helped to make possible.

In order to make this information available to as wide a group as possible, I have avoided technical language and will ask the indulgence of professional readers.

There are some individuals whose assistance I must acknowledge specifically: Reverend Father John Siegen and Doctor Alfred Gysi of Switzerland; Mrs. Lulu Herron and Doctor J. Romig of Alaska; the Indian Department at Ottawa; the Department of Indian Affairs at Washington, D. C.; the officials of the eight archipelagos studied in the Pacific; Colonel J. L. Saunders of New Zealand; the Minister of Health, New Zealand; Dr. W. Stewart Ziele of Sydney, Australia; Sir Herbert Gepp of Melbourne, Australia; Doctor William M. Hughes, Minister of Health, Canberra; Dr. Cummiston, Director-General of Health, Australian Commonwealth, Canberra; Doctor Rapael Cilento of Queensland, Australia; Mr. E. W. Saranealis, Thursday Island; the Department of Health of Kenya, Africa; the Department of Health for Belgian Congo, Brussells; the Department of National Parks, Belgian Congo; Minister of the Interior, Peru; Doctor Albert Giesecke and Esther Giesecke of Peru; the Directors of Museums in Sydney and Canberra, Australia; Auckland, New Zealand; Vancouver, and Toronto, Canada; Washington, New York and Chicago, the United States; Juneau, Alaska; Rome, Italy; and Cairo, Egypt; the publishers of the Ohio State Medical Journal, the Journal of the American Dental Association, the Dental Digest and the Dental Items of Interest; my faithful secretary, Mrs. Ruth MacMaster; Professor W. G. Garnett who so kindly provided the critical reading of the manuscript, and the publishers who furnished constructive suggestions and cooperation. To these and a host of others I am deeply indebted and profoundly grateful.

WESTON A. PRICE

8926 Euclid Avenue,

Cleveland, Ohio, 1938.

TABLE OF CONTENTS

INTRODUCTION

T HIS text provides a new approach to some problems of modern degeneration. Instead of the customary procedure of analyzing the expressions of degeneration, a search has been made for groups to be used as controls who are largely free from these affections.

After spending several years approaching this problem by both clinical and laboratory research methods, I interpreted the accumulating evidence as strongly indicating the absence of some essential factors from our modern program, rather than the presence of injurious factors. This immediately indicated the need for obtaining controls. To accomplish this it became necessary to locate immune groups which were found readily as isolated remnants of primitive racial stocks in different parts of the world. A critical examination of these groups revealed a high immunity to many of our serious affections so long as they were sufficiently isolated from our modern civilization and living in accordance with the nutritional programs which were directed by the accumulated wisdom of the group. In every instance where individuals of the same racial stocks who had lost this isolation and who had adopted the foods and food habits of our modern civilization were examined, there was an early loss of the high immunity characteristics of the isolated group. These studies have included a chemical analysis of foods of the isolated groups and also of the displacing foods of our modern civilization.

These investigations have been made among the following primitive racial stocks including both isolated and modernized groups: the Swiss of Switzerland, the Gaelics in the Outer and Inner Hebrides, the Eskimos of Alaska, the Indians in the far North, West and Central Canada, Western United States and Florida, the Melanesians and Polynesians on eight archipelagos of the Southern Pacific, tribes in eastern and central Africa, the Aborigines of Australia, Malay tribes on islands north of Australia, the Maori of New Zealand and the ancient civilizations and their descendants in Peru both along the coast and in the Sierras, also in the Amazon Basin. Where available the modernized whites in these communities also were studied. There have been many important unexpected developments in these investigations. While a primary quest was to find the cause of tooth decay which was established quite readily as being controlled directly by nutrition, it rapidly became apparent that a chain of disturbances developed in these various primitive racial stocks starting even in the first generation after the adoption of the modernized diet and rapidly increased in severity with expressions quite constantly like the characteristic degenerative processes of our modern civilization of America and Europe. While tooth decay has proved to be almost entirely a matter of the nutrition of the individual at the time and prior to the activity of that disease, a group of affections have expressed themselves in physical form. These have included facial and dental arch changes which, heretofore, have been accounted for as results of admixtures of different racial stocks. My investigations have revealed that these same divergencies from normal are reproduced in all these various racial stocks while the blood is still pure. Indeed, these even develop in those children of the family that are born after the parents adopted the modern nutrition.

Applying these methods of study to our American families, we find readily that a considerable percentage of our families show this same deterioration in the younger members. The percentage of individuals so affected in our American communities in which I have made studies varies through a wide range, usually between 25 per cent to 75 per cent. A certain percentage of this affected group has not only these evidences of physical injury, but also personality disturbances, the most common of which is a lower than normal mental efficiency and acuteness, chiefly observed as so-called mental backwardness which includes the group of children in the schools who are unable to keep up with their classmates. Their I.Q.'s are generally lower than normal and they readily develop inferiority complexes growing out of their handicap. From this group or parallel with it a certain percentage develop personality disturbances which have their expression largely in unsocial traits. They include the delinquents who at this time are causing so much trouble and concern because of evidence of increase in their numbers. This latter group has been accounted for largely on the basis of some conditioning experience that developed after the child had reached an impressionable age. My investigations are revealing a physical structural change and therefore, an organic factor which precedes and underlies these conditioning influences of the environment. The fact that a government survey has shown that 66 per cent of the delinquents who have been treated in the best institutions and released as cured, later have developed their unsocial or criminal tendencies, strongly emphasizes the urgent necessity that if preventive methods are to be applied these must precede and forestall the primary injuries themselves.

While it has been known that certain injuries were directly related to an inadequate nutrition of the mother during the formative period of the child, my investigations are revealing evidence that the problem goes back still further to defects in the germ plasms as contributed by the two parents. These injuries, therefore, are related directly to the physical condition of one or of both of these individuals prior to the time that conception took place.

A very important phase of my investigations has been the obtaining of information from these various primitive racial groups indicating that they were conscious that such injuries would occur if the parents were not in excellent physical condition and nourishment. Indeed, in many groups I found that the girls were not allowed to be married until after they had had a period of special feeding. In some tribes a six months period of special nutrition was required before marriage. An examination of their foods has disclosed special nutritional factors which are utilized for this purpose.

The scope of this work, accordingly, becomes of direct interest in many fields including the various branches of the healing arts, particularly medicine and dentistry, and the social organizations that are concerned with betterment of the racial stock. Similarly, the educational groups are concerned directly since, if we are to stem the tide by passing new information on to the parents of the new generation, it must be done prior to the time the emergency shall arise. This involves a system of education directed particularly to the high school age pupils.

The data that are being presented in the following chapters suggest the need for reorientation in many problems of our modern social organization. The forces involved in heredity have in general been deemed to be so powerful as to be able to resist all impacts and changes in the environment. These data will indicate that much that we have interpreted as being due to heredity is really the result of intercepted heredity. While great emphasis has been placed on the influence of the environment on the character of the individual, the body pattern has generally been supposed to require a great number of impacts of a similar nature to alter the design. The brain has been assumed to be similarly well organized in most individuals except that incidents in the life of the individual such as disappointments, fright, etc., are largely responsible for disturbed behavior. Normal brain functioning has not been thought of as being as biologic as digestion. The data provided in the succeeding chapters indicate that associated with disturbances in the development of the bones of the head, disturbances may at the same time occur in the development of the brain. Such structural defects usually are not hereditary factors even though they appear in other members of the family or parents. They are products of the environment rather than hereditary units transmitted from the ancestry.

In the light of these data important new emphasis is placed on the quality of the germ cells of the two parents as well as on the environment provided by the mother. The new evidence indicates that the paternal contribution may be an injured product and that the responsibility for defective germ cells may have to be about equally divided between the father and mother. The blending of races has been blamed for much of the distortion and defects in body form in our modern generation. It will be seen that these face changes occur in all the pure blood races studied in even the first generation, after the nutrition of the parents has been changed.

The origin of personality and character appear in the light of the newer data to be biologic products and to a much less degree than usually considered pure hereditary traits. Since these various factors are biologic, being directly related to both the nutrition of the parents and to the nutritional environment of the individuals in the formative and growth period any common contributing factor such as food deficiencies due to soil depletion will be seen to produce degeneration of the masses of people due to a common cause. Mass behavior therefore, in this new light becomes the result of natural forces, the expression of which may not be modified by propaganda but will require correction at the source. Nature has been at this process of building human cultures through many millenniums and our culture has not only its own experience to draw from but that of parallel races living today as well as those who lived in the past. This work, accordingly, includes data that have been obtained from several of Nature's other biologic experiments to throw light on the problems of our modern white civilization.

In presenting the evidence I am utilizing photographs very liberally. A good illustration is said to be equivalent to a thousand words of text. This is in keeping too with the recent trend in journalism. The pictures are much more convincing than words can be, and since the text challenges many of the current theories, the most conclusive evidence available is essential.

Owing to the many requests received for slides or the loan of my negatives, provision is being made for supplying a limited number of slides of the illustrations in either black and white or in color. Slides of other subjects are available.

TABLE OF CONTENTS

Chapter 1

WHY SEEK WISDOM FROM PRIMITIVE PEOPLES

S OME of the primitive races have avoided certain of the life problems faced by modernized groups and the methods and knowledge used by the primitive peoples are available to assist modernized individuals in solving their problems. Many primitive races have made habitual use of certain preventive measures in meeting crucial life problems.

Search for controls among remnants of primitive racial stocks has been resorted to as a result of failure to find them in our modernized groups or to find the controlling factors by applying laboratory methods to the affected clinical material. Only the primitive groups have been able to provide adequate normal controls.

In the following chapters, I have presented descriptions of certain peoples and their environments in primitive state, and, for comparative study, descriptions of members of the primitive tribes who have been in contact with modernized white races. I have recorded the effects of that contact as expressed in physical and character changes, and have given a survey of the factors in the environment which have changed. It has been necessary to study in this way a wide variety of primitive groups and physical environments. It will, accordingly, be advisable for the reader to keep in mind the comparative effects of different altitudes, latitudes, temperatures and races, and to note the similarity of the reactions of these primitive groups when contact is made with our modern civilization. The purpose is to glean data that will be applicable for use in correcting certain tragic expressions of our modern degeneration, including tooth decay, general physical degeneration, and facial and dental-arch deformities, and character changes. These data will be useful in preventing race decay and deformities, in establishing a higher resistance to infective diseases, and in reducing the number of prenatal deficiency injuries. These latter include such expressions as mental deficiencies caused by brain defects in the formative period, which result in mental disturbances ranging from moderate backwardness to character abnormalities.

The data presented show the level of susceptibility to dental caries (tooth decay) in each isolated primitive group and, contrasted with that, the level of susceptibility in the modernized natives of the same stock. A résumé of the changes in the environment that are associated with the changes in immunity and susceptibility will be presented. These data reveal an average increase in susceptibility of thirty-five fold. Similar contrasts are shown in relation to the relative incidence of facial and dental arch deformities among primitive natives and modernized natives.

It will be easy for the reader to be prejudiced since many of the applications suggested are not orthodox. I suggest that conclusions be deferred until the new approach has been used to survey the physical and mental status of the reader's own family, of his brothers and sisters, of associated families, and finally, of the mass of people met in business and on the street. Almost everyone who studies the matter will be surprised that such clear-cut evidence of a decline in modern reproductive efficiency could be all about us and not have been previously noted and reviewed.

It is important to preface the observations by constructing a mental pattern of physical excellence from the pictures of the various primitive groups and, with this yardstick or standard of normalcy, observe our modern patterns. Certain preconceived ideas may have to be modified, as for example, that based on the belief that what we see is due to heredity or that deformity is due to mixing of races. If so, why should the last child in a large family generally suffer most, and often be different in facial form; or why should there be these changes in the later children, even in pure racial stocks, after the parents have adopted our modern types of nutrition? Although the causes of physical degeneration that can be seen easily have been hard to trace, the defects in the development of the brain, which affect the mind and character, are much more obscure, and the causes of mental degeneration are exceedingly difficult to trace. Much that formerly has been left to the psychiatrist to explain is now rapidly shifting to the realm of the anatomist and physiologist.

Those contributions of the past cultures which have blended agreeably into our modern experience have been accepted with too little questioning. Much ancient wisdom, however, has been rejected because of prejudice against the wisdom of so-called savages. Some readers may experience this reaction to the primitive wisdom recorded in these chapters.

The writer is fully aware that his message is not orthodox; but since our orthodox theories have not saved us we may have to readjust them to bring them into harmony with Nature's laws. Nature must be obeyed, not orthodoxy. Apparently many primitive races have understood her language better than have our modernized groups. Even the primitive races share our blights when they adopt our conception of nutrition. The supporting evidence for this statement is voluminous and as much of it as space permits is included in this volume. The illustrative material used is taken from the many thousands of my negatives which are available. Photographs alone can tell much of the story, and one illustration is said to be worth as much as one thousand words.

Since the problem of applying the wisdom of the primitives to our modern needs concerns not only health workers and nutritionists, but also educators and social workers, the data are presented without technical details.

While many of the primitive races studied have continued to thrive on the same soil through thousands of years, our American human stock has declined rapidly within a few centuries, and in some localities within a few decades. In the regions in which degeneration has taken place the animal stock has also declined. A decadent individual cannot regenerate himself, although he can reduce the progressive decadence in the next generation, or can vastly improve that generation, by using the demonstrated wisdom of the primitive races. No era in the long journey of mankind reveals in the skeletal remains such a terrible degeneration of teeth and bones as this brief modern period records. Must Nature reject our vaunted culture and call back the more obedient primitives? The alternative seems to be a complete readjustment in accordance with the controlling forces of Nature.

Thinking is as biologic as is digestion, and brain embryonic defects are as biologic as are club feet. Since both are readily produced by lowered parental reproductive capacity, and since Nature in her large-scale human demonstration reveals that this is chiefly the result of inadequate nutrition of the parents and too frequent or too prolonged child bearing, the way back is indicated. Like the successful primitive racial stocks, we, too, can make, as a first requisite, provision for adequate nutrition both for generation and growth, and can make provision for the regulation of the overloads. We, like the successful primitives, can establish programs of instruction for growing youth and acquaint it with Nature s requirements long before the emergencies and stresses arise. This may require a large-scale program of home and classroom instruction, particularly for the high school girls and boys. This would be in accordance with the practice of many of the primitive races reported upon in the following chapters.

If the individuals in our modern society who are sufficiently defective to require some supervision are in part or largely the product of an injured parentage, who should be held responsible? Is it just for society to consign these unsocial individuals which it has made to a life of hard labor or confinement in depressing environments? Is it just for society to permit production of physical and mental cripples? Many primitive races apparently have prevented the distortions which find expressions in unsocial acts. If so, cannot modern society do this by studying and adopting the programs developed through centuries of experience by the primitives? Nature uses a written language which, without the keys, is made up of meaningless hieroglyphics, but which, with the proper keys, becomes a clear story of racial and individual history. The hieroglyphics indicate racial and individual disaster for modernized groups who heed not the warning story. The primitive races have some of these keys and have used them successfully in avoiding many of the disasters of our modern society. The following chapters record many of the excellent practices of the primitives and they are presented here with the hope that they will be helpful in a program designed to relieve mankind of some of the misfortunes common in the present social order and to prevent disorders for future generations of civilized peoples.

TABLE OF CONTENTS

Chapter 2

THE PROGRESSIVE DECLINE OF MODERN CIVILIZATION

T HAT modern man is declining in physical fitness has been emphasized by many eminent sociologists and other scientists. That the rate of degeneration is progressively accelerating constitutes a cause for great alarm, particularly since this is taking place in spite of the advance that is being made in modern science along many lines of investigation.

Dr. Alexis Carrel in his treatise "Man, the Unknown" states:

Medicine is far from having decreased human sufferings as much as it endeavors to make us believe. Indeed, the number of deaths from infectious diseases has greatly diminished. But we still must die in a much larger proportion from degenerative diseases.

After reviewing the reduction in the epidemic infectious diseases he continues as follows:

All diseases of bacterial origin have decreased in a striking manner. . . . Nevertheless, in spite of the triumphs of medical science, the problem of disease is far from solved. Modern man is delicate. Eleven hundred thousand persons have to attend the medical needs of 120,000,000 other persons. Every year, among this population of the United States, there are about 100,000,000 illnesses, serious or slight. In the hospitals, 700,000 beds are occupied every day of the year. . . . Medical care, under all its forms, costs about $3,500,000,000 yearly. . . . The organism seems to have become more susceptible to degenerative diseases.

The present health condition in the United States is reported from time to time by several agencies representing special phases of the health program. The general health problem has been thoroughly surveyed and interpreted by the Surgeon General of the United States Public Health Service, Dr. Parran. Probably no one is so well informed in all of the phases of health as is the head of this important department of the government. In his recent preliminary report (1) to state and local officers for their information and guidance, he presented data that have been gathered by a large group of government workers. The report includes a census of the health conditions of all the groups constituting the population of the United States--records of the health status and of the economic status of 2,660,000 individuals living in various sections, in various types of communities, on various economic levels. The data include records on every age-group. He makes the following interpretations based upon the assumption that the 2,660,000 offer a fair sampling of the population, and he indicates the conclusions which may be drawn regarding conditions of status for the total population of some 130,000,000 people.

Every day one out of twenty people is too sick to go to school or work, or attend his customary activities. Every man, woman and child (on the average) in the nation suffers ten days of incapacity annually. The average youngster is sick in bed seven days of the year, the average oldster 35 days. Two million five hundred thousand people (42 per cent of the 6,000,000 sick every day) suffer from chronic diseases-heart disease, hardening of the arteries, rheumatism, and nervous diseases. Sixty-five thousand people are totally deaf; 75,000 more are deaf and dumb; 200,000 lack a hand, arm, foot or leg; 300,000 have permanent spinal injuries; 500,000 are blind; 1,000,000 more are permanent cripples. Two persons on the Relief income level (less than $1,000 yearly income for the entire family) are disabled for one week or longer for every one person better off economically. Only one in 250 family heads in the income group of more than $2,000 yearly cannot seek work because of chronic disability. In Relief families one in every 20 family heads is disabled. Relief and low-income families are sick longer as well as more often than better-financed families. They call doctors less often. But the poor, especially in big cities, get to stay in hospitals longer than their better-off neighbors.

Concluded Dr. Parran:

It is apparent that inadequate diet, poor housing, the hazards of occupation and the instability of the labor market definitely create immediate health problems.

It will be seen from this report that the group expressed as oldsters, who spend on an average thirty-five days per year in bed, are sick in bed one-tenth of the time. Those of us who are well, who may have been so fortunate as to spend very little time in bed, will contemplate this fact with considerable concern since it expresses a vast amount of suffering and enforced idleness. It is clear that so great an incidence of morbidity must place a heavy load upon those who at the time are well. The problem of the progressive increase in percentage of individuals affected with heart disease and cancer is adequate cause for alarm. Statistics have been published by the Department of Public Health in New York City which show the increase in the incidence of heart disease to have progressed steadily during the years from 1907 to 1936. The figures provided in their report reveal an increase from 203.7 deaths per 100,000 in 1907 to 327.2 per 100,000 in 1936. This constitutes an increase of 60 per cent. Cancer increased 90 per cent from 1907 to 1936.

That this problem of serious degeneration of our modern civilization is not limited to the people of the United States has been commented on at length by workers in many countries. Sir Arbuthnot Lane, one of England's distinguished surgeons, and a student of public welfare, has made this comment: (2)

Long surgical experience has proved to me conclusively that there is something radically and fundamentally wrong with the civilized mode of life, and I believe that unless the present dietetic and health customs of the White Nations are reorganized, social decay and race deterioration are inevitable.

The decline in white population that is taking place in many communities throughout several countries illustrates the widespread working of the forces that are responsible for this degeneration. In discussing this matter in its relation to Australia, S. R. Wolstenhole, (3) lecturer in economics at Sydney University, predicts that:

A decline in Australia's population is inevitable within 40 years because of the absence of a vigorous population policy.

Students of our modern social problems are recognizing that these problems are not limited to health conditions which we have been accustomed to think of as bodily diseases. This is illustrated in a recent discussion by Will Durant: (4)

The American people are face to face with at least 4 major and militant problems that have to do with the continuity and worthwhile progress of modern civilization: The threatened deterioration of our stock. The purchasing power of our people must rise as fast as the power to procure. . . . The third problem is moral. A civilization depends upon morals for a social and governmental order. . . . The sources of statesmanship are drying up. . . .

Dental caries or tooth decay is recognized as affecting more individuals throughout the so-called civilized world today than any other affection. In the United States, England and Europe examinations of highly modernized groups, consisting of several million individuals, reveal the fact that from 85 to 100 per cent of the individuals in various communities are suffering from this affection. As a contributing factor to absence from school among children it leads all other affections. From the standpoint of injury to health, it has been estimated by many to be the most serious contributing factor through its involvement of other organs of the body. The Honorable J. A. Young, Minister of Health of New Zealand, strongly emphasized that the insidiousness of the effect of dental disease lies in the fact that it is the forerunner of other far-reaching disturbances and he has referred to the seriousness with which it is viewed in England as follows: "Sir George Newman, Principal Medical Officer of the Ministry of Health in Great Britain, has said that 'dental disease is one of the chief, if not the chief, cause of the ill health of the people.'"

Dr. Earnest A. Hooton, of Harvard University, has emphasized the importance of oral sepsis and the task of stopping tooth decay. In closing Chapter VII of his recent book "Apes, Men and Morons," (5) he states the case as follows:

I firmly believe that the health of humanity is at stake, and that, unless steps are taken to discover preventives of tooth infection and correctives of dental deformation, the course of human evolution will lead downward to extinction. . . . The facts that we must face are, in brief, that human teeth and the human mouth have become, possibly under the influence of civilization, the foci of infections that undermine the entire bodily health of the species and that degenerative tendencies in evolution have manifested themselves in modern man to such an extent that our jaws are too small for the teeth which they are supposed to accommodate, and that, as a consequence, these teeth erupt so irregularly that their fundamental efficiency is often entirely or nearly destroyed.

In discussing the strategic situation of dental science, Dr. Hooton states.

In my opinion there is one and only one course of action which will check the increase of dental disease and degeneration which may ultimately cause the extinction of the human species. This is to elevate the dental profession to a plane on which it can command the services of our best research minds to study the causes and seek for the cures of these dental evils. . . . The dental practitioner should equip himself to become the agent of an intelligent control of human evolution, insofar as it is affected by diet. Let us go to the ignorant savage, consider his way of eating, and be wise. Let us cease pretending that tooth-brushes and tooth-paste are any more important than shoe-brushes and shoe-polish. It is store food which has given us store teeth.

Students of history have continually commented upon the superior teeth of the so-called savages including the human types that have preceded our modernized groups. While dental caries has been found occasionally in several animal species through the recent geologic ages, the teeth of the human species have been comparatively free from dental caries. Primitive human beings have been freer from the disease than has contemporary animal life. This absence of tooth decay among primitive races has been so striking a characteristic of human kind that many commentators have referred to it as a strikingly modern disease.

Dryer, (6) in discussing dental caries in the pre-historic South Africans, makes this comment:

In not one of a very large collection of teeth from skulls obtained in the Matjes River Shelter (Holocene) was there the slightest sign of dental caries. The indication from this area, therefore, bears out the experience of European anthropologists that caries is a comparatively modern disease and that no skull showing this condition can be regarded as ancient.

In connection with the studies reported in this volume, it is of particular importance that a desire to find the cause of dental caries was the primary reason for undertaking these investigations. Since it was exceedingly difficult to find in our modern social organization any large group with relatively high immunity to dental caries, a search was made for such control groups among remnants of primitive racial stocks that could also be examined at the point of contact with modern civilization in order that the changes associated with their racial loss of immunity might be noted. Probably few problems with which our modern social groups are concerned have been so inadequately understood not only by the laity, but by the members of the medical and dental professions as has this problem of the cause of dental caries.

The problem of correcting dental arch deformities and thereby improving facial form has developed a specialty in dentistry known as "orthodontia." The literature dealing with the cause of facial deformities is now voluminous. The blending of racial stocks that differ radically in facial form has been said by many to be the chief factor contributing to the creation of deformities of the face. Crowded teeth have been said to be due to the inheritance of the large teeth of one parent and the small bone formation of the other and that such inheritances would provide dental arches that are too small for the teeth that have been made for them. A more general explanation for certain types of deformity, particularly for the protruding of the upper teeth over the lower, is that they result from thumb sucking, which tends to bring the upper arch forward and to depress the lower. Among the other contributing factors named have been faulty sleeping and breathing habits. To these has been assigned much of the blame. This problem of facial form, as well as that of bodily design, including dental arch design, is so directly a problem of growth, not only of individuals, but of races themselves, that certain laws have been very definitely worked out by physical anthropologists as laws of development. They have assumed that changes in physical type can occur only through the impact of changes in the environment which have affected a great number of generations. It is important to keep this viewpoint in mind as the succeeding chapters are read, for they contain descriptions of many changes in physical form that have occurred routinely in the various racial groups, even during the first generation after the parents have adopted the foods of modern civilization.

Many of our modern writers have recognized and have emphasized the seriousness of mental and moral degeneration. Laird has made a splendid contribution under the title "The Tail That Wags the Nation," (7) in which he states:

The country's average level of general ability sinks lower with each generation. Should the ballot be restricted to citizens able to take care of themselves? One out of four cannot. . . . The tail is now wagging Washington, and Wall St. and LaSalle Street. . . . Each generation has seen some lowering of the American average level of general ability.

In Laird's analysis of our present situation he has stressed a very important phase. While emphasizing that the degeneration is not limited to restricted areas, he raises the question as to whether local conditions in certain areas play important roles in the rate and extent to which degeneration has taken place. He says further, (7)

Although we might cite any one of nearly two dozen states, we will first mention Vermont by name because that is the place studied by the late Dr. Pearce Bailey. "It would be," he wrote, "safe to assume that there are at least 30 defectives per 1000 in Vermont of the eight-year-old mentality type, and 300 per 1000 of backward or retarded persons, persons of distinctly inferior intelligence. In other words, nearly one-third of the whole population of that state is of a type to require some supervision."

The problem of lowered mentality and its place in our modern conception of bodily diseases has not been placed on a physical basis as have the better understood degenerative processes, with their direct relationship to a diseased organ, but has generally been assigned to a realm entirely outside the domain of disease or injury of a special organ or tissue. Edward Lee Thorndike, (8) of Columbia University, says that "thinking is as biological as digestion." This implies that a disturbance in the capacity to think is directly related to a defect in the brain.

Another of the distinguished students of mental capacity, J. B. Miner, (9) states:

If morality and intellect are finally demonstrated to be correlated throughout the whole range of individual differences, it is probably the most profoundly significant fact with which society has to deal.

The origin of backwardness in a child seems to have been assigned very largely to some experience in that child's life which becomes a conditioning factor and which thereafter strongly influences his behavior. The problem of the relation of physical defects to delinquency in its various phases, including major crime, constitutes one of the most alarming aspects of our modern problems in social degeneration. Chassell (10) has made an exhaustive study of the reports from workers in different fields in several countries and summarizes her finding as follows: "The correlation between delinquency and mental inferiority as found in the case of feeble-minded groups is clearly positive, and tends to be marked in degree."

Burt, (11) who had made an extensive study, over an extended period, of the problems of the backward child and the delinquent child in London, states in his summary and conclusion with regard to the origin of backwardness in the child:

Both at London and at Birmingham between 60 and 70 per cent belong to the (innately) "dull" category. . . . In the majority the outstanding cause is a general inferiority of intellectual capacity, presumably inborn and frequently hereditary.

In discussing the relationship between general physical weakness and the mentally backward, he writes:

Old and time-honoured as it must seem to the schoolmaster, the problem of the backward child has never been attacked by systematic research until quite recently. We know little about causes, and still less about treatment. . . . Thirdly, though the vast majority of backward children--80 per cent in an area like London--prove to be suffering from minor bodily ailments or from continued ill-health, nevertheless general physical weakness is rarely the main factor.

Among the many surveys made in the study of the forces that are responsible for producing delinquency and criminality, practically all the workers in this field have testified to the obscure nature of those forces. Burt (12) says that, "it is almost as though crime were some contagious disease, to which the constitutionally susceptible were suddenly exposed at puberty, or to which puberty left them peculiarly prone." He emphasizes a relationship between delinquency and physical deficiency:

Most repeated offenders are far from robust; they are frail, sickly, and infirm. Indeed, so regularly is chronic moral disorder associated with chronic physical disorder that many have contended that crime is a disease, or at least a symptom of disease, needing the doctor more than the magistrate, physic rather than the whip. . . . . . . . The frequency among juvenile delinquents of bodily weakness and ill health has been remarked by almost every recent writer. In my own series of cases nearly 70 per cent were suffering from such defects; and nearly 50 per cent were in urgent need of medical treatment. . . . Of all the psychological causes of crime, the commonest and the gravest is usually alleged to be defective mind. The most eminent authorities, employing the most elaborate methods of scientific analysis, have been led to enunciate some such belief. In England, for example, Dr. Goring has affirmed that "the one vital mental constitutional factor in the etiology of crime is defective intelligence." In Chicago, Dr. Healy has likewise maintained that among the personal characteristics of the offender "mental deficiency forms the largest single cause of delinquency." And most American investigators would agree.

The assertion of the obscurity of the fundamental causative factors of delinquency constitutes one of the most striking aspects of the extensive literature that has been accumulated through the reporting of intensive studies made by workers in many countries.

Thrasher, (13) in discussing the nature and origin of gangs, expresses this very clearly:

Gangs are gangs, wherever they are found. They represent a specific type or variety of society, and one thing that is particularly interesting about them is the fact that they are, in respect to their organization, so elementary, and in respect to their origin, so spontaneous. Formal society is always more or less conscious of the end for which it exists, and the organization through which this end is achieved is always more or less a product of design. But gangs grow like weeds, without consciousness of their aims, and without administrative machinery to achieve them. They are, in fact, so spontaneous in their origin, and so little conscious of the purposes for which they exist, that one is tempted to think of them as predetermined, foreordained, and "instinctive," and so, quite independent of the environment in which they ordinarily are found.

No doubt, many cities have been provided, as has Cleveland, with a special school for delinquent boys. The institution there has been given the appropriate title, the "Thomas A. Edison School." It usually has an enrollment of 800 to 900 boys. Dr. Watson, (14) who has been of outstanding service in the organization of this work, makes an important comment on the origin of the student population there:

The Thomas A. Edison student population consists of a group of truant and behavior boys, most of them in those earlier stages of mal-adjustment which we have termed predelinquency. . . . In general, they are the products of unhappy experiences in school, home and community. They are sensitive recorders of the total complex of social forces which operate in and combine to constitute what we term their community environment.

It will be seen from these quotations that great emphasis has been placed upon the influence of the environment in determining factors of delinquency.

Hooton, the distinguished physical anthropologist of Harvard, has made important observations regarding our modern physical degeneration. As an approach to this larger problem of man's progressive degeneration, he has proposed the organization and establishment of an Institute of Clinical Anthropology, (15) the purpose of which he has indicated:

. . . for finding out what man is like biologically when he does not need a doctor, in order to further ascertain what he should be like after the doctor has finished with him. I am entirely serious when I suggest that it is a very myopic medical science which works backward from the morgue rather than forward from the cradle.

Very important contributions have been made to the forces that are at work in the development of delinquents through an examination of the families in which affected individuals have appeared. Sullenger, (16) in discussing this phase, states:

Abbott and Breckinridge found in their Chicago studies that a much higher percentage of delinquent boys than girls were from large families. However, Healy and Bronner found in their studies in Chicago and Boston that the large family is conducive to delinquency among children in that the larger the family the greater percentage of cases with more than one delinquent. They were unable to detect whether or not this fact was due to parental neglect, poverty, bad environmental conditions, or the influence of one child on another. In each of the series in both cities the number of delinquents in families of different sizes showed general similarity.

As the investigations outlined in this study are reviewed, many problems not anticipated by the writer when these investigations were undertaken will be presented. These new problems were not, at first, generally thought of as related directly or indirectly to our modern racial degeneration, but have been found recently to be so related.

Since it will be seen that the size and shape of the head and sinuses, including the oral cavity and throat, are directly influenced by forces that are at work in our modern civilization, we shall consider the speaking and singing voice. In traveling among several of the primitive races, one is frequently impressed with the range and resonance of many of the voices--in fact, by almost every voice. We are quite familiar with the high premium that is placed on singing voices of exceptional quality in our modern social order. This is illustrated by the following comment: (17)

Tip-top Italian-style tenors have always been a scarce commodity, and for the past two decades they have been growing scarcer and scarcer. Opera impresarios count on the fingers of one hand the lust-high-voice Latins. . . . Since the death of Enrico Caruso (1921) opera houses have shown a steady decline.

Important light will be thrown on this phase of the problem--the cause of fewer good voices in Italy today than of old--as we note the narrowing of the face and of the dental arches and as we see the change in the form of the palate of the various primitive races. These changes occur even in the first generation after the parents have adopted the foods of modern white civilizations.

As we study the primitives we will find that they have had an entirely different conception of the nature and origin of the controlling forces which have molded individuals and races.

Buckle, (18) in writing his epoch-making "History of Civilization" about the middle of the last century, summed up his years of historical studies with some very important conclusions, some of which are as follows:

2. It is proved by history, and especially by statistics, that human actions are governed by laws as fixed and regular as those which rule in the physical world. 3. Climate, soil, food, and the aspects of Nature are the principal causes of intellectual progress. 6. Religion, literature, and government are, at best, but the products, and not the cause of civilization.

This important view was not orthodox and was met by very severe criticism. The newer knowledge strongly corroborates his view.

My early studies of the relation of nutrition to dental problems were related chiefly to growth defects in the teeth produced long before the eruption of the permanent teeth, chiefly from one year of age to the time of eruption. These often appeared as lines across the teeth. I was able to trace these lines directly to the use of a few highly processed baby foods. I published an extensive report on this phase of the problem, together with illustrations, in 1913. (19) These injuries are disclosed with the x-ray long before the teeth erupt. These disturbances occur much less frequently in connection with the baby foods used today.

The problems of modern degeneration can in general be divided into two main groups, those which relate to the perfection of the physical body and those which relate to its function. The latter include character as expressed in behavior of individuals and of groups of individuals which thus relate to national character and to an entire culture.

In an enumeration of the phases in which there is a progressive decline of modern civilization, it is essential that we keep in mind that in addition to an analysis of the forces responsible for individual degeneration, the ethical standards of the whole group cannot be higher than those of the individuals that compose it. That recent mass degeneration is in progress is attested by daily events throughout the world. The current interpretation for individual character degeneration largely places the responsibility on a conditioning factor which exerts an influence during early childhood and therefore is directly related to the environment of the child. These, therefore, are postnatal conditioning factors. An important contribution to this phase comes directly from the experience of primitive races and indicates that a more fundamental conditioning factor had developed in the prenatal period. If, therefore, large groups of individuals suffer from such a prenatal conditioning influence, new light will be thrown upon the larger problems of group deterioration. History seems to provide records of such mass degeneration as, for example, those which culminated in the so-called "dark ages." That some such mass degeneration is now in progress is suggested by leading students of human welfare. The regius professor of Greek at Oxford in his inaugural lecture in 1937 made the following observation: (20)

In the revolution of thought through which we are living, the profoundest and most disturbing element is the breakdown of that ethical system which, since the days of Constantine, has imposed upon European culture at least the semblance of moral unity.

In commenting on this important statement Sir Alfred Zimmern in his address on the decline of international standards said that "Recent events should convince the dullest mind of the extent to which international standards have deteriorated and the anarchy which threatens the repudiation of law and order in favour of brute force."

The problem of progressive decline in individual and group ethical standards is commanding the attention of great international organizations. In discussing this problem before the International Rotary at its meeting in San Francisco in June, 1938, one of the leaders in mass reform, Mayor Harold Burton of Cleveland, stressed very important phases. He stated that the American boys "are making irrevocable choices" between good and bad citizenship which "may make or wreck the nation. It may be on the battlefield of crime prevention that the life of democracy will be saved." He described great industrial cities as battlefields where "the tests of democracy are the newest and sharpest." (21) . . . "For centuries," he said:

. . . we have fought crime primarily by seeking to catch the criminal after the crime has been committed and then through his punishment to lead or drive him and others to good citizenship. Today the greater range of operation and greater number of criminals argue that we must deal with the flood waters of crime. We must prevent the flood by study, control and diversion of the waters at their respective sources. To do this we must direct the streams of growing boys in each community away from fields of crime to those of good citizenship.

If the "flood waters" that must be controlled lie farther back than the cradle, in order to safeguard individual character and individual citizenship from prenatal conditioning factors which have profound influence in determining the reaction of the individuals to the environment, it is essential that programs that are to be efficient in maintaining national character reach back to those forces which are causing the degeneration of increasing numbers of the population in succeeding generations of our modern cultures.

That the problem of mass degeneration constitutes one of the most alarming problems of our modernized cultures is demonstrated by the urgency of appeals that are being made by students in national and international affairs. The discussion of "An Ethical Declaration for the Times," (22) a declaration of faith, is accompanied by a pledge. This pledge reads:

I pledge myself to use every opportunity for action to uphold the great tradition of civilization to protect all those who may suffer for its sake, and to pass it on to the coming generations. I recognized no loyalty greater than that to the task of preserving truth, toleration, and justice in the coming world order.

The author emphasizes the great danger of taking for granted that the cultural progress that has been attained will continue. There is probably no phase of this whole problem of modern degeneration that is so brilliantly illuminated by the accumulated wisdom of primitive races as group degeneration. They have so organized the life of the family and the individual that the nature of the forces which established individual behavior and character are controlled.

Our problem of modern degeneration involves both individual and group destiny. Our approach to this study will, accordingly, involve first a critical examination of the forces that are responsible for individual degeneration.

In my search for the cause of degeneration of the human face and the dental organs I have been unable to find an approach to the problem through the study of affected individuals and diseased tissues. In my two volume work on "Dental Infections," Volume I, entitled "Dental Infections, Oral and Systemic," and Volume II, entitled "Dental Infections and the Degenerative Diseases," (23) I reviewed at length the researches that I had conducted to throw light on this problem. The evidence seemed to indicate clearly that the forces that were at work were not to be found in the diseased tissues, but that the undesirable conditions were the result of the absence of something, rather than of the presence of something. This strongly indicated the need for finding groups of individuals so physically perfect that they could be used as controls. In order to discover them, I determined to search out primitive racial stocks that were free from the degenerative processes with which we are concerned in order to note what they have that we do not have. These field investigations have taken me to many parts of the world through a series of years. The following chapters review the studies made of primitive groups, first, when still protected by their isolation, and, second, when in contact with modern civilization.

REFERENCES

PARRAN, T. Sickness survey. Time, 31:22, 1938. LANE, A. Preface to Maori Symbolism by Ettie A. Rout. London, Paul Trench Trubner, 1926. WOLSTENHOLE, S. R. Proposes Stork Derby. Cleveland Press, March 12, 1937. DURANT, W. A crisis in civilization. Speakers Library Magazine, p. 2, Jan. 15, 1938. HOOTON, E. A. Apes, Men and Morons. New York, Putnam, 1937. DRYER, T. F. Dental caries in prehistoric South Africans. Nature, 136:302, 1935. LAIRD, D. The tail that wags the nation. Rev, of Revs., 92:44, 1935. THORNDIKE, E. L. Big Chief's G. G. Time, 30:25, 1937. MINER, J. B. Proc. Am. Ass. for Feeble-Minded, p. 54, 1919. CHASSELL, C. F. Relation between morality and intellect. N. Y., Columbia, 1935. BURT, C. L. Backward Child. New York, Appleton, 1937. BURT, C. L. The Young Delinquent. London, University of London Press, 1925. THRASHER, F. M. The Gang. Chicago, University of Chicago Press, 1936. WATSON, M. P. Organization and administration of a public school for pre-delinquent boys in a large city. Thesis, Cleveland, Western Reserve University. HOOTON, E. A. An Anthropologist Looks at Medicine. Reviewed in Time, 27:73, 1936. SULLENGER, T. E. Social Determinants in Juvenile Delinquency. London, Chapman and Hall, 1936. TENORS. Time, 30:50, 1937. BUCKLE, H. T. History of Civilization. New York, Appleton, 1910. PRICE, W. A. Some contributions to dental and medical science. Dental Summary, 34:253, 1914. ZIMMERN, A. Scientific research in international affairs. Nature, 141:947, 1938. Burton Tells of Crime Drive. Cleveland Press, June 22, 1938. WHYTE, L. L. An ethical declaration for the times. Nature, 141:827, 1938. PRICE, W. A. Dental Infections, Oral and Systemic. Cleveland, Penton, 1923.

TABLE OF CONTENTS

Chapter 3

ISOLATED AND MODERNIZED SWISS

I N ORDER to study the possibility of greater nutritive value in foods produced at a high elevation, as indicated by a lowered incidence of morbidity, including tooth decay, I went to Switzerland and made studies in two successive years, 1931 and 1932. It was my desire to find, if possible, groups of Swiss living in a physical environment such that their isolation would compel them to live largely on locally produced foods. Officials of the Swiss Government were consulted as to the possibility of finding people in Switzerland whose physical isolation provided an adequate protection. We were told that the physical conditions that would not permit people to obtain modern foods would prevent us from reaching them without hardship. However, owing to the completion of the Loetschberg Tunnel, eleven miles long, and the building of a railroad that crosses the Loetschental Valley, at a little less than a mile above sea level, a group of about 2,000 people had been made easily accessible for study, shortly prior to 1931. Practically all the human requirements of the people in that valley, except a few items like sea salt, have been produced in the valley for centuries.

A bird's eye view of the Loetschental Valley, looking toward the entrance, is shown in Fig. 1. The people of this valley have a history covering more than a dozen centuries. The architecture of their wooden buildings, some of them several centuries old, indicates a love for simple stability, adapted to expediency and efficiency. Artistically designed mottoes, many of them centuries old, are carved deep in the heavy supporting timbers, both within and without the buildings. They are always expressive of devotion to cultural and spiritual values rather than to material values. These people have never been conquered, although many efforts have been made to invade their valley. Except for the rugged cleft through which the river descends to the Rhone Valley, the Loetschental Valley is almost completely enclosed by three high mountain ranges which are usually snow-capped. This pass could be guarded by a small band against any attacking forces since artificial landslides could easily be released. The natural occurrence of these landslides has made passage through the gorge hazardous, if not impossible, for months of the year. According to early legends of the valley these mountains were the parapets of the universe, and the great glacier of the valley, the end of the universe. The glacier is a branch of the great ice field that stretches away to the west and south from the ice-cap of the Jungfrau and Monch. The mountains, however, are seldom approached from this direction because of the hazardous ice fields. The gateway to them with which the traveling world is familiar is from Interlaken by way of the Lauterbrunnen or Grindelwald valleys.

Fig. 1. Beautiful Loetschental Valley about a mile above sea level. About two thousand Swiss live here. In 1932 no deaths had occurred from tuberculosis in the history of the valley.

At the altitude of the Loetschental Valley the winters are long, and the summers short but beautiful, and accompanied by extraordinarily rapid and luxuriant growth. The meadows are fragrant with Alpine flowers, with violets like pansies, which bloom all summer in deepest hues.

The people of the Loetschental Valley make up a community of two thousand who have been a world unto themselves. They have neither physician nor dentist because they have so little need for them; they have neither policeman nor jail, because they have no need for them. The clothing has been the substantial homespuns made from the wool of their sheep. The valley has produced not only everything that is needed for clothing, but practically everything that is needed for food. It has been the achievement of the valley to build some of the finest physiques in all Europe. This is attested to by the fact that many of the famous Swiss guards of the Vatican at Rome, who are the admiration of the world and are the pride of Switzerland, have been selected from this and other Alpine valleys. It is every Loetschental boy's ambition to be a Vatican guard. Notwithstanding the fact that tuberculosis is the most serious disease of Switzerland, according to a statement given me by a government official, a recent report of inspection of this valley did not reveal a single case. I was aided in my studies in Switzerland by the excellent cooperation of the Reverend John Siegen, the pastor of the one church of this beautiful valley.

The people live largely in a series of villages dotting the valley floor along the river bank. The land that is tilled, chiefly for producing hay for feeding the cattle in the winter and rye for feeding the people, extends from the river and often rises steeply toward the mountains which are wooded with timber so precious for protection that little of it has been disturbed. Fortunately, there is much more on the vast area of the mountain sides than is needed for the relatively small population. The forests have been jealously guarded because they are so greatly needed to prevent slides of snow and rocks which might engulf and destroy the villages.

The valley has a fine educational system of alternate didactic and practical work. All children are required to attend school six months of the year and to spend the other six months helping with the farming and dairying industry in which young and old of both sexes must work. The school system is under the direct supervision of the Catholic Church, and the work is well done. The girls are also taught weaving, dyeing and garment making. The manufacture of wool and clothing is the chief homework for the women in the winter.

No trucks nor even horses and wagons, let alone tractors, are available to bear the burdens up and down the mountain sides. This is all done on human backs for which the hearts of the people have been made especially strong.

We are primarily concerned here with the quality of the teeth and the development of the faces that are associated with such splendid hearts and unusual physiques. I made studies of both adults and growing boys and girls, during the summer of 1931, and arranged to have samples of food, particularly dairy products, sent to me about twice a month, summer and winter. These products have been tested for their mineral and vitamin contents, particularly the fat-soluble activators. The samples were found to be high in vitamins and much higher than the average samples of commercial dairy products in America and Europe, and in the lower areas of Switzerland.

Hay is cut for winter feeding of the cattle, and this hay grows rapidly. The hay proved, on chemical analysis made at my laboratory, to be far above the average in quality for pasturage and storage grasses. Almost every household has goats or cows or both. In the summer the cattle seek the higher pasturage lands and follow the retreating snow which leaves the lower valley free for the harvesting of the hay and rye. The turning of the soil is done by hand, since there are neither plows nor draft animals to drag the plows, in preparation for the next year's rye crop. A limited amount of garden stuff is grown, chiefly green foods for summer use. While the cows spend the warm summer on the verdant knolls and wooded slopes near the glaciers and fields of perpetual snow, they have a period of high and rich productivity of milk. The milk constitutes an important part of the summer's harvesting. While the men and boys gather in the hay and rye, the women and children go in large numbers with the cattle to collect the milk and make and store cheese for the following winter's use. This cheese contains the natural butter fat and minerals of the splendid milk and is a virtual storehouse of life for the coming winter.

From Dr. Siegen, I learned much about the life and customs of these people. He told me that they recognize the presence of Divinity in the life-giving qualities of the butter made in June when the cows have arrived for pasturage near the glaciers. He gathers the people together to thank the kind Father for the evidence of his Being in the life-giving qualities of butter and cheese made when the cows eat the grass near the snow line. This worshipful program includes the lighting of a wick in a bowl of the first butter made after the cows have reached the luscious summer pasturage. This wick is permitted to burn in a special sanctuary built for the purpose. The natives of the valley are able to recognize the superior quality of their June butter, and, without knowing exactly why, pay it due homage.

The nutrition of the people of the Loetschental Valley, particularly that of the growing boys and girls, consists largely of a slice of whole rye bread and a piece of the summer-made cheese (about as large as the slice of bread), which are eaten with fresh milk of goats or cows. Meat is eaten about once a week. In the light of our newer knowledge of activating substances, including vitamins, and the relative values of food for supplying minerals for body building, it is clear why they have healthy bodies and sound teeth. The average total fat-soluble activator and mineral intake of calcium and phosphorus of these children would far exceed that of the daily intake of the average American child. The sturdiness of the child life permits children to play and frolic bareheaded and barefooted even in water running down from the glacier in the late evening's chilly breezes, in weather that made us wear our overcoats and gloves and button our collars. Of all the children in the valley still using the primitive diet of whole rye bread and dairy products the average number of cavities per person was 0.3. On an average it was necessary to examine three persons to find one defective deciduous or permanent tooth. The children examined were between seven and sixteen years of age.

If one is fortunate enough to be in the valley in early August and witness the earnestness with which the people celebrate their national holiday, he will be privileged to see a sight long to be remembered. These celebrations close with the gathering together of the mountaineers on various crags and prominences where great bonfires are lighted from fuel that has been accumulated and built into an enormous mound to make a huge torchlight. These bonfires are lighted at a given hour from end to end of the valley throughout its expanse. Every mountaineer on a distant crag seeing the lights knows that the others are signalling to him that they, too, are making their sacred consecration in song which says one for all and all for one." This motive has been crystallized into action and has become a part of the very souls of the people. One understands why doors do not need to be bolted in the Loetschental Valley.

How different the level of life and horizon of such souls from those in many places in the so-called civilized world in which people have degraded themselves until life has no interest in values that cannot be expressed in gold or pelf, which they would obtain even though the life of the person being cheated or robbed would thereby be crippled or blotted out.

One immediately wonders if there is not something in the life-giving vitamins and minerals of the food that builds not only great physical structures within which their souls reside, but builds minds and hearts capable of a higher type of manhood in which the material values of life are made secondary to individual character. In succeeding chapters we will see evidence that this is the case.

Our quest has been for information relative to the health of the body, the perfection of the teeth, and the normality of development of faces and dental arches, in order that we might through an analysis of the foods learn the secret of such splendid body building and learn from the people of the valley how the nutrition of all groups of people may be reinforced, so that they, too, may be free from mankind's most universal disease, tooth decay and its sequelae. These studies included not only the making of a physical examination of the teeth, the photographing of subjects, the recording of voluminous data, the obtaining of samples of food for chemical analysis, the collecting of detailed information regarding daily menus; but also the collecting of samples of saliva for chemical analysis. The chemical analysis of saliva was used to test out my newly developed procedure for estimating the level of immunity to dental caries for a given person at a given time. This procedure is outlined in following chapters. The samples of saliva were preserved by an addition of formalin equivalent in amount to one per cent of the sample of saliva.

These children will, it is hoped, be reexamined in succeeding years in order to make comparative studies of the effect of the changes in the local nutritional programs. Some of these changes are already in progress. There is now a modern bakery dispensing white bread and many white-flour products which was in full operation in 1932.

I inquired of many persons regarding the most favorable districts in which to make further studies of groups of people living in protected isolation because of their physical environment, and decided to study some special high Alpine valleys between the Rhone Valley and Italy, which I included in 1932. The Canton of Wallis is bordered by French-speaking people on the west, by Italian-speaking people on the south, and by German-speaking people on the east and north. I had as guides and interpreters in Wallis, Dr. Alfred Gysi and also Dr. Adolf Roos through part of the territory.

Our first expedition was into the valley of the Visp which is a great gorge extending southward from the Rhone River, dividing into two gorges, one going to the Saas Fee country, and the other to the vicinity of the Matterhorn with its almost spirelike pinnacle lifting itself above the surrounding snow-capped mountains and visible from eminences in all directions as one of the mightiest and most sublime spectacles in the world. It was one of the last mountains of Europe to be scaled by man. One has not seen the full majesty of the Alps if he has not seen the Matterhorn.

We left the mountain railroad, which makes many of the grades with the cog system, at the town of St. Nicholas, and climbed the mountain trail to an isolated settlement on the east bank of the Mattervisp River, called Grachen, a five-hour journey. The settlement is on a shelf high above the east side of the river where it is exposed to southern sunshine and enjoys a unique isolation because of its physical inaccessibility. An examination made of the children in this community showed that only 2.3 teeth out of every hundred had been attacked by tooth decay.

The hardihood of the people was splendidly illustrated by a woman of 62 years who carried an enormous load of rye on her back at an altitude of about 5,000 feet. We met her later and talked to her, and found that she was extraordinarily well developed and well preserved. She showed us her grandchildren who had fine physiques and facial developments.

The rye is so precious that while being carried the heads are protected by wrapping them in canvas so that not a kernel will be lost. The rye is thrashed by hand and ground in stone mills which were formerly hand-turned like the one shown in Fig. 2. Recently water turbines have been installed. Water power is abundant and the grinding is done for the people of the mountain side in these water-driven mills. Only wholerye flour is available. Each household takes turns in using the community bake-oven, which is shown in Fig. 2. A month's supply of whole-rye bread is baked at one time for a given family.

FIG. 2. For centuries the natives ground their rye in this type of hand mill. This community bake-oven for whole rye bread is passing.

Here again the cows were away in the midsummer, pasturing up near the glaciers. Grachen has an altitude of about 5,000 feet. The church at Grachen was built several hundred years ago. We were shown an embossed certificate of honor and privilege extended to a group of about 120 people who had originally built the edifice. We were given valued assistance by the local priest, and were provided with facilities in his spacious and well-kept rooms for making our studies of the children.

From Grachen we returned to St. Nicholas and proceeded from there by train down the valley and up another steep ascent, requiring several hours, to the hamlet of Visperterminen, on the east side of the mountain above the Visp River, and below the junction of the Mattervisp and Saaservisp. This community is made up of about 1,600 people living on a sheltered shelf high above the river valley. The view from this position is indescribably beautiful. It is a little below the timber line of this and the surrounding mountains. Majestic snow-clad peaks and precipitous mountains dot the horizon and shade off into winding gorges which mark the course of wandering streams several thousand feet below our vantage point. It is a place to stop and ponder.

The gradations in climate range in the summer from a tropical temperature in protected nooks during the daytime to sub-zero weather with raging blizzards at night on the high mountains. It is a place where human stamina can be tempered to meet all the vicissitudes of life.

The village consists of a group of characteristically designed Swiss chalets clustered on the mountain side. The church stands out as a beacon visible from mountains in all directions. Visperterminen is unique in many respects. Notwithstanding its relative proximity to civilization--it is only a few hours' journey to the thoroughfare of the Rhone Valley--it has enjoyed isolation and opportunity for maintaining its characteristic primitive social and civil life. We were greeted here by the president of the village who graciously opened the school house and sent messengers to have the children of the community promptly come to the school building in order that we might make such studies as we desired. This study included a physical examination of the teeth and of the general development of the children, particularly of the faces and dental arches, the making of photographic records, the obtaining of samples of saliva, as in other places, and also the making of a detailed study of the nutrition. In addition, we obtained samples of foods for chemical analysis.

The people of Visperterminen have the unique distinction of owning land in the lower part of the mountain on which they maintain vineyards to supply wine for this country. They have the highest vineyards of Europe. They are grown on banks that are often so steep that one wonders how the tillers of the soil or the gatherers of the fruit can maintain their hold on the precarious and shifting footing. Each terrace has a trench near its lower retaining wall to catch the soil that is washed down, and this soil must be carried back in baskets to the upper boundary of the plot. This is all done by human labor. The vineyards afforded them the additional nutrition of wine and of fruit minerals and vitamins which the two groups we studied at Loetschental and Grachen did not have.

This additional nutrition was of importance because of the opportunity for obtaining through it vitamin C. It is of particular interest in the study of the incidence of tooth decay in Visperterminen that these additional factors had not created a higher immunity to tooth decay, nor a better condition of health in gingival tissues than previously found. In each one hundred teeth examined 5.2 were found to have been attacked at some time by tooth decay. Here again the nutrition consisted of rye, used almost exclusively as the cereal; of dairy products; of meat about once a week; and also some potatoes. Limited green foods were eaten during the summer. The general custom is to have a sheep dressed and distributed to a group of families, thus providing each family with a ration of meat for one day a week, usually Sunday. The bones and scraps are utilized for making soups to be served during the week. The children have goat's milk in the summer when the cows are away in the higher pastures near the snow line. Certain members of the families go to the higher pastures with the cows to make cheese for the coming winter's use.

The problem of identifying goats or cattle for establishing individual ownership is a considerable one where the stock of all are pastured in common herds. It was interesting to us to observe how this problem was met. The president of the village has what is called a "tessel" which is a string of manikins in imitation of goats or cattle made of wood and leather. Every stock owner must provide a manikin to be left in the safekeeping of the president of the village with whom it is registered. It carries on it the individual markings that this member of the colony agrees to put on every member of his animal stock. The marking may be a hole punched in the left ear or a slit in the right ear, or any combination of such markings as is desired. Thereafter all animals carrying that mark are the property of the person who registered it; similarly, any animals that have not this individual symbol of identification cannot be claimed by him.

As one stands in profound admiration before the stalwart physical development and high moral character of these sturdy mountaineers, he is impressed by the superior types of manhood, womanhood, and childhood that Nature has been able to produce from a suitable diet and a suitable environment. Surely, here is evidence enough to answer the question whether cereals should be avoided because they produce acids in the system which if formed will be the cause of tooth decay and many other ills including the acidity of the blood or saliva. Surely, the ultimate control will be found in Nature's laboratory where man has not yet been able to meddle sufficiently with Nature's nutritional program to blight humanity with abnormal and synthetic nutrition. When one has watched for days the childlife in those high Alpine preserves of superior manhood; when one has contrasted these people with the pinched and sallow, and even deformed, faces and distorted bodies that are produced by our modern civilization and its diets; and when one has contrasted the unsurpassed beauty of the faces of these children developed on Nature's primitive foods with the varied assortment of modern civilization's children with their defective facial development, he finds himself filled with an earnest desire to see that this betterment is made available for modern civilization.

Again and again we had the experience of examining a young man or young woman and finding that at some period of his life tooth decay had been rampant and had suddenly ceased; but, during the stress, some teeth had been lost. When we asked such people whether they had gone out of the mountain and at what age, they generally replied that at eighteen or twenty years of age they had gone to this or that city and had stayed a year or two. They stated that they had never had a decayed tooth before they went or after they returned, but that they had lost some teeth in the short period away from home.

At this point of our studies Dr. Roos found it necessary to leave, but Dr. Gysi accompanied us to the Anniviers Valley, which is also on the south side of the Rhone. The river of the valley, the Navizenze, drains from the high Swiss and Italian boundary north to the Rhone River. Here again we had the remarkable experience of finding communities near to each other, one blessed with high immunity to tooth decay, and the other afflicted with rampant tooth decay.

The village of Ayer lies in a beautiful valley well up toward the glaciers. It is still largely primitive, although a government road has recently been developed, which, like many of the new arteries, has made it possible to dispatch military protection when and if necessary to any community. In this beautiful hamlet, until recently isolated, we found a high immunity to dental caries. Only 2.3 teeth out of each hundred examined were found to have been attacked by tooth decay. Here again the people were living on rye and dairy products. We wonder if history will repeat itself in the next few years and if there, too, this enviable immunity will be lost with the advent of the highway. Usually it is not long after tunnels and roads are built that automobiles and wagons enter with modern foods, which begin their destructive work. This fact has been tragically demonstrated in this valley since a roadway was extended as far as Vissoie several years ago. In this village modern foods have been available for some time. One could probably walk the distance from Ayer to Vissoie in an hour. The number of teeth found to be attacked with caries for each one hundred children's teeth examined at Vissoie was 20.2 as compared with 2.3 at Ayer. We had here a splendid opportunity to study the changes that had occurred in the nutritional programs. With the coming of transportation and new markets there had been shipped in modern white flour; equipment for a bakery to make white-flour goods; highly sweetened fruit, such as jams, marmalades, jellies, sugar and syrups--all to be traded for the locally produced high-vitamin dairy products and high-mineral cheese and rye; and with the exchange there was enough money as premium to permit buying machine-made clothing and various novelties that would soon be translated into necessities.

Each valley or village has its own special feast days of which athletic contests are the principal events. The feasting in the past has been largely on dairy products. The athletes were provided with large bowls of cream as constituting one of the most popular and healthful beverages, and special cheese was always available. Practically no wine was used because no grapes grew in that valley, and for centuries the isolation of the people prevented access to much material that would provide wine. In the Visperterminen community, however, the special vineyards owned by these people on the lower level of the mountain side provided grape juice in various stages of fermentation, and their feasts in the past have been celebrated by the use of wines of rare vintage as well as by the use of cream and other dairy products. Their cream products took the place of our modern ice cream. It was a matter of deep interest to have the President of Visperterminen show us the tankards that had been in use in that community for nine or ten centuries. The care of these was one of the many responsibilities of the chief executive of the hamlet.

It is reported that practically all skulls that are exhumed in the Rhone valley, and, indeed, practically throughout all of Switzerland where graves have existed for more than a hundred years, show relatively perfect teeth; whereas the teeth of people recently buried have been riddled with caries or lost through this disease. It is of interest that each church usually has associated with it a cemetery in which the graves are kept decorated, often with beautiful designs of fresh or artificial flowers. Members of succeeding generations of families are said to be buried one above the other to a depth of many feet. Then, after a sufficient number of generations have been so honored, their bodies are exhumed to make a place for present and coming generations. These skeletons are usually preserved with honor and deference. The bones are stacked in basements of certain buildings of the church edifice with the skulls facing outward. These often constitute a solid wall of considerable extent. In Naters there is such a group said to contain 20,000 skeletons and skulls. These were studied with great interest as was also a smaller collection in connection with the cathedral at Visp. While many of the single straight-rooted teeth had been lost in the handling, many were present. It was a matter of importance to find that only a small percentage of teeth had had caries. Teeth that had been attacked with deep caries had developed apical abscesses with consequent destruction of the alveolar processes. Evidence of this bone change was readily visible. Sockets of missing teeth still had continuous walls, indicating that the teeth had been vital at death.

The reader will scarcely believe it possible that such marked differences in facial form, in the shape of the dental arches, and in the health condition of the teeth as are to be noted when passing from the highly modernized lower valleys and plains country in Switzerland to the isolated high valleys can exist. Fig. 3 shows four girls with typically broad dental arches and regular arrangement of the teeth. They have been born and raised in the Loetschental Valley or other isolated valleys of Switzerland which provide the excellent nutrition that we have been reviewing. They have been taught little regarding the use of tooth brushes. Their teeth have typical deposits of unscrubbed mouths; yet they are almost completely free from dental caries, as are the other individuals of the group they represent. In a study of 4,280 teeth of the children of these high valleys, only 3.4 per cent were found to have been attacked by tooth decay. This is in striking contrast to conditions found in the modernized sections using the modern foods.

FIG. 3. Normal design of face and dental arches when adequate nutrition is provided for both the parents and the children.

Note the well developed nostrils.

In Loetschental, Grachen, Visperterminen and Ayer, we have found communities of native Swiss living almost exclusively on locally produced foods consisting of the cereal, rye, and the animal product, milk, in its various forms. At Vissoie, with its available modern nutrition, there has been a complete change in the level of immunity to dental caries. It is important that studies be made in other communities which correspond in altitude with the first four places studied in which there was a high immunity to dental caries. Modern foods should be available in the new communities selected for comparative study. To find such places one would naturally think of those that are world-famed as health resorts providing the best things that modern science and industry can assemble. Surely St. Moritz would be such a place. It is situated in the southeastern part of the Republic of Switzerland near the headwaters of the Danube in the upper Engadin. This world-famous watering place attracts people of all continents for both summer and winter health building and for the enjoyment of the mountain lakes, snow-capped peaks, forested mountain sides, and crystal clear atmosphere with abundance of sunshine.

The journey from the Canton of Wallis (Valais) to the upper Engadin takes one up the Rhone valley, climbing continually to get above cascades and beautiful waterfalls until one comes to the great Rhone glacier which blocks the end of the valley. The water gushes from beneath the mountain of ice to become the parent stream of the Rhone river which passes westward through the Rhone valley receiving tributaries from snow-fed streams from both north and south watersheds, as it rolls westward to the beautiful Lake Geneva and then onward west and south to the Mediterranean.

It is of significance that a study of the child life in the Rhone valley, as made by Swiss officials and reported by Dr. Adolf Roos and his associates, shows that practically every child had tooth decay and the majority of the children had decay in an aggravated form. People of this valley are provided with adequate railroad transportation for bringing them the luxuries of the world. As we pass eastward over the pass through Andermatt, we are reminded that the trains of the St. Gotthard tunnel go thundering through the mountain a mile below our feet en route to Italy. To reach our goal, the beautiful modern city and summer resort of St. Moritz, we enter the Engadin country famed for its beauty and crystal-clear atmosphere. We already know something of the beauty that awaits us which has attracted pleasure seekers and beauty lovers of the world to St. Moritz. One would scarcely expect to see so modern a city as St. Mortiz at an altitude of a little over a mile, with little else to attract people than its climate in winter and summer, the magnificent scenery, and the clear atmosphere. We have passed from the communities where almost everyone wears homespuns to one of English walking coats and the most elegant of feminine attire. Everyone shows the effect of contact with culture. The hotels in their appointments and design are reminiscent of Atlantic City. Immediately one sees something is different here than in the primitive localities: the children have not the splendidly developed features, and the people give no evidence of the great physical reserve that is present in the smaller communities.

Through the kindness of Dr. William Barry, a local dentist, and through that of the superintendent of the public schools, we were invited to use one of the school buildings for our studies of the children. The summer classes were dismissed with instructions that the children be retained so that we could have them for study. Several factors were immediately apparent. The teeth were shining and clean, giving eloquent testimony of the thoroughness of the instructions in the use of the modern dentifrices for efficient oral prophylaxis. The gums looked better and the teeth more beautiful for having the debris and deposits removed. Surely this superb climate, this magnificent setting, combined with the best of the findings of modern prophylactic science, should provide a 100-per-cent immunity to tooth decay. But in a study of the children from eight to fifteen years of age, 29.8 per cent of the teeth had already been attacked by dental caries. Our study of each case included careful examining of the mouth; photographing of the face and teeth; obtaining of samples of saliva for chemical analysis; and a study of the program of nutrition followed by the given case. In most cases, the diet was strikingly modern, and the only children found who did not have tooth decay proved to be children who were eating the natural foods, whole rye bread and plenty of milk.

In Chapter 15, a detailed discussion of the chemical differences in the food constituents is presented for both the districts subject to immunity, and for those subject to susceptibility.

I was told by a former resident of this upper Engadin country that in one of the isolated valleys only a few decades ago the children were still carrying their luncheons to school in the form of roasted rye carried dry in their pockets. Their ancestors had eaten cereal in this dry form for centuries.

St. Moritz is a typical Alpine community with a physical setting lar to that in the Cantons of Bern and Wallis (Valais). It is, however, provided with modern nutrition consisting of an abundance of white-flour products, marmalades, jams, canned vegetables, confections, and fruits--all of which are transported to the district. Only a limited supply of vegetables is grown locally. We studied some children here whose parents retained their primitive methods of food selection, and without exception those who were immune to dental caries were eating a distinctly different food from those with high susceptibility to dental caries.

Few countries of the world have had officials so untiring in their efforts to study and tabulate the incidence of dental caries in various geographic localities as has Switzerland. In the section lying to the north and east, and near Lake Constance, there is a considerable district where it is reported that 100 per cent of the people are suffering from dental caries. In almost all the other parts of Switzerland in which the population is large 95 to 98 per cent of the people suffer from dental caries. Of the two remaining districts, in one there is from 90 to 95 per cent and in the other from 85 to 90 per cent individual susceptibility to dental caries. Since in the district in the vicinity of Lake Constance the incidence of dental caries is so high that it is recorded as 100 per cent, it seemed especially desirable to make a similar critical study there and to obtain samples of saliva and detailed information regarding the food, and to make detailed physical examinations of growing children in this community, and through the great kindness of Dr. Hans Eggenberger, Director of Public Health for this general district, we were given an opportunity to do so.

Arrangements were made by Dr. Eggenberger so that typical groups of children, some in institutions, could be studied. He is located at Herisau in the Canton of St. Gall. We found work well organized for building up the health of these children in so far as outdoor treatment, fresh air, and sunshine were concerned. As dental caries is a major problem, and probably nutritional, it is treated by sunshine. The boys' group and girls' group are both given suitable athletic sports under skillfully trained directors. These groups are located in different parts of the city. Their recreation grounds are open lawns adjoining wooded knolls which give the children protection and isolation in which to play in their sunsuits and build vigorous appetites, and thus to prepare for their institutional foods which were largely from a modern menu. Critical dental examinations were made and an analysis of the data obtained revealed that one-fourth of all teeth of these growing boys and girls had already been attacked by dental caries, and that only 4 per cent of the children had escaped from the ravages of tooth decay, which disease many of them had in an aggravated form.

In the Herisau group 25.5 per cent of the 2,065 teeth examined had been attacked by dental caries and many teeth were abscessed. The upper photographs in Fig. 4 are of two girls with typically rampant tooth decay. The one to the left is sixteen years of age and several of her permanent teeth are decayed to the gum line. Her appearance is seriously marred, as is also that of the girl to the right.

Another change that is seen in passing from the isolated groups with their more nearly normal facial developments, to the groups of the lower valleys, is the marked irregularity of the teeth with narrowing of the arches and other facial features. In the lower half of Fig. 4 may be seen two such cases. While in the isolated groups not a single case of a typical mouth breather was found, many were seen among the children of the lower-plains group. The children studied were from ten to sixteen years of age.

Fig. 4. In the modernized districts of Switzerland tooth decay is rampant. The girl, upper left, is sixteen and the one to the right is younger. They use white bread and sweets liberally. The two children below have very badly formed dental arches with crowding of the teeth. this deformity is not due to heredity.

Many individuals in the modernized districts bore on their faces scars which indicated that the abscess of an infected tooth had broken through to the external surface where it had developed a fistula with resultant scar tissue, thus producing permanent deformity.

Bad as these conditions were, we were told that they were better than the average for the community. The ravages of dental caries had been strikingly evident as we came in contact with the local and traveling public. As we had at St. Moritz, we found an occasional child with much better teeth than the average. Usually the answer was not far to seek. For example, in one of the St. Moritz groups, in a class of sixteen boys, there were 158 cavities, or an average of 9.8 cavities per person (fillings are counted as cavities). In the cases of three other children in the same group, there were only three cavities, and one case was without dental caries. Two of these three had been eating dark bread or entire-grain bread, and on