Recent History
April 15, 1990
Fred Bruemmer
Arctic Memories - Return to Diomede
"Long ago, when I was young, said Albert Iyahuk, "people were never sick." Now cancer and heart disease were common; one of the causes may be a partial change to Western food. Recent studies by scientists have shown "that the incidence of cancer [among Inuit] has increased significantly following westernization."
I flew to Anchorage, Alaska, in the spring of 1990 and the news was bad. Hunting for ivory had fallen into ill repute. To save Africa's elephants a world-wide ban on ivory trade was now in effect. There had been reports in magazines and in Alaskas press of Inuit "headhunting, of killing walruses only for their tusks, leaving the headless carcasses upon the ice. The more lurid reports spoke of "chainsaw gangs" that lopped off walrus heads. The Diomeders, I guessed, would be very touchy. A Japanese TV crew, I was told, had offered the Diomeders big money to film the walrus hunt and had been curtly advised that they and their money were not wanted. "I wouldn't be surprised," a biologist friend in Anchorage told me, "if they put you back on the helicopter and tell you to fly off."
That was another change: a heliport at Diomede and weekly helicopter service from Nome. It all looked so familiar: the fields of ice in Bering Strait; the soaring cliffs of Diomede; the weather-gray houses glued to the mountainside; the umiaks on their racks; the great rust-red tanks for oil and gas. I stared down and worried about my welcome. The helicopter landed on a new metal pad on the beach. There was the familiar smell of sea and wrack and walrus oil. And there stood Tom Menadelook and Mary. He recognized me instantly and was as brief and decisive as ever. "Good to see you back," he said. "Mary and I are going to Portland [Oregon] for Etta's graduation. You can stay at our house." Junior," he called, and from the crowd around the helicopter came a heavyset, sturdy young man: Tom, Jr., now twenty-six, father of three lovely children, a fine hunter, and the village policeman. "This is Fred," his father said. "He'll stay at our place. Get him the keys. And he'll go out again with our boat." All my worries vanished.
Young men carried the bags up to "my" house. I followed slowly, up the steep, familiar cobbled path. Annie Iyahuk sat on the steps of her house. "Come in," she said. "Albert will be glad to see you." Albert, with whom long ago I had collected greens on the slopes of Diomede, now in his seventies, was thin and frail but still an excellent carver. He grasped my hand in both of his. "Ah," he said. "You came back to us." I was given tea and bread, and hard-boiled eggs with seal oil. After fifteen years, it was like coming home.
There had been many changes in these years: a large new school had been built, a new store, some new houses, a "washateria" owned, like the store, by the islanders and paid for, in large part, with money made from ivory carving. It was kept spotlessly clean and for three dollars one could shower, wash a load of clothing, and dry it. The washateria brought in $100,000 in its first year of operation.
There was one drastic change: Diomede was dry. All alcohol was forbidden. The planes with booze, the wild parties, the fights, the smashed windows, the drunken threats, the bilious hangovers were now only memories of a violent past. "It sure is quiet, kidded George Milligrock, once one of the wild young men of Diomede and now approaching portly middle age. "Yes," he agreed with a touch of regret, "we're getting to be quite civilized." Young Inuit who had tried city life in Nome, Anchorage, or Seattle and were nearly crushed by drink and other problems, had returned to Diomede, to their roots, to an older, simpler way of life. The population of Ignaluk, after shrinking for many years to a low of 84 in 1970, had increased to 121 in 1975, and to 171 in 1990.
Life on Diomede was peaceful, pleasant, quiet. It certainly was a nicer, gentler place than on my first visit - and yet, some of the panache, the verve, that devil-may-care daring was gone, and at times I felt a certain perverse nostalgia for the wildness of the bad old days.
"Civilization" also seemed to have exacted a bitter price. Once Diomeders had been famous for their daring and their vigorous health. The Smithsonian Institution anthropologist Ales Hrdlicka visited Little Diomede in 1926. "The natives look sturdy, " he noted. "None other could survive here." Shortly after I arrived, I met John Iyapana who, on my previous visit, had taken me by umiak back to the mainland. I remembered him as a weather-beaten, bluff bear of a man, violent when drunk, affable when sober, with an immense fund of stories about Diomede. Now he was a broken hulk, wan and weak. He pulled a notebook from his pocket and wrote: "Welcome back, Fred! Cancer had destroyed his throat and vocal cords; he could no longer speak. He would never tell stories again.
"Long ago, when I was young, said Albert Iyahuk, "people were never sick." Now cancer and heart disease were common; one of the causes may be a partial change to Western food. Recent studies by scientists from the Emory University Medical School have shown "that the incidence of cancer [among Inuit] has increased significantly following westernization."
April 1, 1997
Why I Am Not A Vegetarian
William T. Jarvis, Ph.D. is a famous exvegetarian who wrote: "Because of the influence of my Seventh-day Adventist (SDA) environment, I practiced vegetarianism for many years. My wife and I even tried to give up consuming all animal products, but this didn't work."
Vegetarianism has taken on a "political correctness" comparable to the respectability it had in the last century, when many social and scientific progressives advocated it. Today, crusaders extol meatless eating not only as healthful but also as a solution to world hunger and as a safeguard of "Mother Earth." The Physicians Committee for Responsible Medicine (PCRM) aggressively attacks the use of animal foods and has proposed its own food-groups model, which excludes all animal products.
I disclaimed vegetarianism after many years of observance. Although the arguments in favor of it appear compelling, I have learned to be suspicious, and to search for hidden agendas, when I evaluate claims of the benefits of vegetarianism. Vegetarianism is riddled with delusional thinking from which even scientists and medical professionals are not immune.
Don't get me wrong: I know that meatless diets can be healthful, even desirable, for some people. For example: (a) Men with an iron-loading gene are better off without red meat, because it contains heme iron, which is highly absorbable and can increase their risk of heart disease. (b) Because vegetarian diets are likely to contain less saturated fat than nonvegetarian diets, they may be preferable for persons with familial hypercholesterolemia. (c) Vegetables contain phytochemicals that appear protective against colorectal cancer. (d) Homocysteinemia (elevated plasma homocysteine) approximately doubles the risk of coronary artery disease. Several congenital and nutritional disorders, including deficiencies of vitamins B6 and B12 and folic acid, can cause this condition. Since folic acid occurs mostly in vegetables, low intakes of the vitamin are less likely among vegetarians than among nonvegetarians. (e) Some people find that being a vegetarian helps to control their weight. Vegetarianism tends to facilitate weight control because it is a form of food restriction; and in our overfed society, food restriction is a plus unless it entails a deficit of some essential nutrient.
However, one need not eliminate meat from one's diet for any of the foregoing reasons. Apparently, it is ample consumption of fruits and vegetables, not the exclusion of meat, that makes vegetarianism healthful.
Dog Day Afternoon?
The term "vegetarian" is misleading, for it is not a name for people who favor vegetable consumption, but a code word for those who disfavor or protest the consumption of animal foods. The neologism anticarnivorist better characterizes the majority of those who call themselves vegetarians. I call myself a "vegetable enthusiast," because I strongly encourage eating lots of vegetables, including legumes, whole grains, and fruits. I believe that these foods are desirable not only because of their high nutrient density and low caloric density, but also because of aesthetic and gustatory factors. Being a vegetable enthusiast doesn't entail rejecting the use of meat or animal products.
Most people who categorize vegetarians identify at least five different kinds, based on which types of animal food they consume: Semivegetarians consume dairy products, eggs, fish, and chicken; pesco-vegetarians consume dairy products, eggs, and fish; lacto-ovo-vegetarians, dairy products and eggs; ovo-vegetarians, eggs; and vegans, no animal foods. From a behavioral standpoint, I categorize vegetarians as either pragmatic or ideologic. A pragmatic vegetarian is one whose dietary behavior stems from objective health considerations (e.g., hypercholesterolemia or obesity). Pragmatic vegetarians are rational, rather than emotional, in their approach to making lifestyle decisions. In contrast, vegetarianism is a "matter of principle" for ideologic vegetarians; its appropriateness is a given.
One can spot ideologic vegetarians by their exaggerations of the benefits of vegetarianism, their lack of skepticism, and their failure to recognize (or their glossing over of) the potential risks even of extreme vegetarian diets. Ideologic vegetarians make a pretense of being scientific, but they approach the subject of vegetarianism more like lawyers than scientists. Promoters of vegetarianism gather data selectively and gear their arguments toward discrediting information that is contrary to their dogma. This approach to defending a position is suitable for a debate, but it cannot engender scientific understanding.
Because of the influence of my Seventh-day Adventist (SDA) environment, I practiced vegetarianism for many years. My wife and I even tried to give up consuming all animal products, but this didn't work. We sometimes muse aloud about the morning we put soymilk on our breakfast cereal. We ended up eating the cereal with a fork because we found the mixture repulsive. We had another unforgettable experience when we ate with a group of vegetarian hippies in the Oregon woods. We were there at their request to advise them on vegetarian eating. They had already prepared the worst-looking vegetarian stew I have ever seen or tasted. It consisted of raw peanuts and a variety of half-cooked vegetables. After eating it, I had heartburn for hours. Digestive distress is legendary among SDAs.
Reasons for adopting vegetarianism can be very personal. Some years ago I shared a podium for several days with a vegetarian. It became clear from our informal conversations that he was not religious; so I asked him why he had opted for vegetarianism. He told me a touching story about having been a lonely boy whose closest companion was his pet dog. He said that, peering into the dog's eyes one day, he had come to see the animal as a fellow being. Soon he had applied this view to all animals, and since he could not bear the thought of eating his dog, he could no longer eat other animals.
Ancient History
8000
B.C.E.
Evolutionary and Population Genomics of the Cavity Causing Bacteria Streptococcus mutans
S. Mutans, the bacteria involved in creating cavities likely evolved and expanded with the population growth 10,000 years ago as humans started relying more on starches and sugars.
Streptococcus mutans is widely recognized as one of the key etiological agents of human dental caries. Despite its role in this important disease, our present knowledge of gene content variability across the species and its relationship to adaptation is minimal. Estimates of its demographic history are not available. In this study, we generated genome sequences of 57 S. mutans isolates, as well as representative strains of the most closely related species to S. mutans (S. ratti, S. macaccae, and S. criceti), to identify the overall structure and potential adaptive features of the dispensable and core components of the genome. We also performed population genetic analyses on the core genome of the species aimed at understanding the demographic history, and impact of selection shaping its genetic variation. The maximum gene content divergence among strains was approximately 23%, with the majority of strains diverging by 5–15%. The core genome consisted of 1,490 genes and the pan-genome approximately 3,296. Maximum likelihood analysis of the synonymous site frequency spectrum (SFS) suggested that the S. mutans population started expanding exponentially approximately 10,000 years ago (95% confidence interval [CI]: 3,268–14,344 years ago), coincidental with the onset of human agriculture. Analysis of the replacement SFS indicated that a majority of these substitutions are under strong negative selection, and the remainder evolved neutrally. A set of 14 genes was identified as being under positive selection, most of which were involved in either sugar metabolism or acid tolerance. Analysis of the core genome suggested that among 73 genes present in all isolates of S. mutans but absent in other species of the mutans taxonomic group, the majority can be associated with metabolic processes that could have contributed to the successful adaptation of S. mutans to its new niche, the human mouth, and with the dietary changes that accompanied the origin of agriculture.
Undoubtedly, one of the major challenges that S. mutans had to overcome as the carbohydrate content of the human diet increased was surviving at low pH. Although S. mutans does not constitute a significant proportion of the oral flora colonizing healthy dentition, it can become numerically significant when there is repeated and sustained acidification of the biofilms associated with excess dietary carbohydrates or impaired salivary function (Burne 1998).
Luxor, Luxor Governorate, Egypt
2475
B.C.E.
The Earliest Record of Sudden Death Possibly Due to Atherosclerotic Coronary Occlusion
WALTER L. BRUETSCH
The sudden death of an Egyptian noble man is portrayed in the relief of a tomb from the Sixth Dynasty (2625-2475 B.C.). Since there is indisputable evidence from the dissections of Egyptian mummies that atherosclerosis was prevalent in ancient Egypt, it was conjectured that the sudden death might have been due to atherosclerotic occlusion of the coronary arteries.
It may be presumptuous to assume that an Egyptian relief sculpture from the tomb of a noble of the Sixth Dynasty (2625-2475 B.C.) may suggest sudden death possibly due
to coronary atherosclerosis and occlusion. Much of the daily life of the ancient Egyptians has been disclosed to us through well-preserved tomb reliefs. In the same tomb that contains the scene of the dying noble, there is the more widely known relief "Netting Wildfowl in the Marshes." The latter sculpture reveals some of the devices used four thousand years ago for catching waterbirds alive. It gives a minute account of this occupation, which in ancient Egypt was both a sport and a means of livelihood for the professional hunter.
The relief (fig. 1), entitled "Sudden Death," by the Egyptologist von Bissing2 represents a nobleman collapsing in the presence of his servants. The revelant part of the explanatory text, as given by von Bissing, follows (translation by the author):
The interpretation of the details of the theme is left to the observer. We must attempt to comprehend the intentions of the ancient artist who sculptured this unusual scene. In the upper half (to the right) are two men with the customary brief apron, short hair covering the ears, busying themselves with a third man, who obviously has collapsed. One of them, bending over him, has grasped with both hands the left arm of the fallen man; the other servant, bent in his left knee, tries to uphold him by elevating the head and neck, using the knee as a support. Alas, all is in vain. The movement of the left hand of this figure, beat- ing against the forehead, seems to express the despair; and also in the tightly shut lips one can possibly recognize a distressed expression. The body of the fallen noble is limp. . . . Despite great restraint in the interpretation, the impression which the artist tried to convey is quite obvious. The grief and despair are also expressed by the figures to the left. The first has put his left hand to his forehead. (This gesture represents the Egyptian way of expressing sorrow.) At the same time he grasps with the other arm his companion who covers his face with both hands. The third, more impulsively, unites both hands over his head. ... The lord of the tomb, Sesi, whom we can identify here, has suddenly collapsed, causing consternation among his household.
In the section below (to the left) is shown the wife who, struck by terror, has fainted and sunk totheflor. Two women attendants are seen giving her first aid. To the right, one observes the wife, holding on to two distressed servants, leaving the scene. . . .
von Bissing mentions that the artist of the relief must have been a keen observer of real life. This ancient Egyptian scene is not unlike the tragedy that one encounters in present days, when someone drops dead of a "heart attack." The physician of today has almost no other choice than to certify the cause of such a death as due to coronary occlusion or thrombosis, unless the patient was known tohave been aflictedwith rheumatic heart disease or with any of the other more rare conditions which may result in sudden death.
Atherosclerosis among the Ancient Egyptians
The most frequent disease of the coronary arteries, causing sudden death, is atherosclerosis. What evidence is available that atherosclerosis was prevalent in ancient Egypt?
The first occasion to study his condition in peoples of ancient civilizations presented itself when the mummified body of Menephtah (approx.1280-1211B.C.), the reported "Pharaoh of the Hebrew Exodus" from Egypt was found. King Menephtah had severe atherosclerosis. The mummy was unwrapped by the archaeologist Dr. G. Elliot Smith, who sent a piece of the Pharaoh's aorta to Dr. S. G. Shattock of London (1908). Dr. Shattock was able to prepare satisfactory microscopic sections which revealed advanced aortic atherosclerosis with extensive depositions of calcium phosphate.
This marked the beginning of the important study of arteriosclerosis in Egyptian mummies by Sir Mare Armand Ruffer, of the Cairo Medical School(1910-11). His material included mummies ranging over a period of about 2,000 years (1580 B.C. - 525 A.D.).
The technic of embalming in the days of ancient Egypt consisted of the removal of all the viscera and of most of the muscles, destroying much of the arterial system. Often, however, a part or at times the whole aorta or one of the large peripheral arteries was left behind. The peroneal artery, owing to its deep situation, frequently escaped the em- balmer'sknife. Otherarteries,suchasthe femorals, brachials, and common carotids, had persisted.
In some mummies examined by Ruffer the abdominal aorta was calcified in its entirety, the extreme calcification extending into the iliae arteries. Calcified plaques were also found in some of the larger branches of the aorta. The common carotid arteries frequently revealed patches of atheroma, but the most marked atheroselerotic alterations were in the arteries of the lower extremities. The common iliae arteries were not infrequently studded with calcareous plaques and in some instances the femoral arteries were converted into rigid tubes. In other mummies, however, the same arteries were near normal.
What is known as Mdnekeberg's medial calcification was also observed in some of the mummified bodies. In a histologic section of a peronieal artery, the muscular coat had been changed almost wholly by calcification. In one of Ruffer's photographic plates, a part of a calcified ulnar artery is shown. The muscular fibers had been completely replaced by calcification.
In the aorta, as in present days, the atherosclerotic process had a predilection for the points of origin of the intercostal and other arteries. The characteristics and the localization of the arterial lesions observed in Egyptian mummies leaves litle doubt that atherosclerosis in ancient times was of the same nature and degree as seen in today's postmortem examinations.
As to the prevalence of the disease, Ruffer ventured to say that the Egyptians of ancient times suffered as much as modern man from arterial lesions, identical with those found in our times. Ruffer was well qualified to make this statement having performed many autopsies on modern Egyptians, Moslems, and other people of the Middle East. In going over his material and examining the accompanying photographic plates of arteries, one can have litle doubt that what Ruffer had observed in Egyptian mummies represented arteriosclerosis as it is known today.
Although the embalming left no opportunity to examine the coronary arteries inl mummified bodies, the condition of the aorta is a good index of the decree of atheroselerosis present elsewhere. In individuals with extensive atheroselerosis of the aorta, there is almost always a considerable degree of atherosclerosis in the coronary arteries. If Ruffer's statement is correct that the Egyptians of 3,000 years ago were afflicted with arteriosclerosis as much as we are nowadays, coronary occlusion must have been common among the elderly population of the pre-Christian civilizations.
Furthermore, gangrene of the lower extremities in the aged has been recognized since the earliest records of disease. Gangrene of the extremities for centuries did not undergo critical investigation until Cruveilhier (1791- 1873) showed that it was caused by atherosclerotic arteries, associated at times with a terminal thrombus.
SUMMARY
The record of a sudden death occurring in an Egyptian noble of the Sixth Dynasty (2625-2475 B.C.) is presented. Because of the prevalence of arteriosclerosis in ancient Egyptian mummies there is presumptive evidence that this incident might represent sudden death due to atheroselerotic occlusion of the coronary arteries.
Cairo, Cairo Governorate, Egypt
1580
B.C.E.
ON ARTERIAL LESIONS FOUND IN EGYPTIAN MUMMIES
Arteries of Egyptian mummies from 1580 B.C.E. to 525 A.D. have extensive calcification of the arteries, the same nature as we see today, and unlikely to be due to a very heavy meat diet, which was always a luxury in ancient Egypt. Instead, the diet was mostly a course vegetarian one.
DISCUSSION OF RESULTS.
Nature of the lesions. There can be no doubt respecting the calcification of the arteries, and that it is of exactly of the game nature as we see at the present day, namely, calcification following on atheroma.
The small patches seen in the arteries are atheromatous, and though the vessels have without doubt been altered by the three thousand years or so which have elapsed since death, nevertheless the lesions are still recognisable by their position and microscopical structure.
The earliest signs of the disease are always seen in or close below the fenestrated membrane,-that is, just in the position where early lesions are seen at the present time. The disease is characteiised by a marked degeneration of the muscular coat and of the endothelium. These diseased patches, discrete at first, fuse together later, and finally form comparatively large areas of degenerated tissue, which may reach the surface and open out into the lumen of the tube. I need not point out how completely this description agrees with that of the same disease as seen at the present time.
I have already mentioned the absence of leucocytes and cellular infiltration, and need not therefore return to it here.
In my opinion, therefore, the old Egyptians suffered as much as we do now from arterial lesions identical with those found in the present time. Moreover, when we consider that few of the arteries examined were quite healthy, it would appear that such lesions were as frequent three thousand years ago as they are to-day.
I do not think we can accuse a very heavy meat diet. Meat is and always has been something of a luxury in Egypt, and although on the tables of offerings of old Egyptians haunches of beef, geese, and ducks are prominent, the vegetable offerings are always present in greater number. The diet then as now was mostly a vegetable one, and often very coarse, as is shown by the worn appearance of the crown of the teeth.
Nevertheless I cannot exclude a high meat diet as a cause with certainty, as the mummies examined were mostly those of priests and priestesses of Deir el-Bahari, who, owing to their high position, undoubtedly lived well. I must add, however, that I have seen advanced arterial disease in young modern Egyptians who ate meat very occasionally. In fact, my experience in Egypt and in the East has not strengthened the theory that meat-eating is a cause of arterial disease.
Finally, strenuous muscular exercise can also be excluded as a cause, aa there is no evidence that ancient Egyptians were greatly addicted to athletic sport, although we know that they liked watching professional acrobats and dancers. I n the ca6e of the priests of Deir el-Bahari, it is very improbable, indeed, that they were in the habit of doing very hard manual work or of taking much muscular exercise.
I cannot therefore at present give any reason why arterial disease should have been so prevalent in ancient Egypt. I think, however, that it is interesting to find that it was common, and that three thousand years ago it represented the same anatomical characters as it does now.
FIG. 1.-Pelvic and arteries of thigh completely calcified (XVIlIth-XXth Dynasty).
Fro. 2.-Completely dcifiedprofundaarteryaftersoakinginglycerine(XXIstDynasty). FIQ. 8.-Partly calcified aorta (XXVIIth Dynasty).
Fro. 4.-Calcified patches in aorta (XXVIIth Dynasty).
Fio. 5.-Calcified atheromatous ulcer of subclavian artery (XVIIIth-XXth Dynasty). Fro. &-Patch of atheroma i n anterior tibia1 artery (glycerine). The centre of the patch
is calcified (XXIst Dynasty).
FIG. 7.-Atheroma of brachial artery (glycerin) (XXIst Dynasty).
Fro. &-Unopened ulnar artery, atheromatous patch shining through (glycehne) (XXIst Dynasty). 31
FIG. 9.-Section through almost completely calcified posterior peroneal artery (low power). Van Gieson staining. a,al, n2, Remnants of endothelium and
fenestrated membrane. b, Calcified patches.
Many more are seen.
Same stain. (Leitz, Oc. 1, x &.)
FIG. 10.-Section
FIG. 11.-Section m(Leitz, Oc. 1, x *.)
a,Remains of endothelium.
b, Fenestrated membrane.
c, Muscular coat.
d,f,Membrane coat undergoing degenerntion.
e, Completely degenerated remnants of muscular coat.
atheroniatous patch of n h a r artery. Same stain. (Leitz, (Reference letters the same as in Fig. 11.)
FIG. 12.-Section Oc. 1, x fa.)
through calcified patch of ulnar artery. a,d, Calcified patches.
b, Partially calcified m wular coat. c, Annular muscular fibre.
through atheromatous patch of anterior tibia1 artery. Same stain through
FIG. 13.-Section at edge of atheromatous patch. Hreniatoxylin stain (Leitz, Oc. 1, XTh.1 a,Leucocytes (1). The atheromatous part on the left stains intensely dark with hamatoxylin.
