- Email: [email protected]
Primitive Peoples Without Salt: A Perspective for Industrialized Societies
Book reviews / Social Science & Medicine 51 (2000) 1569±1572
®ve examples of historical studies from pre-history to the recent past, in which an examination of relations of power and production have helped explain health and mortality data. For instance, Debra Martin explains how understanding the social circumstances and experience of oppression among current societies provides an insight into archeological evidence and vice versa, then gives an example of gender dierences in physical violence between native Americans living in a developed hierarchical society and those living in a marginal but more equal society (pp. 171±190) the gist of which is that in the more socialised society women are forced into inferior positions of power and commodity production, and become subject to more severe physical violence. This section also includes accounts of health inequalities in American prehistory and in European antiquity, of infant mortality in nineteenth century Massachusetts and of mortality in the 1813 Typhus epidemic in Mexico City. The third section gives examples from studies among contemporary populations, all from the Americas. A highlight for me was the analysis of illness and household production in the Andes by Leatherman (pp. 245±267). Social and economic relations are shown to aect health and in return, poor health aects household production, while the hitherto predominant in¯uence in anthropological studies of altitude and environmental hardship are shown to be of negligible importance. A chapter by DeWalt on population increase and malnutrition in Southern Honduras (pp. 295±316) ®nds the prevalent Malthusian explanation to be without substance, whereas it is economic and political inequalities that have forced farmers into destructive and non-sustainable land use. Other chapters in this section cover the eects of tourism on Mayan communities in Mexico, changes in health and nutrition among amazonian Indians, and a study of poverty and childhood growth in Kentucky. The ®nal section discusses the implications of adopting a political economic approach to analysis in anthropology and the practical bene®ts this oers both
1571
anthropologists and the wider society. In addition to the two aforementioned chapters on racism, Lynn Morgan compares parallels between the way the social medicine movement in Latin America has adopted a political economic perspective, and the lessons that anthropology could learn. Hvalkov and Escobar discuss a postmodern approach to the way ``nature'' and the environment are conceptualized and how a political economic perspective oers anthropologists an opportunity to work constructively with the people they study. Finally, Gavin Smith and Brooke Thomas draw the book to a close with a plea for further collaborative work between biological and cultural anthropologists. This book provides a careful, thorough and wideranging analysis of a topic which is of broad disciplinary relevance. Even so, I suspect the main audience will be within anthropology. There is a strong American bias in the authors, the subject matter and, more tellingly, in the way the problems are presented. That being so, the way that dierent groups of immigrant and indigenous populations have interacted and oppressed each other in the American continent provides a rich fermenting brew for anthropologists. The chapters are well balanced and edited although suer a little from repetition of the basic message that political economy is good for you (or at least for anthropologists). Some of the analyses were rather super®cial and the authors might have taken their own message to heart by collaborating with like minded researchers outside their own discipline, such as epidemiologists, sociologists and geographers and statisticians. Despite these quibbles I enjoyed reading this stimulating and thought-provoking book.
Richard Reading School of Health Policy and Practice, University of East Anglia Norwich NR4 7TJ, UK
PII: S 0 2 7 7 - 9 5 3 6 ( 0 0 ) 0 0 0 3 5 - 6
Primitive Peoples Without Salt: A Perspective for Industrialized Societies William Oliver, Quality Books, Ann Arbor, MI, 1998, 290 pp., (cloth) $20.50
Dr William Oliver's book `Primitive Peoples Without
Salt' catalogues the diets of hunter±gatherer societies as observed by European or American explorers, traders, and scientists over the last four hundred years or, in his words, post-Columbian period. The focus is on diets of those cultures in North America, South America, Australia, Paci®c Islands and Central Africa still isolated from western culture at the time of the con-
1572
Book reviews / Social Science & Medicine 51 (2000) 1569±1572
tact. The book begins in North America with accounts of various Amerindians from the St Lawrence River Valley in the sixteenth century to those in the Southwestern United States and on to those on the West Coast as far north as Alaska. This coverage includes tribes living in the plains where food was plentiful in summer but scarce in winter to those dependent on the sea as a source of most of their food. As is the case for all his reports, there was scant evidence of salt de®ciency. Children were healthy, and, despite problems of food spoilage, no diarrhea was noted. The most detailed report is from South American Indians, particularly the Yanomamo who were the subjects of Dr Oliver's own important work documenting the response of Yanomamo women to pregnancy and lactation. This clear challenge to salt homeostasis was met by elevating renin and aldosterone levels and maximally conserving such salt as was a part of their diet. For example, urine was near salt free. This, more than any other case study, noted a robust physiological response to the challenge of pregnancy which requires a positive salt balance to support fetal growth. The reproductive rate and success in child rearing con®rm success in meeting the challenge of pregnancy. It is the warlike nature of these people who would regularly raid neighboring tribes to avenge slights that kept population under control and not dietary de®ciency of salt. Another example documented was the reported cannibalism of the Paci®c Maori who `lived largely on fern root and other vegetation' and `who had little in the way of ¯esh food'. Yet another colorful tale concerned the Bushmen of the Kalahari in southern PII: S 0 2 7 7 - 9 5 3 6 ( 0 0 ) 0 0 0 3 6 - 8
* Tel.: +1-415/669-1422.
Africa. Theirs is one long struggle for food, including `Bushman rice' or ants gathered in abundance as a staple to provide calories and protein. In a summary chapter on salt appetite describing the evolution of renal conservation of sodium and chloride, Oliver reviews the distinction between salt need [low] and salt appetite, an acculturated taste that some of the low salt people adapted, but not before initially rejecting it. The theme emerges that speci®c nutritional de®ciencies among hunter±gatherers were not common once food was sucient to meet calorie needs. Oliver notes this circumstance in light of the health consequences of dietary excess that marks our present culture and the diseases that dietary excess is bringing. The book has an informal tone, and is enriched by generous and colorful quotes of early chroniclers. The text would have bene®ted from an editor willing to use a sharp pencil and impose a certain consistency. Nonetheless, the book provides a lively account of how we survived as hunter±gatherers with just enough salt. The diets would satisfy Dr Ornish, but not measure up to the gourmand meals regular touted in our present culture. He is wise to leave open the question of `what is an ideal salt intake?'
Malcolm Holliday* Emeritus Professor of Pediatrics, University of California San Francisco, Box 648, Inverness, CA 94937, USA E-mail address: [email protected]
®ve examples of historical studies from pre-history to the recent past, in which an examination of relations of power and production have helped explain health and mortality data. For instance, Debra Martin explains how understanding the social circumstances and experience of oppression among current societies provides an insight into archeological evidence and vice versa, then gives an example of gender dierences in physical violence between native Americans living in a developed hierarchical society and those living in a marginal but more equal society (pp. 171±190) the gist of which is that in the more socialised society women are forced into inferior positions of power and commodity production, and become subject to more severe physical violence. This section also includes accounts of health inequalities in American prehistory and in European antiquity, of infant mortality in nineteenth century Massachusetts and of mortality in the 1813 Typhus epidemic in Mexico City. The third section gives examples from studies among contemporary populations, all from the Americas. A highlight for me was the analysis of illness and household production in the Andes by Leatherman (pp. 245±267). Social and economic relations are shown to aect health and in return, poor health aects household production, while the hitherto predominant in¯uence in anthropological studies of altitude and environmental hardship are shown to be of negligible importance. A chapter by DeWalt on population increase and malnutrition in Southern Honduras (pp. 295±316) ®nds the prevalent Malthusian explanation to be without substance, whereas it is economic and political inequalities that have forced farmers into destructive and non-sustainable land use. Other chapters in this section cover the eects of tourism on Mayan communities in Mexico, changes in health and nutrition among amazonian Indians, and a study of poverty and childhood growth in Kentucky. The ®nal section discusses the implications of adopting a political economic approach to analysis in anthropology and the practical bene®ts this oers both
1571
anthropologists and the wider society. In addition to the two aforementioned chapters on racism, Lynn Morgan compares parallels between the way the social medicine movement in Latin America has adopted a political economic perspective, and the lessons that anthropology could learn. Hvalkov and Escobar discuss a postmodern approach to the way ``nature'' and the environment are conceptualized and how a political economic perspective oers anthropologists an opportunity to work constructively with the people they study. Finally, Gavin Smith and Brooke Thomas draw the book to a close with a plea for further collaborative work between biological and cultural anthropologists. This book provides a careful, thorough and wideranging analysis of a topic which is of broad disciplinary relevance. Even so, I suspect the main audience will be within anthropology. There is a strong American bias in the authors, the subject matter and, more tellingly, in the way the problems are presented. That being so, the way that dierent groups of immigrant and indigenous populations have interacted and oppressed each other in the American continent provides a rich fermenting brew for anthropologists. The chapters are well balanced and edited although suer a little from repetition of the basic message that political economy is good for you (or at least for anthropologists). Some of the analyses were rather super®cial and the authors might have taken their own message to heart by collaborating with like minded researchers outside their own discipline, such as epidemiologists, sociologists and geographers and statisticians. Despite these quibbles I enjoyed reading this stimulating and thought-provoking book.
Richard Reading School of Health Policy and Practice, University of East Anglia Norwich NR4 7TJ, UK
PII: S 0 2 7 7 - 9 5 3 6 ( 0 0 ) 0 0 0 3 5 - 6
Primitive Peoples Without Salt: A Perspective for Industrialized Societies William Oliver, Quality Books, Ann Arbor, MI, 1998, 290 pp., (cloth) $20.50
Dr William Oliver's book `Primitive Peoples Without
Salt' catalogues the diets of hunter±gatherer societies as observed by European or American explorers, traders, and scientists over the last four hundred years or, in his words, post-Columbian period. The focus is on diets of those cultures in North America, South America, Australia, Paci®c Islands and Central Africa still isolated from western culture at the time of the con-
1572
Book reviews / Social Science & Medicine 51 (2000) 1569±1572
tact. The book begins in North America with accounts of various Amerindians from the St Lawrence River Valley in the sixteenth century to those in the Southwestern United States and on to those on the West Coast as far north as Alaska. This coverage includes tribes living in the plains where food was plentiful in summer but scarce in winter to those dependent on the sea as a source of most of their food. As is the case for all his reports, there was scant evidence of salt de®ciency. Children were healthy, and, despite problems of food spoilage, no diarrhea was noted. The most detailed report is from South American Indians, particularly the Yanomamo who were the subjects of Dr Oliver's own important work documenting the response of Yanomamo women to pregnancy and lactation. This clear challenge to salt homeostasis was met by elevating renin and aldosterone levels and maximally conserving such salt as was a part of their diet. For example, urine was near salt free. This, more than any other case study, noted a robust physiological response to the challenge of pregnancy which requires a positive salt balance to support fetal growth. The reproductive rate and success in child rearing con®rm success in meeting the challenge of pregnancy. It is the warlike nature of these people who would regularly raid neighboring tribes to avenge slights that kept population under control and not dietary de®ciency of salt. Another example documented was the reported cannibalism of the Paci®c Maori who `lived largely on fern root and other vegetation' and `who had little in the way of ¯esh food'. Yet another colorful tale concerned the Bushmen of the Kalahari in southern PII: S 0 2 7 7 - 9 5 3 6 ( 0 0 ) 0 0 0 3 6 - 8
* Tel.: +1-415/669-1422.
Africa. Theirs is one long struggle for food, including `Bushman rice' or ants gathered in abundance as a staple to provide calories and protein. In a summary chapter on salt appetite describing the evolution of renal conservation of sodium and chloride, Oliver reviews the distinction between salt need [low] and salt appetite, an acculturated taste that some of the low salt people adapted, but not before initially rejecting it. The theme emerges that speci®c nutritional de®ciencies among hunter±gatherers were not common once food was sucient to meet calorie needs. Oliver notes this circumstance in light of the health consequences of dietary excess that marks our present culture and the diseases that dietary excess is bringing. The book has an informal tone, and is enriched by generous and colorful quotes of early chroniclers. The text would have bene®ted from an editor willing to use a sharp pencil and impose a certain consistency. Nonetheless, the book provides a lively account of how we survived as hunter±gatherers with just enough salt. The diets would satisfy Dr Ornish, but not measure up to the gourmand meals regular touted in our present culture. He is wise to leave open the question of `what is an ideal salt intake?'
Malcolm Holliday* Emeritus Professor of Pediatrics, University of California San Francisco, Box 648, Inverness, CA 94937, USA E-mail address: [email protected]