10 страница. A great service could be rendered to these people who are in the process of modernization, but who have no opportunity for dental assistance

A great service could be rendered to these people who are in the process of modernization, but who have no opportunity for dental assistance, by teaching some of the bright young men certain of the procedures for rendering first aid. They could be compensated by contributions of native foods and native wares much as our itinerant dentists were in earlier days. The people would not have money to pay an American or European dentist for his service until trade is carried on with currency.

Nearly all these racial stocks are magnificent singers for which Nature has well-equipped them physically. Their artistry can be judged by the fact that they sing very difficult music unaccompanied and undirected. A large native chorus at Nukualofa, in the Tongan Group, sang without accompaniment "The Hallelujah Chorus" from Handel's Messiah with all the parts and with phenominal volume and modulation. Much of their work, such as rowing their largest boats, and many of their sports are carried out to the rhythm of hilarious music.

Many of the island groups recognize that their races are doomed since they are melting away with degenerative diseases, chiefly tuberculosis. Their one overwhelming desire is that their race shall not die out. They know that something serious has happened since they have been touched by civilization. Surely our civilization is on trial both at home and abroad.

The nutrition of the primitive Polynesians is continually reinforced with animal life from the sea which includes both soft- and hard-shell forms. The incidence of tooth decay varied from 0.6 per cent for the most isolated groups to 33.4 per cent for the modernized groups. Those individuals living in their native environment on their native foods have universally normal facial and dental arch form reproducing the characteristics of the race. Those living on the normal environment except for using the imported foods of white flour, sugar, sugar products, syrup, polished rice, and the like, have in the succeeding generations marked changes in facial and dental arch forms.

REFERENCE

1. FERGUSON, R. A. A dental survey of the school children of American Samoa. J. Am. Dent. A., 21:534, 1934.

TABLE OF CONTENTS

Chapter 9

ISOLATED AND MODERNIZED AFRICAN TRIBES

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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