Cancer

This “inevitable doom” must have seemed even blacker to the Moravian medical missionaries who had dreamed it could be staved off indefinitely by avoiding the Europeanization of the food — by inducing healthy people to remain healthy through continuing to eat the raw foods which they loved and which they could secure in ample quantity from their own land and waters.

Ruefully Superintendent Peacock admits that the best they were able to do was to slow up Europeanization by a few generations. Among the first subversive influences, tending toward eventual dependence on the white man, was the fact that the Eskimos contracted first the tobacco habit and then the tea habit. Thereafter followed gradually the use of bread, salt, and sugar; then came increased cooking and the use of hot drinks. Still it was possible as late as the period 1902-13 for Dr. Hutton to conclude from his own observation that “cookery holds a very secondary place in the preparation of food.”

While he makes this observation on cooking as part of a suggested explanation as to why he could find no hearsay or other sign of cancer among the Labrador Eskimos, Dr. Hutton also makes, elsewhere, the general observations on the health of the Labrador Eskimo that “... his muscles are rested by a shorter period of sleep than is customary among civilized peoples. Men and women alike show the power of withstanding fatigue.” So long as their diet continued to consist exclusively of their own fresh foods, hardly cooked or raw, their robust health broke down only when they were exposed to European diseases against which they had no inherited immunity, such as the deadly measles and the almost equally deadly tuberculosis. But on the Europeanized diet they became prey to a swarm of other new diseases.

The territory most specifically observed by Romig is Temperate Zone southwestern Alaska, south of the Yukon River and west of a line drawn north from Seward and Anchorage to Fairbanks. The Europeanization of these parts started in the 1740's, soon after Bering's visit, and was intense in the Aleutians and along mainland Alaska's south coast and the southern west coast. There were little-touched sections, particularly the west coast farther north than the Kuskokwim; and then the interior, which is forested and chiefly inhabited by Athapaska Indians. So there were districts and families that had been “modernized” even before Romig first came; but there were others still so primitive that we might consider them untouched by such influences as those of European foods and food-handling methods. Which these little-influenced spots were, the medical missionary, when of sympathetic temper, would soon know. The total population, before the 1900 measles epidemic, would have been considerably more than 10,000; after the measles, considerably less.

During his first seven years, 1896-1903, Romig worked from Bethel, the Moravian mission on the lower Kuskokwim. He traveled considerably, by dog team in winter and canoe or launch in summer. His patients were chiefly Aleuts, Eskimos, and Athapaskans; but there was a scattering of Russian and other European whites, and of Chinese, Japanese, and Negroes. Some native women were married to these immigrants. They and their children were the chief modernized elements among whom — as among the immigrants themselves — Romig was now and then discovering malignancy cases.

In reply to a further query, the rector wrote again from Sitka on September 16, 1958. He confirmed that he had lived at Anvik all but three of the years between his birth in 1895 and his first journey in 1908 when he went out to become a graduate of Middlebury College, Vermont. “I returned to Anvik as a missionary in 1922 and lived there until 1948, except for furloughs and the four years I was in Fairbanks.

“The native people of the Anvik area are Athapaskans. During my youth the main parts of their food were meat (caribou, rabbits, grouse, waterfowl, beaver, porcupine, black bear and lynx) and fish (salmon, whitefish, shellfish, loche and lampreys). The loche has a large liver which is said to be even richer in vitamins than ordinary cod liver. The Indians also ate raw foods such as berries, wild rhubarb, and a root which they called ‘mouseberries’ because it was gathered and hoarded by field mice.

“They obtained fat from caribou, black bear, and beaver tails. The lampreys were rich in oil, which was highly prized. They also bought seal oil from the Eskimos. Even in my boyhood they supplemented their native diet with white man's food, including lard ...

“The usual way of cooking meat was either boiling or frying. As a boy I was once invited by a party of Indians to eat bear meat with them. It was boiled and well done ... I do not know that any flesh foods were eaten raw, except for dried fish ...”

Neither does the published literature on the forest Indians report that any flesh foods were customarily eaten raw by the forest Indians of Alaska or northern Canada. Indeed, the name “Eskimos” is believed by many to have been derived from an Algonquin expression meaning “they eat their meat raw.”

When I went down north along the Mackenzie, in 1906 and 1908, I now and then heard talk of how horrified the Athapaskans had been when they first saw white men of the Northwest Company and Hudson's Bay Company eating the customary British underdone roast meats. In 1910, when we met the Athapaskans northeast of Great Bear Lake — Dogribs, Slaves, and Yellowknives — we found that they were still mildly horrified to see the Hudson's Bay Company Canadian Joseph Hodgson and the Old Country British John Hornby and Cosmo Melvil, who were then living among them, eating rare caribou steaks and roasts.

In a presentation of evidence regarding the views of frontier doctors on the incidence of cancer, it is of consequence to make clear that early testimony regarding the rarity or absence of malignancies is as clear and strong for the forest Indian north as for the grassland Eskimo country. Some of the early medical missionaries — notably Dr. Hutton in Labrador — have inclined to credit a diet of raw flesh with that former absence of cancer in which they believed. To emphasize this point let me quote again Dr. Hutton's book Health Conditions (1925), Page 35:

“Some diseases common in Europe have no t come under my notice ... Of these diseases the most striking is cancer ... In this connection it may be noted that cookery holds a very secondary place in the preparation of food — most of the food is eaten raw ...”

If only Eskimos are considered, in relation to the alleged former absence of cancer, and of these only the Labradorians, then the logical deduction for one who believes nutrition to be fundamental in relation to malignancy, is that actual rawness of food may be the crucially important cancer-inhibiting factor. But the force of this logic diminishes as we go westward from Labrador, among the Eskimos. Without cancer's appearing at all, cooking grows steadily more important as we move west. From Dr. Hutton's and other accounts, the Labradorians, east of Hudson Bay, were the greatest raw-flesh eaters of the whole Eskimo world. West of the Bay the boiling of flesh increases; and inland from the Bay, among the Caribou Eskimos, the roasting of caribou supplements the boiling. At Coronation Gulf, near where Dr. Jenness and I spent the first years during which the Copper Eskimos ever associated closely with Europeans, the years 1910 to 1915, there was considerable summer use of roasting, though the winter cooking, if any, was by boiling. Among the Mackenzie Eskimos, as described from the 1860's by Father Emile Petitot and from the early 1900's by myself, boiling and roasting were both considerable. These methods were even a bit more common in northern Alaska, as described by John Simpson in the 1850's and Murdoch in the 1880's. In southwestern Alaska as described by Dr. Romig in the manuscript he submitted to our Encyclopedia Antarctica, for the last decade of the nineteenth century and the first one of the twentieth, the cooking of flesh foods reached its Eskimo high point.

Yet the mission testimony, starting from Labrador, remains equally clear, from east to west: the medical missionaries all looked for cancer, and they never found it among the “primitive,” though they did find it among the “modernized.”

Thus clarification is important for whoever expects a nutritional key to this Eskimo cancer situation. Among the Athapaska and western Eskimos cooking was hardly ever carried to the point of “well done,” or “boiled to pieces.” Instead the native meats resembled our fashionable roasts, which have a well-done layer on the outside, medium done just under that, and the center pink or red. And so it was with the forest Indians — at least with those Athapaskans from Great Bear Lake to just west of the Mackenzie, with whom I hunted and lived — though they insisted on some cooking, they were in practice as careful as Eskimo cooks to see that the centers of most pieces were pink.

To sum up the raw and cooked-food elements of northern medical missionary theorizing about cancer:

During the time when large numbers of non-Europeanized northern natives were allegedly free of cancer, there was little cooking of flesh foods beyond the degree which we call medium. Among grassland and coastal Eskimos raw flesh eating ranged from a great deal in northern Labrador to a good deal in southwestern Alaska. Only among forest Indians were raw flesh foods avoided, and even among these there was little use of overcooked flesh.

Vegetable foods, where eaten at all, were always raw, among prairie and woodland natives alike. Among Eskimos, vegetable foods were important only in the farthest west — along the west coast of Alaska, among the Aleutians, and along the south coast of Alaska. In the most northerly region from Baffin Island, Canada, to Point Barrow, Alaska, vegetable eating was negligible, except in time of famine. Among woodland Indians, vegetables were negligible with the Athapaskans from the west shore of Hudson Bay to beyond the Mackenzie. In Alaska the eating of raw vegetables by forest Indians increased westward along the northern belt and then increased still more southward, into the country of the Tlingit.

During the time when the medical missionaries reported cancer difficult or impossible to find among large numbers of primitive natives, there was no usual cooking of any vegetables, whether among grassland or forest natives. The cooking of vegetables is part of that Europeanization which is considered by some missionaries to be responsible for the introduction of cancer, or for the change from its being hard to find to its being impossible not to notice.

The European-style application of intense heat to food through frying was new to all northern North American natives.

All this was conversational stock in trade on the river in 1906; and, to a slightly lesser extent, also during my second journey, in 1908. There were humorous tales of amateur dentistry against toothache, and far from humorous ones of scurvy through which teeth came loose and finally dropped out, as death approached.

Speaking of the Klondikers, everybody was saying what the bishop had been the first to tell me — that, so far as scurvy was concerned, those tenderfeet were best off who brought the least food with them. For the Athapaskans would not see them die of hunger; and they fed the tenderfeet on medium-cooked fresh fish and game, to the general benefit of their health and the complete avoidance of scurvy.

No one, that I can remember, was seriously worried about cancer; nor was I myself particularly interested. As intimated, I now remember about malignant disease from my first journey chiefly that Bishop Reeve thought it to belong to a group of ills which had behind them nutritional issues. But I do remember noticing more talk of cancer as we approached the Eskimo country, to the effect that the New England whalers, who wintered among the Eskimos east and west of the Mackenzie delta, could find no more cancer among them than missionaries and fur traders had been able to find among the Athapaskans — meaning none. The bishop said he had discussed this with other missionaries who knew more than he did about the Eskimos; I think he mentioned the bishops Bompas and Stringer, and that he had sent messages through Stringer to the whaling captains bolstering their seacoast results with his own from the interior.

In their absence, the Flaxman Island base of the Anglo-American Polar Expedition was commanded by Dr. George Plummer Howe, the expedition's surgeon. It turned out that he and I had been contemporaries at Harvard, though we had never met — not strange, for the medical school is in Boston, and I had been in the divinity school and then in the graduate school, both of which are in Cambridge. He was A.B. 1900 and M.D. 1904.

Though a medical man by training, Dr. Howe proved to be an anthropologist at heart. What he told me included his having heard in the summer of 1906, almost as soon as the Duchess reached Alaska waters, that “Eskimos never have cancer,” and that Captain Leavitt was credited with originating the local search on which this view rested. One of the first to tell Howe this had been the surgeon on the United States revenue cutter Thetis, whose name I neglected to record; but more extensive detail had been given Howe by the head of the Presbyterian medical mission at Point Barrow, Dr. Horatio Richmond Marsh, a native of Illinois.

In talking with Dr. Howe, both the surgeon of the Thetis and the medical missionary at Barrow had agreed on several points, among these that in northern Alaska Leavitt had originated the local quest; that he had been indefatigable in urging government doctors, medical missionaries, expedition surgeons, everybody, to look for malignant disease; that many of these searchers, including Howe's informants, had expected to find cancer; but that all of those who remained in the Alaskan Arctic had been convinced eventually, that cancer was not to be found among Eskimos who still lived native style.

“It has been said that cancer does not exist among the Eskimos. So far as I could find out, this is true ...”