FUNCTIONAL AND INFLAMMATORY DISEASES OF THE STOMACH.

BY SAMUEL G. ARMOR, M.D., LL.D.

Functional Dyspepsia (Atonic Dyspepsia, Indigestion).

As a rule, the food should be such as will require the least possible exertion on the part of the stomach. Raw vegetables should be forbidden; pastries, fried dishes, and all rich and greasy compounds should be eschewed; and whatever food be taken should be eaten slowly and well masticated. Many patients digest animal better than vegetable food. Tender brown meats, plainly but well cooked, such as beef, mutton, and game, are to be preferred. Lightly-cooked mutton is more digestible than beef, pork, or lamb, and roast beef is more digestible than boiled. Pork and veal and salted and preserved meats are comparatively indigestible. Bread should never be eaten hot or fresh—better be slightly stale—and bread made from the whole meal is better than that made from the mere starchy part of the grain. Milk and eggs and well-boiled rice are of special value.

But to all these general dietetic rules there may be exceptions growing out of the peculiarities of individual cases. These should be carefully studied. The aged, for obvious reasons, require less food than the young; the middle-aged, inclined to obesity and troubled with feeble digestion, should avoid potatoes, sweets, and fatty substances and spirituous liquors; persons suffering from functional derangements of the liver should be put, for a time, on the most restricted regimen; while, on the contrary, the illy fed and badly-nourished require the most nutritious food that can be digested with comfort to the patient.

To these general predisposing causes may be added indigestion occurring in febrile states of the system. The cause here is obvious. In all general febrile conditions the secretions are markedly disturbed; the tongue is dry and furred; the urine is scanty; the excretions lessened; the bowels constipated; and the appetite gone. The nervous system also participates in the general disturbance. In this condition the gastric juice is changed both quantitatively and qualitatively, and digestion, as a consequence, becomes weak and imperfect—a fact that should be taken into account in regulating the diet of febrile patients. From mere theoretical considerations there can be no doubt that fever patients are often overfed. To counteract the relatively increased tissue-metamorphosis known to exist, and the consequent excessive waste, forced nutrition is frequently resorted to. Then the traditional saying of the justly-celebrated Graves, that he fed fevers, has also rendered popular the practice. Within certain bounds alimentation is undoubtedly an important part of the treatment of all the essential forms of fever. But if more food is crowded upon the stomach than can be digested and assimilated, it merely imposes a burden instead of supplying a want. The excess of food beyond the digestive capacity decomposes, giving rise to fetid gases, and often to troublesome intestinal complications. The true mode of restoring strength in such cases is to administer only such quantities of food as the patient is capable of digesting and assimilating. To this end resort has been had to food in a partially predigested state, such as peptonized milk, milk gruel, soups, jellies, and beef-tea; and clinical experience has thus far shown encouraging results from such nutrition in the management of general fevers. In these febrile conditions, and in all cases of general debility, the weak digestion does not necessarily involve positive disease of the stomach, for by regulating the diet according to the digestive capacity healthy digestion may be obtained for an indefinite time.

Exhaustion of the nerves of organic life strongly predisposes to the atonic forms of dyspepsia. We have already seen how markedly the digestive process is influenced by certain mental states, and it is a well-recognized fact that the sympathetic system of nerves is intimately associated with all the vegetative functions of the body. Without a certain amount of nervous energy derived from this portion of the nervous system, there is failure of the two most important conditions of digestion—viz. muscular movements of the stomach and healthy secretion of gastric juice. This form of indigestion is peculiar to [p. 441]the ill-fed and badly-nourished. It follows in the wake of privation and want, and is often seen in the peculiarly careworn and sallow classes who throng our public dispensaries. In this dyspepsia of exhaustion the solvent power of the stomach is so diminished that if food is forced upon the patient it is apt to be followed by flatulence, headache, uneasy or painful sensations in the stomach, and sometimes by nausea and diarrhoea. It is best treated by improving in every possible way the general system of nutrition, and by adapting the food, both in quantity and quality, to the enfeebled condition of the digestive powers. Hygienic measures are also of great importance in the management of this form of dyspepsia, and especially such as restore the lost energy of the nervous system. If it occur in badly-nourished persons who take little outdoor exercise, the food should be adapted to the feeble digestive power. It should consist for a time largely of milk and eggs, oatmeal, peptonized milk gruels, stale bread; to which should be added digestible nitrogenous meat diet in proportion to increased muscular exercise. Systematic outdoor exercise should be insisted upon as a sine quâ non. Much benefit may be derived from the employment of electric currents, and hydrotherapy has also given excellent results. If the indigestion occur in the badly-fed outdoor day-laborer, his food should be more generous and mixed. It should consist largely, however, of digestible nitrogenous food, and meat, par excellence, should be increased in proportion to the exercise taken. Medicinally, such cases should be treated on general principles. Benefit may be derived from the mineral acids added to simple bitters, or in cases of extreme nervous prostration small doses of nux vomica are a valuable addition to dilute hydrochloric acid. The not unfrequent resort to phosphorus in such cases is of more than doubtful utility. Some interesting contributions have been recently made to this subject of gastric neuroses by Buchard, Sée, and Mathieu. Buchard claims that atonic dilatation of the stomach is a very frequent result of an adynamic state of the general system. He compares it to certain forms of cardiac dilatation—both expressions of myasthenia. It may result from profound anæmia or from psychical causes. Mathieu regards mental depression as only second in frequency. Much stress is laid upon poisons generated by fermenting food in the stomach in such cases. It may cause a true toxæmia, just as renal diseases give rise to uræmia. Of course treatment in such cases must be addressed principally to the general constitution.

But of all predisposing causes of dyspepsia, deficient gastric secretion, with resulting fermentation of food, is perhaps the most prevalent. It is true this deficient secretion may be, and often is, a secondary condition; many causes contribute to its production; but still, the practical fact remains that the immediate cause of the indigestion is disproportion between the quantity of gastric juice secreted and the amount of food taken into the stomach. In all such cases we have what is popularly known as torpidity of digestion, and the condition described is that of atony of the stomach. The two main constituents of gastric juice—namely, acid and pepsin—may be deficient in quantity or disturbed in their relative proportions. A certain amount of acid is absolutely essential to the digestive process, while a small amount of pepsin may be sufficient to digest a large amount of albuminoid food. [p. 442]Pure unmixed gastric juice was first analyzed by Bidder and Schmidt. The mean analyses of ten specimens free from saliva, procured from dogs, gave the following results:

Lack of the normal amount of the gastric secretion must be met by restoring the physiological conditions upon which the secretion depends. In the mean time, hydrochloric and lactic acids may be tried for the purpose of strengthening the solvent powers of the gastric secretion.

EXCITING CAUSES.—The immediate causes of dyspepsia are such as act more directly on the stomach. They embrace all causes which produce conditions of gastric catarrh, such as excess in eating and drinking, imperfect mastication and insalivation, the use of indigestible or unwholesome food and of alcohol, the imperfect arrangement of meals, over-drugging, etc.

Of exciting causes, errors of diet are amongst the most constantly operative, and of these errors excess of food is doubtless the most common. The influence of this as an etiological factor in derangement of digestion can scarcely be exaggerated. In very many instances more food is taken into the stomach than is actually required to restore tissue-waste, and the effects of such excess upon the organism are as numerous as they are hurtful. Indeed, few elements of disease are more constantly operative in a great variety of ailments. In the first place, if food be introduced into the stomach beyond tissue-requirements, symptoms of indigestion at once manifest themselves. The natural balance betwixt [p. 443]supply and demand is disturbed; the general nutrition of the body is interfered with; local disturbances of nutrition follow; and mal-products of digestion find their way into the blood. Especially is this the case when the excessive amount of food contains a disproportionate amount of nitrogenous matter. All proteid principles require a considerable amount of chemical alteration before they are fitted for the metabolic changes of the organism; the processes of assimilative conversion are more complex than those undergone by fats and amyloids; and it follows that there is proportional danger of disturbance of these processes from overwork. Moreover, if nitrogenous food is in excess of tissue-requirement, it undergoes certain oxidation changes in the blood without becoming previously woven into tissue, with resulting compounds which become positive poisons in the economy. The kidneys and skin are largely concerned in the elimination of these compounds, and the frequency with which these organs become diseased is largely due, no doubt, to the excessive use of unassimilated nitrogenous food. Then, again, if food be introduced in excess of the digestive capacity, the undigested portion acts directly upon the stomach as a foreign body, and in undergoing decomposition and putrefying changes frets and irritates the mucous membrane. It can scarcely be a matter of doubt that large groups of diseases have for their principal causes excess of alimentation beyond the actual requirements of the system. All such patients suffer from symptoms of catarrhal indigestion, such as gastric uneasiness, headache, vertigo, a general feeling of lassitude, constipation, and high-colored urine with abundant urates, together with varied skin eruptions. Such cases are greatly relieved by reducing the amount of food taken, especially nitrogenous food, and by a systematic and somewhat prolonged course of purgative mineral waters. Europe is especially rich in these springs. The waters of Carlsbad, Ems, Seltzer, Friedrichshall, and Marienbad, and many of the alkaline purgative waters of our own country, not unfrequently prove valuable to those who can afford to try them, and their value shows how often deranged primary assimilation is at the foundation of many human ailments. The absurd height to which so-called restorative medicine has attained within the last twenty years or more has contributed largely to the production of inflammatory forms of indigestion, with all the evil consequences growing out of general deranged nutrition.

The use of indigestible and unwholesome food entails somewhat the same consequences. This may consist in the use of food essentially unhealthy or indigestible, or made so by imperfect preparation (cooking, etc.). Certain substances taken as food cannot be dissolved by the gastric or intestinal secretions: the seeds, the skins, and rinds of fruit, the husks of corn and bran, and gristle and elastic tissue, as well as hairs in animal food, are thrown off as they are swallowed, and if taken in excess they mechanically irritate the gastro-intestinal mucous membrane and excite symptoms of acute dyspepsia, and not unfrequently give rise to pain of a griping character accompanied by diarrhoea. Symptoms of acute dyspepsia also frequently follow the ingestion of special kinds of food, such as mushrooms, shellfish, or indeed fish of any kind; and food not adapted to the individual organism is apt to excite dyspeptic symptoms. Appetite and digestion are also very much influenced by the life and [p. 444]habits of the individual. The diet, for instance, of bodily labor should consist largely of digestible nitrogenous food, and meat, par excellence, should be increased in proportion as muscular exercise is increased. For all sorts of muscular laborers a mixed diet is best in which animal food enters as a prominent ingredient. Thus, it has been found, according to the researches of Chambers, that in forced military marches meat extract has greater sustaining properties than any other kind of food. But with those who do not take much outdoor exercise the error is apt to be, as already pointed out, in the direction of over-feeding. It cannot be doubted at the present time that over-eating (gluttony) is one of our popular vices. Hufeland says: "In general we find that men who live sparingly attain to the greatest age." While preventive medicine in the way of improved hygiene—better drainage, better ventilation, etc.—is contributing largely to the longevity of the race, we unfortunately encounter in more recent times an antagonizing influence in the elegant art of cookery. Every conceivable ingenuity is resorted to to tempt men to eat more than their stomachs can properly or easily digest or tissue-changes require. The injurious consequences of such over-feeding may finally correct itself by destroying the capacity of the stomach to digest the food.

Food may also be introduced into the stomach in an undigestible form [p. 445]from defects of cookery. The process of cooking food produces certain well-known chemical changes in alimentary substances which render them more digestible than in the uncooked state. By the use of fire in cooking his food new sources of strength have been opened up to man which have doubtless contributed immeasurably to his physical development, and has led to his classification as the cooking animal. With regard to most articles the practice of cooking his food beforehand is wellnigh universal; and especially is this the case with all farinaceous articles of food. The gluten of wheat is almost indigestible in the uncooked state. By the process of cooking the starchy matter of the grain is not only liberated from its protecting envelopes, but it is converted into a gelatinous condition which readily yields to the diastasic ferments. Roberts, in his lectures on the Digestive Ferments, points out the fact that when men under the stress of circumstances have been compelled to subsist on uncooked grains of the cereals, they soon fell into a state of inanition and disease.

Animal diet is also more easily digested in the cooked than in the raw state. The advantage consists chiefly in the effects of heat on the connective tissue and in the separation of the muscular fibre. In this respect cooking aids the digestive process. The gastric juice cannot get at the albumen-containing fibrillæ until the connective tissue is broken up, removed, or dissolved. Hot water softens and removes this connective tissue. Hence raw meat is less easily digestible. Carnivorous animals, that get their food at long intervals, digest it slowly. By cutting, bruising, and scraping meat we to a certain extent imitate the process of cooking. In many cases, indeed, ill-nourished children and dyspeptics digest raw beef thus comminuted better than cooked, and it is a matter of observation that steamed and underdone roast meats are more digestible than when submitted to greater heat.

Some interesting observations have been made by Roberts on the effects of the digestive ferments on cooked and uncooked albuminoids. He employed in his experiments a solution of egg albumen made by mixing white of egg with nine times its volume of water. "This solution," says Roberts, "when boiled in the water-bath does not coagulate nor sensibly change its appearance, but its behavior with the digestive ferments is completely altered. In the raw state this solution is attacked very slowly by pepsin and acid, and pancreatic extract has no effect on it; but after being cooked in the water-bath the albumen is rapidly and entirely digested by artificial gastric juice, and a moiety of it is rapidly digested by pancreatic extract."

It is a mistake, however, to suppose that cooking is equally necessary for all kinds of albuminoids. The oyster, at least, is quite exceptional, for it contains a digestive ferment—the hepatic diastase—which is wholly destroyed by cooking. Milk may be indifferently used either in the cooked or uncooked state, and fruits, which owe their value chiefly to sugar, are not altered by cooking.

The object in introducing here these remarks on cooking food is to show that it forms an important integral part of the work of digestion, and has a direct bearing on the management of all forms of dyspepsia.

Elsie Kava - page 97 - Volume 2 - Date is a rough guess.

Every part of the reindeer can be eaten. The jowls, the ears, the velvet on the antlers, and the knuckles are barbecued and eaten. 

The stomach is first removed. Then, the fat on the outside of the stomach, called pugughyi, is peeled off very carefully without puncturing the stomach. Next, some of the contents of the stomach are squeezed out, while some is left in the stomach to ferment and be eaten later. That part of the stomach, called alamka, is washed thoroughly and eaten raw. The alamka, which has the texture like the nap of a towel, is rinsed thoroughly along with the stomach and eaten. 

Somewhere in the reindeer is a part called the kevighqat This is turned inside out and filled with fat from another reindeer. The container it makes is called a keviq. The large intestine also is turned inside out so that the fat [on it] can be stored inside. Our family did not eat the kidneys nor the livers, but some people did. 

The fat on the intestines is carefully peeled off all the way around and removed. Then the glands [on the intestines] are removed. There is a lot of this fat and when it is removed it takes on a tubular shape. Everything in the body of a reindeer is eaten. 

Fall reindeer hides, which have thick fur, are used for bedding. In the spring, when the reindeer are shedding, the fur becomes scruffy. The fur gets very thin and the hair is short. This was saved for parka trim. Sometime in the month of July the fawn hides were ideal for clothing. The length of the hair had gotten just right and was of good quality. Even the hair on the adult reindeer got short. 

Fawning began in April and only men took part in it. They worked in shifts of a week at a time. 

We used to be there at Ivgaq when the reindeer would come to the camp on their own to give birth to their fawns. We would lie down and watch them giving birth. As soon as the fawns dried off, they began to walk and run with the mother. If there was a snowstorm while tending to the fawning, we used tents. Reindeer herders used tents at fawning time. There were lots of reindeer in those days.

"Nekretoritse!"..."Come and eat!"

Above the snarling voice of the wind that sweeps across the ice, the Eskimo's ear always catches this call, his neighbor's invitiation to come and eat. He is suddenly roused from his winter revery.

"Nekrekroyatigot!" he announces, clambering to his feet. "They are calling us to eat."

The call is an indiscriminate invitation, to himself and everyone else. The Eskimo hostess never has trouble making up a guest list for dinner. A social secretary wouldn't be of much use to her. For when there is food, everyone is asked, without exception, and there aren't any place cards. The whole camp crowds into the host's igloo, the men taking teh best places, sitting on the skins, the women standing in the middle of the snowhouse, half consciously swafing back and forth to set up a rhythm that will keep the babies on their backs asleep, the children backed agaounst the wal,l blowing on their numbed fingers and banging their chilled feet on the floor. 

On a board in front of the lamp is an armful of frozen fish, or a basin of raw caribou meat, or a potful of half-cooked seal meat. If the meat is raw, or frozen, everyone just pitches in. If it is cooked meat, the hostess first squeeezes each piece in her fingers to get rid of the brownish froth, then tosses a chunk of frozen blood into the pot to add piquance to the consomme that will later be consumed as a chaser, after the meal. First she gives her husband his share, then it is every man for himself, and a squadron of filthy hands descends upon the meat pot, closing around the half-cooked food like so many greasy pairs of pincers. It is not a delicate cuisine, and the manners that go with it aren't elegant. The Eskimo takes a huge piece of meat, stuffs it into his mouth, and then, with a quick swipe of the "oloo"--a razor-sharp knife--snips off the part that won't fit in his mouth. All this is done with a surprising nonchalance, and for fifteen years I have been betting with myself, and losing every time, that one of them will miss and leave a piece of nose or chin on the snow.

Fish bones, and other bones they cannot crack and eat, plus inedible bits of gristle or skin, are spat back into the common pot, on top of the rest of the meat, from which you are expected to serve yourself a second helping, if you are so promted.

From time to time, craving a slightly more vibrant flavor, the Eskimo dips a morsel of meat into a rusty tin can filled with rancid seal oil. Another delicacy is meat that has been buried for a few weeks and is nicely overripe, soft and mushy right down to the bone. When the Eskimo gets hold of a piece of such stuff he smacks his lips with delight.

"Mamaronaktok!" he exclaims stuffing his mouth with the spoiled meat. "Now you are talking!"

The missionary, after a few sojourns in Eskimo camps, gets used to the most bizarre items in the Arctic diet and learns to partake of everything with a smile and at least the semblance of gusto, for at stake are both his own reputation and his host's honor. To turn down a choice morsel of rotten meat or a scabrous bit of dried fish would be taken as a mortal insult to the whole Eskimo village and a terrible reflection on the white man's taste.

Most of the time, living as he does, on the trail, in the open, the priest is hungry enough to ignore the smell or unpleasant associaton, and soon learns not only to eat but to relish Eskimo viands. As to quantity, though, he cannot keep up with them.

No one can eat like an Eskimo. The true Inuk eats all day long, everything, and anything, in sight. The poor wihte man, used to eating on schedule, has no chance against such competition. His best bet is to stop after the first course and excuse himself. Then the Eskimos will smile.

"Ah," they will say. "It is true. You Great Eyebrows have a watch in your stomachs."

The Arctic is a dietician's nightmare, and anyone conscious of vitamins or a balanced diet will make himself miserable. Eskimos are almost exclusively carnivorous--at least, they were until very recently. Now they have developed a taste for the white man's flour, sugar, and other soft foods. Their classical food is meat, and they still live on it almost altogether. In the fall, the women and children search for berries, if they don't mind endless hours of labor for a few ounces of food, and they also dig from the ground a root called "Maso," insipid and quite diruretic, but nevertheless appreciated. 

The only green that they eat is half-digested lichen and moss taken from the caribou's stomach--a deep green mush, of a dishonest color, though the taste might not be bad if the origin of the food were unknown. 

But the diet of most people is ruled by prejudice. We French eat snails and love frogs, though both these make the Englishman wince and the American shudder. The Americans love maize--Indian corn--and eat it in season by the armful, while the French regard it as food fit for chickens. The Englishman regales himself on suet pudding, though this shocks everyone else. The Arabs like locusts, preferring them fried, and I'm told that people unknowingly served grasshoppers pronounce them the gastronomic find of the century. I'm sure that if you dished up a nice fat cat, being sure to put it on the menu as rabbit, everyone would smack his lips and eat his fill--until you produced poor Tabb's head. 

So far as the odor and doubtful appearance of some Eskimo food is concerned--well, it is generally known that the best hunters amoung our people prefer their game somewhat high, and certanily connoisseurs of fine cheese maintain that it is best when well ripened. Turkish tobacco, they say, gets its distinctive flavor from being impregnated with the smoke of burning camel dung.

Surely, it is all a matter of taste.

As for myself, I think I can say I have tried every item on the Eskimo menu. I have enjoyed a drink of blood, and, when hungry, eaten meat that was still warm with the life blood of the caribou. I have lived on frozen raw fish, and been thankful for the meat that was almost ready to get up and walk away. I have eatn seal guts braided with blubber--a la mode de Victoria--and sampled all the birds: sea gulls, hawks, owls. Owls, believe me, are very good, and so is the liver of the scorpion fish. 

It is surprising how quickly one revises food prejudices, and what a persuading effect on the taste is worked by a fifty mile soujourn in fifty-below weather. Appetite, as they say, is the best of sauces. And the white man who refuses to follow the customs of the country is apt to go hungry more often than not.

WE TRAVELED FROM NOWHERE TO NOWHERE IN A WORLD ALL WHITE, eleven dogs, a long sled, a fur-clad Inuk and I. We had spent a week at the floe edge, the limit of landfast ice, and the hunting had been good. Jes had shot and harpooned eight seals. We had eaten well and our sled was heavy with meat - food for his family and dogs - and with seal pelts he would sell at the store. 

We felt the coming of the storm. The air was still and oppressive. Gulls, screaming, flew toward the distant land. The sky turned leaden black. We should have left hours ago. But a pod of narwhals was feeding close to the floe edge; the eerie stillness was filled with the plosive "pooff," "pooff," "pooff" of their breathing. Small plumes of exhaled breath hung briefly in the icy air, and a few times we saw the gleaming ivory tusks of the males. 

Jes wanted a whale. His entire hunter's spirit was focused on those whales, wishing them closer, closer. He was the perfect predator, quietly poised in total concentration, the ultimate Arctic hunter, as his people had been since the dawn of time. The whale meant food and life and glory, the primal thrill of being, and at that moment nothing else mattered. 

While Jes's soul was in that strange mystic sphere that links the hunter to his prey, I sat apart and nursed my white man's worries. I had spent far too many years in the Arctic not to know that the coming storm would be hell, the trip home utter misery and, if the ice broke up, exceedingly dangerous. It was 60 miles (96 km) back to the village. 

The storm struck, and Jes did not get his whale. He rose slowly, reluctantly. The tension seeped out of him and then he smiled a marvelously boyish smile, shrugged, and said: "Ayornamat. (It can't be helped.)" An Inuk does not rant and rave; his language has no swearwords. He does not rail against God or Nature, but simply accepts adversity. He does his best; the rest is fate. 

We lashed the load upon the long pliant sled with utmost care, passing the bearded-seal thong back and forth, pulling it tight with all our strength. Jes called to the dogs. Normally they would have leapt into a joyous gallop. Now they moved without enthusiasm, their tails, usually cockily curled, drooping sadly. Like me, they feared the storm. 

At first, brief lulls alternated with vicious gusts. Then the storm became steady and we traveled into a hissing, roaring avalanche of snow. The dogs hated it. The wind-lashed ice spicules hurt their eyes, and they tried to veer away from the wind. Jes beat them, coaxed them, directed them. There was only snow, the screaming wind, and nothingness; we seemed suspended in time and space. But Jes was guided by sastrugi, snow ripples created by prevailing winds, and by the knowledge of a thousand trips since he had first gone to the floe edge as a small boy with his father. 

We traveled for hours, our faces seared by the wind, our fur clothing plastered with snow. The ice changed, became rugged, hummocky. We were in a tidal zone, close to a coast. For a moment I saw a cliff and then it vanished again in the whirling white. Jes walked ahead now, leading the dogs through a maze of ice blocks. Near the base of the cliff he tied the dogs securely to a stone upon the ice. "Come," he said. We clambered up an incline, perhaps a beach in summertime, walked past a house-high rock, squeezed through a triangular hole between the rock and the cliff, and were suddenly in a spacious cave. Jes laughed, delighted by my amazement, the magician who has performed the perfect trick. 

Jes unharnessed and tethered the dogs, then cut up a seal and fed them. They rolled into balls, noses tucked under bushy tails, and soon the snow covered them with an insulating blanket. I lugged our sled load into the cave, shook the snow out of the bedding furs and my clothing, and made supper: a big pot of seal meat boiled on a Primus stove. 

After the elemental chaos of the storm, the cave felt calm and secure. It had obviously served as sanctuary to other Arctic hunters for hundreds, perhaps thousands of years. In the back were low sleeping platforms of pebbles and flat stones. Soot streaks along the walls and roof showed where seal-oil lamps had burned and flared. The cave floor was scattered with bones, remnants of past meals. Bone, stone, and ivory shavings and splinters marked places where men had sat and made or repaired tools or hunting weapons, and broken toys spoke of children who had once played in the cave. 

We ate the steaming seal meat; drank the fat, scalding broth; and glowed with marvelous warmth. Jes made tea, boiled it until it was coffee-black, and we drank it syrupy-thick with sugar. We were safe, warm, full of food, relaxed and utterly content. Long, long ago, said Jes, Tunit had lived in this cave, a giant people but stupid, and the Inuit had killed them. His stories - part myths, part ancient oral history - - spanned the ages. The Primus hissed, and outside roared the storm. 

We spread our furs on the ancient sleeping platforms and, minutes later, his deep, even breathing told me that Jes was sound asleep. Cozy in my furry cocoon, I looked at the soot patterns on the cave wall, listened to the eldritch screeching of the storm, and thought sleepily about my other life: our pleasant, book-filled home in Montreal; my wife; our children. It was early May. Maud would be working in the garden. The boys should be home from school. The first tulips would be blooming. As I drifted off to sleep, it seemed part of a dream.

Eating Christmas in the Kalahari

Richard Lee

“Eating Christmas in the Kalahari” by Richard Borshay Lee was published in the December 1969 issue of Natural History. It is one of the magazine’s most frequently reprinted stories. In the final paragraph, Lee wondered what the future would hold for the !Kung Bushmen with whom he had shared a memorable Christmas feast. The University of Toronto anthropologist answers that question for the Botswana San, in a 2000 postscript to his original article. (The postscript follows the main story). A more recent update will be found in Unit 3.

The "Bushmen" are more properly referred to as San in anthropology, and refer to themselves as Ju/’hoansi. The San will also be our example of a foraging mode of production, since that is what they were when Lee began his study in the late 1960's. Lee studied the San in Botswana, although they are also found in Namibia, living in one of the most difficult environments, the Kalahari Desert. Foraging will be discussed later in Unit 1, and you will read more about the San.

Editor’s Note: The !Kung and other Bushmen speak click languages. In the story, three different clicks are used:

1. The dental click (/), as in /Xai/xai, /ontah, and /gaugo. The click is sometimes written in English as tsk-tsk.

2. The alveopalatal click (!), as in Ben!a and !Kung.

3. The lateral click (//), as in //gom. Clicks function as consonants; a word may have more than one, as in /n!au.

he !Kung Bushmen’s knowledge of Christmas is thirdhand. The London Missionary Society brought the holiday to the southern Tswana tribes in the early nineteenth century. Later, native catechists spread the idea far and wide among the Bantu-speaking pastoralists, even in the remotest corners of the Kalahari Desert. The Bushmen’s idea of the Christmas story, stripped to its essentials, is “praise the birth of white man’s god-chief”; what keeps their interest in the holiday high is the Tswana-Herero custom of slaughtering an ox for his Bushmen neighbors as an annual goodwill gesture. Since the 1930’s, part of the Bushmen’s annual round of activities has included a December congregation at the cattle posts for trading, marriage brokering, and several days of trance-dance feasting at which the local Tswana headman is host.

As a social anthropologist working with !Kung Bushmen, I found that the Christmas ox custom suited my purposes. I had come to the Kalahari to study the hunting and gathering subsistence economy of the !Kung, and to accomplish this it was essential not to provide them with food, share my own food, or interfere in any way with their food-gathering activities. While liberal handouts of tobacco and medical supplies were appreciated, they were scarcely adequate to erase the glaring disparity in wealth between the anthropologist, who maintained a two-month inventory of canned goods, and the Bushmen, who rarely had a day’s supply of food on hand. My approach, while paying off in terms of data, left me open to frequent accusations of stinginess and hard-heartedness. By their lights, I was a miser.

The Christmas ox was to be my way of saying thank you for the co-operation of the past year; and since it was to be our last Christmas in the field, I determined to slaughter the largest, meatiest ox that money could buy, insuring that the feast and trance dance would be a success.

Through December I kept my eyes open at the wells as the cattle were brought down for watering. Several animals were offered, but none had quite the grossness that I had in mind. Then, ten days before the holiday, a Herero friend led an ox of astonishing size and mass up to our camp. It was solid black, stood five feet high at the shoulder, had a five-foot span of horns, and must have weighed 1,200 pounds on the hoof. Food consumption calculations are my specialty, and I quickly figured that bones and viscera aside, there was enough meat—at least four pounds—for every man, woman, and child of the 150 Bushmen in the vicinity of the /Xai/xai who were expected at the feast.

Having found the right animal at last, I paid the Herero £20 ($56) and asked him to keep the beast with his herd until Christmas day. The next morning word spread among the people that the big solid black one was the ox chosen by /ontah (my Bushman name; it means, roughly, “whitey”) for the Christmas feast. That afternoon I received the first delegation. Ben!a, an outspoken sixty-year-old mother of five, came to the point slowly.

“Where were you planning to eat Christmas?”

“Right here at /Xai/xai,” I replied.

“Alone or with others?”

“I expect to invite all the people to eat Christmas with me.

“Eat what?”

“I have purchased Yehave’s black ox, and I am going to slaughter and cook it.”

“That’s what we were told at the well but refused to believe it until we heard it from yourself.”

“Well, it’s the black one,” I replied expansively, although wondering what she was driving at.

“Oh, no!” Ben!a groaned, turning to her group. “They were right.” Turning back to me she asked, “Do you expect us to eat that bag of bones?”

“Bag of bones! It’s the biggest ox at /Xai/xai.”

“Big, yes, but old. And thin. Everybody knows there’s no meat on that old ox. What did you expect us to eat off it, the horns?”

Everybody chuckled at Ben!a’s one-liner as they walked away, but all I could manage was a weak grin.

That evening it was the turn of the young men. They came to sit at our evening fire. /gaugo, about my age, spoke to me man-to-man.

“/ontah, you have always been square with us,” he lied. “What has happened to change your heart? That sack of guts and bones of Yehave’s will hardly feed one camp, let alone all the Bushmen around /Xai/xai.” And he proceeded to enumerate the seven camps in the /Xai/xai vicinity, family by family. “Perhaps you have forgotten that we are not few, but many. Or are you too blind to tell the difference between a proper cow and an old wreck? That ox is thin to the point of death.”

“Look, you guys,” I retorted, “that is a beautiful animal, and I’m sure you will eat it with pleasure at Christmas.”

“Of course we will eat it; it’s food. But it won’t fill us up to the point where we will have enough strength to dance. We will eat and go home to bed with stomachs rumbling.”

That night as we turned in, I asked my wife, Nancy: “What did you think of the black ox?”

“It looked enormous to me. Why?”

“Well, about eight different people have told me I got gypped; that the ox is nothing but bones.”

“What’s the angle?” Nancy asked. “Did they have a better one to sell?”

“No, they just said that it was going to be a grim Christmas because there won’t be enough meat to go around. Maybe I’ll get an independent judge to look at the beast in the morning.”

Bright and early, Halingisi, a Tswana cattle owner, appeared at our camp. But before I could ask him to give me his opinion on Yehave’s black ox, he gave me the eye signal that indicated a confidential chat. We left the camp and sat down.

“/ontah, I’m surprised at you; you’ve lived here for three years and still haven’t learned anything about cattle.”

“But what else can a person do but choose the biggest, strongest animal one can find?” I retorted.

“Look, just because an animal is big doesn’t mean that it has plenty of meat on it. The black one was a beauty when it was younger, but now it is thin to the point of death.”

“Well I’ve already bought it. What can I do at this stage?”

“Bought it already? I thought you were just considering it. Well, you’ll have to kill it and serve it, I suppose. But don’t expect much of a dance to follow.”

My spirits dropped rapidly. I could believe that Ben!a and /gaugo just might be putting me on about the black ox, but Halingisi seemed to be an impartial critic. I went around that day feeling as though I had bought a lemon of a used car.

“My friend, the way it is with us Bushmen,” he began, “is that we love meat. And even more than that, we love fat.”

In the afternoon it was Tomazo’s turn. Tomazo is a fine hunter, a top trance performer, and one of my most reliable informants. He approached the subject of the Christmas cow as part of my continuing Bushmen education.

“My friend, the way it is with us Bushmen,” he began, “is that we love meat. And even more than that, we love fat. When we hunt we always search for the fat ones, the ones dripping with layers of white fat: fat that turns into a clear, thick oil in the cooking pot, fat that slides down your gullet, fills your stomach and gives you a roaring diarrhea,” he rhapsodized.

“So, feeling as we do,” he continued, “it gives us pain to be served such a scrawny thing as Yehave’s black ox. It is big, yes, and no doubt its giant bones are good for soup, but fat is what we really crave and so we will eat Christmas this year with a heavy heart.”

The prospect of a gloomy Christmas now had me worried, so I asked Tomazo what I could do about it.

“Look for a fat one, a young one . . . smaller, but fat. Fat enough to make us //gom (‘evacuate the bowels’), then we will be happy.”

My suspicions were aroused when Tomazo said that he happened to know of a young, fat, barren cow that the owner was willing to part with. Was Toma working on commission, I wondered? But I dispelled this unworthy thought when we approached the Herero owner of the cow in question and found that he had decided not to sell.

The scrawny wreck of a Christmas ox now became the talk of the /Xai/xai water hole and was the first news told to the outlying groups as they began to come in from the bush for the feast. What finally convinced me that real trouble might be brewing was the visit from u!lau, an old conservative with a reputation for fierceness. His nickname meant spear and referred to an incident thirty years ago in which he had speared a man to death. He had an intense manner; fixing me with his eyes, he said in clipped tones:

“I have only just heard about the black ox today, or else I would have come here earlier. /ontah, do you honestly think you can serve meat like that to people and avoid a fight?” He paused, letting the implications sink in. “I don’t mean fight you, /ontah; you are a white man. I mean a fight between Bushmen. There are many fierce ones here, and with such a small quantity of meat to distribute, how can you give everybody a fair share? Someone is sure to accuse another of taking too much or hogging all the choice pieces. Then you will see what happens when some go hungry while others eat.”

The possibility of at least a serious argument struck me as all too real. I had witnessed the tension that surrounds the distribution of meat from a kudu or gemsbok kill, and had documented many arguments that sprang up from a real or imagined slight in meat distribution. The owners of a kill may spend up to two hours arranging and rearranging the piles of meat under the gaze of a circle of recipients before handing them out. And I also knew that the Christmas feast at /Xai/xai would be bringing together groups that had feuded in the past.

Convinced now of the gravity of the situation, I went in earnest to search for a second cow; but all my inquiries failed to turn one up.

The Christmas feast was evidently going to be a disaster, and the incessant complaints about the meagerness of the ox had already taken the fun out of it for me. Moreover, I was getting bored with the wisecracks, and after losing my temper a few times, I resolved to serve the beast anyway. If the meat fell short, the hell with it. In the Bushmen idiom, I announced to all who would listen:

“I am a poor man and blind. If I have chosen one that is too old and too thin, we will eat it anyway and see if there is enough meat there to quiet the rumbling of our stomachs.”

On hearing this speech, Ben!a offered me a rare word of comfort. “It’s thin,” she said philosophically, “but the bones will make a good soup.”

At dawn Christmas morning, instinct told me to turn over the butchering and cooking to a friend and take off with Nancy to spend Christmas alone in the bush. But curiosity kept me from retreating. I wanted to see what such a scrawny ox looked like on butchering, and if there was going to be a fight, I wanted to catch every word of it. Anthropologists are incurable that way.

The great beast was driven up to our dancing ground, and a shot in the forehead dropped it in its tracks. Then, freshly cut branches were heaped around the fallen carcass to receive the meat. Ten men volunteered to help with the cutting. I asked /gaugo to make the breast bone cut. This cut, which begins the butchering process for most large game, offers easy access for removal of the viscera. But it also allows the hunter to spot-check the amount of fat on the animal. A fat game animal carries a white layer up to an inch thick on the chest, while in a thin one, the knife will quickly cut to bone. All eyes fixed on his hand as /gaugo, dwarfed by the great carcass, knelt to the breast. The first cut opened a pool of solid white in the black skin. The second and third cut widened and deepened the creamy white. Still no bone. It was pure fat; it must have been two inches thick.

“Hey /gau,” I burst out, “that ox is loaded with fat. What’s this about the ox being too thin to bother eating? Are you out of your mind?”

“Fat?” /gau shot back, “You call that fat? This wreck is thin, sick, dead!” And he broke out laughing. So did everyone else. They rolled on the ground, paralyzed with laughter. Everybody laughed except me; I was thinking.

I ran back to the tent and burst in just as Nancy was getting up. “Hey, the black ox. It’s fat as hell! They were kidding about it being too thin to eat. It was a joke or something. A put-on. Everyone is really delighted with it!”

“Some joke,” my wife replied. “It was so funny that you were ready to pack up and leave /Xai/xai.”

If it had indeed been a joke, it had been an extraordinarily convincing one, and tinged, I thought, with more than a touch of malice as many jokes are. Nevertheless, that it was a joke lifted my spirits considerably, and I returned to the butchering site where the shape of the ox was rapidly disappearing under the axes and knives of the butchers. The atmosphere had become festive. Grinning broadly, their arms covered with blood well past the elbow, men packed chunks of meat into the big cast-iron cooking pots, fifty pounds to the load, and muttered and chuckled all the while about the thinness and worthlessness of the animal and /ontah’s poor judgment.

We danced and ate that ox two days and two nights; we cooked and distributed fourteen potfuls of meat and no one went home hungry and no fights broke out.

But the “joke” stayed in my mind. I had a growing feeling that something important had happened in my relationship with the Bushmen and that the clue lay in the meaning of the joke. Several days later, when most of the people had dispersed back to the bush camps, I raised the question with Hakekgose, a Tswana man who had grown up among the !Kung, married a !Kung girl, and who probably knew their culture better than any other non-Bushmen.

“With us whites,” I began, “Christmas is supposed to be the day of friendship and brotherly love. What I can’t figure out is why the Bushmen went to such lengths to criticize and belittle the ox I had bought for the feast. The animal was perfectly good and their jokes and wisecracks practically ruined the holiday for me.”

“So it really did bother you,” said Hakekgose. “Well, that’s the way they always talk. When I take my rifle and go hunting with them, if I miss, they laugh at me for the rest of the day. But even if I hit and bring one down, it’s no better. To them, the kill is always too small or too old or too thin; and as we sit down on the kill site to cook and eat the liver, they keep grumbling, even with their mouths full of meat. They say things like, ‘Oh, this is awful! What a worthless animal! Whatever made me think that this Tswana rascal could hunt!’”

“Is this the way outsiders are treated?” I asked.

“No, it is their custom; they talk that way to each other too. Go and ask them.”

/gaugo had been one of the most enthusiastic in making me feel bad about the merit of the Christmas ox. I sought him out first.

“Why did you tell me the black ox was worthless, when you could see that it was loaded with fat and meat?”

“It is our way,” he said smiling. “We always like to fool people about that. Say there is a Bushman who has been hunting. He must not come home and announce like a braggard, ‘I have killed a big one in the bush!’ He must first sit down in silence until I or someone else comes up to his fire and asks, ‘What did you see today?’ He replies quietly, ‘Ah, I’m no good for hunting. I saw nothing at all [pause] just a little tiny one.’ Then I smile to myself,” /gaugo continued, “because I know he has killed something big.”

In the morning we make up a party of four or five people to cut up and carry the meat back to the camp. When we arrive at the kill we examine it and cry out, ‘You mean to say you have dragged us all the way out here in order to make us cart home your pile of bones? Oh, if I had known it was this thin I wouldn’t have come.’ Another one pipes up, ‘People, to think I gave up a nice day in the shade for this. At home we may be hungry but at least we have nice cool water to drink.’ If the horns are big, someone says, ’Did you think that somehow you were going to boil down the horns for soup?’

“To all this you must respond in kind. ‘I agree,’” you say, ’this one is not worth the effort; let’s just cook the liver for strength and leave the rest for the hyenas. It is not too late to hunt today and even a duiker or a steenbok would be better than this mess.’”

“Then you set to work nevertheless; butcher the animal, carry the meat back to the camp and everyone eats,” /gaugo concluded.

“But,” I asked, “why insult a man after he has gone to all that trouble to track and kill an animal and when he is going to share the meat with you so that your children will have something to eat?”

Things were beginning to make sense. Next, I went to Tomazo. He corroborated /gaugo’s story of the obligatory insults over a kill and added a few details of his own.

“But,” I asked, “why insult a man after he has gone to all that trouble to track and kill an animal and when he is going to share the meat with you so that your children will have something to eat?”

“Arrogance,” was his cryptic answer.

“Arrogance?”

“Yes, when a young man kills much meat he comes to think of himself as a chief or a big man, and he thinks of the rest of us as his servants or inferiors. We can’t accept this. We refuse one who boasts, for someday his pride will make him kill somebody. So we always speak of his meat as worthless. This way we cool his heart and make him gentle.”

“But why didn’t you tell me this before?” I asked Tomazo with some heat.

“Because you never asked me,” said Tomazo, echoing the refrain that has come to haunt every field ethnographer.

I had been taught an object lesson by the Bushmen; it had come from an unexpected corner and had hurt me in a vulnerable area.

The pieces now fell into place. I had known for a long time that in situations of social conflict with Bushmen I held all the cards. I was the only source of tobacco in a thousand square miles, and I was not incapable of cutting an individual off for noncooperation. Though my boycott never lasted longer than a few days, it was an indication of my strength. People resented my presence at the water hole, yet simultaneously dreaded my leaving. In short I was a perfect target for the charge of arrogance and for the Bushmen tactic of enforcing humility.

I had been taught an object lesson by the Bushmen; it had come from an unexpected corner and had hurt me in a vulnerable area. For the big black ox was to be the one totally generous, unstinting act of my year at /Xai/xai, and I was quite unprepared for the reaction I received.

As I read it, their message was this: There are no totally generous acts. All “acts” have an element of calculation. One black ox slaughtered at Christmas does not wipe out a year of careful manipulation of gifts given to serve your own ends. After all, to kill an animal and share the meat with people is really no more than Bushmen do for each other every day and with far less fanfare.

In the end, I had to admire how the Bushmen had played out the farce-collectively straight-faced to the end. Curiously, the episode reminded me of the Good Soldier Schweik and his marvelous encounters with authority. Like Schweik, the Bushmen had retained a thoroughgoing skepticism of good intentions. Was it this independence of spirit, I wondered, that had kept them culturally viable in the face of generations of contact with more powerful societies, both black and white? The thought that the Bushmen were alive and well in the Kalahari was strangely comforting. Perhaps, armed with that independence and with their superb knowledge of their environment, they might yet survive the future.