Diseases of Civilization

Common diseases that appear in civilization - such as cancer, diabetes, IBS, gout, heart disease

Diseases of Civilization

Recent History

January 1, 1885

Gout by W.H. Draper MD

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There is a popular prejudice in favor of this class of foods, and a corresponding prejudice against the too free indulgence in animal foods. The purely starchy aliments, such as potatoes and the preparations of corn and rice, and even those which contain a considerable portion of gluten, like wheat, oatmeal, and barley, often provoke in gouty subjects a great deal of mischievous and painful indigestion.

GOUT.

BY W. H. DRAPER, M.D.


DIET.—The prevention of the accumulation of azotized matters in the [p. 128]blood involves, first, a consideration of the question of the diet appropriate to the gouty dyscrasia. The almost uniform counsel upon this point of all the authorities from Sydenham to the present time is, that albuminous foods should be sparingly allowed in the diet of the gouty patient, and that vegetable foods, especially the farinaceous, should constitute the principal aliment. This counsel is based upon the theory that uric acid is the offending substance, and, this being the outcome of a nitrogenous diet, the nitrogenous element in diet must be reduced. My own observation has led me to believe that while this may be a legitimate deduction from the uric-acid theory of gout, it is not supported by the results of clinical experience. If there is one signal peculiarity in the digestive derangements of gouty persons, it is their limited power to digest the carbohydrates, the sugars and starches. In whatever form these foods are used, they are more commonly the source of the dyspeptic troubles of sufferers from gout than the albuminous foods. They provoke the acid and flatulent dyspepsia which so generally precedes the explosion of the gouty paroxysm; and it must have attracted the attention of every observer who has studied the dyspeptic disorders of sufferers from inherited gout, who have sought to control their unhappy heritage by abstemious habits, that these disorders are especially provoked by over-indulgence in saccharine and amylaceous foods.

It is not possible to explain satisfactorily why the lithæmic condition should be induced by the carbonaceous aliments, but we believe there can be no question as to the fact. If, as modern physiological investigations tend to show, the liver is the organ in which urea as well as glycogen is formed, it may be that the overtaxing of its functions manifests itself more readily in the conversion of the albuminous than in that of the carbonaceous foods; or it is possible that the carbonaceous foods are destined chiefly for the evolution of mechanical energy, and that when this destiny is not fulfilled through indolence and imperfect oxygen-supply, they escape complete combustion, and so vitiate the blood. But whatever may be the cause of this anomaly, the clinical fact remains that in gouty persons the conversion of the azotized foods is more complete with a minimum of carbohydrates than it is with an excess of them—in other words, that one of the best means of avoiding an accumulation of lithates in the blood is to diminish the carbohydrates rather than the azotized foods.


The diet which a considerable experience has led me to adopt in the treatment of the gouty dyscrasia is very similar to that which glycosuria requires. The exclusion of the carbohydrates is of course not so strict. Abstinence from all the fermented preparations of alcohol is perhaps the most important restriction, on account of the unfermented dextrin and sugar which they contain. This restriction accords with the common experience respecting the part which wine and beer play as predisposing causes of the gouty disease and as occasional exciting causes of gouty lesions.


Next to the fermented liquors, the use of saccharine food in the diet of gouty persons needs to be restricted. This limitation also is one which common experience confirms. Sweet foods cannot be said to be as provocative of the dyspeptic derangements of the lithæmic subjects as wine and beer, but they are certainly often responsible for the formation of [p. 129]the dyscrasia and for perpetuating many most distressing ailments. Their more or less strict prohibition may constitute the essential point of treatment not only in controlling the progress of the constitutional vice, but in subduing some of the most rebellious lesions. It is important to observe that this prohibition sometimes involves abstinence from sweet and subacid fruits, in the raw as well as in the preserved state. Paroxysms of articular gout have been known to follow indulgence in strawberries, apples, watermelons, and grapes, and the cutaneous and mucous irritations which follow even the most moderate use of these fruits in some gouty persons are certainly not uncommon.


Next in order to the saccharine foods as the source of indigestion in gouty persons come the amylaceous aliments. These constitute, necessarily, so large an element in ordinary diet that the limitation of them in the dietary of gouty persons applies, in the majority of cases, only to their excessive use. This excessive use, however, is often observed. There is a popular prejudice in favor of this class of foods, and a corresponding prejudice against the too free indulgence in animal foods. The purely starchy aliments, such as potatoes and the preparations of corn and rice, and even those which contain a considerable portion of gluten, like wheat, oatmeal, and barley, often provoke in gouty subjects a great deal of mischievous and painful indigestion. This feeble capacity for the digestion of farinaceous foods is most frequently observed in the children of gouty parents, and especially in persons inclined to obesity, and in those whose occupations are sedentary and whose lives are passed for the most part in-doors, and they are least common in those whom necessity or pleasure leads to much active muscular exercise in the open air.


The fats are as a rule easily digested by gouty dyspeptics. This is a fortunate circumstance, for the reason that in the anæmia which is frequently one of the consequences of chronic gout the fatty foods are of inestimable value. In cases of persistent and rebellious lithæmia an exclusively milk diet constitutes a precious resource.

The succulent vegetables, such as tomatoes, cucumbers, cauliflower, cabbage, and the different varieties of salads, constitute for the gouty as well as the diabetic subject agreeable and wholesome additions to a diet from which the starchy and saccharine vegetables have to be largely excluded.

January 1, 1951

Roger Buliard

Carnivore

Inuk

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"Kakertogot taima"..."We are always hungry now."
Of course they were hungry. The Eskimo is a carnivore. His body craves meat--seal, bear, caribou, fish--and the climate and his hard life aren't satisfied by anything else. Half a grapefruit and a couple of pieces of toast are not the breakfast for the Inuk at all, but for another class of people.

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The Eskimo used to hunt only what he needed--bear, seal, caribou.

The little foxes--Tiriganiak--he despised. In the old days the Copper Eskimo hardly recognized the existence of the fox. If he met one on the trail he might risk an arrow on him, just to try his skill, but never because he wanted the animal. Fox meat makes poor eating, and fox fur is too frail for anything but baby clothes.

But fashionable women in Paris and New York did not share the Inuk's contempt for the fox. They regarded Tiriganiak's silvery fur as a perfect complement to their gleaming shoulders. What women want, men will get, and so the white man came to the Arctic after foxes and dinned into the Eskimo's ear the value of fox pelts.

"Do you want a rifle, eh, Inuk? Ammunition? Then go and get us foxes, plenty of foxes. Plenty of foxes."

The Eskimo wanted the white man's rifle, steel knife, fish net, boat. So he went after foxes. And soon he found he was so busy getting the miserable little animals that he had no time left in which to hunt for real meat--for bear and caribou. Observing the white traders, he saw them eating bread and jam, and tea with sugar. The new food was no good. It had no taste, and certainly didn't stay with one on the trail. But the Inuk wanted to imitate the Krabloonak. He ate the white man's sugar, and soon it became a habit. He found that he could not do without it. 

"Sugar!" he says. "The Eyebrows offered it to us for nothing, just to try, and we threw it away. The taste of that sand was so bad. Now we have got to like it, but they no longer give it to us. They sell it, and dearly. Mamianar! Calamity!"

Systematically, the white traders ensared the Eskimos, making them slaves to commodities of which they had felt no need before the Eyebrows came, unnecessary luxuries such as flour, silk, sugar, even chewing gum. All these things the Inuit paid for--by giving up his healthy, free life in exchange for trivial luxuries. He ceased to be a hunter, in many cases, and became a trapper, a slave to the little foxes he despised. Thus Tiriganiak--the smallest of all--revolutionized the Eskimo's life, at least the lives of those Eskimos close enough to the traders' posts to come under their influence.

Not too long ago, all Eskimos hunted to clothe and feed themselves. Now they go after foxes, with which to buy some jam, or a Micky Mouse watch, or a cheap, tinny-sounding phonograph. They haven't time to hunt fo seal to provide oil for their lamps, so they buy the white man's kerosene. More foxes. There is no caribou meat on hand, so he eats the white man's flour. More foxes. Soon he lives in a vicious circle, like a knifegrinder's dog in his wheel cage.

Thus, in those areas where the traders hold sway, the happy hunter of old has become a kind of clerk. Once fierce and independent, ignoring tomorrow and contemptuous of anyone who mentioned it, now he is always in debt, as badly off as a petty office worker caught in the clutches of the race-track bookmaker. Once his life was diversified--today hunting, tomorrow sealing, the next day fishing--whatever satisifed the whim of the moment. Now he must turn all his energies toward the capture of the fox. And the supreme irony, of which he is aware, is in the fact that he, the Agun, the male, must outstrip himself to satisfy the desires of the scorned Arna--the woman. And the Krabloonak's woman, at that.

Along the coast, noawadays, one often hears from the Eskimos a bitter, disillusioned cry. "Kakertogot taima"..."We are always hungry now."

Of course they were hungry. The Eskimo is a carnivore. His body craves meat--seal, bear, caribou, fish--and the climate and his hard life aren't satisfied by anything else. Half a grapefruit and a couple of pieces of toast are not the breakfast for the Inuk at all, but for another class of people.

Yet the Inuk counts on the little foxes to provide his sustenance all the year round, and sometimes the foxes don't turn up. Then he's in trouble. Then there is famine. And it is usually too late before the Inuit resign themselves to going out on the ice after seals, as they should have done early in the winter. They starve. At Coppermine, in 1948, for example the whole Eskimo colony kept alive only by eating old skins, boots, and other rubbish--and this not fifteen miles from a white man's settlement.

You might blame the traders themselves, and it is true that some are mightily unscrupulous, but it is not the individuals who should be blamed, but the system, and the government that encourages it. I am told that such tragedy is not known among the Eskimos in Greenland, under Danish rule, though it matches the colonial pattern elsewhere--in the sugar islands of the Caribbean, for eample, where the natives were persuaded to forego their food crops in order to plant sugar cane, and where starvation results when the sugar crop is poor or when the market drops and the price breaks. 

The Eskimos have never heard of the seven lean kine. A trapper may bag three hundred foxes in one year and three the next, but it never occurs to him to store provisions against a bad season. Of course, we must blame him for his improvidence. But must we not also blame the white men who profit vilely from the Eskimo's ignorance, who take advantage of a good fox season by importing diamond rings, gold watches, silk dresses, chronometers, and similar goods? Of what use is a diamond ring to a woman who's going to wear it for cutting seal blubber, if she's lucky enough to have a seal to cut up? What good is a chronometer, complete with sweep second hand, to a man who doesn't care a whit for time? Of what use is a silk dress under a greasy caribou parka?

With melancholy one must watch a venal civilization displace the old Eskimo style. The white man is as devious as Sila. He takes much, and gives little. He talks big, and the rewards look inviting, but when the season is over he has the foxes and what has Inuk?

An empty belly. A forlorn view of the future. The precious watch will soon be opened to see what makes it tick and ruined by snow or water. The elegant dress will soon because a greasy snot-stained rag. The diamong ring will not be worn long before it is lost down a seals' hole. Alas!

January 1, 1951

Roger Buliard

Carnivore

Inuk

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Buliard questions whether civilization has been positive for the people of the North: The Eskimo's fur clothing is perfect for the climate, and his diet, heavy with fat, was just the thing for a man who was going to hunt on the ice in forty-below-zero weather. In one sense, civilization, by making things easier for the Eskimo, has really set the stage for the Eskimo's destruction.

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One cannot deny the great benefits that civilization has bestowed upon the Eskimos. Certainly the white man has made life easier for the Eskimo, giving him nets, rifles, and steady trade. And the possibilities for human development implicit in the word "civilization" have at least been indicated to the Inuit.


But it would be idle to contest the contest the statement that civilization has been a mixed blessing so far as the Eskimos are concerned, and sometimes the advantages seem to be outweighed by the real harm that has been done. The trade-store rifles helped the Inuk kill his caribou more easily, but they also led to wholesale destruction of caribou and a change in the animals' migratory habits. The substitution of wool for fur clothing has not been beneficial, nor has the introduction of unsuitable foods into the Eskimo diet. The Eskimo's fur clothing is perfect for the climate, and his diet, heavy with fat, was just the thing for a man who was going to hunt on the ice in forty-below-zero weather. In one sense, civilization, by making things easier for the Eskimo, has really set the stage for the Eskimo's destruction. And the introduction of disease germs has inflicted on the Eskimos the same scourges that decimated the Indians and destroyed their pride. The ravages of disease are plain enough here, and one may deplore the havoc wrought during the last fifteen years alone.


Who is responsible[not God, obviously]?


The government, of course, since any government is always responsible for the welfare of people under its jurisdiction.


What has been Canada's attitude toward "Natives" generally?[The same attitude that Catholic schools had?]


The goverment was unfair to the Indians. After the treaty, by means of which the Indians sold their birthright--the limitless prairies and rich forests--for a mess of lentils, the government permitted tuberculosis, starvation, and loss of liberty to reduce them from a proud, self-sufficient people to a race of permanent invalids.


Was this done innocently, or through oversight? Through ignorance?


One wonders. As an official told Bishop Breynat: "it had been thought that the Indian problem would resolve itself. Their number was diminishing steadily. They would disappear."


The same policy was adopted where Eskimos were concerned.


Toward them Canada had no written obligation, as it had toward the Indians, but only the Biblical warning that we are all our brothers' keepers. Nor did the government have any specific duty toward them, except in moral terms. And so the goverment fell back on a policy that can be summed up in a word: indifference.


Indifference!

January 1, 1951

Roger Buliard

Carnivore

Inuk

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It is fat, fish, and meat that a man wants in this country. Are we white men harbingers of a new and brilliant era, or simply advance agents of destruction? Do we bring with us anything more than dollar corruption, and the corporal and moral germs that have afflicted our own civilization?

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The government family allowances, distributed to the Eskimos by the Hudson's Bay Company, have been precious help, especially to large families, and have been of great assistance in enabling the Eskimo people to bridge the gap created by the change in their economy wrought by the introduction to fox hunting. One deficiency of the allowance system is that it does not encourage Eskimos to teach their children to live off the country wherever possible. If the Eskimo takes his allowance every month or two, he can only obtain such items as fruit, tinned milk, jam, and so forth--things he doesn't particularly care for or need. It is fat, fish, and meat that a man wants in this country. To acquire credit for nets and ammunition an Eskimo must refrain from drawing his allowance until it amounts to forty dollars. Some arrangement should be made that would encourage the Eskimo to hunt, rather than to live on foods that are unsuitable. 


Whatever the deficiencies of the new dispensantion, it is certainly true that the Inuk is less abandoned than he was a year, two years, ten years ago. And this we must applaud, for when we look at certain statistical data we are forced to shudder at what the figures demonstrate of man's inhumanity toward man.


Monez, in the wake of Diamond Genness, estimated the number of Canadian Eskimos to be twenty-two thousand before the arrival of the white man. Some eight thousand were left in 1921, six thousand in 1931, and about five thousand in 1950. 


We are told that the Eskimo population trend has been reversed, that next year, and the year after, there will be more of them.


Will they be the same caliber of Eskimo, energetic, tough, healthy?


Or will they be a people broken in spirit and health, like the Chippewas to the south?


A single glance at the specimens now growing up seems to show that we may be gaining in quantity only what we have irretrievably lost in quality. The answer to this problem is in better government, better medical services, better police work. Only if epidemics are prevented, tuberculosis checked, ignorance ameliorated, and the methods of trade improved will the Eskimo people have a real chance of surviving with their own peculiar usefulness and beauty intact.


Are we white men harbingers of a new and brilliant era, or simply advance agents of destruction?


Do we bring with us anything more than dollar corruption, and the corporal and moral germs that have afflicted our own civilization?


If the future is to provide a satisfactory answer to these thorny problems, it is imperative that all those who work for the Eskimo, in any field or capacity whatsoever (the government, the civilian commercial enterprises, the Christian Churches), dedicate all their endeavors with supreme determination and utter selflessness not only to save the poor Inuk from extermination, but also to assure him a human "modus vivendi" compatible with the unique environment in which Providence wishes him to work out not only his temporal existence, but his eternal salvation. Then, and only then, will the Inuk, out there on the ice, perceive at last the promise of a bright new dawn that will scatter the darkness forever.

January 1, 1954

Observations on Blood Pressure in Eskimos

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When comparing the Eskimo men with white men of corresponding age, it is observed that both the systolic and diastolic blood pressures are lower in Eskimos than in Whites. It appears to be the impression of most physicians who have had occasion to examine large numbers of Eskimos, that the blood pressure in Eskimos is lower than in normal Whites of corresponding age.

It appears to be the impression of most physicians who have had occasion to examine large numbers of Eskimos, that the blood pressure in Eskimos is lower than in normal Whites of corresponding age (P. B. Haggland, M. D. , E. S. Rabeau, M. D. , and E. Albrecht, M. D. , personal communications). Abnormally elevated blood pressures (systolic blood pressure in the order of 170 mm or higher) are apparently quite rare. Thus, in the 213 Eskimo patients who were subject to medical examination by the author during a two-year period in Alaska, the blood pressure was measured in 1 17 cases, and only one of the patients had systolic blood pressure above 145 mm. 


In contrast to this, Saxtorph (quoted by A. Bertelsen, 1940) reported in 1926 that he had seen a considerable number of cases of hypertensio arterial is, both in old and middle-aged Greenland Eskimos. In 12 cases he measured blood pressures between 200 and 240 mm. 


Thomas ( 1927) on the other hand examined 142 Greenland Eskimos, 40-60 years of age, and found the average blood pressure to be 129/76 mm, with a single case of 170/ 1 00. He concluded that hypertension with associated complications is extremely rare among Eskimos. 


Holbeck (quoted by Bertelsen, 1940) has reported that the average systolic blood pressure in Greenland Eskimos, between 40 and 55 years uf age, was 141 in men and 131 in women. According to Bertelsen ( 1940) Svendsen examined, in 1930, the blood pressure of 106 Eskimos taken at random, some of whom had active pulmonary tuberculosis. He made the following findings: 15-30 years of age: 120/70 mm; 30-50 years ()f age: 137/77 mm; 50 years of age or over: 167/82 mm. Bertelsen (1940) concludes, on the basis of his experiences in Greenland, that the average blood pressure does not appear to deviate from that of Whites of corresponding age. 


Probably the most extensive study of Eskimo blood pressure has been reported by Hoygaard (1941). He measured the blood pressure systematically of 283 Angmagssalik Eskimos, South East Greenland, of both sexes, living on their primitive diet, using the standard technique in lying or sitting position at least one hour after exercise. He found no material difference between males and females. Twelve persons out of 283 (4%) had a systolic blood pressure of 150 or higher; only two subjects had as much as 168 mm Hg. (Table 1). He concludes that hypertonia is not common. 


According to MacMillan ( 1951) Or. E. Morse found no instance of high blood pressure among the Thule Eskimos during the Bowdoin's voyage to Greenland in 1950. 


In the case of Canadian Eskimos, Brown (1 951) states with regard to the Southampton Island and the Igloolik Eskimos: "Arterial hypertension has also been found both in the group at Southampton Island and in the group at Igloolik." However, in the 63 Eskimos living in the vicinity of Chesterfield Inlet (30 males and 33 females) examined by Crile and Quiring ( 1939) the average blood pressure in the males (average age 38 years) was: systolic pressure 1 19 mm, diastolic pressure 75. In the females (average age 31 years) the figures were 1 12 and 72 respectively. The average pulse rate was 62-69 in the males and 79-82 in the females. These authors conclude that "the blood pressure for both the males and the females is lower than that of Whites of corresponding age, the pulse rate corresponds rather closely to that of White individuals". 


Heinbecker (193 1) reports an average pulse rate of 64 in 5 Eskimos (4 females and 1 male, 15-50 years of age) from Baffin Island. Bollerud, et at. ( 1950) report an average pulse rate of 58 in their 23 male St. Lawrence Island Eskimos, 17--41 years old. 


In connection with extensive studies on the patho-physiology of Eskimos which were in progress at the Arctic Aeromedical Laboratory as part of a survey of human adaptation to cold, we had an opportunity of recording various physical and physiological measurements during a two-year period 1950-1952. In this paper we are only concerned with blood pressure. pulse rate and age. 


4. Results and Discussion. 


The results from all 104 Eskimo subjects of both sexes are presented in Table 2. The average age is just over 29 years, but the ages vary widely from 3 to 75. However, of the 104 subjects, 73 were between 15 and 40 years old and only 13 were below 15 years. 


From this table it is observed that the pulse rate at rest, when considering the mean figure for all observations in each subject, is 71 beats per minute, but the figures show considerable individual variations. If only the final reading is considered, the mean value is 67 beats per minute, ranging from 44 to 120. The average systolic and diastolic blood pressures in Eskimos of both sexes, when considering the mean values of all readings in each subject, were 110 and 71 respectively. The mean values of the final blood pressure readings obtained when the lower level was established after several repeated examinations, were slightly less, the systolic pressure being 107 and the diastolic pressure 69. The range of these measurements is considerable. 


Thus the resting systolic blood pressure varies from a minimum value of 84 to a maximum value of 140; the diastolic blood pressure varies from 56 to 100. Only one subject, a 14-year old boy, showed as high an average value for the systolic blood pressure as 140. No systolic blood pressure higher than 162 mm was recorded in this series. 80.76 o/c of the recorded systolic blood pressures were below 116 mm. 


Table 3 shows the results of similar measurements in 40 normal white men examined in Alaska by the same investigator. In this material the average age is 23 years. It appears that the figures for pulse rate are very similar to the corresponding figures for Eskimos. The mean figures for blood pressure are higher than in the Eskimos, both in the case of systolic and diastolic pressure, and in the case of both the mean values of all observations as well as in the case of the final values, recorded when the lower level had been established as the result of repeated examinations. It is observed that the figures, both for pulse rate and blood pressure in these White subjects, are lower than the figures published by McKiniay and Walker (1935) for 566 normal white men with a mean age of 23.2 years. The difference is over 5 times the standard error, both in the case of pulse rate and blood pressure. 


The wide range of "normal" variations in blood pressure in Whites, has been emphasized by McKinlay and Walker (1935). According to American sources the average values for systolic pressure in healthy males, as measured in the brachial artery with the individual at rest, vary from 100 to 120 in early manhood, from 125 to 136 in the middle years of adult life, and from 145 to 150 above the age of sixty years. 


The range of individual measurements. however, may show much wider variations. Alvarez, quoted by McKinlay and Walker (1935), found that the systolic blood pressure in 6,000 University students and graduates between the ages of 16 and 40 years may be as low as 85 mm or as high as 190 mm. He concludes that 22 per cent of men have a systolic blood pressure exceeding 140 mm and that one man in every forty has Cl systolic blood pressure higher than 160 ml. According to Diehl and Sutherland (1925), nine per cent of male students, 16-40 years of age, at the University of Minnesota had blood pressures over 140 mm. None of our Eskimo men, 15-40 years old. had mean blood pressures over 140 ml. 


As a rule, the lowest blood pressure readings were obtained at the fourth examination in Whites, but ne,t until the fifth examination in Eskimos. 


McKinlay and Walker (1935) had examined the variability and interrelationship of heart rate, systolic and diastolic blood pressure, pulse pressure and age in healthy men of ages ranging from 16 to 40. They conclude that within the period of life studied, age is not of great importance in determining the level of any of these factors. They find definitely significant, positive relationship between age and both systolic and diastolic blood pressure. but in such a degree as to form anything like a reasonably accurate basis for prediction. They find positive, but not very intimate, association between heart rate and blood pressure. 


In Tables 4, 5 and 6 our data are separated into three age groups: 15-25 years, 26-40 years, and over 40 years old. 


Twenty-five of the male Eskimos were between 15 and 25 years old. the average age being slightly over 21 years in this group. The same number of male Eskimos fell in the second age group: 26-40 years, the average age in this group being 33 years. Only twelve of the male Eskimo subjects were over 40 years old. 


There is no difference in the mean value of all readings in each subject for the 15-25-year-old group as compared with the 26-40- year-old group, but the mean value for the group over 40 years old is higher than the first two groups. The difference is 4 times the standard error, and is therefore probably statistically significant. 


The data for the 29 Eskimo women, divided into the three age groups: 15-25 years old (12 subjects), 26-40 years old (11 subjects), and over 40 years old (6 subjects), are given in Table 5. On the basis of this limited material it appears that the average blood pressure in Eskimo women is somewhat higher than in Eskimo men, but this difference is not statistically significant. There is also a tendency towards increased blood pressure with increasing age in Eskimo women. 


Of the 40 white men, 34 fell into the first age group (15-25 years) and 5 in the second age group (26-40 years) while only one subject was over 40 years old. If we compare these white men with Eskimo men of corresponding age, it is observed that the average blood pressure is slightly higher in Whites than in Eskimos but the difference is too small to be significant statistically (less than 3 times the standard error). The mean of the lowest measured blood pressure in each subject in the first age group is considerably lower in Eskimos than in Whites, however. The difference is about 4 times the standard error, and may be statistically significant. The number of subjects is too small, nevertheless, to allow any definite conclusion to be drawn from this material. 


It should also be noted that a larger proportion of the blood pressure measurements were recorded in the lying position in the Eskimos (70 C,c) than is the case in the Whites (25 o/c) and since the blood pressure tends to be lower in the lying position (Tables 7 and 8), this may partly account for the difference, although the difference between sitting and lying blood pressure in Whites in this material is not significant statistically. Thus, in Whites 15-25 years old, the difference between the means for sitting and lying systolic blood pressure is 5 mm, which is less than twice the standard error, as is also the case when comparing the diastolic blood pressure in the sitting and lying position. However, out of the 24 lowest measured blood pressures in Whites 15-25 years old, 76.47 per cent were measured in the lying pOSitIOn, and of the highest measured blood pressures in the same subjects, 97.06 per cent were measured in the sitting position. It may be noted however that in Eskimos the difference between sitting and lying blood pressure is about 3 times the standard error. 


In Whites 15-25 years old, the mean pulse rate is 72 measured sitting, and only 58 when measured lying. The difference is 4 times the standard error, and may therefore be considered significant in a statistical sense, although the number of observations is very small. The range of the pulse rate measured sitting is 68-86, against 51-67 measured lying.


From Table 10 it appears that the Kotzebue and Gambell Eskimos in the age group 26-40 years have a lower mean blood pressure than the corresponding age groups from Anaktuvuk Pass and Barter Island. The difference between the Gambell and the Anaktuvuk Pass groups (the groups showing the most pronounced difference), as regards the means of the lowest measured blood pressures, is 12 mm, and the standard error is 3.20. Thus, the difference is over three times the standard error. However, the material is too small to allow any conclusion. No significant difference was detected in the blood pressure in Eskimos 15 -25 years old from the 4 different settlements (Table 9). 


5. Summary and Conclusion. 


735 blood pressure and pulse rate measurements were made in a consecutive series of 104 Eskimos (75 males and 29 females) from 4 different Eskimo settlements in Alaska. Similar measurements were made in 40 normal white men for comparison. 


In Eskimos the mean resting systolic blood pressure varied from a minimum value of 84 to a maximum value of 140. No systolic blood pressure higher than 162 mm was ever recorded in our Eskimo subjects. 80 o/c of the recorded systolic blood pressures were below 1 16 mm. The mean diastolic blood pressures varied from 56 to 100. In Eskimos the mean blood pressure is somewhat higher in women than in men of corresponding age although the difference is not statistically significant, and there is a tendency towards increased blood pressure with increasing age. 


In Eskimo men the mean blood pressure was 108/69 at ages 15-40 years, and 119/77 above 40 years of age. In Eskimo women the figures were 111/71 and 122 /74 respectively. When comparing the Eskimo men with white men of corresponding age, it is observed that both the systolic and diastolic blood pressures are lower in Eskimos than in Whites. This difference appears to be statistically significant in the case of the lowest measured blood pressure in each subject in the two groups. The mean pulse rates in Eskimos at rest were not materially different from the corresponding figures for Whites.

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