bones in the basement: postmortem racism in nineteenth-century medical training

7
Book Reviews Guns, Germs and Steel: The Fates of Human Societies. By Jared Diamond. 480 pp. New York: W.W. Norton & Co. 1997. $27.50 (cloth). Reading Guns, Germs and Steel as I trav- eled through Mexico this summer gave a new twist to the usual small talk. When a taxi driver in Monterrey explained that northern Mexico is wealthier than southern Mexico because people in the south are dis- tracted by religious faith and fiestas, I thought, hmm, proximate causation. When I repeated his argument to a religiously ob- servant friend in a northern city, my friend responded that it is easier to grow food in the south; hence the north developed (wealth-making) technology. Hmm, I won- dered, is that the ultimate cause? People create stories to explain inequali- ties. Jared Diamond does the same in his Pulitzer Prize-winning book, but on a global scale. Instead of wondering why the north differs from the south, Diamond wonders why the Spanish conquered Mexico. Why did the Aztecs not conquer Spain? Religion, technology, and government are proximate causes but, Diamond concludes, the pat- terns of world history are explained, ulti- mately, by plant and animal domestication or, more to the point, “differences in real estate” (p. 401). As he has frequently demonstrated in Discover magazine and Natural History, Diamond is a superb organizer of informa- tion. The sweep of this book leads us from anthropology to geography, horticulture, zo- ology, the study of infectious disease, and the history of writing, technology, govern- ment, and religion, or “the main sets of proximate agents leading to history’s broad- est pattern” (p. 267). Throughout this book, Diamond uses his friendship with people of New Guinea to personalize his global under- taking, beginning with a local politician’s question “Why is it that you white people developed so much cargo and brought it to New Guinea, but we black people had little cargo of our own?” (p. 14). Diamond’s question/answer format is both provocative and manipulative. For ex- ample, Yali’s question is immediately re- phrased. First, “Why did wealth and power become distributed as they now are, rather in some other way?” (p. 15), and then “why did human development proceed at such dif- ferent rates on different continents?” (p. 16). Finally, Diamond asks, “Why did New Guin- eans wind up technologically primitive, de- spite what I believe to be their superior in- telligence?” (p. 22). One part of the answer is that although New Guinea has had “po- tential Edisons,” “they directed their inge- nuity toward technological problems appro- priate to their situations, . . . rather than the problem of inventing phonographs” (p. 264). Simply stated, this book is a description of people’s “situations.” It is organized into four parts. In Part One, “From Eden to Ca- jamarca,” Diamond establishes why proxi- mate (first-stage) explanations do not offer ultimate answers, and why racist biological explanations are without validity in ex- plaining the lopsided outcome of the modern world. Diamond also examines how pat- terns of human evolution relate to uneven technological development, how cultures evolve, and how past collisions between cul- tures with disparate resources (proximate causes) are responsible for contemporary economic relationships. Part Two, “The Rise and Spread of Food Production,” delivers the ultimate causes of resource disparity and is the strongest part of the book. Dia- mond offers a comprehensive discussion of the effects of plant and animal domestica- tion on human societies. Engaging chapters overflow with details of how, when, and where food production and animal domesti- cation originated. His basic argument is that “food production evolved as a by- product of decisions made without aware- ness of their consequences” (p. 106, empha- sis in original). Culture is either determined by resources or relegated to the role of arbi- trary preferences, “such as considering fish either delicacies or taboo” (p. 108). Accord- ing to Diamond, the bases for social inequal- ities lie in climate, environment, the tilt of the earth’s axes, and the wild plants and animals available for domestication. Part Three, “From Food to Guns, Germs and Steel,” brings us back to proximate causes with a review of microbe strategies AMERICAN JOURNAL OF HUMAN BIOLOGY 11:565–571 (1999) © 1999 Wiley-Liss, Inc.

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Page 1: Bones in the basement: Postmortem racism in nineteenth-century medical training

Book Reviews

Guns, Germs and Steel: The Fates of HumanSocieties. By Jared Diamond. 480 pp. NewYork: W.W. Norton & Co. 1997. $27.50(cloth).

Reading Guns, Germs and Steel as I trav-eled through Mexico this summer gave anew twist to the usual small talk. When ataxi driver in Monterrey explained thatnorthern Mexico is wealthier than southernMexico because people in the south are dis-tracted by religious faith and fiestas, Ithought, hmm, proximate causation. WhenI repeated his argument to a religiously ob-servant friend in a northern city, my friendresponded that it is easier to grow food inthe south; hence the north developed(wealth-making) technology. Hmm, I won-dered, is that the ultimate cause?

People create stories to explain inequali-ties. Jared Diamond does the same in hisPulitzer Prize-winning book, but on a globalscale. Instead of wondering why the northdiffers from the south, Diamond wonderswhy the Spanish conquered Mexico. Whydid the Aztecs not conquer Spain? Religion,technology, and government are proximatecauses but, Diamond concludes, the pat-terns of world history are explained, ulti-mately, by plant and animal domesticationor, more to the point, “differences in realestate” (p. 401).

As he has frequently demonstrated inDiscover magazine and Natural History,Diamond is a superb organizer of informa-tion. The sweep of this book leads us fromanthropology to geography, horticulture, zo-ology, the study of infectious disease, andthe history of writing, technology, govern-ment, and religion, or “the main sets ofproximate agents leading to history’s broad-est pattern” (p. 267). Throughout this book,Diamond uses his friendship with people ofNew Guinea to personalize his global under-taking, beginning with a local politician’squestion “Why is it that you white peopledeveloped so much cargo and brought it toNew Guinea, but we black people had littlecargo of our own?” (p. 14).

Diamond’s question/answer format isboth provocative and manipulative. For ex-

ample, Yali’s question is immediately re-phrased. First, “Why did wealth and powerbecome distributed as they now are, ratherin some other way?” (p. 15), and then “whydid human development proceed at such dif-ferent rates on different continents?” (p. 16).Finally, Diamond asks, “Why did New Guin-eans wind up technologically primitive, de-spite what I believe to be their superior in-telligence?” (p. 22). One part of the answeris that although New Guinea has had “po-tential Edisons,” “they directed their inge-nuity toward technological problems appro-priate to their situations, . . . rather thanthe problem of inventing phonographs” (p.264).

Simply stated, this book is a description ofpeople’s “situations.” It is organized intofour parts. In Part One, “From Eden to Ca-jamarca,” Diamond establishes why proxi-mate (first-stage) explanations do not offerultimate answers, and why racist biologicalexplanations are without validity in ex-plaining the lopsided outcome of the modernworld. Diamond also examines how pat-terns of human evolution relate to uneventechnological development, how culturesevolve, and how past collisions between cul-tures with disparate resources (proximatecauses) are responsible for contemporaryeconomic relationships. Part Two, “The Riseand Spread of Food Production,” deliversthe ultimate causes of resource disparityand is the strongest part of the book. Dia-mond offers a comprehensive discussion ofthe effects of plant and animal domestica-tion on human societies. Engaging chaptersoverflow with details of how, when, andwhere food production and animal domesti-cation originated. His basic argument isthat “food production evolved as a by-product of decisions made without aware-ness of their consequences” (p. 106, empha-sis in original). Culture is either determinedby resources or relegated to the role of arbi-trary preferences, “such as considering fisheither delicacies or taboo” (p. 108). Accord-ing to Diamond, the bases for social inequal-ities lie in climate, environment, the tilt ofthe earth’s axes, and the wild plants andanimals available for domestication.

Part Three, “From Food to Guns, Germsand Steel,” brings us back to proximatecauses with a review of microbe strategies

AMERICAN JOURNAL OF HUMAN BIOLOGY 11:565–571 (1999)

© 1999 Wiley-Liss, Inc.

PROD #M98124

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and human vulnerabilities, followed by anaccount of the development of writing as a“modern agent of conquest” (p. 216) madepossible by stored food surpluses. In a moredifficult chapter, Diamond documents 14 ex-planatory factors for how differences intechnology arose (p. 249), including the hy-pothesis offered by my friend in northernMexico, “that technology thrives in a rigor-ous climate where survival is impossiblewithout technology” (p. 251). Diamond doeshis best to show that these proximate ex-planatory factors fall short. That, instead,broad historical patterns need to be ex-plained in terms of geography, ecology, andpopulation density. He carries out a similartreatment for government and religion, con-tinuing his central argument that food pro-duction makes complex societies possible.Part Four, “Around the World in Five Chap-ters,” is in many ways a repeat of all thatcame before, but specific in reference to fivegeographic areas: Australia and NewGuinea, East and Southeast Asia, Polyne-sia, the collision between Old World andNew World, and Africa. Because of the rep-etition, each chapter in this section couldstand alone from the book, and each couldbe assigned in a course on a particular cul-tural area. The book could end at the con-clusion of Part Three.

I read this book as a potential supplementfor my undergraduate course on HumanVariation. However, I did not assign thebook. Diamond is intent on demonstratingthat biological explanations cannot accountfor either cultural differences or resource in-equalities. He misses opportunities to detailaspects of human variation related to histopics, such as differential ability to digestavailable foods (e.g., lactose), genetic varia-tion in relation to infectious diseases(briefly mentioned, p. 201), or variation inhuman fertility (briefly discussed as birthspacing, p. 89). This would be an appropri-ate recommended text for undergraduatesin Introduction to Anthropology, HumanEcology, or Nutritional Anthropology. Thestyle is conversational, little anthropologi-cal knowledge is assumed, the index is good,and the 32 portrait-like photographic platesare beautiful.

Two bothersome points should be men-tioned. First, the question/answer format isa manipulative device to move the argu-ment in one direction. Sometimes six ormore questions are added consecutively to

get to the path Diamond wants to follow.Second, although Diamond discusses pointsof contention, it becomes obvious that hechooses dates needed to support his ulti-mate arguments. For example, he arguesthat humans did not arrive in the NewWorld until 11,000 BC. Therefore, theylacked the time necessary to develop whatwas needed to turn the patterns of historyaround (i.e., guns, germs, and steel). Thatsaid, the book is consistent in argument, in-teresting, and accessible.

For anthropologists and human biologistsfamiliar with the basics of cultural evolu-tion (Marshall Sahlins and Elman Service)and cultural materialism, the first fewchapters are an introductory review. How-ever, as the book progresses and Diamond’sarguments become more specific, the bookbecomes both informative and enjoyable,and highly recommended for a bus tripthrough Mexico.

LYNETTE E. LEIDYDepartment of AnthropologyUniversity of MassachusettsAmherst, Massachusetts

Encyclopedia of Human Biology, 2nd edition.Edited by Renato Dulbecco. 9 Volumes.San Diego, CA: Academic Press. 1997.$2,100 (cloth).

This encyclopedia purports to provide acomplete overview of the current state ofknowledge in contemporary human biology.It is intended to serve as a “solid base onwhich subsequent information can bereadily integrated.” The target audience isbroad, including general readers with abackground in science, undergraduates,graduate students, and practicing research-ers and scientists. The articles, therefore,strive to be written so that the material con-tained in them is accessible to this generalaudience. Only a general knowledge of biol-ogy is assumed of the reader. Therefore, theamount of detail is limited to what is suffi-cient for an overview of topics. Specializedterminology is kept to a minimum, andwhen relatively arcane terms are used, theyare explained in a glossary at the beginningof the article. A bibliography is provided atthe end of each article for the more sophis-ticated reader.

Typical of an encyclopedia, topics are or-ganized alphabetically. A most useful fea-

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ture is the inclusion of an index volume (Vol.9). This volume provides a guide to usingthe encyclopedia, which includes a brief de-scription of the general organization of theencyclopedia, the specific format of the ar-ticles, and a list of contributors, as well as acumulative contents, a subject index, andcontents by subject area. The latter is par-ticularly useful for locating information ongeneral topics. The 8 volumes contain over170 articles, covering human biology from Ato Z, grouped into the following major sub-jects: behavior, biochemistry, biotechnology,the cardiovascular system, cell biology, den-tal and oral biology, the digestive system,endocrinology, evolution, food and nutrition,genetics, gerontology, hematology, immu-nology, the integumentary system, methodsand materials used in human biology, mi-crobial diseases, muscles, the nervous sys-tem, oncology, osteology and histology,parasitology, pathology, pediatrics, phar-macology, physiology, psychiatry, publichealth, the reproductive system, the respi-ratory system, sense organs, sociobiology,toxicology, and virology. The list of authorsis quite distinguished, including recognizedexperts and Nobel Prize recipients.

Consistent with the encyclopedia’s overallorganization, the format of individual ar-ticles is designed to be user-friendly. Eacharticle begins with an outline of its generalcontent, which is followed by a glossary ofimportant terms and a short statement thatdefines the nature of the topic under discus-sion and summarizes its content.

To evaluate the extent to which this workachieves its stated overall purpose of pro-viding a complete overview of the currentstate of knowledge of contemporary humanbiology, I constructed a list of topics perti-nent to an undergraduate introductory hu-man biology course. In addition, to assess itsmore general usefulness for anthropolo-gists, several departmental colleagues pro-vided additional topics that they, or theirstudents, would have cause to look up in anencyclopedia of human biology. The list in-cluded topics that can be broadly organizedunder the following seven general subjects.

The first general subject explored by thereviewer was life cycle, which included thebroad topic of reproduction, as well as themore specific topics of gametogenesis, preg-nancy, childbirth, reproductive endocrinol-ogy, embryology, gestation, puberty, menar-che, senescence, and menopause.

The general subject of growth and devel-opment included the topics of developmen-tal stages (the embryo, infancy and child-hood, and adolescence), genetic and hor-monal factors, growth disorders, speech andlanguage pathology, psychobiology, andcomparative anatomy (human/macaque).

Adaptation to altitude, heat, cold, hypo-gravity, and stress were included under thegeneral subject of adaptation. Additionaltopics included on this subject are adapta-tional physiology, adaptation and humangeographic variation, and adaptation in an-cient populations.

Fifteen topics under the general subject ofhealth and disease were explored: epidemi-ology, AIDS, infectious disease, anemia, im-munity, stress, heart disease, prions, diabe-tes, antibiotics, osteoporosis, atherosclero-sis, steroids, interleukins, and parasitism.Examples of other topics encountered dur-ing the review that would be of particularinterest in anthropology are primate ecologyand ecology in relation to emergent disease.

Human genome, heritability, populationgenetics, and behavioral genetics were top-ics suggested for the general subject of ge-netics. As would be expected, coverage ofthese topics, as well as many others, underthis subject is extensive.

The general subject of evolution is ad-equately represented in this encyclopedia.All of the topics suggested by my colleagueswere covered. These topics included humanorigins, the origins of language, early evi-dence for tool use, australopithecines, theevolution of bipedalism, and the origins ofanatomically modern humans. The extent towhich the coverage of this material is cur-rent is evidenced by inclusion of more recentfossil evidence, such as Ardipithecus rami-dus, and the competing multiregional conti-nuity and “out of Africa” theories for the ori-gin of anatomically modern humans.

Finally, a number of other miscellaneoustopics were suggested, including demogra-phy, race, carrying capacity, biorhythms,biomechanics, intelligence, the senses, workcapacity, and ergonomics. Of the topics sug-gested, only carrying capacity and fluctuat-ing asymmetry are not covered, and mate-rial on the important and perpetually con-troversial subject of intelligence is minimal.

Overall, coverage of the subject of humanbiology by this encyclopedia is thorough,providing several articles relating to a par-ticular subject. Developmental biology and

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genetics, for example, have 18 and 58 list-ings, respectively, and include subjects asbroad as puberty and population genetics,and as specialized as the embryonic devel-opment of bone, craniofacial genetics, andhistones. From the reviewer’s perspective asa physical anthropologist specializing inskeletal biology, the coverage of bone biol-ogy is quite good. The material on the em-bryonic development of bone, bone remodel-ing, metabolism, and health and disease isclear, concise, and up to date. The value ofthis encyclopedia to a broad audience is en-hanced by its inclusion of sociocultural andpsychological material as well as biological,e.g., rites of passage, sexual behavior, anddental mutilation. There is even a chapterthat presents examples from nonliterate so-cieties of how cultural (ritual) activity rein-forces life transitions during the aging pro-cess.

In summary, the Encyclopedia of HumanBiology is comprehensive, well organized,and appropriate for a wide audience of read-ers interested in human biology. The onlysignificant drawback is its $2,100 price. Pe-riodic publication of yearbooks, rather thancompletely new editions, might help mini-mize the cost of upgrading. It would be use-ful if it were made available on CD.

SAM D. STOUTDepartment of AnthropologyUniversity of MissouriColumbia, Missouri

Bones in the Basement: Postmortem Racismin Nineteenth-Century Medical Training. Ed-ited by Robert L. Blakely and Judith M. Har-rington. xxi + 380 pp. Washington, DC:Smithsonian Institution Press. 1997. $45.00(cloth).

I have been looking forward to this booksince 1993 and a couple of phone conversa-tions with the late Bob Blakely in the courseof trying frantically to save from incinera-tion the contents of Michigan’s 19th centurymedical school cadaver disposal pit. Likethose of the Medical Colleges of Georgia andVirginia, Michigan’s had been discoveredduring the course of construction on cam-pus. The grant proposal copies and articledrafts Bob sent me were instrumental inconvincing a reticent Business Administra-tion Vice President of the scientific value ofthe site and the need to save the contents.

I can say Bones in the Basement wasworth the wait with few reservations. Thedozen contributors (including the editors)have worked through a mountain of mate-rial to produce an impressive piece of mul-tidisciplinary anthropology. The 12 chap-ters present a scientific and social analysisof the Medical College of Georgia (MCG) ar-chaeological site and its considerable as-semblage of cultural and material artifacts.The fact that only three of the 12 contribu-tors held doctoral degrees when the bookwent to press in no way detracts from thetechnical competency of the analysis. WhileI may take issue with the details of some ofthe conclusions they reach, I highly recom-mend this volume as background readingfor anyone interested in historical archaeol-ogy or medical history. These researchersdid a superb job in the design and executionof this project, and the National Endow-ment for the Humanities, source of most ofthe support for the project, certainly gottheir money’s worth.

The first of three sections covers the dis-covery of the site, an overview of the contex-tual history of the building, and an analysisof the trove of artifactual and faunal mate-rial recovered. Part 2 focuses on recon-structing 19th century dissection proce-dures from a comparative experimental per-s p e c t i v e , a n o v e r v i e w o f c a d a v e rprocurement at MCG, and a discussion ofrace and the political context of medicine insociety in 19th century Georgia. This sec-tion also presents a sociobiographical por-trait of Grandison Harris, the individual atMCG responsible for making certain therewas an ample supply of cadavers for ana-tomical and surgical instruction. The finalsection provides a physical and sociocul-tural examination of the human remains.Trace element analysis is used for dietaryreconstruction and compared with perspec-tives drawn from the comparative osteologi-cal literature. A general picture of thehealth status of the MCG sample is pre-sented in a chapter on paleopathologicalanalysis. The two final chapters move awayfrom physical anthropology to present anethnographic interpretation of data col-lected in interviews with modern medicalstudents and Augusta residents.

The authors conclude that White, Euro-pean-derived society perpetrated and per-petuated horrendous injustices on the poor,disempowered, and disenfranchised. They

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suggest that this was standard social proto-col throughout the developing 19th centuryUnited States, and that in many cases thesepractices continue to the present day. This,of course, is not new and would hardly meritmention in the face of the new informationthat is presented, but this theme is stressedcontinually, predictably, and finally some-what repetitively at every possible opportu-nity. The authors leave no doubt in thereader’s mind that medical education in the19th century US, not just the antebellumSouth, was actually part of a larger socialscheme specifically engineered to disem-power and bar the underclasses, particu-larly those of sub-Saharan West African de-scent, from achieving the developing Ameri-can Dream. Much of the contention forsociopolitical separation along color lines isbased on the forensic analysis of the skeletalmaterial, specifically 24 tibiae, used for “ra-cial” identification. In the editor’s chapter,“Grave Consequences,” the frequency of 19tibiae judged to be from Blacks to 5 tibiaejudged to be from Whites does indeed sug-gest an approximately 4 to 1 preference forBlacks over Whites as dissecting-room sub-jects. In a subsequent chapter, however, an-other of the contributors finds those sameratios to be 1.5 and 1.1 to 1 (Blacks toWhites), still a majority but by a consider-ably smaller margin. These sorts of smallmaterial discrepancies may lead the readerto consider that they may be overstating thecase somewhat. In the spring of 1878, thebody of John Scott Harrison (son of Presi-dent William Henry Harrison) was discov-ered hanging in the anatomy lab at theMedical College of Ohio in Cincinnati. Thebody of a recently deceased family friend ofthe Harrison’s, Augustus Devin, was tracedto the anatomical laboratory of the Univer-sity of Michigan at Ann Arbor (Huelke1961). Neither of these men were poor,Black, or indigent, and the occurrence ofevents of this nature north of the Mason-Dixon line scarcely lends support to the“white supremacist upper classes preyingon the poor black underclass” theme thatruns through much of the interpretationpresented in the book. The preceding as wellas other incidents from the early years ofMichigan’s medical school are documentedby Huelke (1961), an article discussed byBob Blakely and myself over the phone, but,curiously, never cited by any of the authorsin the MCG volume. This volume presents a

sterling example of project design and ex-ecution, but the authors’ interpretationsand extrapolations beyond 19th century Au-gusta may be projecting a little beyond thetemplate.

On the other hand, they may not. There isno comparative osteological work and docu-mentation. I am familiar with much of theliterature cited by these authors, and thereis little in the way of osteological reports on19th century medical ossuaries (or dumps)from north of the Mason-Dixon Line. A criti-cal distinction in the interpretation of thismaterial is to be made regarding treatmenton a local or regional versus national scale.This volume provides a great start, butmore sites should be investigated, perhapsbeginning with the Michigan Anatomy De-partment, in order to determine if the au-thors’ generalizations are accurate region-ally or nationally. The claims for a nation-wide conspiracy to denigrate Blacks,particularly in death, demand independentverification.

LITERATURE CITED

Huelke DF. 1961. The history of the Department ofAnatomy, the University of Michigan. Part I. 1850–1894. Univ Mich Med Bull 27:1–27.

RUSSELL NELSONMuseum of AnthropologyUniversity of MichiganAnn Arbor, Michigan

Adaptation to Malaria: The Interaction of Biol-ogy and Culture. Edited by Lawrence S.Greene and Maria Enrica Danubio. xiv +490 pp. New York: Gordon and Breach.1997. $68.00 (cloth).

In areas where Plasmodium falciparummalaria is or has been endemic, it has leftits mark on the genetic structure of the hu-man population. The presence and high fre-quency of sickle cell anemia, thalassemia,and glucose-6-phosphate deficiency (G6PD)have been attributed to natural selection bythe malaria parasite. It has often been sug-gested that malaria must also have selectedfor certain other biocultural factors, such asdietary patterns, which might augment,complement, or even hasten the genetic ba-sis of resistance. This book focuses on thestudy of selection in humans due to both themalaria parasite and human dietary pat-terns, which affect over 400 million people

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worldwide, as a model for genetic selectionin humans due to both the malaria parasiteand human dietary patterns. One of the cen-tral points brought out in the book is thatthe various alleles for G6PD-deficiency haveco-evolved with culturally constructed cui-sines that incorporate oxidant-containingplant foods and therapeutic regimens thatlower erythrocyte reducing capacity andthus maximize the antimalarial protectionoffered by alleles for G6PD deficiency.

This book is structured in three sectionsand 16 chapters discussing various aspectsof G6PD-deficiency in human populationsand its link to resistance to malaria. Theentire spectrum of the biology of G6PD-deficiency is presented, spanning from mo-lecular biology of the gene to enzyme kinet-ics, red cell metabolism, and finally to clini-cal and cultural manifestations.

The first section of the book focuses on themolecular genetics and biochemistry ofG6PD-deficiency. Particularly outstandingis the first chapter, by Gaetani and Ferraris,dealing with the basic biochemistry of oxi-dative stress and G6PD-deficiency. Thischapter also usefully categorizes theplethora of G6PD alleles and their proper-ties, and the role of catalase in G6PD-deficiency. The second chapter, by Turriniet al., presents a detailed biochemical de-scription of favism, the hemolytic crisis fol-lowing consumption of fava beans, andthereby introduces a biological basis for di-etary interaction with G6PD deficiency. Healso presents evidence supporting a novelhypothesis involving auto-antibodies whichfacilitate the antimalarial effects of G6PD-deficiency. Following a provocative chapterby Meloni and Meloni detailing clinical con-sequences selecting against G6PD defi-ciency, Ruwende et al. present an outstand-ing case-control study detailing the relativeprotection against uncomplicated and se-vere malaria afforded G6PD-deficient indi-viduals in Africa.

The second section of the book examinesthe mechanism of antimalarial protection ofG6PD-deficient erythrocytes and interac-tions between dietary and medicinal factorspromoting parasite destruction. Chapter 6,by Har-El and Chevion, and Chapter 10, byGreene, stand out as excellent discussions ofthe roles of other nutrients such as iron, vi-tamin C, copper, zinc, calcium, and ribofla-vin in modulating favism and antimalarialprotection. Greene also presents some evi-

dence supporting the notion that dietarypatterns have been developed that potenti-ate the antimalarial effect of G6PD-deficiency. Chapter 8, by Etkin, and Chap-ter 9, by Jackson, focus on specific plantsthat promote pro-oxidant status that mightpotentiate protection against malaria. Et-kin’s summary of plants from indigenouspharmacopeias that have been shown tohave antimalarial action is very useful. Et-kin contends that the biocultural use of oxi-dant-containing plants and medicines is thebiocultural analog to G6PD-deficiency,achieving the same effect but at a lower costthan genetic adaptations. Jackson, in themost theoretical chapter of the book, at-tempts to develop a conceptual model forhuman–plant–parasite interactions.

The last section of the book is essentiallya series of historical and genetic studies ex-amining factors accounting for distributionof G6PD-deficiency alleles in southern Italyand Sardinia. Particularly noteworthy areChapter 13, by Tagarelli et al., presentingevidence for a selective advantage in fertil-ity provided by G6PD-deficiency, and Chap-ter 16, by Bottini et al., dealing with inter-actions between G6PD-deficiency and otherhemoglobinopathies, such as thalassemia,and allelic forms of acid phosphatase.

Though well conceived and executed,there are certain aspects of the book thatmay present minor irritations to some read-ers. First, the title is somewhat misleading,as it implies that a greater scope of informa-tion may be discussed regarding biologicaland cultural adaptation to malaria, such assickle cell trait, thalassemia, or other hemo-globinopathies, as well as other cultural be-liefs surrounding malaria sickness. Also,the basic underlying mechanism wherebyG6PD-deficiency confers resistance to ma-laria, by promoting oxidant stress, is men-tioned in the Introduction of almost everychapter, along with basic data on malariadisease burden worldwide. When read inone sitting, this tends to detract from thecontinuity, although it would be useful tothose reading only selected chapters. Asmall section or chapter dealing with ma-laria immunity and pathology would havebeen useful. This is particularly so due tothe heavy focus on oxidative stress as themain mechanism underlying resistance tomalaria via G6PD-deficiency, which mightleave many readers unfamiliar with ma-laria with an unbalanced view of the role of

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oxidative stress on the immunopathophysi-ology of malaria. It would also have beenuseful to have discussed some of the datasuggesting that the modulation of oxidant-status may not be the only mechanism un-derlying the effects of G6PD-deficiency. Thelast section of the book, dealing with the his-tory of malaria and the distribution ofG6PD-deficiency in southern Italy andSardinia, consists of well-written scholarlyworks, but may appear less relevant giventhe greater focus on African data for G6PD-deficiency and diet in most of the otherchapters.

Overall, the volume is very well put to-gether and extremely informative. It can behighly recommended for anyone interestedin aspects of human adaptation to malariaand infectious diseases in general. It alsocontains information of interest to biochem-ists, molecular biologists, and evolutionarybiologists with an interest in malaria or oxi-dative metabolism of the red cell. Its ap-pearance is particularly timely given recentinterest in the role of micronutrients in theprevention and treatment of malaria. Thebook sets a positive precedent for futuresuch volumes which might focus on othergenetic traits conferring resistance to ma-laria and their biocultural modifiers.

ANURAJ H. SHANKARPETER WINCHDepartment of International HealthJohns Hopkins University School of PublicHealthBaltimore, Maryland

Revista Espanola de Antropologia Biologica,Vol. 18, Especial Biodemografia. 272 pp.Madrid: Sociedad Espanola de Antropolo-gıa Biologica. 1997. $20.00 (paper).

This special issue/monograph consists of18 papers by an international group of au-thors reporting on biological anthropologyresearch conducted in several differentcountries in Europe (e.g., Belgium, En-gland, Spain, Portugal, Czech Republic) andthe Americas (e.g., Argentina, Brazil, Chile,Cuba, Peru, Venezuela). The collection isnot organized into sections, although threebasic topics are covered. Seven articles dealwith population genetic structure, includingpedigree analyses, genetic marker distribu-tions within and among populations,

isonymy, heritability, gene flow and admix-ture/heterozygosity estimates, and trackingthe evolutionary fate of mutations and ge-netic diseases. Six contributions are con-cerned with biodemographic correlates ofgenetic phenomena—fertility, mortality,mate selection patterns (e.g., inbreeding vs.exogamy), and migration effects on gene fre-quencies. Two of these papers describe ge-netic consequences of fertility and natalityvariations, including seasonality of wed-dings and births as well as the outcomes ofcontraceptive usage. The final five papersaddress the epidemiological and health as-pects of population dynamics and the demo-graphic impacts on genetic diseases. Threeof the latter articles focus on the interactionof health, disease, and patterns of mortality:causes of death, mortality rates, age andgender differences, and biological/geneticresults of epidemiological transition.

Examples of specific studies include thegeographic origin of particular genes amongthe Berbers of Morocco, intermarriage be-tween indigenous and immigrant popula-tions in Belgium, inbreeding and consan-guinity in high and low altitude regions ofArgentina, mortality trends over a 150-yearperiod in Spain (1841–1990), populationhistory and demographic change in Tierradel Fuego, and migration and mate selectionin rural communities in England. Crow’s In-dex for the Opportunity of Natural Selectionwas calculated with ample data in two pa-pers. An outstanding piece by P.D. Raspeand G.W. Lasker provides novel estimatesof genetic diversity based on statisticalanalyses of surname distributions in ruralEnglish villages. A thorough case study ispresented on endogamy and consanguinityin a rural community in Spain.

This special issue/monograph containssome solid and concise research results ofinterest to population geneticists and bio-logical anthropologists investigating humanvariation, especially the interaction of ge-netics and demographic forces. Brief trans-lations are included in Spanish and Englishto allow wider readership. The only realnegative is the lack of editorial introductionor commentary (condensed on one page).

ROBERT A. HALBERSTEINDepartment of AnthropologyUniversity of MiamiCoral Gables, Florida

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