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The biology of human starvation


The biology of human starvation







DOI: 10.1136/jech.5.2.120-b

This two-volume monograph includes a full account of the Minnesota experiment in human "semi-starvation ". It does much more than that. To those who had the privilege of seeing the slim interim reports it must have come as a surprise. By inclusion of assembled data on natural famines and on starvation deliberately induced during wars, or incidental to these catastrophes, it has been enormously expanded and offers the most complete account in existence of the effect of restriction of food to the extent of causing great emaciation in young adults. It was natural that the team should be anxious to make detailed comparisons between their results and the ob servations on starving people recorded elsewhere, and it is obvious that the book could have been arranged in several different ways. As it is, the system adopted, of sustained discussion of the general problem and of other people's observations, the treatment of the Minnesota data, especially in the first volume, as if they constituted only an item in the assembly, provokingly blurs the outline of that amazing experiment. Which seems a pity because, however searching and diligent other planned investigations may have been, they do not compare with this; and most of the more detailed observations on war victims were made, not during starvation, when there was no remedy but after, under conditions not likely to provide the technical accuracy of the Minnesota work, and on subjects in such states that the claims of rehabilitation would scarcely be resisted by scientific curiosity for the length of time necessary to make very close observation. It is, in fact, difficult to believe that all of the observa tions discussed were worthy- of the amount of attention given them. On the other hand, the book is almost harshly critical on occasion. This is, of course, merely being difficult because we cannot have it both ways. If we have the relevant bits assembled together, then we cannot read straight through the Minnesota story. But the text pieces are worth searching for, and the data are tabulated in satisfying detail at the end. The Minnesota experiment is the third on con scientious objectors to be published. It operated with a limited supply of a balanced diet. The other two, the (British) Medical Research Council's experiments, were in deficiency of vitamin A and vitamin C (see Absts. 2643, Vol. 19; 2449, Vol. 18). The published accounts of these were disappoint ingly brief. The Minnesota results are reported in detail and they cover the morphology, bio chemistry, physiology and psychology of 32 subjects during 24 weeks of restricted diet and 12 or 20 weeks of rehabilitation. There is a further section on special problems, oedema (still not satisfactorily explained), the relation of starvation to a number of clinical questions, and diets for rehabilitation. There are appendixes on methods, data, war-time diets and rations, and "Notable Famines in History ". With reference to the war-time diets and rations and at the risk of appearing to search for faults, it should be noted that the rations in the Changi (Singapore) Camp are quoted (p. 1243) from Spillane, not from the original, and are given only in small part (1942 data) (see Abst. 3397, Vol. 16). The period of real,, starvation in the spring of 1945 is not included, and other observations, painfully compiled in that camp, mgt also have been quoted. An interesting parallel to the tachycardia of later " rehabilitation recorded on p. 622 has just appeared in a report of late observations on re turned prisoners of war, who after 6 to 9 months' rehabilitation, and having passed through the stage of " lipophilic dystrophy ",. switched over from bradycardia to tachycardia and loss of weight (see Abst. 5689, Vol. 20). It is impossible to attempt to comment on the whole report, or even to single out parts of it for special comment. All of it merits study. It is a model of objective- treatment. Probably many will find the psychological changes in the starved subjects most interesting; these are of the most far-reaching' importance for all sociological and agricultural policies. Again we have so much and wish for more; we wish that there had been more than one level of underfeeding, as there was of rehabilitation, so that we might have perhaps had an idea of the level at which these psychological changes become serious. An important service is the demonstration that it takes a lot of food to rehabilitate the starved and that it is food, not fancy chemical preparations, that should be provided. The book is beautifully printed and easy to read, in every way. It is expensive, but no one engaged in the study of nutrition -or in the planning of food policies can afford not to have it.

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Related references

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