Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Metabolic Maladaptation
Table 6. Continued
T 4 normal 4.5-12.5 µg/dl TSH normal 0.3-5 µIU/ml
Person Pre-Inj 1 Inject 2 Inject Pre-Inj 1 Inject 2 Inject
43 3.0 6.0 5.3 0.8 1.7 5.2
44 4.9 2.8 5.3 2.1 1.1 3.0
45 5.6 7.3 8.0 1.8 1.1 0.6
46 8.7 8.1 9.5 1.9 2.6 0.6
47 2.9 8.0 6.2 3.1 1.3 4.6
48 3.3 10.2 6.3 2.2 2.5 15.0
49 5.5 4.5 5.2 2.2 0..3 3.2
50 6.0 5.7 7.4 1.4 1.4 0.8
Mean 3.12 6.61 6.14 48.36 3.91 4.21
1 SD 2.68 2.45 2.25 123.81 7.83 7.57
303
When the author has gone hunting with members of this population, volunteers
to carry meat back from a kill are numerous. The parts most eagerly sought after are
fat, often viscera, with offal preferred over lean skeletal meat. This reflects a craving
for higher energy food value in animal fats. This craving for animal fats is rarely
satisfied, given the marginal grazing capacity, the high incidence of trypanosomiasis,
and the heavy natural predation on and by large mammals in this wilderness
area. Leopards and lions make livestock husbandry impossible, besides luring the
predators close in to human habitation with the easy prey as bait. Elephant and
buffalo herds can destroy a whole village’s collection of shambas in a single night
ruining a year’s effort at clearing and gardening. Hunting and gathering remain the
principal sources of occasional high energy foods, and for a more predictable source
of calories, palm oil is collected. Fats from animal or vegetable sources have similar
Table 7. Thyroid hormone and TSH of a population of cretins
Name - Specimen T 4 TSH
1. Panzio 1.0 171.7
2. Ruta 0.2 248.4
3. Jamboli 0.9 216.8
4. Malingo 0.8 392.9
5. Isolongu 0.4 395.0
6. Fongosende 1.2 586.6
7. Kufuo 1.5 40.6
8. Gasikpio 1.6 133.5
9. Anibotibe 0.8 628.8
10. Ngbogbo 0.8 337.0
11. Nafuo 0.5 287.7
T 4 Normal: 4.5-12.5 µg/dl; Mean: 0.88; SD = 0.4. TSH Normal: 0.3-5 µIU/ml; Mean:
312.48; SD = 181.3
29