5. The Moravians Search For Cancer In Southwestern Alaska

In 1888, as I have said, the California State Board of Health published Le Conte's third presentation of the Tanchou hypothesis, that cancer is a disease of the civilized. At this time George Leavitt was in the sixth year of his vain search for cancer among the uncivilized natives of northern Alaska. He was hearing from the more civilized southern parts of the territory that malignant disease among natives was known there.

In 1896 a man destined to become the territory's most famous doctor reached southwestern Alaska fresh from medical school; he was Kansas-born, Austrian-descended Joseph Herman Romig. His observations and views on cancer, in relation to Alaska natives, were soon to become well known locally. They do not appear to have reached international circulation until 1939, through the publication of the widely noticed Nutrition and Physical Degeneration by Dr. Weston A. Price (New York and London). In regard to an interview between these two in 1933, I quote the cited book from the fourth American edition (1945), pages 90-91:

“Anchorage ... has an excellent government hospital which has been built around the life of one man who, many people told us, was the most beloved man in all Alaska. He is Dr. Josef [Joseph] Romig, a surgeon of great skill with experience among the Eskimos and Indians, both the primitive and the modernized ... He stated that in his thirty-six years of contact with these people he had never seen a case of malignant disease among the truly primitive Eskimos and Indians, although it frequently occurs when they become modernized.”

This being a forthright confirmation of the Tanchou-Le Conte principle, I shall go at special length into the competence of the witness and into his opportunity for continued observation of large numbers of people, many of whom he knew — some of them through having officiated at their birth or baptism.

The territory most specifically observed by Romig is Temperate Zone southwestern Alaska, south of the Yukon River and west of a line drawn north from Seward and Anchorage to Fairbanks. The Europeanization of these parts started in the 1740's, soon after Bering's visit, and was intense in the Aleutians and along mainland Alaska's south coast and the southern west coast. There were little-touched sections, particularly the west coast farther north than the Kuskokwim; and then the interior, which is forested and chiefly inhabited by Athapaska Indians. So there were districts and families that had been “modernized” even before Romig first came; but there were others still so primitive that we might consider them untouched by such influences as those of European foods and food-handling methods. Which these little-influenced spots were, the medical missionary, when of sympathetic temper, would soon know. The total population, before the 1900 measles epidemic, would have been considerably more than 10,000; after the measles, considerably less.

During his first seven years, 1896-1903, Romig worked from Bethel, the Moravian mission on the lower Kuskokwim. He traveled considerably, by dog team in winter and canoe or launch in summer. His patients were chiefly Aleuts, Eskimos, and Athapaskans; but there was a scattering of Russian and other European whites, and of Chinese, Japanese, and Negroes. Some native women were married to these immigrants. They and their children were the chief modernized elements among whom — as among the immigrants themselves — Romig was now and then discovering malignancy cases.

In 1903 Romig ceased his formal employment in the Moravian Church, though he was to be closely affiliated with it during most of the next forty years. Upon resigning, he went to San Francisco and entered private practice. But in 1906 he lost both house and office through the earthquake and its fiery aftermath. Thus uprooted, but also because he liked frontier service, he returned to Alaska, first as a cannery doctor on Bristol Bay, just south of the Kuskokwim. His patients, more than half of them, were now whites, Asiatics, and a few modernized natives — Aleuts, Eskimos, and Athapaskans. Romig still traveled widely and kept in touch with people whom he regarded as strictly primitive, though they were using a small amount of European foods, chiefly tea and a little bread.

Resigning from the cannery work after some years, Romig became a government doctor and a health and welfare officer, traveling as before and with patients from all nationalities and classes, the natives still ranging from the most modernized to the most primitive. When the federal government started building railways, he served in their hospitals and was for the last few years chief surgeon of the largest hospital of Alaska, at Anchorage — where he was interviewed during 1933 by Dr. Price, as quoted above.

In 1940, when I first met Romig, he was gradually severing his government connections but was still living in Anchorage. Among other things, I asked him then if he had been rightly quoted by Dr. Price — on cancer, dental caries, scurvy, and on that whole group of diseases which are usually considered by medical missionaries to be largely nutritional. He said he had been in the main quoted accurately by Price in his book. He specifically confirmed that he had been rightly quoted as to cancer.

In 1948 my staff in New York was editing an arctic encyclopedia for the Office of Naval Research, United States Navy. We asked Romig for an article on Eskimo health and welfare, as he had observed it during the first few years he spent in southwestern Alaska, immediately following 1896. I promised him we would rewrite his material and let him see it before publication. Relying on this, he sent us a first draft, as he himself (evidently) had typed it. But he died before we rewrote it; and, apart from a few omissions and some added punctuation, I shall use his wording here, quoting whatever appears as possibly having some bearing on cancer. The statement, about 1,000 words, is undated; but our records show we received it in New York on December 12, 1948.

It is written on a letterhead: “J. H. Romig, M.D., 115 East Columbia, Colorado Springs, Colo. ... 1948 ...” and signed, in ink, “J. H. Romig, M.D.” In the first part of this paper he speaks of himself in the third person:

“When Dr, J. H. Romig went to the Bering Sea region of Alaska, in the year 1896, he found the Eskimos living according to tradition, ideology, and diet, the same as they had lived for hundreds of years before.” He gives the general impression of average good health and considerable longevity. He describes their houses and housekeeping and tells that during winter most of the men spend much of their time at what whites have called club houses or bath houses, the native karrigi or kadjigi.

“The women brought the largest meal of the day to their husbands, fathers, and sons. The food was in a wooden dish ... mostly game and fish ... Dried smoked salmon was much used, and other dried fish. Seal and fish oil was much in demand and was a necessity; no one could be well without fats. Their food was cooked mostly by boiling, and was rather rare; they ate as well, especially in winter, raw frozen fish and raw meat. They kept some wild cranberries for the favored dish of akutok — made [of lean meat and] of seal or fish oil mixed with warm tallow, sprinkled with cranberries, stirred, and hardened with a little snow.

“On this diet the people were strong, and did not get scurvy ... the did not have gastric ulcer, cancer, diabetes, malaria, or typhoid fever, or the common diseases of childhood known so well among the whites. For the most part they were a happy, carefree people ...

“With the advent of gold discovery, government schools and missions, and the high price of furs, came a new era ... They were able to buy white men's food and clothing, neither of which fitted their real need. The children were sent to school and learned white man's ways ...

“These people have changed from the old way, to eating pancakes with syrup and canned goods from the store. The children have poor teeth now, as well as the older ones. They have white man's epidemics, and neither the home nor the food that once was good for them ...

“The Government is now doing much to cover up and ease these changes in native life ... It is with regret that we can see the slow passing of these once hardy people ...”

 

Next after Leavitt and his group of north Alaska revenue doctors and medical missionaries, Romig is our most important witness for what the typical Alaskan medical missionary believed himself to have seen and for what conclusions these early observers drew. Therefore it seemed important to obtain, from the few men still living of those who knew Romig in his early and middle period, some further information as to his character, reliability, and competence. Letters have come from two of these.

Benjamin D. Stewart, of Sitka, Alaska, is a retired territorial commissioner of mines, now past eighty, who knew Romig in his middle years. I sent him for comment the Price interview of 1933, including the statement that Romig was a surgeon of great skill and that he was “the best loved man in all Alaska.” Mr. Stewart replied February 6, 1958:

“As to my first-hand knowledge of Dr. Romig, I can confirm all of the good things said of him in the extracts you sent ... I knew him well during the time he was in charge of the Railway Hospital in Anchorage and later when he was for a time practicing privately in Seward. In fact I called on him to help me recover [from a heart attack] ... I have always believed [that he] actually saved my life. Naturally I have always looked upon him as a highly skilled doctor ... There is no doubt he was widely beloved and that he was regarded as the outstanding doctor in Southwestern Alaska.”

The second letter on Romig is from the Reverend Henry H. Chapman, rector of St. Peter’s-by-the-Sea, Sitka, who wrote September 8, 1958:

“My father was a missionary of the Episcopal Church at Anvik, Alaska. I was born in Anvik, in 1895. The native people of that area are [Athapaska] Indians. My acquaintance with Dr. Romig dates from the years 1923-27 when I was in charge of the Episcopal Church at Fairbanks. Dr. Romig was my physician, surgeon and friend during those years. At that time the Episcopal Church maintained a boarding school for Indian boys and girls at Nenana, 65 miles south of Fairbanks. Dr. Romig used to visit the mission periodically examining the children in the school ... always without charge.”

This is the sort of man and physician it was who told Dr. Price in 1933 that “he had never seen a case of malignant disease among the truly primitive Eskimos and Indians, although it frequently occurs when they become modernized.” Confirming this to me in 1940, Dr. Romig further indicated, both then and later, that he looked upon cancer as nonracial in its selection of victims. He thought it certainly environmental in its cause, and probably nutritional.

Romig thought it interesting to compare malignancies with other troubles that were extremely rare, if found at all, among the primitive Athapaskans and Eskimos of southwestern Alaska around 1900. What some of these rare or missing diseases and troubles were we here set down alphabetically from two sources, the extended text of the Price interview [from which we earlier extracted the quoted remarks on cancer], and then the 1948 paper which Romig submitted in first draft as a contribution to our Encyclopedia Arctica. According to Romig, the very rare or missing nutrition-linked difficulties of the pre-Europeanization time were these, among others: appendicitis, arthritis, beri-beri, cancer, caries (dental), constipation, corpulence, diabetes, epilepsy, gall stones, gastric ulcer, hypertension, night blindness, pellagra, rheumatism, rickets, and scurvy.

 

Southwestern Alaska thus briefly considered, I shall turn east and south, postponing for the time being a discussion of the medical missions of northern Alaska. Let us now travel 3,000 miles southeast to another Moravian Eskimo field, that of northern Labrador.



Chapter 6 >>