How multi-disciplinary drive

beat 'the laughing death'

Kuru Sorcery Disease and Danger in the New Guinea Highlands. By Shirley Lindenbaum. Published by Mayfield Publishing Co, 285 Hamilton Ave, Palo Alto, Calif, USA, 94301, ISBN 0 87484 362 6. Australian price 5A4.95.

When, in 1953, Patrol Officer McArthur, travelling in the Eastern Highlands of Papua New Guinea, reported that he had observed ‘a small girl,

shivering violently and jerking

her head’, he was making the first official description of kuru, an invariably fatal dis ease at that time becoming common amongst the Fore tribe and their near neigh bours, but unknown elsewhere in the world.

The provisional diagnosis of

a patient with these symptoms sent to Kainantu for treatment was that of ‘hysteria’, but by 1957. Dr Vincent Zigas of the PNG department of health, with Dr D. Carleton Gajdusek of the US institute of health, and Dr Sinclair of the Royal Melbourne Hospital. had decided that kuru was an

advanced degenerative neuro

logical disease characterised by

progressive muscular inco

ordination. personality

changes, and accompanied by

a peculiar grimacing which had caused the disorder to be

termed ‘the laughing death’.

The first published clinical description of the disease attracted the attention of W. J.

Hadlow, an English veterinary

virologist, who pointed out the resemblance of the symptoms of kuru to those of the disease of scrapie in sheep, and this ob servation proved to be the first clue as to the cause of kuru.

Stimulated by the parallel of

Hadlow’s veterinary findings,

research by Zigas and Gaj

dusek which later brought a Nobel Prize for the latter eventually confirmed that kuru was a viral disease with an

extraordinarily long incu

bation period.

The Fore believed - and many still do that the disease was the result of sorcery, and in this monograph, Linden baum describes in great detail the means whereby members of the tribe attempted to avoid, or combat, such malevolent activities. She investigated the social, economic, religious, and political effects of the disease on the community when,

reaching almost epidemic pro

portions in the ’6os, it threa tened the tribe with extinction by denuding it of women. She further discovered that the Fore, noting that the disease had declined among people to their north, had attributed this to the greater social harmony prevailing in that area. In the face of the common emerg ency, kibungs were called at which hostile septs sank dif ferences to demand the outlaw ing of kuru sorcery and the repair of the sexual imbalance, in the belief that kuru would end if surreptitious and con cealed internecine strife were to cease. At these kibungs al leged sorcerers ‘confessed’ and were ceremonially ‘cleansed’.

But kuru persisted.

Although the basic pathol

ogy had been determined, there still remained many questions to be answered. How was the disease transmitted?

Why the Fore and not other

tribes? Why mainly in women and especially in the wives of victims’ brothers? By demo

graphic analysis Lindenbaum

and her fellow-worker Glasse were able to demonstrate the specific kinship affinities of the affected individuals and to show that the disease had an in cubation period of between two and twenty-three years.

Extending their research into the special problems of the mode of transmission and the reason for its selective incidence in females and young children, they found the answers in a socio-economic aspect of Fore life which the author has called ‘the politics of protein'. After long and detailed study she was able to

explain the complicated pro

tocol of status and affinity which regulated the tribal habits, customs and prohib itions, and of those specifically related to food, whereby men had the first choice of the most favoured protein pig and that whilst Fore men very rarely ate human flesh, when

they did so, they avoided eating

from the bodies of women.

With increasing depletion of

feral animals to be hunted, for the flesh of which the hunters had priority, women and chil dren supplemented their diet with insects, small rodents, birds, frogs and until the mid-’6os human flesh. The brains of recently interred vic tims of kuru were especially favoured, and the virus was thereby transmitted to new hosts. Thus, with the prohib ition of cannibalism, and the possible exceptions of a few individuals still incubating the disease, kuru will disappear.

This monograph, with its extensive bibliography and photographs is a tribute to the long and patient work of the author and her colleagues in a difficult primitive environ ment, but even more, it is a fas

cinating and outstanding

example of the solution of a

problem by multi-disciplinary

effort, and the pooling of infor mation from workers in the fields of anthropology, de

mography, genetics, virology,

and clinical medicine.

By coincidence, an American television programme of Dr Gajdusek’s work on kuru is about to be released. It is to be hoped that the contribution of the many other patient investigators in the kuru saga

will not be overlooked.

(Dr)

Leonard Goodman.