Good Calories, Bad Calories: A Critical Review; Chapter 5 – Diseases of Civilization


Blogging is a dying art form, but recent events have led me to at least attempt to complete my review of Good Calories, Bad Calories. Below is my entry for Chapter Five: Diseases of Civilization.

Not the Introduction

In this chapter Taubes attempts to make the case that modern diseases such as heart disease, cancer, and diabetes are the result of modern diets (which he defines as being high in CHOs), and that isolated populations living on more primitive diets (which he defines as consisting almost exclusively of meat) such as the Inuit/Eskimo are nearly free of such diseases.

Page 90

As [Samuel Hutton, a physician] told it, his Eskimo patients fell into two categories: There were those who lived isolated from European settlements and ate a traditional Eskimo diet. “The Eskimo is a meat eater,” he wrote, “the vegetable part of his diet is a meager one.” Then there were those Eskimos living in Nain or near other European settlers who had taken to consuming a “settler’s dietary,” consisting primarily of “tea, bread, ship’s biscuits, molasses, and salt fish or pork.” Among the former, European diseases were uncommon or remarkably rare. “The most striking is cancer,” noted Hutton on the basis of his eleven years in Labrador. “I have not seen or heard of a case of malignant growth in an Eskimo.” He also observed no asthma and, like Schweitzer, no appendicitis, with the sole exception of a young Eskimo who had been “living on a ‘settler’ dietary.” Hutton observed that the Eskimos who had adopted the settlers’ diet tended to suffer more from scurvy, were “less robust,” and endured “fatigue less easily, and their children are puny and feeble.”

Wow, it sounds like the Eskimos eating meat were much more healthy than those that mingled with the Europeans and ate their bread and pork! Maybe we would all be better off if we ate more seal meat and less tea and biscuits, right? At least that’s the implication here. But before we start radically changing our diet to a carnivorous one, perhaps we should read what Hutton actually wrote. On page 17 of the source text Hutton states “The Eskimo constitution shows a low resisting power to disease.” (1) (Emphasis in original.)

As it turns out, the Eskimos that Hutton observed for years were not as healthy as Taubes characterizes them. In fact, they were riddled with diseases. The entire source text is devoted to describing the diseases of the Eskimo population, so you really have to do some advanced cherry-picking and spin to create a paragraph that might seem like traditional Eskimos are healthier and more robust than others. Hutton observes many diseases among the Eskimos, but he makes particular note of their weak circulatory system, which includes a weak heart and common hemorrhaging. Consider the rapid aging mentioned on page 17: “The Eskimo constitution, speaking broadly, is a weak one. Old age sets in at fifty, and its signs are strongly marked by the time sixty is reached. In the years beyond sixty the Eskimo is aged and feeble.” There is also a chapter on child mortality which was apparently very high, with nearly half of all children dying before the age of five.

Of course, it is important to mention that the lifestyle, climate, and environment of these people were so radically different from what most people experienced that it would be malpractice if anyone were to claim that diet alone was responsible for either the health or diseases of these Eskimos.

* * *

Taubes continues to make up lies about Ancel Keys, as he does throughout the book, by writing “When it was suggested to Keys that other nutrition transitions, including those witnessed by Schweitzer and Hutton, could be edifying, he argued that not enough was known about the diets or about the health of those isolated populations for us to draw reliable conclusions.” As evidence he cites pages 54-55 of a publication of a Swedish symposium on nutrition.(2) The cited text has nothing to do with any of what Taubes is claiming here. It’s a talk about food manufacturers and how they engineer food to increase palatability. Schweitzer and Hutton are not even cited much less mentioned and neither are isolated populations.

This symposium was also cited by Taubes in the prologue of GCBC as support for these two claims “As clinical investigators were demonstrating the singular ability of carbohydrate-restricted diets to generate significant weight loss without hunger” and, when referencing this symposium specifically, “Carbohydrate-restricted diets were portrayed as uniquely effective at inducing weight loss.”

Again, not true. There is nothing in this symposium supporting anything of the sort. A couple of paragraphs later Taubes presents his thesis of this chapter, which is that “obesity, diabetes mellitus, cardiovascular disease, hypertension and stroke, various forms of cancer, cavities, periodontal disease, appendicitis, peptic ulcers, diverticulitis, gallstones, hemorrhoids, varicose veins, and constipation” are all caused by white flour, white rice, and sugar. To push the libel of a dead scientist a bit further,

This led investigators to propose that all these diseases had a single common cause-the consumption of easily digestible, refined carbohydrates. The hypothesis was rejected in the early 1970s, when it could not be reconciled with Keys’s hypothesis that fat was the problem […]

None of that is true. None of it. The piece about Keys is unsourced and I suspect completely made up. The rest of the main thesis of the causes of the “diseases of civilization” is sourced to a book called Western Diseases: Their Emergence and Prevention by Hugh Trowell and Denis Burkitt, and it does not support Taubes’s statements at all. In fact, nearly the opposite. In the text they say that as diets rise in total fat, sugar, and cholesterol and decrease in fiber, unsaturated fat, and starch these diseases emerge.

To say that disease is traced to carbohydrates or sugar alone is nonsense and not at all what the authors say. Moreover, in order to help treat and prevent the onset of these diseases the authors recommend two diets: a high fiber diet (HF) and a high carbohydrate, high fiber diet (HCF). “An HCF diet of high unrefined starch (complex carbohydrates) is of necessity also low fat and low sucrose.”(3)

If the grift is not obvious to you by now, I just don’t know what to say.

* * *

Continuing with the Eskimo/Inuit narrative…

Page 91

[Ancel Keys] argued that not enough was known about the diets or about the health of those isolated populations for us to draw reliable conclusions. He also insisted that in many of these populations—particularly the Inuit —relatively few individuals were likely to live long enough to develop chronic disease, so little could be learned.

Page 106

Ancel Keys used the early-death rationale a quarter-century later to explain away their reported freedom from heart disease and cancer […]

You might have noticed that Taubes attempts to invalidate Inuit-early-death argument by using his rhetorical skills and associating it with the villain of the book, Ancel Keys. What is not addressed is whether the assertion that the Inuit die early enough that they don’t suffer from many chronic diseases is actually true. Nor is it addressed whether there in fact exists good-quality and reliable dietary data on the Inuit/Eskimo populations in the first half of the 20th century.

As it happens Inuit/Eskimo life-expectancy used to be and still is considerably shorter than their non-indigenous and mainland counterparts.(4–8) This is true of Greenland, Canada, or Alaska. A recent article published in The Lancet Oncology remarked that malignant diseases were nearly non-existant in the Inuit populations in the early 20th century, but as their life expectancy grew so did their incidence of carcinomas.(9) Whether this has anything to do with diet is another matter entirely.

Moreover, since the Inuit/Eskimo populations were very isolated there was not any good scientific evidence of their dietary patterns for quite a long time. Probably the best reports on the Inuit diet were anecdotal, coming from Vilhjalmur Stefansson and Samuel Hutton. Facinating perhaps, but not rigorous or at all scientific.

But the fact remains that, despite what Taubes might have you believe, Keys was right again. Regarding these isolated arctic populations, very little data was collected on the diet of the Inuit up to and including the time Keys made those remarks. Additionally, the Inuit were presumably free of chronic diseases such as heart disease and cancer BECAUSE of their much shorter lifespan compared to their “Western” brethren.  I say “presumably” because these populations lived in remote areas without much access to regular check-ups from physicians, health care, and emergency rooms.

But if Taubes can just discredit contrary arguments using no evidence then he is free to posit his own claims like the Inuit were free of heart disease and cancer BECAUSE of their meat-heavy diet.

Related to this theme is the question of diagnostics, and even if the Inuit were to live long enough to suffer from cancer, would it be accurately diagnosed and recorded? On page 94 Taubes snatches a quote from the introduction of a case study on cancer in an Eskimo, stating “It is commonly stated that cancer does not occur in the Eskimos, and to our knowledge no case has so far been reported.” But the conclusion of that study argues the opposite:

Though the apparent absence of cancer among the Eskimo has been made much of in some popular discussions, we know of no reason why it should not occur, and the present case demonstrates that it may in fact be found when adequate facilities for investigation are available. The difficulties of medical observation of these people are great, and in the majority of instances the cause of death is not determined by medical men. Even when it is, the conclusion must of necessity frequently be based on bedside data alone. These considerations are probably chiefly responsible for the absence until now of definite reports of cancer in the Eskimo.

Cancer may, however, occur relatively rarely in the Eskimo. In this connection, however, it should be pointed out that this may be due to the difference in the age distribution of the population as compared with, for instance, Canada as a whole. This difference is shown in Fig. 1. The preponderance of Eskimos in the age groups less than 25 years and the proportionately lower numbers above that age can be noted. The relatively younger average age of the Eskimo population would be expected to influence the incidence of cancer.


On page 91-92 Taubes mentions that several reports of European physicians traveling to remote areas with mainly native populations were published in places like the British Medical Journal. These reports show, according to Taubes, that chronic diseases are virtually absent from the native population unless and until Europeans arrive with their flour and molasses. When these foods arrive, Taubes claims, then the “diseases of civilization” inevitably follow. Taubes summarizes these physicians’ reports:

They would typically report a few cancers in towns where the “natives mingled with Europeans” and had copied their “dietetic and other domestic practices,” but not in those areas where lifestyles and diets remained traditional.

Interestingly enough, one of those reports where those quotes are pulled also mentions something Taubes doesn’t want you to know so he leaves it out.

This information led me to further inquiries, and I ascertained that native races of other continents were similarly immune when not brought in contact with civilization. I also noted the belief of several of my correspondents that it was the vegetarian diet of the natives which accounted for the exemption. (10)

Emphasis mine. Other BMJ reports mention similar patterns, like this one that says “Roughly the difference between the civilized and the uncivilized is a matter of diet. […] The diet of these people is very simple. They live chiefly on corn ground between stones. This is made into a cake which is imperfectly roasted over a charcoal fire. They very rarely eat meat.” (11)

I‘m not an Ivy-trained journalist like Taubes, but this seems like very relevant information that is worthy of inclusion in this chapter.

Taubes then goes on to surgically remove additional relevant information from Hrdlicka’s work. For a bit of context see this passage on page 92:

In 1908, the Smithsonian Institution’s Bureau of American Ethnology published the first significant report on the health status of Native Americans. The author was the physician-turned-anthropologist Ales Hrdlicka, who served for three decades as curator of the Division of Physical Anthropology at the National Museum in Washington (now the Smithsonian’s National Museum of Natural History). In a 460-page report entitled Physiological and Medical Observations Among the Indians of Southwestern United States and Northern Mexico, Hrdlicka described his observations from six expeditions he had undertaken. “Malignant diseases,” he said, “if they exist at all-that they do would be difficult to doubt-must be extremely rare.” He had not encountered “unequivocal signs of a malignant growth on an Indian bone.” Hrdlicka also noted that he saw only three cases of “organic heart trouble” among more than two thousand Native Americans he examined, and “not one pronounced instance of advanced arterial sclerosis.” Varicose veins were rare, and hemorrhoids infrequent. “No case of appendicitis, peritonitis, ulcer of the stomach, or of any grave disease of the liver was observed,” he wrote.

What Taubes removes are the passages on the observation of the native diet, which he likely hopes the reader will default to assuming what was asserted at the beginning of the chapter, which is “traditional diets” are meat-based, and the diseases of civilization are due to carbohydrates. Consider the following excerpts from the Hrdlicka text (emphasis mine):

  • The principal article of diet among the Indians throughout the Southwest and Mexico is maize, which is eaten in the form of bread of various kinds, or as mush, or boiled entire. […] Next in importance to corn and wheat in the Indian diet are meat and fat and beans. Meat is scarce.
  • Pork is rarely eaten, owing, perhaps, to Indian beliefs concerning swine, though the writer has been told a number of times by the natives that they dislike the taste of the meat.
  • Beans of many varieties are a more important article of diet, especially to the Mexican Indians, than meat.
  • In common with all the other Indians of the Southwest, [the Hopi and Zuni] have acquired the habit of using flour and baking powder, as well as canned fruit, and of drinking at their meals considerable quantities of weak, sweetened, warm, black coffee. They also hunt rabbits for food. Meat in general is very scarce.
  • Other important articles of the Indian diet are squashes, melons, sugar cane in the hot valleys of Mexico, and wild and cultivated fruit of many varieties, as well as pinons and other nuts, and some mushrooms. […] The tribes in the Southwest raise large quantities of peaches, which they consume either fresh or dried.
  • Milk is either disliked or is used but little, and of their own initiative the Indians make neither cheese nor butter.

This information kind of undercuts the thesis of this whole chapter, or even the entire book! No wonder it was left out.

* * *

Continuing this theme is the text The Natural History of Cancer, with Special Reference to its Causation and Prevention by the duplicately named William Williams.(12) The text is cited on page 93 and 95 where Taubes claims again that people in less developed countries and regions like Polynesia, Fiji, India, and Borneo have fewer cases of cancer than the more developed nations like the United States. This difference is chiefly because the less developed countries are carnivorous while the US is not.  At least that’s Taubes’s argument. If you look at the Willaims text, however, the argument is quite different: it seems as if the native diets are plant-based and perhaps that is what is protecting the natives from cancer? Could also be problem of diagnosis that was discussed earlier. In any case, here are some quotes from the text.

The natives of India live on millet or rice, a little milk, with the butter from the milk, and the vegetables they grow and of these they partake sparingly. They seldom eat any meat. It is only the Brahmins, the priestly caste, who form but a small fraction of the immense Hindoo population, whoever eat any flesh food. The immense majority of the people live a rural life, depending upon agriculture for their subsistence. Such are the conditions of existence in India; and India is typical of the tropics.

Now contrast the tropical mode of living with that prevalent in our country, where all the conditions are so different; where the average wage of the worker amounts to thirty-eight shillings a week; and where the alimentation comprises a meat consumption of over 130 pounds per head per year, together with an abundance of other highly nutritive proteid food products, fats etc.

Moreover, it is in the tropics that the human race is believed to have originated, and there the anthropoid apes, our nearest animal connexions; who are mainly vegetarians, still flourish and are seldom, if ever, affected with malignant tumours.

[Discussing Uganda, where cancer rates were much less than Europe] The natives are clean, intelligent, and “splendidly developed physically.” Their staple food comprises plantains, bananas, and sweet potatoes, while banana wine is extensively consumed but meat can seldom be obtained.

[When discussing Australia] Owing to the cheapness of meat and the gluttonous habits of the people, the amount consumed per head is exceedingly high. Under these circumstances, the tubercle mortality has diminished, while the incidence of cancer has greatly increased.

[In reference to New Zealand] Cancer and insanity have increased, and are; increasing while tubercle is declining. The people are prosperous, with; a diminishing birth-rate and immense quantities of flesh food chiefly beef and mutton are consumed. “Meat for breakfast, lunch, dinner, tea, supper, etc., just like the porridge-pot in Scotland,” as Dr. G. Macdonald, of Dunedin, wrote in answer to my letter of inquiry.

I could cite passages from pretty much each country in the 519-page text but suffice it to say that the link between meat consumption and cancer is not lost on Mr. Williams.

* * *

Taubes gives his audience a real gem on page 96, when he claims that flour and sugar are to blame for appendicitis. He cites as proof a text by A. Rendle Short entitled The Causation of Appendicitis.(13) However, Short states the exact opposite in the text. Some tidbits from the paper (emphasis in original source):

  • Wheat, Flour, and Grain need not be taken into account as directly giving rise to appendicitis. Such a theory would be incompatible with the facts to be explained.
  • Butter. — This cannot be the cause.
  • Tea cannot be accused of causing appendicitis
  • Coffee must be exonerated.
  • Sugar may be dismissed the court.
  • Rice cannot be blamed.
  • Currants and Raisins may safely be exonerated.
  • Meat. — There is much to be said for the widely accepted view that meat-eating is the cause of appendicitis.

Short also give a handy visual comparing sugar and appendicitis versus meat and appendicitis, in case you can’t read words on a page.

Short also lays some of the blame of rising appendicitis on a declining fiber intake. In chapter seven Taubes tried to make the case that dietary fiber has little to no value.

Also on page 96 Taubes singles out white flour and sugar as being implicated in cancer mortality. As evidence he cites a pre-20th century text titled Air, Food, and Exercises by Andrea Carlo Francesco Rabagliati, claiming it is an “intelligent” discussion on the diseases of civilization.(14) It’s very poorly written and even more poorly though-out so I can see why Taubes likes it. For one, Rabagliati writes in excruciatingly long paragraphs that go on for pages at a time. He doesn’t break up his thoughts into chapters or subchapters. There is no table of contents. He prints his own notes in the margins of the text. It just seems like a stream of consciousness writing style, like he wrote it in the span of three sleepless days while hopped up on bennies. And he somehow managed to find a place to publish it. Secondly, a lot of what he says just doesn’t make a lot of sense both from the vantage point of the 21st century as well as from the 19th century, as a book review from 1898 attests. The review states that the thesis is supported (in part) “by a good deal of inaccurate chemistry and pathology, and by the ignoring of facts which tell against the author’s views. […] Books of this class are generally written by able men in busy practice who have time for thought but not for research.”(15) Hmmm… Sound like anyone you know?

From the benefit of hindsight it seems even worse. For example, Rabagliati states that heredity doesn’t really matter when we talk about disease, and much of the book is devoted to a term that I think he coins: triphthaemia carbonifera, which is apparently the accumulation in the blood of waste products from the metabolism of starch and saccharine. According to Rabagliati, triphthaemia carbonifera causes herpes, pneumonia, cancer, bronchitis, tonsillitis, rheumatism, and the flu. He states that the people who get these diseases often invariably “live largely on bread, potatoes, puddings, and sugar.” There is no mention of viruses or bacteria or any of the actual causes, despite the germ theory of disease being pretty much accepted at the time. Additionally, his treatment of women is kind of laughable today:

I may add here what I am firmly convinced of, viz., that the diseases of women in general, the little ailments they have, the frequent complaints they make, amounting often not to illness but to malaise, or being “out of sorts,” are due, not to their sex but to their habits, and in particular to their habit of eating too often.

Having been written in the late 1800s perhaps I can cut the author a bit of slack, although it’s difficult to cut someone like Taubes some slack for thinking this is an intelligent discussion of disease from a 20th century perspective with the help of modern medicine.

* * *

Speaking of the ignoring of facts which tell against the author’s views, page 98 has yet another demonstration of that phenomenon:

The Scottish nutritionist Robert McCarrison was perhaps the leading proponent of the hypothesis that the chronic illnesses of civilization could be attributed to “the extensive use of vitamin-poor white flour and to the inordinate use of vitamin-less sugar.”

Of course, if you read McCarrison’s work, he is talking about malnutrition and not getting enough vitamins. His theory of the case, as it were, is not at all Taubes’s view as he includes meat this vitamin-poor milieu, stating “Meat is at best but poor in vitamins, and its value in these essentials is not enhanced by freezing and thawing.”(16) He is what you might call today a Raw Foodie, as he believes that cooking, canning, processing, pickling, freezing, and drying food all detrimental to their nutritional value. He states this because the cooking and boiling and processing removes the vitamin content. He also thinks fresh foods are just better for reasons that are unclear even to him, writing “there is something in the freshness of food, especially vegetable food — some form of energy perhaps; it may be certain rays of light or electrical property — which gives to it a health-promoting influence.” (17) It has nothing to do with carbohydrates, per se, but how the nutrients are effectively processed out of them. In fact, when he lists foods that provide “perfect nutrition” the first thing he lists is whole grain cereal and whole grain bread.

But let’s blame everything on flour and sugar anyway. Why not? No one is going to actually check your work — certainly not the publishing company.

* * *

On page 97 Taubes writes “In 1874, with the removal of tariffs on sugar importation in Britain, sugar consumption skyrocketed and led to the eventual development of the biscuit, cake, chocolate, confectionery, and soft-drink industries.” The source cited for this is an article by Berta Friend that is about consumption patterns in the US not Britain and begins in 1909, not 1874. All of that information is in the title, by the way.(18) There was a modest increase in sugar consumption in the US around 1930 but the paper states that increase was diverted to alcohol production. In fact, sugar consumption was pretty steady until 1960 when it started declining, according to the paper.

For good measure, the paper also has kind of an interesting graph of macronutrient consumption over time. According to the paper, total carbohydrate consumption steadily decreases while fat intake increases.



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  2. Blix G. Occurrence, Causes, and Prevention of Overnutrition [Internet]. Uppsala: Printed by Almqvist & Wiksells; 1964. (Symposia of the Swedish Nutrition Foundation). Available from:
  3. Trowell HC, Burkitt DP, editors. Western Diseases: Their Emergence and Prevention. London: Edward Arnold; 1981.
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  5. Bothwell R, Drummond IM, English J. Chapter 15: The Social and Economic Impact of the Depression. In University of Toronto Press; 1990. p. 248. Available from:
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  7. CQ Researcher, Inc CQ. Chapter 12: Saving Indigenous Peoples. In SAGE; 2012. p. 304. Available from:
  8. Inuit Tapiriit Kanatami. Inuit and Cancer: Discussion Paper. 2008 Sep.
  9. Friborg JT, Melbye M. Cancer patterns in Inuit populations. Lancet Oncol [Internet]. 2008 Sep [cited 2014 May 4];9(9):892–900. Available from:
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  12. Williams WR. The natural history of cancer, with special reference to its causation and prevention [Internet]. New York: William Wood and Co; 1908 [cited 2019 Nov 28]. 519 p. Available from:
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  14. Rabagliati ACF. Air, food, and exercises : an essay on the predisposing causes of disease [Internet]. London: Bailliere, Tindall & Cox; 1897 [cited 2019 Nov 30]. 278 p. Available from:
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  16. McCarrison R. An Address ON FAULTY FOOD IN RELATION TO GASTRO-INTESTINAL DISORDER.: Being the Sixth Mellon Lecture delivered before the Society of Biological Research, University of Pittsburg, Nov. 18th, 1921,. Lancet [Internet]. 1922 Feb [cited 2013 Aug 6];199(5136):207–12. Available from:
  17. McCarrison R. Nutrition and national health. [Internet]. Health and social welfare. London: Royal Society of Arts; 1945 [cited 2019 Dec 7]. p. 33–8. Available from:
  18. Friend B, Page L, Marston R. Food Consumption Patters in the US: 1909-13 to 1976. In: Levy RI, Rifkind BM, Dennis BH, editors. Nutrition, lipids, and coronary heart disease, a global view. New York: Raven Press; 1979. p. 489–522.
  19. Barker JE. Cancer: How it is Caused, How it Can be Prevented. New York: E. P. Dutton & Company; 1924.
This is perhaps not worth including in the main text, but it is some interesting fodder, nonetheless. On pages 91, 92, and 98 in this chapter Taubes cites an early 20th century text on cancer by J. Ellis Barker.(19) After reading this text, a few things became clear to me. One is that Barker was prescient regarding at least a few factors that are now known to be linked to cancer in one way or another. For example, he mentions pollution, a lack of dietary fruits and vegetables, smoking, lack of exercise, and industrial chemicals as potential causes of cancer. He even indicts meat, which Taubes of course doesn’t mention. A couple quotes to this effect are found on page 63 “On the question of the relation of diet to diseases, some medical authorities have asserted that butcher’s meat is undoubtedly one of the means by which cancer is propagated” and page 401 “Cancer districts and cancer villages may be created by local food customs, such as the abuse of chemical preservatives. A wretched butcher introduces the habit of keeping meat fresh by the liberal application of poisonous chemicals. His assistants start businesses of their own and act in the same manner. Thus a local trade custom favouring cancer is created.”
The second thing I learned is that Barker also held some views that today we might consider somewhere between backward and abhorrent. On women: “The emancipation of women has benefited them. Fifty years ago the Englishwoman stayed at home and took no exercise. Now the women, having more leisure, take more exercise than the men, if only in shopping and in going after their amusements, while the men sit about in stuffy offices and workrooms and factories.” Page 453:” The disaster of our nutrition is increased by the improvement of the cooking appliances, by the cheapness of fuel and by the emancipation of the women. […] The emancipation of women has led to a widespread unwillingness to do the domestic cooking, an unwillingness which threatens to become universal.” And on race: ”Mr. Lothrop Stoddard in a most interesting book entitled The Rising Tide of Colour has pointed out the danger which threatens the civilized nations from a possible rising of the coloured races. A far greater danger threatens them from cancer. Chronic poisoning and vitamine starvation combined may increase the cancer death-rate to an unbelievable extent and may destroy the predominance of the white race.” (page 457)
He also accurately describes Taubes’s argument of this entire chapter on page 47. Namely, taking bits of anecdotes from very old sources to try and craft a scientific argument: “Unfortunately, those writers who maintain that cancer is a disease of civilization give only very meagre proof in support of their view. In most books, addresses, etc., in which it is stated that cancer is a disease of civilization, the evidence is restricted to one or two opinions received from a doctor residing in the wilds of Africa or Asia.”