Saturday August 18 2007
Every now and then something comes along which is so bonkers and so unhinged that it unmoors itself from all cultural anchoring points, and floats off into a baffling universe all of its own. I am a connoisseur of freaky ideas, but nothing prepared me for this gem from the academic journal Medical Hypotheses: an article called “Down subjects and Oriental population share several specific attitudes and characteristics”.
You’d be right to experience a shudder of nervousness at the title alone, since this is an academic journal, from 2007, and not 1866 when John Langdon Down wrote his classic “Observations on the Ethnic Classification of Idiots”. This paper was the first to describe Down syndrome (which Down called “mongolism”) and in it, the author explained that different forms of genetic disorder were, in fact, evolutionary regressions to what he viewed as the less advanced, non-white forms of humanity. He described an Ethiopian form of “idiot”, a mongoloid form, and so on. Looking back, it reads as spectacularly offensive.
Now. People with Down syndrome – who have three copies of chromosome 21, learning difficulties, and other congenital health problems – do indeed look a tiny bit like people from east Asia, to westerners. This is because they have something called an “epicanthic fold”, a piece of skin that joins the upper part of the nose to the inner part of the eyebrow. It makes the eyes almond shaped. You’ll find epicanthic folds on faces from east Asia, south-east Asia, and some west Africans and Native Americans. People with Down syndrome have various other incidental anatomical differences too, if you’re interested, such as a single crease in their palm.
Flash forward to 2007 – I think that’s where we are – to two Italian doctors. They offer their theory that the parallels between Down syndrome and “oriental” people go beyond this fleeting facial similarity. What is the evidence they have amassed? I offer it almost in its totality.
One aspect, they say, is alimentary characteristics. “Down subjects adore having several dishes displayed on the table, and have a propensity for food which is rich in monosodium glutamate.”
I, too, adore having several dishes displayed upon the table. Two doctors, in an academic journal, in 2007, go on: “The tendencies of Down subjects to carry out recreative-rehabilitative activities, such as embroidery, wicker-working, ceramics, book-binding, etc., that is renowned, remind [us of] the Chinese hand-crafts, which need a notable ability, such as Chinese vases, or the use of chopsticks employed for eating by Asiatic populations.”
Perhaps you can think of cultural rather than genetic explanations for these observations. There’s more. “Down persons during waiting periods, when they get tired of standing up straight, crouch, squatting down, reminding us of the ‘squatting’ position … They remain in this position for several minutes and only to rest themselves.” Amazing. “This position is the same taken by the Vietnamese, the Thai, the Cambodian, the Chinese, while they are waiting at a bus stop, for instance, or while they are chatting.”
And that’s not all. “There is another pose taken by Down subjects while they are sitting on a chair: they sit with their legs crossed while they are eating, writing, watching TV, as the Oriental peoples do.”
To me, and I may be wrong, this article is so fantastical and so thoughtlessly crass that it’s impossible to experience anything like outrage. But this is a proper academic journal, published by Elsevier, with a respectable “impact factor” – a measure of how frequently a journal is cited – of 1.299. I contacted the editor. He told me this paper was a very short, discursive and preliminary communication, floating a general idea for discussion and debate, and that taking scientific ideas out of their context could be misleading. I hope I am not misleading anybody. I contacted Elsevier, the journal publisher: they will consider making the article free to access, so that anyone can read it for themselves, and reach their own conclusion. I’ll let you know… [see below]
· Please send your bad science to email@example.com
[Ooh, in case you're wondering why I wrote about this, it's a setup for something more interesting, and related, next week, assuming nothing topical comes in. And also because it is a fantastic paper.]
And here is the paper.
Down subjects and Oriental population share
several specific attitudes and characteristics q
Federica Mafrica 1, Vincenzo Fodale *,2
Department of Neuroscience, Psychiatric and Anesthesiological Sciences, University of Messina,
Policlinico Universitario ‘‘G.Martino’’, Via Consolare Valeria, 98125 Messina, Italy
Summary Down’s syndrome is characterized not only by a typical ‘‘habitus’’, mental retardation of variable gravity and several alterations of the cardiovascular, respiratory, gastrenteric and immunitary system, but also by specific attitudes and characteristics that are in common with the Oriental population. Starting from the origin of the term mongolism, replaced with other terms such as Trisomy 21, Down’s syndrome, and anomaly of Down because of the racist use made in the last century, we propose, in the light of modern knowledge about the heredity of features, a reflection on those aspects and attitudes which highlight a very particular twinning between a Down person and Asiatic peoples.
Down’s syndrome is a condition characterized by a
typical ‘‘habitus’’ and a mental retardation of variable
gravity. The face is oriental: the fissures of
eyes are oblique and present the epicantus; the
nose is short and the root is flat, the knape of the
neck is flat and covered with very loose skin and
subcutaneous. The limbs are short and stocky and
a marked laxity of ligaments is present. Several
alterations of the cardiovascular, respiratory,
gastrenteric and immunitary system can be associated.
In addition, specific attitudes and characteristics
may be shown evidences.
Origin of term ‘‘Mongolism’’
The first description of Down’s syndrome dates
back to 1846 when Seguin  spoke about a ‘‘furfuraceous
cretinism’’. In 1866 John Langdon Haydon
Down published an ethnic classification of idiotis.
In this classification, the author distinguished the
idiotis according to an ethnic typology: the Ethiopic,
the Caucasian, the mongoloid. Therefore for
the first time the term ‘‘mongolism’’ appeared .
Today this syndrome is nominated with other
terms such as Trisomy 21, Down’s syndrome, anomaly
Down peoples and Asiatic peoples
The strong characteristic, that leads Langdon to
compare the Down population to the Asiatic one,
is the eyes with a typical almond-form. However,
it is possible to highlight other aspects of Down
subjects which remind the Asiatic population, such
as fine and straight hair, the distribution of apparatus
piliferous, which appears to be sparse.
Some attitudes and any daily habitus observed in
Down subjects, recall those of the oriental
Down persons during waiting periods, when they
get tired of standing up straight, crouch, squatting
down, reminding us of the ‘‘squatting’’ position
described by medical semeiotic which helps the venous
return. They remain in this position for several
minutes and only to rest themselves this
position is the same taken by the Vietnamese, the
Thai, the Cambodian, the Chinese, while they are
waiting at a the bus stop, for instance, or while
they are chatting.
There is another pose taken by Down subjects
while they are sitting on a chair: they sit with their
legs crossed while they are eating, writing, watching
TV, as the Oriental peoples do.
Another aspect of Down person that remind the
Asiatic population, are alimentary characteristics.
Down subjects adore having several dishes displayed
on the table and have a propensity for food
which is rich in monosodium glutamate (a salt of
glutamate), such as parmigiano, beef broth, tinned
food, etc. . The Chinese food abounds in monosodium
glutamate that seems to be responsible for
the fifth taste or ‘‘umami taste’’  and of the
‘‘Chinese restaurant syndrome’’ , (a syndrome
characterized by flushing, tightness and breathing-
difficulties). Furthermore, it has been observed
that Down subjects present a deficit of GABA transmission
due to a higher consumption of glutamate.
In fact, it seems that a biological limit keeps the
brain of Down individuals from having too much
glucose, by acting on its intake. Glucose is a precursor
of l-glutamate acid via the Kreb’s cycle
and glutamatic acid, in its turn, is the precursor
of GABA .
The incidence of thyroid disease in the Down
population is another aspect that may be highlighted
since it recall the Asiatic population. In
fact, thyroid disorders are common in the Down’s
syndrome. The prevalence of hypothyroidism has
been found to be greater than that of hyperthyroidism.
Hypothyroidism may be either present from
birth or be acquired .
In several studies about the incidence of thyroid
disorders in the Asiatic populations, childhood
Grave’s disease has been reported to be rare, but
epidemiological data showed to be higher in Hong
Kong children . Another study observed that
one large Chinese family harboured susceptibility
loci for autoimmune thyroid disease which is distinct
from those previously found in the Caucasian
population. This suggests that different susceptibility
loci exist between different ethnic groups
The tendencies of Down subjects to carry out
recreative–reabilitative activities, such as embroidery,
wicker-working ceramics, book-binding, etc.,
that is renowned, remind the Chinese hand-crafts,
which need a notable ability, such as Chinese vases
or the use of chop-sticks employed for eating by
Perhaps the explanation for their capacities resides
in the monkey-like cast of the hand or rather
in the single transversal solcus that replaces the
normal creases of the flexion of the hand, and their
laxity of ligaments. Also this characteristic of the
Down syndrome may be considered a point in common
with oriental populations.
The trisomy-16 murine, a biological model,
could be utilized to understand the molecular and
developmental effects associated with abnormal
chromosome numbers. In fact, the distal segment
of murine chromosome-16 is homologous to nearly
the entire long arm of human chromosome-21 .
These observations might highlight very interesting
aspects connected to the supernumerary chromosome
21 in Down’s syndrome, whereas they are
natural features of Asians. It would be just as interesting
to understand why the chromosome should
be in triple copy to express ‘‘these coincidences’’
in the Down subject, whereas it is sufficient in double
copy in Asians, who do not show mental retardation
or malformation in various organs or
Furthermore, it may be interesting to know the
gravity with which the Downs syndrome occurs in
Asiatic population, especially in Chinese population.
This study may offer the possibility of to know
better the neuropathology mechanisms that are
responsible of mental retardation in Downs syn-
drome and to open a new diagnostic and therapeutic
way for to operate precociously.
Perhaps we could even clear Langdon of all
blame from the accusation of being a ‘‘racist’’
for having first observed a sort of twinning which
could be looked at in more depth in the light of
modern knowledge on the heredity of features
and on genic expression and inactivation.
 Seguin E. Idiocy and its treatment by physiological methods.
New York: William Wood; 1866.
 Langdon-Down J. Observation on an ethnic classification of
idiots. London Hospital Reports 1866;3:259–62.
 Cocchi R. Food habits in Down of 10 years or more. Int
J Intellect Impair 1994;7:149–57.
 de Araujio IE, Kringelbach ML, Rolls ET, Hobden P.
Representation of umami taste in the Human brain.
J Neurophysiol 2003;90:313–9.
 Keney RA. The Chinese restaurant syndrome: anecdote
revisited. Food Chem Toxicol 1986;24:351–4.
 Cocchi R. Precursori dell’ac. Glutammico e del GABA
e abitudini alimentari nei Down: Indagine epidemiologica
su 460 soggetti. Int J Intellect Impair 1990;3:
 Prasher VP. Down sindrome and thyroid disorder: a review.
Down Syndr Res Pract 1999;6:25–42.
 Wong GW, Cheng PS. Increasing incidence pf childhood
Graves’ disease in Hong Kong: a follow-up study. Clin
Endocrinol (Oxf.) 2001;54:547–50.
 Villanueva R, Tomer Y, Greenberg DA, et al. Autoimmune
thyroid disease susceptibility loci in a large Chinese family.
Clin Endocrinol (Oxf.) 2002;56:45–51.
 Galdzicki Z, Siarey RJ. Understanding mental retardation in
Down’s syndrome using trisomy 16 mouse models. Genes
Brain Behav 2003;2(3):167–78.