Dr. Loren Cordain describes himself as the “world’s foremost authority on the evolutionary basis of diet and disease” and as “one of the world’s leading experts on the natural human diet of our Stone Age ancestors.” He is the self-proclaimed founder of the Paleo Diet Movement and champions a way of eating that mimics that of our hunter-gatherer ancestors. Hugely popular, the Paleo Diet is easily accommodated within the contemporary landscape of “clean” eating. This movement subtly constructs a moral hierarchy of food, all the while insisting on its inclusivity and body positivity. The Paleo Diet and its cousins seem closely tied to the peculiarities of the twenty-first century. Online advocates perform their commitment to this arcane way of eating through the very modern mediums of blogging, twitter, and Instagram. And yet, the Paleo premise is not new. In 2014, Cordain published an article on his website, titled “Breast Cancer and Other Cancers: Diseases of Western Civilization.” In it, he claims that cancer was “rare or non-existent in historically studied hunter gatherers and other less westernized peoples.” In support of this, he quotes various early-twentieth-century authorities, including the Nobel prize winning physician Dr. Albert Schweitzer, who wrote on his arrival in Gabon in 1913: “I was astonished to encounter no case of cancer…. This absence of cancer seemed to me due to the difference in nutrition of the natives as compared with the Europeans.” This quotation, which Cordain takes as irrefutable evidence, provokes him to insist at the end of the article, “Anyway you look at it, the Paleo Diet is a good remedy to prevent cancer.” This article is intriguing to me — not least because it is unusual for someone positioning themselves as a contemporary scientific authority to make use of and directly quote historical sources, not as errors to be debunked but as evidence for their claims. What are not unusual, however, are the assumptions that underlie the cancer-preventing claims of the Paleo Diet. It is a well-known and often rehashed trope that cancer constitutes a “pathology of progress” — an unintended consequence of modernity. Or, as Charles Rosenberg puts it, “the notion that the incidence of much late-20th-century chronic disease reflects a poor fit between modern styles of life and humankind’s genetic heritage.”1 However, as Cordain noticed, the idea that “civilized’ ways of life made certain races more susceptible to cancer has its origins in the nineteenth century. The collection of vital statistics in Britain from the 1840s onwards suggested to troubled observers that cancer’s incidence was increasing exponentially. This perceived “cancer epidemic” captured the medical and lay imagination, and provoked fierce debate in medical journals, general interest publications, and parliament. Even the fashion magazine Vogue despaired: “It is sad news indeed that cancer is increasing at such a rate.”2 In 1899, the physician Woods Hutchinson posed cancer as “the riddle of the Sphinx’ for the twentieth century, and positioned the disease as an unintended consequence of Victorian civilization and progress.3 Global Geographies of Cancer The uneven global distribution of cancer incidence supported this conclusion. Doctors across the British Empire plotted populations on a gradient — from immune to cancer riddled. At one end were Sub-Saharan African communities, at the other Anglo-Saxon or Teutonic races. “Observation has shown that cancer has a certain geographical distribution. It prevails extensively in some parts of the globe, and is scarcely known in others.”4 Not only was the disease on the increase, the epidemic was confined to biologically, culturally, and economically “superior” nations. In contrast, Victorians conceptualized the Colonies as practically immune. In 1906, an article published in the British Medical Journal wrote, “there can be no doubt that cancer in natives of British Central Africa is of the utmost rarity. Repeated efforts made by Government medical officers throughout the country for some time past have so far resulted in the discovery of but a single case.”5 Dr. A. J. Craigen, writing from Port Moresby in New Guinea in 1905, reported, “that during his stay of nearly four years in the Possession he has not yet seen a single case of cancer among the native population.”6 The differentiation of racial groups according to disease profile was for some a manifestation of inherent bodily distinctions. That certain races were biologically predisposed to certain diseases was a common concept in Victorian medicine. In 1883, the parasitologist Charles Creighton wrote that smallpox was “peculiarly an African disease.” This particularity was an organic one — “the loathsomeness, the peculiar odour, and the no less peculiar scars of small-pox, might of themselves suggest another skin than ours.”7 In contrast, cancer was a disease of white skin. However, for most fin de siècle commenters, cancer was less a product of the civilized body, and more of the civilized way of living — and that included a civilized diet. Diet and Disease The idea that certain foods could make specific populations prone to cancer continued to be widespread at the turn of the twentieth century. As the surgeon W. Roger Williams wrote in 1902, “The reputation of Egypt for comparative immunity from cancer is well founded…. The conditions of existence are unfavourable to the development of cancer. If I am asked to define these conditions, it may be answered that they comprise extreme frugality in living; open-air existence, and last — but not least — an alimentation which includes but little animal food.”8Williams was suggesting that a simpler, less decadent, diet was unlikely to initiate cancer. The impact of the civilized diet was clearest in “Creole” populations. The medical officer of Freetown, W. Renner, wrote about the Creole populations of Sierra Leone — “the descendants of the liberated Africans.” He claimed that cancer was comparatively common, in contrast to “its apparent rarity among the aborigines in the colony and in the hinterland of Sierra Leone.” Renner’s argument was that this was due to the influences of European civilization and the adoption of the “European mode of living”: “The existence of cancer and other malignant growths among the creoles, and its absence or rarity among the aborigines, are due in my opinion to the civilized habits of, and the civilizing influences operating upon, the former, and to the primitive mode of living of the latter.”9 Renner was concerned that changes in lifestyle were making the Creoles more prone to cancer: “The creoles … have to a great extent discarded the simple food of their forefathers, have been craving for and indulging in preserved and imported foreign food — have substituted the European for the natural African environment, and entailed on themselves in their eager pursuit for wealth and luxury the anxieties and worries incidental to civilization and consequent liability to premature decline.”10 W. Roger Williams made parallel arguments about African-Americans: “In their native habitat negroes appear to be almost exempt from cancer. Transplanted to the United States, and living there in slavery — with hard work and frugal diet — cancer was not common among them …. Since the abolition of slavery, however, and the altered habits thus entailed, the United States negroes have become almost as prone to cancer as their white neighbours.”11 Moral Ways of Eating The Paleo Diet — like other twenty-first-century food fads — implies that “eating well’ is not just advisable, but a moral duty. Similarly, Renner and Roger Williams framed their analyses as concern for Creole or African-American well-being. However, we can equally read these texts as invectives against populations deviating from their “proper’ and “natural” state of existence. In “their eager pursuit for wealth and luxury,” the Creoles were subverting the hierarchy inherent in the British Empire’s system of rulers and ruled, and suffering increased rates of cancer as a result. Renner was reflecting commonly held views at the turn of the twentieth century. His concerns manifested widespread beliefs about the dangers of transgressing natural racial divisions. Nature was aristocratic, mercilessly punishing impure blood.12 With the help of these Victorians, Dr Loren Cordain and the Paleo Diet tie cancer to modernity — and to a modernity of our own making. Our reckless decadence has made chronic disease common. You might think this critique of civilization — this celebration of non-Western diets — would work to upset conventional hierarchies. But instead, we live in a strange world in which cancer is a marker of social success and civilization — an inversion of the expected order. It is not uncommon for public health practitioners today to comment on increases in chronic disease in low- and middle-income countries as a “sign of success.” This strange world is a Victorian inheritance, an inheritance that Cordain acknowledges. This article originally appeared on Nursing Clio. Featured image courtesy of Library of Congress. Notes \tC. E. Rosenberg, “Pathologies of Progress: The Idea of Civilization as Risk,” Bulletin of the History of Medicine 72, no. 4 (1998), 714. Return to text. \t“Cancer Increasing at an Alarming Rate,” Vogue, (April 15, 1909), 726. Return to text. \tWoods Hutchinson, “The Cancer Problem: Or, Treason in the Republic of the Body,” The Contemporary Review, (July 1899), 105. Return to text. \tH. P. Dunn, “English Experience with Cancer,” The Popular Science Monthly, (March, 1885), 689. Return to text. \t“Cancer in the Colonies,” The British Medical Journal 1, no. 2362 (April 7, 1906), 812. Return to text. \t“Cancer in the Colonies,” The British Medical Journal 1, no. 2362 (April 7, 1906), 812. Return to text. \tCharles Creighton, “Address in Pathology,” The British Medical Journal 2, no. 1179 (August 4, 1883), 221. Return to text. \tW. Roger Williams, “Cancer in Egypt and the Causation of Cancer,” The British Medical Journal 2, no. 2177 (September 20, 1902), 917. Return to text. \tW. Renner, “The Spread of Cancer Among the Descendants of the Liberated Africans or Creoles of Sierra Leone,” The British Medical Journal 2, no. 2592 (September 3, 1910), 588. Return to text. \tIbid. Return to text. \tRoger Williams, “Cancer in Egypt and the Causation of Cancer,” 917. Return to text. \tArthur de Gobineau, “The inequality of Human Races,” in Bernasconi and Lott, The Idea of Race, (Indianapolis, 2000). Return to text.