<i>Lytico-bodig</i> in Guam: Historical links between diet and illness during and after Spanish colonization

This paper analyses documents on health and disease among Chamorro people during and after 333 years (1565–1898) of the Spanish claim to and occupation of Guam. Here, a complex neurodegenerative disease—known locally as <i>lytico-bodig</i> and medically as amyotrophic lateral sclerosis and Parkinsonism-dementia complex (ALS/PDC)—reached hyperendemic proportions in the mid-twentieth century but then declined and is now disappearing. A tau-dominated polyproteinopathy, clinical phenotypes included amyotrophic lateral sclerosis (ALS or <i>lytico</i>), atypical parkinsonism with dementia (P-D or <i>bodig</i>), and dementia alone. A plausible etiology for <i>lytico-bodig</i> is consumption of flour derived from the incompletely detoxified seed of <i>Cycas micronesica</i> (<i>fadang</i> in Chamorro; <i>Federico</i> in Spanish), a poisonous gymnosperm that survives climatic extremes that can affect the island. Traditional methods for safe consumption appear to have been lost over the course of time since governors Francisco de Villalobos (1796–1862) and Felipe de la Corte (1855–1866) proposed banning consumption in view of its acute toxic effects. A death certificate issued in 1823 might suggest ALS/PDC in people dying with disability or <i>impedidos</i>, and premature aging and a short life was linked to food use of <i>fadang</i> in the mid-1850s (Guam Vital Statistics Report, 1823). During the Japanese occupation of Guam (1941–1944), Chamorro people took refuge in the jungle for months, where they relied on insufficiently processed <i>fadang</i> as a staple food. After World War II, traditional foods and medicines were subsequently replaced as islanders rapidly acculturated to North American life.本研究分析了西班牙主张并占领关岛的333年（1565年—1898年）期间及之后，查莫罗人（Chamorro）的健康与疾病相关文献。其中，一种复杂的神经退行性疾病——当地称为<i>lytico-bodig</i>，医学上称为肌萎缩侧索硬化症-帕金森痴呆复合征（amyotrophic lateral sclerosis and Parkinsonism-dementia complex, ALS/PDC）——在20世纪中期达到超地方性流行比例，随后逐渐消退，现已近乎消失。该疾病属于以tau蛋白异常聚集为特征的多蛋白病（tau-dominated polyproteinopathy），临床表型包括肌萎缩侧索硬化症（amyotrophic lateral sclerosis, ALS 或 <i>lytico</i>）、伴痴呆的非典型帕金森症（Parkinsonism-dementia, P-D 或 <i>bodig</i>）以及单纯性痴呆。目前较为合理的致病假说为：人群食用了未完全脱毒的密克罗尼西亚苏铁（<i>Cycas micronesica</i>，查莫罗语称<i>fadang</i>，西班牙语称<i>Federico</i>）的种子制成的面粉，该物种为有毒裸子植物，可在影响关岛的极端气候条件下存活。自1796年—1862年任关岛总督的弗朗西斯科·德·比亚洛沃斯（Francisco de Villalobos）与1855年—1866年任总督的费利佩·德拉科尔特（Felipe de la Corte）鉴于其急性毒性提议禁止食用以来，安全食用该植物的传统方法随时间推移逐渐失传。1823年出具的一份死亡证明或可提示，因残疾或残障（<i>impedidos</i>）离世的人群中存在ALS/PDC病例；19世纪50年代中期的研究将早衰与短寿与食用<i>fadang</i>相关联（《关岛生命统计报告》，1823年）。在日本占领关岛期间（1941年—1944年），查莫罗民众曾在丛林中避难数月，期间以加工不充分的<i>fadang</i>作为主食。第二次世界大战结束后，随着岛上居民快速融入北美生活方式，传统食物与药物逐渐被替代。