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April 25, 1977


JAMA. 1977;237(17):1825-1826. doi:10.1001/jama.1977.03270440015007

To the Editor.—  Bravo for highlighting the need for nutrition instruction in medical schools (236:2534, 1976), the problems of undernourishment (236:2513, 1976), and the cultural problems of deprivation. Cross-cultural data richly illustrate the universalities as well as the infinite varieties with which human groups learn to negotiate and adjust to environmental constraints, and the adaptive and maladaptive outcomes of such action.Dr Bomgarrs' (236:2513, 1976) description of undernutrition as "a bizarre syndrome termed 'runche,'" which occurred in a high percentage of 1- to 4-year-old Nepalese children, corresponds to a case study of protein-calorie malnutrition in Jamaican children reported by A. Fonaroff1 and L. Fonaroff.2 Like Bomgaars, we found traditional taxonomies used to identify complex symptomotologies and diagnoses of undernutrition. The Jamaican undernourished child, like the Nepalese counterpart with runche, is miserable, whining, cries, is hard to live with, refuses to eat and cooperate with family activities. The Jamaican counterpart