The disorder described by Racette et al was identified as related to a particular gene area. I don't have the absolute facts about the incidence of Parkinson's disease within the Amish community but it was recently thought that Parkinson's disease had no genetic component. What is important is that there is now being identified a genetic cause, or perhaps predisposition to lead to a type of disease- perhaps using the two-hit theory - there has to be an anomalie which reacts in a certain way when there is contact with a particular type of toxin or toxins, in some cases.

This research was made possible by the high degree of interest and availabliity of genealogy in a relatively homogeneous population and a high degree of cooperation within the Amish community, whose leaders understood what the researchers needed to know.

Its been my limited experience that the Amish do not reject immunizations out of hand, but accept tools which will advance their lives but on their terms. They do not choose to be controlled by others, but to depend upon themselves to pick and choose what they do. A week ago, I learned that in some areas, while the Amish will not have electric lines - the electric grid -hooked into their farm, they see nothing amiss to get their own generator to create their own electricity for selective operation.

In Wayne County, Ohio, nearly 85% of those born within the community remain there. Further, consider the strength within that community, and with the individuals who often have 6 to 10 children or more. They create a climate where these children are raised to adulthood, and go forth to raise their own children.

Consider also how the community has dealt with the four horsemen of the Apocolypse - War, famine, pestilence and Pain.

The Amish and Anabaptists are pacificists and endured the wrath of governments by refusing to fight. In Europe, this caused distress for the local knight who could not get a strong young Amish or Mennonite farmer to go out and carry a spear. Some did become non-combattants, as there is a relative known as "Old-Eye Patch" who was a deserter from Napoleon's army after forced conscription, but some do put themselves n harms way in the service of those how are the combattants. This was seen often in the ambulance drivers in WWI - particularly among the Mennonites.

Consider famine: As farmers, they were closest to the soil, knew how to grow things and how to husband livestock. Look at their farms today. They knew how to make cheese whcih would store and could be sold to the outsiders. Remember that they were confined to the mountains in Switzerland - the Emmenthal and Jura mountains, somewhere above 3500 feet.

Consider Pestilence - while they were subjected to many of the infectious diseases - they were not exposed to the hords of others, but lived apart. Their moral structure limited their relationships to members of their own religion, and I've not heard of comments about various STDs which were rampant. I wonder if lues was tranmitted?

Then there's pain - I don't have an answer for this. I do know that they are not anti-physician, and that they paid for things which they needed. I do know that the current climate of HMOs and various social programs have created more hardship by causing them to be in a "self pay" category.

Medicaid, for example, is forced charity. Medicaid does not pay full or even half price, and most physicians find that their cost of giving service is greater than that which they would collect - and the cost of giving service is their own overhead - and consequently they 'give' it away. One fellow I know said that it would actually pay him to pay the patient to stay away. The same is for many hospital services - what they lose for patients with medicaid is made up by someone else. When you are on medicaide, the doctor/hospital can't collect from the patient. WHen you don't have a negotiated price, such as is done with HMOs, or one of the state-run-forced-charity, then you pay full price, which can be simply outragenous - but pushed there by cutting down on the payment from other services.

Alcohol is a problem often when the young men come off the farm and go into the city and go to the bars and drink too much. I don't have recent experience, but do recall going into a bar in Lancaster back in about 1962, when there were two young fellows who were really sloshed.

Amish are killed OFTEN by automobiles - there are some communities which refuse to have their members have a red reflective triangle on the back of the buggy, and they get smashed by a fast driver. In fact, they had a demonstration of an acceptable lighting pattern for buggies outside the Kidron Farm Auction, along with multiple pictures of what happens to the buggy as well as the horse and passengers when squashed. When you travel the roads of Holmes and Wayne Counties you must be aware of this, especially at dusk and often in the rain.

John Steiner