CONTROL YOUR HEALTH
VOLUME 3, NO. 8
Many authorities in medicine admit that most of the drug therapies
for asthma are making the problem worse.
Asthma
A medical
ne of the biggest medical fail - crease may be due to changes in di- death has ever been caused by un-
O ures of recent years is treat -
ment for asthma. Despite
greater diagnostic skills, better iden -
tification of causes of the disease and
ever whizzier drug cocktails to treat
it, doctors and asthma associations
are stymied by the fact that the epi -
demic incidence of asthma and
asthma-related deaths are continu -
ing to go up. Indeed, many authori -
ties in medicine admit the cure is
infinitely worse than the disease and
that the drugs developed to alleviate
symptoms of asthma are mainly be -
hind the sharp rise in deaths.
Things have reached such crisis
proportions that last April a UK task
force on asthma was set up by the Na -
tional Asthma Campaign to investi -
gate why deaths are going up and
how safe or appropriate the drugs are
for relief of the problem. A similar
study is also being conducted with
participating medical centres from
New Zealand, Germany, Britain and
America. Here is the latest about the
dangers of conventional treatments
and a variety of alternatives for con -
trolling your symptoms without
drugs.
As with most allergies, cases of
asthma are sharply on the rise.
In a recent study of children in Ab-
erdeen, cases diagnosed as asthma
had more than doubled over a simi-
lar survey in the same area con-
ducted 25 years ago. (The
researchers said that part of the in-
1
Special Report: Asthma: how drugs
often make the problem worse.
4 6
Updates: MMR vaccine withdrawn;
What Doctors Don't Tell You, 4 Wallace Road, London N1 2PG. Editor Lynne McTaggart Editor's PA Jan Green Contributing Editor Fiona Bawdon
Editorial Assistants Dorothy Rothermel, Kerry Johnsonl Designer Clerkenwell Design Group Printed by Premier Press Publisher The Wallace Press
Copyright The Wallace Press No part of this publication may be reproduced without permission.
wh e eze
agnostic labelling—that is, more
wheezing identified as asthma—and
heightened awareness by GPs of res-
piratory symptoms.) But other en-
quiries suggest the real percentage
increase may be higher; the UK
asthma taskforce disclosed that
treatment for asthma has doubled in
the past 10 years. During that time,
hospital admissions have trebled for
all victims and risen fivefold among
young children. In Britain alone, the
number of deaths rose to 2000 in
‘The drugs
used to treat
asthma
could be
behind the
sharp rise in
deaths or near
deaths. . .’
1988 and has only fallen slightly
since. This compares to a death rate
of virtually zero before the 1950s.
Allergist Dr David Freed quotes a
1929 medical textbook (J J Cony-
bears' A Textbook of Medicine, pub-
lished by Livingstone in Edinburgh)
as saying, "It is doubtful whether
C O N T E N T S
5
What Doctors Read: Cataracts and
vitamin C; fluoride and hip fractures.
Q&A: The new "improved" hepatitis
complicated asthma [ie, asthma
without emphysema]." The rise of
asthma corresponds to an epidemic
of all forms of atopic (hypersensitiv-
ity) disease, including hay fever and
eczema.
Why is this happening in such
epidemic proportions? No one
doubts that the hypersensitivity
causing the muscles of the little
bronchioles to constrict (and the
tubes to become inflamed and filled
with mucus) has to do with allergies.
The conventional view maintains
that the main culprits are grass
pollen or the house dust mite Der -
matophagodies pteronyssinus. This
little creature is much more preva-
lent in homes today because of fitted
carpets, heat and insulation, accord-
ing to Sporik et al, writing in the
New England Journal of Medicine in
1990. It is also believed to be genetic.
One-third of patients have a relative
who has suffered from asthma, ac-
cording to Dr Ruth Lever in A Guide
to Common Illness (Penguin 1990).
In people prone to asthma, the low
ozone levels of urban environments
can make things worse, according to
a Canadian study in the Lancet (27
July 1991). A recent study from
France also showed that bron-
chospasm can be triggered by com-
mercial polyurethane foam for
insulating homes. But house dust
mites seem to be a very small part of
the story (see box, p 3 for other
7
Books: Inequalities in Health and
Which? Medicine.
8
Second Opinion: Harald Gaier.
The trouble with "scientific" tests.
 prevalent causes).
The root of the allergy could be a
slight malfunction in the immune
system, having to do with essential
fatty acids (EFAs). American immu-
nologist and WDDTY panel member
Leo Galland, who has performed a
good deal of groundbreaking work in
this field, cites several studies in Su -
perimmunity for Kids (Bloomsbury
£9.99) showing that children with
asthma have difficulty converting
EFAs into prostaglandins—which reg-
ulate the function of the immune sys-
tem. Prostaglandins are controlled by
enzymes; a vital one in converting
omega-6 EFAs into an intermediate
stage from which they go on to become
prostaglandins is D-6-D, or what Gal-
land calls the Delta Force. Galland
has found that in children and adults
with allergic asthma (as well as
eczema and hay fever) the Delta Force
is much less active than normal. "As a
result," he writes, "prostaglandin pro-
duction is short-circuited."
Drug treatment for asthma is
given largely on a suck-it-and-see
(or more properly, an inhale-it-
and-see) basis, ending up with the
patient taking a medicine chest of
potentially lethal drugs. Recently
the British Thoracic Society published
new guidelines for following a "step"
approach, only graduating on to the
next step in terms of potency of drugs
if the step before hasn't helped. It also
advises that when control is estab-
lished with one step, to consider mov-
ing down to the step below.
Step one begins with short-acting in-
haled beta2-agonists for patients who
experience symptoms infrequently or
with only mild exercise-induced
asthma. These adrenoreceptor stimu-
lants cause the nervous system to act
on adrenaline receptors throughout
the body. But unless the drugs are
highly selective, aiming only to stimu-
late "beta2" receptors (which relax
bronchial muscles and reduce the
chemicals causing inflammation) they
can cause the heart to race and force it
to produce larger quantities of blood,
thus raising the blood pressure. In
the past, doctors made use of non-se-
lective adrenoreceptor stimulants like
adrenaline or isoprenaline, which
work on the heart muscles. But other
than for life-and-death emergencies,
it's now agreed that drugs like
adrenaline shouldn't be used since
they can induce a heart attack.
The selective beta2-agonists of drugs
are sold in the UK as salbutamol, or
albuterol in the States (with brand
2 WDDTY Vol.3 No.8
names Ventolin ,Ventodisks or Salbu- breath in, and utilize more drug than
lin), fenoterol (Berotec) and terbu- the usual pressurized aerosol car-
taline (Bricanyl). tridges. Another possibility is the use
If inhaled beta2-agonists don't do the of a spacer, which offers a "space" be-
job or you find you're using them more tween the inhaler and the mouth to al-
than three times a week, the doctor low more time for the propellant
moves up to step two, which includes chemical to evaporate before the drug
anti-inflammatories. Children are reaches you. There are also nebulizers
usually started on a six-to-eight week which produce a spray, slowly releas-
trials of sodium cromoglycate (Intal) ing the drug into the bronchial tubes.
three or four times a day. This drug, If this still doesn't control your
called a mast cell stabilizer, works by asthma or you have persistent symp-
preventing the mast cells lining the toms at night despite all the other in-
bronchial tubes from releasing chemi- haled therapies, the BTS suggests
cals causing the bronchial muscles to that you move on to step four, increas-
contract. It is effective in preventing ing the daily dose of inhaled steroids
an attack from starting, but cannot and using an additional bronchodila-
treat an attack once it has begun. tor such as theophylline or amino-
A similar but more potent drug is phylline on top of the other
deocromil (Tilade). medication. Theophylline belongs to a
Most adults (and children who drug category called the xanthines,
haven't been helped by the sodium cro- which includes caffeine. Theophylline
moglycate trial) are placed on inhaled works by relaxing the bronchial mus-
steroids, which are supposed to reduce cles and also breaking down a chemi-
the daily dose and hence the general cal that controls the muscles in the
risks of corticosteroids. These drugs bronchial tubes. Another possibility is
include beclomethasone (Becotide) to take oral beta2-agonists, which re-
and budesonide (Pulmicort). This lease more drug into the body, or a
anti-inflammatory drug is used con- non-selective adrenoreceptor stimu-
currently with a beta2-agonist inhaled lant like ipratropium bromide, which
up to four times a day. affects your heart as well as your
Step three employs the same bronchial muscles.
steroids but a more powerful inhaler. If all else fails, you are put on a
Dry powder inhalers have cartridges course of oral steroids, in addition to
which blast the powder when you the other drugs in step four. You
Asthma treatment
without drugs
If you are alarmed by medicine's hit-and-miss approach to asthma with dangerous drugs,
there are many sensible approaches that may lessen or even eliminate your symptoms. As
Leo Galland writes: "If an effective allergy-desensitization technique is used and as much en-
vironmental control as possible is exercised, drug-free treatment is virtually always possible
in children."
Find an experienced clinical ecologist or allergist who can find out what you are allergic to.
This may mean going to someone who is familiar with exclusion diets or, in the case of air-
borne triggers, EPD desensitization methods which will locate your allergies with far more
accuracy than the old prick-test method .
●Avoid any food or ingested allergens. That particularly includes milk products. Use a cal-
cium supplement if you don't add enough calcium from other sources.
●Add the following supplements to your daily diet: vitamin B6 50-100 mg, linseed (1-2 Tbs
per day) or walnut oil (2 to 4 Tbs) plus evening primrose oil (4-8 capsules); vitamin C (at least
500 mg );' zinc (10-20 mg ); vitamin E (at least 600 IUs); and magnesium.
●Follow a diet low in sugar, animal fat and additives, and high in grains and vegetables.
●Take regular gentle aerobic exercise like swimming or walking, which reduces symptoms.
Dr Galland recommends that asthmatic children have the following supplements, which
play a role in assisting or curing asthma:
High doses of essential fatty acids. (I Tbs of linseed oil and 1 Tbs of cod-liver oil or 3 g of
MAX EPA per day). Magnesium: 3mg per pound of body weight per day. Calcium: 600 mg
per day if dairy products are eliminated. High doses of vitamin C (2 gms a day). B6: at least
200 mg a day. B12: 1 mg twice a day for six weeks.
might even be given a trial of cy-
closporin, originally developed to pre-
vent the body's rejection of organ
transplants and now medicine's drug
of the month, investigated for every-
thing from psoriasis to arthritis.
Beta2-agonists have been associ -
ated with an increased risk of
death or near death. According to
the Adverse Drug Reaction Bulletin
(June 1992), which devoted an entire
issue to asthma, the marked rise in
asthma deaths during the 1960s in
many countries "coincided with the in-
troduction of high strength isopre-
naline inhalers". When the inhalers
were withdrawn, mortality fell to pre-
vious levels. But the problems haven't
just been due to non-selective beta2-
agonists. In many countries, a re-
newed rise in asthma deaths occurred
in the 1980s, particularly in New
Zealand, which one study showed was
linked to the popularity of fenoterol,
but also theopylline and oral steroids.
Another study of beta2-agonists con-
ducted by a variety of medical schools
in America and Canada, including
Montreal General Hospital and Yale
University (New England Journal of
Medicine, 20 February 1992) showed
that the use of beta-agonists adminis-
tered by a metered-dose inhaler,
specifically albuterol (salbutamol) and
fenoterol, was associated with an in-
creased risk of death or near death.
Several other studies have shown
that regular inhalation of beta2-ago-
nists cause "hyperresponsiveness"—
that is, excessive constriction of the
bronchi (Journal of Allergy and Clini-
cal Immunology 1985: 76).
The June issue of the Adverse Drug
Reaction Bulletin postulated that
beta2-agonists could be behind the in-
crease in deaths by causing fatal
abnormal heartbeats, spreading
whatever the allergen is to more re-
mote airways and thus increasing in-
flammation, or causing the bronchial
muscles to constrict to a fatal degree.
Regular use of these drugs also
causes the disease to worsen. Yet
another study published in the Lancet
in 1990 (336:1391:6) showed that pa-
tients receiving fenoterol regularly
(that is four times a day) with addi-
tional inhalations as necessary had
worse outcomes after six months than
those given inhaled drugs only as
needed. Regular use of certain beta2-
agonists also causes a greater decline
in lung function than does "on-de-
mand" use (The British Medical Jour-
nal, 7 December 1991). And some
patients have been shown to have
symptoms improve once doses of in- glands. This dosage also produced sig-
haled beta2-agonists are reduced. nificant growth retardation in a group
The new long-lasting and high po- of children studied.
tency beta2-agonists like salmeterol Inhaled steroids have also caused
(Serevent), soon to be available for symptoms characteristic of Cushing's
children, which control asthma symp- syndrome: obesity, moon face, thin-
toms for 12 hours at a puff, could exac- ning skin and stretch marks, as well
erbate the problem. as bruising.
Steroids used for asthma control Another unforeseen risk is that
pose many more risks than previ - many otherwise benign infections be-
ously thought. Many doctors are come life-threatening in children on
turning to steroids as a first port of drugs like steroids, which suppress
call after all the recent bad press for the immune system. America's Food
and Drug Administration has asked
manufacturers of all steroids to add
Beyond the following warning on all drug
dust mites packs: "Children who are on immuno-
suppressant drugs are more suscepti-
ble to infections than healthy children.
In Food Allergy and Intolerance Chickenpox and measles, for example,
(Bloomsbury1989), Jonathan Brostoff can have a more serious or even fatal
says that you should look to many other course in children on immunosuppres-
causes besides dust and mites. These in- sant corticosteroids. " Besides the dis-
clude infections (as many as 40 per cent ease itself, the risks of vaccination
of cases can be caused by them); indeed, multiply (particularly with one em-
many children can be allergic to the ploying a live virus) if a child's im-
viruses, as well as infected by them. mune system has been suppressed.
(Pattemore et al in Clinical Exper Allergy As for adults, some studies have
1992: 22:325-336). Another aggravating shown that even low doses of inhaled
factor is too much salt in the diet and beclomethasone (400 ug) per day) re-
monosodium glutamate, mainly found in duce bone formation (The Lancet 6
tinned and packet soups, Chinese food July 1991). Deaths from lack of
and other convenience foods. A New adrenal gland function have occurred
England Journal of Medicine study (April when patients have switched from
25 1991) demonstrated that parental oral to inhaled steroids without over-
smoking can contribute to elevated lev- lapping the drugs. There is also the
els of airway responsiveness (ie, problem of recurrent thrush of the
bronchial constriction) early in life. mouth.
Don't discount food as a potential trig- Because some of the drug escapes
ger. Dr Freed finds that many patients into the blood stream, even when in-
with asthma are intolerant of dairy haled, people on high doses run the
products. usual risks of steroids. These include
Indeed, allergy specialist Dr Keith over-activity of the adrenal glands,
Mumby (see p 7 ) finds that food is often which produces Cushing's disease, a
a more potent trigger than are environ- fat abdomen, buffalo hump in the back
mental factors. Chicken and wheat were of the neck, high blood pressure and
the frontrunners in provoking symp- muscle weakness.
toms in a random sampling of 16 patients Steroids can also cause muscle wast-
in Dr Mumby's practice. ing, hyperglycaemia, water retention,
beta2-agonists. But recent studies skin atrophy, bruising and stretch
have shown that inhaled steroids marks, insomnia, serious mood
(which were supposed not to pose the changes, symptoms of schizophrenia
usual risks that swallowed ones do) or manic-depression, possibly cataracts
are not as harmless as medicine previ- or glaucoma, menstrual problems, im-
ously supposed. The consensus up un- potence, loss of libido or even allergic
til now has been that beclomethasone shock. More dangerously, prolonged
dipropionate (BDP) of 400-800 ug use of steroids causes the pituitary
daily is appropriate for the 3-5 year gland to stop producing ACTH, a hor-
old age group. However, a group of mone which regulates the adrenal
paediatric consultants from various glands, needed by the body during
hospitals in Britain wrote to the stress.
Lancet (14 December 1991) to point All this in a drug which can only
out various studies showing that this suppress inflammation, not cure it, by
dose of BDP was the equivalent of 20- constantly masking what is undoubt-
40 mg of prenisoline in causing sup- edly a healthy allergic response.
pression of the adrenal and pituitary Lynne McTaggart
WDDTY Vol.3 No.8 3
 UPDATES

decide just where to draw the skills, and should provide

A DEADLY CASE OF MUMPS line between drugs and foods.
As most of our British readers have no doubt heard, last The French, for instance,
want anything labelled as a
month the UK Department of Health announced the hasty drug if the dose exceeds the
withdrawal of two brands of the combined measles, mumps required daily intake. Should
and rubella (MMR) vaccine. the French win the argu-
Pharmacies have been told to discontinue Immravax, ment, the British health food
manufactured by Merieux, and Pluserix, manufactured by manufacturers will be the
SmithKline Beecham. All orders for this particular vaccine major losers. Their goods are
sold in greater quantities as
will be fulfilled by the MMR II, produced by
foods in British shops than al-
Merck Sharp and Dohme and distributed by most anywhere else in the
Wellcome. EC.
The official line circulated to the press about Ostensibly, the draft direc-
why these drugs were withdrawn, after having tive, which should be pub-
been jabbed into millions of 15-month-olds, is lished early next year, is
merely being drawn up to
the results of a study showing that the two
help remove barriers to trade
withdrawn brands have a negligible (1 in in the single European mar-
11,000 ) risk of causing a "transient" and "mild" kets.
(all DOH words, these) case of meningitis. But it is part of a general
The MMR II, made from a different strain, wave which is already sweep-
supposedly does not pose this risk. ing the US. There, the Food
This news was greeted by a good deal of and Drug Administration is
proposing to reclassify vita-
cheering in the offices of WDDTY, since we
have noisily protested this vaccine as unsafe
min and mineral prepara-
tions as drugs and to restrict
from our very first issue. the sale of herbs. Only sub-
Our celebrations were shortlived, however, as we ob- stantiated claims made by al-
served the decidedly docile press coverage of this event. Vir- ternative medicines will be
permitted.
tually every paper and TV station dutifully printed the
Similarly, the EC directive
standard party line about the problem not being very severe may be less innocuous than
and the remaining vaccine being perfectly safe. And not a sin- the bureaucrats maintain.
gle reporter stopped to ask : if this vaccine, herded in amid a Already in the wings is a sec-
blazing publicity campaign four years ago, was so hastily with- ond directive covering herbal
drawn, how "mild" and "rare" could this side effect be? extracts, slimming aids, gin-
seng and royal jelly.
We then observed a curious bit of arithmetic, which hap-
While the British health
pens whenever medicine needs to justify a bad call: the turn-
food manufacturers are lob-
ing of a benign problem into a life-threatening illness by the bying hard, there could be a
manipulation of statistics. When I was preparing our first is- more powerful lobby at
sue about MMR in 1989, I interviewed Dr Norman Begg, of work—the drug industry.
the Public Health Laboratory Service, which recommended And guess who stands to win
if the directive is passed?
the vaccine in Britain. He assured me that mumps is a very
mild illness in children. Now, however, we hear from Chief
Medical Officer Dr Kenneth Calman that mumps leads on to
meningitis in 1 in 400 cases.
In other words, because mumps is a dangerous illness, tak- Doc teaching
ing the old unsafe vaccine was still better than getting the dis-
ease itself. How long will it be before we start hearing about standards low
the latest killer of children: athlete's foot? The quality of the teaching in
Lynne McTaggart British hospitals has been
criticized in a new report.
Consultants and registrars
The argument, already be-
involved in teaching are
ing aired in the US, pivots rarely required to have any
around the reclassification of
formal training and few royal
vitamins, minerals, amino
acids, fish liver oils, yeasts
colleges have plans to assess
EC: new assault and other nutrients as drugs
the competence of teachers.
This alarming situation is
education that is pertinent
to the trainees. Time should
also be set aside for study
and for contact and feedback
between trainee and
teacher.
Until and unless the
changes are made, training
for doctors and dentists will
remain unsatisfactory and
ineffective, the report con-
cluded.
Teaching Hospital Doctors
and Dentists to Teach: Its
Role in Creating A Better
Learning Environment. (The
Standing Committee on
Postgraduate Medical Edu -
cation, 26 Park Crescent,
London W1N 3PB)
Cholesterol:
drug dangerous
If your doctor is still pre-
scribing clofibrate (Atroid)—
a drug that lowers
cholesterol —he could be en-
dangering your life.
Most doctors have stopped
prescribing the drug, follow-
ing a World Health Organi-
zation trial which revealed
that it increased the mortal-
ity rate among sufferers by
47 per cent.
The tests showed that
while clofibrate reduced the
incidence of non-fatal my-
ocardial infarction, it did not
lower mortality from artery
disease; indeed, mortality
levels rose by 47 per cent,
and then fell back to normal
levels once the drug was
withdrawn.
While the industry consid-
ers carrying out further
tests before the drug is with-
drawn, the WHO findings
indicate that drugs compa-
nies are vigorously market-
ing these types of drug
before waiting for the results
from controlled trials cur-
rently in progress.
QUOTE OF THE MONTH
"I have been in general prac-

on vitamins rather than foods. tice for 30 years. I sit at a slight

The well-publicized assault
by the EC on vitamins and
nutrients—which could put
the smaller manufacturers
out of business—is only the
first wave of a sustained cam-
paign, we can reveal.
A second European direc-
tive is in the wings which will
curb the sale of herbal ex-
tracts, ginseng and royal jelly.
4 WDDTY Vol.3 No.8
As foods, they are subject to
the minimum of restraints.
But as drugs, they will need
to be registered and to ac-
quire a product licence before
they can be sold. This route is
both costly and time-consum-
ing, and several industry
watchers have said it will be
enough to cripple all but the
very biggest vitamin manu-
facturers.
However, the EC has yet to
set against a major revalua-
tion of postgraduate training.
Annual spend is increasing—
in 1988-9, it was already at
£96m—and the General Med-
ical Council is conducting a
review of basic medical edu-
cation.
The new report, prepared
by the Standing Committee
on Postgraduate Medical Ed-
ucation, recommends that
trainers should first be
taught effective teaching
angle to my desk; the patient
sits near me on the same side,
within touching distance.. . .
In my consultation I use
touch quite frequently such
as holding a hand or putting an
arm round a shoulder. . . . And
I have noticed that some pa-
tients touch me. . . .
What is being communi-
cated? . . . Perhaps it shows
that the patient has solved the
problem with the doctor's
help–"Let's do this to-
gether."–Alun J B Edwards,
Barnstaple.

Fluoride: hip
fracture risk
Fluoride in the water supply
actually increases the risk of
hip fracture among the el-
derly, a seven-year study
among the over-65s of Utah
has discovered.
While fluoridized water is
supposed to help treat osteo-
porosis, the survey confirms
suspicions that it may in fact
weaken bones. Researchers
had earlier noted increased
hip fracture rates among
women who were treated
with supplemental fluoride.
Fluoride apparently causes
new bone formation of an in-
ferior quality, especially
around the femoral neck (the
hip). While its compressive
strength increases, the bone's
tensile strength diminishes.
The study, carried out by
the Department of Family
and Preventive Medicine at
the University of Utah,
wanted to discover if people
exposed to much lower quan-
tities of fluoride through their
tap water would be similarly
affected. The water supply in
the area is fluoridized at 1
ppm.
They were tested against
two communities with no flu-
oridization of their water.
The team concluded that
fluoride does increase the
risk of hip fracture. They
point out that, according to
other tests, the numbers of
hip fractures actually in-
crease in areas where there
are higher levels of fluoride in
the water.—Journal of Amer-
ican Medical Association, 12
August 1992.
Cataracts: eat
your greens
The risk of cataracts appears
to diminish among those who
regularly eat spinach and
those who have taken vita-
min C supplements for more
than 10 years.
These were the main find-
ings of a long-term survey by
Harvard Medical School
among 50,000 women across
11 states of the US.
Surgery to remove
cataracts accounts for 12 per
cent of the US Medicare bud-
WHAT DOCTORS READ
get. Delaying the onset of
cataracts by 10 years could
reduce the need for surgery
by 45 per cent.
It was against this back-
drop that the survey was
started in 1980 among female
registered nurses over the
age of 45; others were in-
cluded as they reached that
age.
During the survey period,
493 cataracts were removed.
Those in the study group who
took regular doses of vitamin
A had a 39 per cent lower risk
of developing cataracts.
Among the food groups, those
who regularly ate spinach
also seemed to face lower risk
of developing cataracts, al-
though no evidence seemed to
support the remedy of folk-
lore that carrots could im-
prove the eyes.
The risk was also low
among those who regularly
took vitamin C for 10 years or
more, although this was not
so among those who took vita-
min C as part of a multivita-
min. The beneficial effects of
vitamin C were particularly
strong among those who have
never smoked.
The study team said their
findings lend support to the
antioxidant hypothesis of
cataract prevention.—British
Medical Journal, 8 August
1992.
● Another study has shown
that smoking cigarettes sub-
stantially increases the risk
of developing cataracts in
later life.—Journal of Ameri-
can Medical Association, 25
August 1992.
Breastfeeding:
lip service only
Despite all the recent find-
ings that underline the bene-
fits of breast milk, health
professionals seem to be pay-
ing little more than lip ser-
vice to breastfeeding.
A survey among midwives
and health visitors in New-
castle upon Tyne showed an
alarming disregard for the
needs of both baby and
mother.
Of the 50 first-time mothers
who took part in the survey,
30 were separated from their
babies on the first night,
while 28 babies had received
food or water rather than
breast milk.
Nearly half the profession-
als in the survey confirmed
that breastfed babies were
frequently given water to
drink.
The survey, conducted by
Sally Beeken and Tony Wa-
terston of the Community
Child Health department at
Newcastle General Hospital,
was intended to measure atti-
tudes of professionals to
breastfeeding.
Most professionals agreed
that breast milk is better for
babies than formula milk,
but 28 per cent disagreed that
breastfed babies are health-
ier, and nearly half disagreed
that milk company advertis-
ing should be banned in ante-
natal clinics.
Although 71 per cent of pro-
fessionals agreed that lay or-
ganizations should be
advertised, only 45 per cent
felt they should be allowed
into hospital to help women
with their breastfeeding.
This was a surprising re-
sponse, as 35 of the 50 partic-
ipating mothers had
difficulties with breastfeed-
ing. Twelve had stopped
breastfeeding by three weeks,
and nine had stopped in the
first week. The most common
reasons were that the baby
was not getting enough milk;
the mother could not tell how
much milk the baby was get-
ting; the mother was too ill;
the baby was ill or rejected
the milk; and engorgement
and painful nipples.
The study team also points
out the ambivalence of the
professional toward breast-
feeding. While they seem to
agree about the superiority of
breast milk, they seem less
clear about the reasons.
They were also concerned
that all is not well with hospi-
tal management if so many
mothers found it difficult to
breastfeed. The high rate of
mothers who stop breastfeed-
ing in the early weeks—in the
survey, 18 per cent had
stopped within the first 10
days—is disturbing, but cor-
responds with national
trends.
The team recommends that
health professionals are up-
dated more often, while the
involvement of lay groups,
such as the National Child-
birth Trust and La Leche
League, should be encour-
aged.
●These findings have been
endorsed by a separate and
earlier study in Fife, Scot-
land. There, just 40 per cent
of mothers were still breast-
feeding by the tenth day, ac-
cording to Sarah Williams of
Cambridge University School
of Clinical Medicine.—
British Medical Journal, 1
August 1992.
..
Hib vaccine:
poor showing
A major study examining two
versions of the new
haemophilus influenzae b
(Hib) vaccine, introduced this
month in Britain, shows that
they don't work as well as
they should.
The vaccine, being offered
to infants at two, three and
four months, is supposed to
protect against Hib-caused
meningitis.
However, the study by the
National Centers for Disease
Control in Atlanta, Georgia,
of 10,400,000 children,
showed that the "polysaccha-
ride" version of the vaccine of-
fered protection in 64 per
cent of cases and the new
"conjugate" vaccine, only 74
per cent protection.
Nine of 75 children with
Hib disease had received the
vaccine just two weeks before
they became ill.––JAMA, 19
August 1992.
SHORT TAKES
●For several low back
disorders such as herni-
ated disks, spinal steno-
sis, spondylolisthesis
and degenerative disk
disease, a study of 47 ar-
ticles in the medical lit-
erature could find no
advantage demon-
strated for using spinal
fusion over simple
surgery without fusions
(and indeed no truly sci-
entific trials supporting
the use of the proce-
dure). Spinal fusion
was also associated with
frequent complications,
including chronic
pain.—JAMA, 19 August
1992.
●Vaccination against in-
fluenza has been associ-
ated with false positives
on tests for HIV, HTLV-1
and hepatitic C virus.—
JAMA 26 August 1992.
●Skin lightening creams
can permanently dam-
age skin by causing
thickening of the colla-
gen layer and patchy
pigmentation.—BMJ, 8
August 1992.
WDDTY Vol.3 No.6 5

Q I was amazed to read the
inaccurate, outdated and
unnecessarily alarmist ar-
ticle on hepatitis B vacci-
nation by Anthony Morris and Hilary
Butler (WDDTY Vol 3 No 4)
I am not going to get involved with
the pros and cons of mass hepatitis B
vaccination. Suffice it to say that
hepatitis B disease can be a lethal
infection in a small proportion of suf-
ferers. Furthermore, those who be-
come chronic carriers (about 10 per
cent) of the virus have 400 times
greater chance of getting liver can-
cer than the general population.
Some of the contents of the article
would probably have applied to the
vaccines produced in the early 80s.
However, the hepatitis B vaccines
that are now being used, especially
those proposed for mass vaccination
of children, are genetically engi-
neered. This means that they do not
come into contact with human blood
or serums, and therefore there is no
possibility of catching HIV or any
other infections from them. The only
side effects listed are occasional lo-
cal redness and swelling, as well as
transient mild fever, headache, joint
and muscle pains, nausea and ab-
dominal pain. Whether or not the
generalized side effects are related
to the actual vaccine has not yet
been established.—Dr Kai Kermani,
Loughton. Essex.
A
As some of you may or may
not know, Dr Kermani is
one of our panel members,
who has treated many AIDS
patients through a combination of
conventional and alternative treat -
ments such as autogenic training.
It's worth remembering that the ar -
ticle to which you refer mainly con -
cerned the wisdom of launching a
nationwide immunization pro -
gramme for infants.
We went back to another panel
member, immunization expert An -
thony Morris, who authored the re -
port on vaccination. Here is what he
had to say.
"Most of the work in New Zealand
was based on vaccines made from hu -
man plasma. However, as recently as
the early 1990s, Smith Klein and
French was licensed to use the geneti -
cally engineered vaccine, which is
grown on yeast cells. However, the
earlier plasma-derived vaccine was
never withdrawn, and even those
drug companies which stopped pro -
ducing the blood-derived product
kept selling it until it was used up. So
until very recently, anyone receiving
the vaccine could have received a
blood-based vaccine.
"The other issue you raise concerns
the safety and efficacy of the yeast-de -
rived or 'recombinant' vaccine. You
say that the contents of our article
only applied to this earlier vaccine.
6 WDDTY Vol.3 No.8
QUESTIONS FROM READERS
CASE STUDY
My daughter, Jennifer, was vaccinated against
measles at the age of approximately one
year. After the injection she suffered various
side effects for a few days (these included a
chesty cough, runny nose and a general "un-
wellness"). For the following four and a half
years, Jennifer had problems with her left
arm at the site of the injection. There were
lumps under the skin and obvious discomfort
and irritation which caused her to scratch the
area continually, often resulting in bleeding.
Then about six months ago, the problems
with the skin at the injection site disap-
peared. At the same time, Jennifer started to
exhibit symptoms of not being 100 per cent
well. She was easily tired, quite lethargic and
subject to quite violent mood swings. She
became more and more uncooperative in
her general behaviour. She also started to
drink a lot of fluids and lose weight. On 10
August this year she was diagnosed as dia-
betic. I was devastated. There is no history
of diabetes in our immediate family. I was
faced with the prospect of injecting her with
insulin at least once a day for the rest of her
life and the prognosis for the quality of a dia-
betic'slife is not good.
After the initial shock, I decided not to ac-
cept the fatalistic attitude of the medical pro-
fession. I know that Jennifer's condition is a
direct result of her measles vaccination. I
have started treating her condition in a vari-
ety of unorthodox ways . She maintains her
normal regime of insulin and diet during my
treatment.
I will continue treating Jennifer, reading all
available data and pestering the hell out of
anyone I think might help. I've never even
studied biology at school—but I've got some-
thing that no doctor has got: I love my
daughter. The depth of that love will allow
no barriers in my search for a cure. —S.A.,
East Grinstead.
Thank you for your heartfelt letter. We
can sympathize with your enormous
anger and frustation. The late medical
critic Dr Robert Mendelsohn maintained
that the many long-term side effects of
the live measles vaccine included multiple
sclerosis, juvenile onset diabetes and
Reye's syndrome. Reye's syndrome can
cause the degeneration of organs such as
the pancreas, particularly when aspirin
has been used. Mendelsohn once cited a
batch of cases of Reye's syndrome in
Montreal in which five of the children had
been vaccinated within three weeks of
coming down with the illness. In Shot a says that 'in 1-2 per cent of cases the
in the Dark (Avery), Harris Coulter also
provides ample evidence of the relation
ship between pertussis vaccination and
the failure of children to maintain stable
glucose levels. Now that two of the MMR
vaccines have been withdrawn, you might
get a legal opinion as to whether you
have a case against the supplier.
While we applaud your determination,
we would strongly urge you not to take
matters entirely into your own hands with
such a potentially serious condition . We
recommend that you work in partnership
with a doctor with great experience in
treating diabetics nutritionally.Also, our
issue Vol 3 No 7 on diabetes may be of
However, let us call your attention to
several paragraphs toward the end of
the article, which included extracts
from a report prepared by one very
concerned New Zealand doctor about
the effect of the new vaccine on chil -
dren. As we reported, the doctor wrote
that the HB vaccine, given with the
DPT triple jab and/or the polio vac -
cine, causes a 'significant immune
suppression in a significant number
of children, as witnessed by the num -
ber of recurrent infections.' The doc -
tor also points out that the HB
vaccine, when given to newborns,
caused a number of cases of pro -
longed, post-natal jaundice, lasting
up to two or three weeks. This doctor
had never seen either problem in vac -
cinated babies before the HB vaccine
was introduced.
"My biggest reservation with the
new HB vaccine is that there's a good
deal we don't know about it. Al -
though the American Centers for Dis -
ease Control recommends that all
newborns get the jab and the UK is be -
ginning nationwide prenatal screen -
ing for the disease, top medical
authorities basically admit that we
don't really know whether it is effec -
tive, what the side effects are in ba -
bies and children, or even when the
effect wears off. For instance, the
1991 edition of The Red Book, pro -
duced by the American Academy of
Pediatrics, includes the report of the
Committee on Infectious Diseases of
the AAP, which says that routine
screening of mothers-to-be for HB
virus is 'recommended,' not manda -
tory—tacit acknowledgement that
the jab itself is only necessary for the
newborns of infected mothers. Else -
where in the volume, the AAP admits
that the duration of protection and
the need for booster doses is 'not yet
fully divined. ' And between 30 and 50
per cent of people vaccinated with
three doses of the vaccine lose de -
tectable antibodies within seven
years. This could mean that you may
need a booster shot every five years
for the rest of your life.
"Again, the AAP admits this with
the statement that 'the possible need
for booster doses after longer inter -
vals than five to seven years will be
assessed as additional information
becomes available.' Finally the AAP
recommended regime . . . is not effec -
- tive.' Therefore, infants should be
tested at nine months or later to see if
it's taken. This means that 2 out of
every 100 babies won't be protected by
the vaccine.
"This high failure rate has been re -
produced in adults; a study pub -
lished in the Journal of Infectious
Diseases (April 1992) showed that 10
per cent of volunteers vaccinated
failed to produce antibodies.
"There is also the possibility that
the hepatitis B vaccine can itself
cause a mutant strain of the virus. In
a study in southern Italy published in

the Lancet (11 August 1990), 44 of the
1,590 infants born of HB carriers be -
came HB positive, 32 of whom showed
evidence of infection and one, serious
disease. The study group concluded
that the vaccine caused a viral ‘escape’
mutation—ie, a slightly different or -
ganism resistant to the protective ef -
fects of the vaccine.
"Finally, there have been reports (the
Lancet, 25 April 1992) of people misdi -
agnosed as HIV positive after being
vaccinated with the HB vaccine. "
In our view, the studies Dr Morris
cites demonstrate that no definitive
statements can be made as to the safety
or efficacy of either the old or new HB
vaccine for children.
Q
For the past few years I've
suffered from a number of
bowel problems and almost
constant fatigue. I've seen
allergy doctors and alterna-
tive practitioners, who have treated
me for possible allergies, candida al-
bicans and ME—all to no avail. Any
suggestions?—B. M., Shropshire.
A
Have you looked into the pos -
sibility that your problems
may be caused by an intesti -
nal parasite? Allergy spe -
cialist Keith Mumby has
done a good deal of work on parasites
and their treatment. Here is what he
had to say:
"It is now accepted by many clinical
ecologists that as many as one in six
people in Britain may be carrying
around giardia lamblia, a minute,
flagellated protozoan that causes se -
vere fatigue and bowel disturbance.
Perhaps 10 to 12 per cent carry cryp -
tosporidia infestation, a mild enough
infestation in healthy individuals but
a potentially fatal one for those with
compromised immunity, such as AIDS
victims.
"The majority of patients simply get
vague, grumbling symptoms that come
and go, never quite adding up to a ‘dis -
ease' or something the doctor would
wish to have fully investigated. Most
especially occur in the bowel, where
mild symptoms of the ‘irritable bowel' -
type are quite common. However, sys -
temic symptoms—particularly fatigue,
lack of energy, muscle weakness,
headache, sore throats, enlarged
lymph glands, night sweats and occa -
sional fever—can be caused as well.
"Giardia lamblia is an important
cause of traveller's diarrhoea and
chronic fatigue. Patients with irrita -
ble bowel or ' food allergy' can often
date the onset of their symptoms to an
episode of tummy upset on a holiday
abroad.
"Giardiasis can cause severe malab -
sorption, not unlike that caused by
QUESTIONS FROM READERS
coeliac disease, and even total atrophy
of the gut lining.
"Commonly, patients with giardiasis
have a deficiency of the enzyme lac -
tase, required to digest cow's milk, and
they may also fail to absorb folic acid
and vitamin B12, leading to anaemia.
"At the moment, diagnosis of giardia -
sis is very difficult, since most labs do
not have the requisite detection skills.
Routine hospital screening of faeces
for the presence of giardiasis misses
the diagnosis 98 per cent of the time.
"A newer and probably better
method, described by Bueno and Par -
rish in the USA, consists of a superfi -
cial biopsy of rectal mucosa taken by
means of a small cotton bud swab
pressed firmly into the mucosal lining.
"There are various other, less com -
mon parasites, and because of the
deplorable state of diagnostic tech -
niques, doctors like myself consider it
a good idea—when parasites are the
likely culprit of a complaint—to try a
therapeutic trial of treatment to see if
it helps.
"For many of these organisms, the
metronidazoles (Flagyl) are the treat -
ment of first choice. Therapy may need
to be kept up for several weeks. Even if
apparently successful, relapses are
common, probably due to incomplete
eradication, rather than re-infection.
"A new drug, tinadazole (Fasigyn)
has become available and appears to
be effective. Nevertheless, it may cause
short-lived abdominal discomfort and
drowsiness. Treatment should be
avoided during pregnancy and breast -
feeding, and patients under treatment
should avoid alcohol, which will make
them ill if taken concurrently with the
drug.
"Herbal treatment can be strikingly
effective, particularly plants from the
genus Artemesia. These are the worts,
such as wormwood (Artemesia ab-
sinthium) and mugwort (Artemesia
vulgaris). Moxa, used in moxybustion
by acupuncturists, is from this group
of plants.
"Best known as an antiparasitic is
Artemesia annua. It is currently un -
der study by the WHO as a possible
treatment for chloroquine-resistant
malaria. It is available as a bowel
preparation; usually, 1 gram is taken
three times a day for 60-90 days. Better
results may come from combining it
with some other herbs.
"Grapefruit-seed extract, known un -
der several brand names such as
DF/100, Parcan and Citrocida, has a
similar range of activity. The two com -
bine very well. If a short-term course of
Flagyl is added, this makes up just
about the best ammunition we've got."
"If a doctor diagnoses you as having
a parasite and you respond to treat -
ment, it is vital to investigate other
members of your family to prevent
cross-infection.
“In the UK, rectal swabs and the
Bueno-Parrish method can be done at
the London Clinic, 20 Devonshire Pl,
London WDN 2DH (tel: 071-723 6581)."
BOOKS
Title: Which? Medicine
Author: Rosalind Grant
( Consumer's Association ) £12.99
This rather expensive paperback aims to
give a handy guide to the 80 most com-
monly prescribed generic drugs and
advice on 1500 prescription and over-
the-counter medicines.
Its basic message is one which WDDTY
fully endorses. Be an active patient, it
says. Ask your doctor questions and take
nothing for granted, it exhorts.
As well as information on drugs, it sets
out 20 questions you should ask each
time you are prescribed a drug.
However, perhaps inevitably for a book
from the CA, it errs on the side of con-
servatism. The prevalence of side effects
is played down, and it barely nods in the
direction of alternative approaches. "Diet
does not seem to affect the course of
acne," it baldly states. The section on vi-
tamin supplements is headed pejoratively:
Money down the drain?
No doubt the author would point to the
question mark as proof of her impartial-
ity, but the same heading could have been
used equally well for many of the more
orthodox treatments covered.
Title: Inequalities in Health
Author: P Townsend & N Davidson
(Penguin) £7.99
Just as the feminists used to say the per-
sonal is political, this book leaves you in
no doubt that the state of your personal
health is political.
It brings together in one edition The
Black Report—which caused a political
storm when it was published in 1980—
and an updated edition of The Health Di-
vide by Margaret Whitehead.
Both reports argue convincingly that
governmental policies have a devastating
effect on the nation's health. If you want
to have a long and healthy life, be sure to
be rich, white and living in the South East.
It gives an excellent overview of the fac-
tors which go towards shaping the pat-
tern of health care provision—just in case
you thought it was determined by need—
and explains how the medical establish-
ment conspires to ensure that so-called
fringe medicine remains there.
It also sets out a series of measures
government could take to improve the
health of its citizens; like uprating child
benefit, making clinics more user friendly,
and ceasing to conspire in the promotion
of a major killer, by banning all tobacco
advertising.
WDDTY Vol.3 No. 8 7
 SECOND OPINION

Testing the test

T
he first signs of an incipient pa-
tients' revolt against the controlled
clinical trial (CCT) have begun to
appear. Those are the supposedly airtight
scientific studies in which patients are
randomly selected to be given either the
drug under study or a placebo.
Last year, the Hastings Centre in New
York, an eminent medical ethics author-
ity, issued a 57-point table of recommen-
dations, agreeing with the emerging
healthcare activists that "there are cir-
cumstances in which other designs [radi-
cally different to the CCT] are more
appropriate". The (US) National Wom-
en's Health Network in Washington, DC,
is currently campaigning on two heavily
politicized issues in women's health. In
February 1992 it lobbied the Food and
Drug Administration (FDA) and
Congress over the safety of breast im-
plants, and is pointing to the inadequa-
cies of the clinical trials that preceded
this dubious procedure. In May 1992 ac-
tivists were at the National Cancer Insti-
tute, voicing their well-founded concern
over the design of a clinical trial of a drug
to prevent breast cancer in healthy
women. Healthcare campaigners are get-
ting participants in CCTs to have their
tablets analyzed in order to find out
whether they are getting the real drug or
a placebo, and some participants then
share their drugs with others.
These developments represent a con-
certed challenge by those who champion
the rights of individuals against the col-
lective ethic of science, represented here
by the controlled clinical trial.
Behind all these individual rumblings
is the first challenge to the notion, hith-
erto accepted as read in the medical com-
munity, that "if it's good science, it will be
ethically good as well". Indeed, there are
grave doubts that the CCT can even be
regarded as "good science".
Dr Harris L Coulter, the distinguished
medical philosopher-historian, addresses
these sorts of issues comprehensively in a
book entitled The Controlled Clinical
Trial: an Analysis.
Coulter concludes that it is seriously
‘The controlled
clinical trial is
not scientific
in any sense
of the word .’
flawed in every fundamental
respect.First of all there are a variety of
practical problems, for instance:
● Confusion in international terminolo-
gies makes it very difficult to make com-
parisons in investigations.
●Reliability is compromised by the
enormous costs (and financial rewards) of
engaging in CCTs that contribute to
many inadequate protocols and the cor-
ruption of not a few investigators.
● An idiosyncratic variety in the health
and disease of humans presents insuper-
able difficulties in interpretability of CCT
results.
Coulter demonstrates that the utopian
ideal of the CCT is rather far removed
from reality, by showing convincingly in
well-researched arguments that:
●In practice the CCT is at best a trade-
off between scientific and economic re-
straints.
● Because the CCT is incapable of pre-
cise identification, accurate prediction or
valid specification—at best, it manages
no more than statistical correlations be-
tween the ill-defined—it is not 'scientific'
in any sense of the word.
●Its results do not affect physicians'
prescribing patterns the way they are
supposed to do.
●Although misrepresentation and con-
cealment are fairly common,there is no
fail-proof method of correcting the medi-
cal literature following fraudulent publi-
cations.
●The CCT is dehumanizing: patients
become the objects of a scientific quest,
are treated with aloofness and are seen as
a source of irritation if they turn out to be
individual deviants from the sample-
norm).
● A doctor's ability and duty to observe
is consistently subverted by the assump-
tion now in medicine that the only reli-
able source of information is the CCT).
Clearly, the days of trying to make all
pharmacological questions fit the CCT's
unwieldy and very expensive mould are
now numbered, not least by the economic
reality of the horrendous cost involved for
often such paltry bits of information. It is
this which may hasten the displacement
of the CCT in the foreseeable future.
Harald Gaier
Harald Gaier, author of The Ency-
lopaedic Dictionary of Homoeopathy.

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8 WDDTY Vol.3 No.8