The Illusion of American Health and Longevity

I. Introduction

Humanity is again passing through an intellectual revolution, and there is need for authoritative perspective on some of the fundamental questions of our time, to rescue men from conceptual poverty and failure. Interpretations fathered by our intellectual paternity are badly in need of revision in the light of current knowledge and advanced understanding. In addition, the knowledge of man has been compartmentalized and atomized with tragic implications. It requires courage and dedication to truth and to humanity to give critical articulation and evaluation in areas long since demanding conventionalized thinking traceable to entrenched commercial interests, and to financial prepossessions. The twentieth century cries for a surrender to novel and enlarged points of view. We shall leave it to reason, the principal distinguishing principle of man, to produce elisions in historical, parochial and provincial interpretations, and thus make way for intelligent transformations and translations of modern scientific thought. We must exercise a maximum of intellectual elasticity. Where evidence is incomplete, we shall remain uncommitted, and so exercise the principle of suspended judgment, until more information is available.

Widespread indeed among the peoples of civilized and literate nations is the belief that disease generally, and for the most part, arises through an invasion of microscopic and submicroscopic living organisms into the body of man and other creatures. This belief is as current among most of the medical and dental circles, as among those who are laymen in these particular matters.

The Nature of Disease

That this should be so is explainable on the basis of historical development. With the advance of Renaissance learning, there was discovered the very first RATIONAL explanation of disease, a radical departure from ancient and classical concepts which related to unsatisfactory divine, supernatural and metaphysical explanations.

So hungered and eager were men for an explanation amenable to and susceptible of experimental analysis, testing and demonstration, that in their enthusiasm they accepted what proved to be part of the truth, as the whole truth, and dismissed the question as essentially settled. This left the germ theory of disease as the only rational explanation for the cause of disease, and this theory was elevated to the status of an incontestable doctrine, without peer, and without fear of contradiction–and later, very profitable withal!

Since, as it was then believed, “germs” invade, attack, alter and otherwise corrupt the human and other organisms, it becomes necessary to foil these unwelcome assaults and metabolic insults. With the discovery of Lister in preventing the ripening activity in garbage through the application of carbolic acid spray, there developed the idea of carrying on a form of aggressive chemical warfare against these intruders. And even now the end is not in sight, with the endless parade and kaleidoscopic spectrum of antibiotics, which come and go more rapidly than the change in ladies’ lingerie fashions. What is medically fashionable today, will probably not be so tomorrow.

Marvels of Medicine

In fairness to ourselves, to all others, and to science itself, we must except from criticism, and give adulation to those developments in science, skillfully applied by physician and dentist, in the surgical repair of malformation, the wounds of accidents and such like. Here indeed are applicable the safest of the pain-quieting and sleep-inducing drug-poisons, the blade of the surgeon, the drill of the dentist, and prosthetics where and as required. One hastens to add that even much of this would be unnecessary if the ounce of prevention philosophy were part and parcel of daily living–indeed if man could exercise such caution in this overly poisoned and abused world.

II. The Doctrine of the Specific Etiology of Disease (Germ Theory) is Largely (But Not Entirely) Invalid

The doctrine of specific etiology has been at least something of a constructive force in medical research for nearly a century, and the bulk of modern medicine arose as a result. Yet in only a few cases did this doctrine render a full account of disease causation, since most disease states are the indirect resultant of a constellation of circumstances rather than the direct result of a single decisive causative factor, as witness our many great medical problems including cancer, cardiovascular disease, peptic and duodenal ulcer, collagen disease, and mental affections.

A search for the cause has at times led to effective control steps, but leaves us ignorant of the nature of the trouble corrected, even as drenching a blaze with water may put out the fire, yet fire hardly has its origin in the lack of water. Similarly, insulin administration is helpful in diabetes, but it does not cure it, nor prevent kidney and retinal degeneration. Cortisone is helpful in inflammation, but this does not arise from a lack of the hormone. Aspirin, a drug foreign to the body, can alleviate pain, but pain does not arise from a lack of aspirin in the body. Rev. Edward Stone discovered in 1763 that an extract of willow bark was highly effective in relieving the pain of rheumatism; within 50 years chemists found salicylic acid (salix, Latin, means willow) in this plant. Gerland in 1835 synthesized salicylic acid and in 1853 Gerhardt synthesized its derivative, acetyl salicylic acid, even more effective. These therapies do not constitute evidence for the doctrine of specific etiology.

Robert Koch, M.D.

Koch discovered the tubercle bacillus in association with T.B., and read a paper on it in 1882. He injected tuberculin into his own arm in 1880 and suffered a violent allergic reaction, indicating he himself had been infected, yet he did not have clinical T.B., and remained a vigorous man till he died of cerebral hemorrhage.

Florence Nightingale wrote: “There are no specific diseases. There are specific disease conditions.” We no longer hold with Virchow that a specific pathology accompanies each disease entity. Today we think in terms of disease, rather than of diseases.

About 1900 Pettenkofer (hygienist) in Germany, and Metchnikoff in France, along with associates, drank tumblerfuls of cultures isolated from fatal cases of cholera. Even with enormous numbers of cholera vibrios in their stools, some of these developed mild diarrhea only, but no true cholera appeared in any of them.

Human volunteers who recently ingested billions of dysentery bacilli remained essentially free of symptoms referable to dysentery.

Pasteur and Koch dealt with experimental artifacts and not with natural events. Nature is not well reproduced in the laboratory. Koch and Pasteur merely demonstrated that microbes could cause certain disease manifestations.

Frank L. Horsfall, Jr., in The Burns Amberson Lecture (The American Review) states that the older idea of “one disease, one agent” has had to give way to a newer concept, namely, that a well-defined clinical syndrome may be induced by any one of a number of viruses, and that one virus may induce several different symptom complexes. To exemplify, the clinical syndrome known as influenza, may be induced by some ten or eleven different viruses, yet not all of these forms are designated as the influenza virus. (J.A.M., 171 (15): 113/2055, 1959).

Experimentation

The experimenter works in a closed system where “under the conditions of the experiment,” and, “all other things being equal,” conclusions may be valid, but natural events never occur in such a system, and “all other things” are never equal. This consideration is of prime importance when dealing in the area of epidemiology.

In the natural world, many factors play a part in disease causation–the physiological status of the individual and his environment. There are predisposing causes, precipitating causes, and perpetuating causes. Since in cholera, there is loss of fluid and electrolytes from the intestinal tract, successful treatment for cholera replaces these items lost. Hence the real cause of cholera is the mechanism which increases gut permeability. The etiology of most diseases is multifactorial rather than specific, and involves agent, host, and environment.

Contrary to the tenets of the original germ theory, the living agent (a virus) of the disease, herpes simplex, can be permanently present in the host, having been acquired in childhood.. Although latent in the body without causing symptoms, it can be provoked to produce herpetic fever blisters through menstruation, eating Wisconsin cheese, ultraviolet radiation, etc.

A disease can take only those forms of which the organism is capable, and cannot reflect the peculiarities of the stimuli from which the disease originated. Thus symptoms of diverse disease may entertain marked similarities. Any given pathological effect can also be the result of many varied types of insults, but one type of pathological effect may predominate for any given insult. The general process of inflammation is the same whether it be initiated by burns, wounds, bacteria, or injected chemicals.

In concentration camps of World War II, bronchopneumonias, pulmonary T.B., colds and skin infections, normally endemic in European populations flared into overt disease through malnutrition and other misery, but rapidly receded at war’s end without the help of specific therapy.

Seventeen Pregnancies

Queen Anne had 17 pregnancies and not a single survivor, due to infectious disease. Today the survival of most children in Europe and N. America is a dominant influence in the planned parenthood movement, the aims of which include a stable population enjoying a decent standard of living. All this requires a modernization of social, religious and medical ethics.

A half century ago, Osler wrote: “It is much more important to know what sort of a patient has a disease, than what sort of a disease a patient has!”

Three factors at least are involved in the genesis of mammary cancer in inbred mice: the milk virus, estrogenic hormone injection in males, and a genetic susceptibility to the action of the first two. And limited caloric intake will drastically reduce the incidence of mammary cancer in spite of the presence of other factors.

In opposing Pasteur, Pidoux in the 1880’s reasoned that disease “is the common result of a variety of diverse external and internal causes…bringing about the destruction of an organ by a number of roads which the hygienist and the physician must endeavour to close.”

And so health is an equilibrium. We usher now the Hippocratic doctrine of harmony into the modern scientific arena. His basic tenets bear the sanction of both authority and time. Hippocrates is a symbol of rational concepts based on objective knowledge; he is a symbol of the liberation of science in general and of medicine in particular, from mystic demonic influences, to natural explanations.

Role of Bacteria

Microbes convert plant and animal debris to humus and thus add to the texture, tilth and fertility of the soil. They can also destroy crops. In technology, they effect certain steps and make fermented milks and cheeses. They can also rot goods and foods. They play a useful role in the intestines and stomach under normal circumstances, but under others can cause toxic reactions and even death. Ecological equilibrium with microbes is an ideal state of affairs, but one not readily achieved and frequently upset. The upset can affect the internal or external environment, weather, food, habits, stress, economic status, etc. And so, as G. B. Shaw stated in his preface to The Doctor’s Dilemma, “The characteristic microbe of a disease might be a symptom instead of a cause.” Much earlier, Pasteur concluded that the large numbers of microorganisms (flacherie disease) present in the gut of sick silk worms was “more an effect than a cause of the disease.” The same can be said for the Great Blight leading to the potato blight and famine in Ireland in 1845. A million Irish died of starvation and others acquired T. B. in epidemic proportions. Many Irish emigrated, especially to America. Even today Ireland has but half the population of what it had before the potato famine. Phytophthora infestans, a normal parasite of the potato in the Andes, had multiplied beyond ecological equilibrium due to the excessively wet weather, and killed the potato plants. Thus in sequence, the weather caused a potato blight, potato famine, starvation, tuberculosis, emigration, and the arrival in America of the wit of the Irish, their faith, and their political genius. For the most part, the microbe remains today as of old, largely an undisciplined force of nature.

That bacteria of the wrong kind and in sufficient numbers can produce untoward effects, is attested by such organisms as Clostridium botulinum, which is a spore-former, strictly anaerobic rod-shaped bacterium. Botulism is a matter of food poisoning wherein the toxemia does not involve an infectious process. The toxin is a simple globular protein, and is known to be without question the most potent poison known, less than a 0.1 x 10-3 microgram causing death of a mouse. It is a neurotoxin producing paralysis of skeletal musculature which interferes with breathing and produces terminal asphyxia. Botulism is a paralysis of the efferent automatic nervous system, the site of poisoning being at the synapses of efferent parasympathetic nerves and somatic motor nerves (motor end plate or myoneural junction). Aconitine, one of the most poisonous nonprotein materials, is much less toxic than botulinal toxin. Only tetanus and Shigella neurotoxins appear to possess potency of the same or nearly the same order as that of Clostridium. Orally taken, the poison passes into the blood before reaching the digestive enzymes of the intestine, and even there much passes thru before the enzymes have been able to destroy it. It may pass thru the oropharyngeal and esophageal mucosa and via oral wounds and dental caries, and also thru the stomach and colon walls. In the gut the toxin is passed into the lymph rather than directly into the blood.

Oral Toxin

An article in Science (Vol. 131, 15 April 1960, p. 1100), under the title of “Toxicity of bacterial exotoxins by the oral route,” states both tetanus and diphtheria toxins are demonstrably orally toxic, reports to the contrary notwithstanding. The significance of this finding is considered in relation to the definition of those factors which are determinants of the potency of bacterial protein toxins by the oral route.

Some microbes can even penetrate the unbroken skin of animals. This is true of Bacterium tularense (Pasteurella tularensis), the organism associated with tularemia. It can also induce infection when taken in orally.

More than 150 different viruses have been recovered from humans; 50 of these are known or thought to induce diseases in man. Of the 50, 30 are known to be associated with respiratory diseases, and most of the other 20 may initiate infections in the respiratory tract, the major portal of virus entry into the human system.

When virus isolated from early trachoma in man is instilled into monkey eyes, it produces acute follicular conjunctivitis with typical inclusion bodies; this virus belongs morphologically and serologically in the psittacosis-lymphogranuloma group. It is calculated that over 400 millions of people, mainly in Africa, Asia and some parts of Europe, suffer from trachoma as a serious eye disease; its endemic level in the U. S. is low.

Recently rabies virus has been demonstrated in mice by inoculating them with brain and salivary gland suspensions made from a Montana bat.

III. Historical Incidence and Geographic Distribution of Infectious (and Other) Diseases

Malaria rifled ancient Babylon, Assyria, India and S. China. Malaria killed Alexander the Great by the waters of Babylon, and played a dominant role in the physical, intellectual and moral decline of Greece. In pre-Roman times, at the height of the Empire, in the 8th and 9th centuries, and during the Renaissance, the Campagna flourished because malaria was unimportant. But at other times when the Roman Campagna was afflicted with malaria, the Romans worshipped Dea Febris, the goddess of tertian and quartan fever. Malaria attacked the Gauls besieging Rome, and upset the Italian expeditions of Lothaire and Frederick I Barbarossa during the Middle Ages. The English troops in the Low Countries had it in the 17th century. Malaria was active during the American Civil War, in the Crimean War, and in European colonial wars. Eastern Armies in World War I were affected, and so also the Pacific Theatre in World War II; the [Japanese] seized the Dutch Indies early and denied quinine to the Allies, but the synthetic atabrine soon took its place. Malaria produced 10 times more casualties to the Burmese than Japanese arms. One-half million American soldiers were at some time hospitalized with malaria. More recently, malaria operated among combatants in Korea and Indochina.

In 1701 scarlet fever was scarcely anything more than its name. From 1801-2, it ravaged Dublin. It ceased in summer and returned at intervals from 1803-4 in a very mild form. Another epidemic occurred from 1834-35. In 1840 scarlet fever mortality doubled in Wales and England and until 1880 remained the principal infective cause of death to children, and accounted for 4-6% of deaths in all age groups combined. In 1863 the death rate for scarlet fever in England was 1500 per million, and 27,000 children out of every million born in Liverpool, died before the age of 5 of scarlet fever. By 1900 it had so declined that first measles and then diphtheria passed it as a cause of mortality. Recently it again appeared in mild form probably due to spontaneous causes rather than to modern drug and other treatments.

Leprosy

Leprosy was known among the ancient Hebrews and is mentioned in the book of Leviticus; this leprosy was that of the true Hansen bacillus, although the Hebrews had also other skin ailments. Leprosy was indeed prevalent in Europe in the 15th century, but already in the 11th century, leper visiting (much like slumming in Victorian and Edwardian days in England) had become quite fashionable in spite of the horrible stench of the lazarettos. (Leprosy is named after the disease of Lazarus, hence also the term “lazar houses.”) In the 16th century, leprosy disappeared almost completely from Europe and has subsequently never reestablished itself in Western Civilization, though remaining a major affliction in other areas of the world.

According to S. Rothman in his “A Dermatologist’s Trip to Japan”, published in the A.M.A. Archives of Dermatology for July 1959 (JAMA 172(12):108/1244), leprosy is common in Japan. There were 15,000 lepers in 1959, but in 1904 there were 30,000. The World Health Organization’s second expert committee on leprosy states that this disease, leprosy, affects at least 12 millions of persons throughout the world. Of these, not more than 100,000 can be given inpatient treatment at hospitals; some 1,500,000 sufferers receive treatment while remaining with their families. (JAMA 172(2): 166/186, 1960.) J. A. K. Brown in an article entitled “Factors influencing the transmission of leprosy” which appeared in the International J. of Leprosy, July-September 1959, states that climate, density of population and overcrowding are of secondary importance in transmission. Under natural conditions leprosy is not a children’s disease. The age of onset is determined by the opportunity for infection. Individual susceptibility or lack of resistance decide the issue whenever there is contact with infection. Susceptibility is a compound factor, and some or all of its components behave genetically; thus susceptible individuals belong to a race within a race.

Measles

To William Heberden, measles in 1785 was a mild distemper. In 1804 measles killed as many (mostly adults) as smallpox, and surpassed it in 1808. Until 1840 measles remained No. 1 killer for children, then began to ebb, and scarlet fever took first place for 40 years as the chief infection. Toward 1900 measles resumed its importance and by 1915 it caused deaths outnumbering those caused by a combination of smallpox, scarlet fever and diphtheria. Smallpox, measles and tuberculosis were epidemic in the 18th and 19th centuries and decimated Amerindian and Polynesian populations through contact with European explorers and invaders, but after a few generations, these diseases began to decline spontaneously and progressively. Measles, for which no vaccination, drug or therapeutic procedure is available, is much less a problem now than it was a few decades ago. The infection monster had been reduced to a mere shadow of itself before scientific medicine provided any rational or specific methods of control. German measles, formerly a trivial matter when contracted during childhood, today causes during early pregnancy, congenital malformation in the child. Professor B. F. Parker, New York Medical College, once said to his medical class: “I have recently given no medicine in the treatment of measles and scarlet fever, and I have had excellent success.”

Measles (and so also smallpox) were first described by Rhazes, a leader in Arabic medicine; he was born in Persia in 865 A.D. The Western World is deeply indebted to the Arabic World for the preservation of medical knowledge during Europe’s strife-torn Middle Ages.

It is of interest to note that comparative studies between the virus of measles and the distemper virus, made by Dr. Gun Carlstrom of the Karolinska Institute, shows that human beings who have had measles have antibodies against distemper also, and that injection of distemper virus in animals is followed by immunity against measles as well as against distemper. Comparisons between the two viruses showed that in spite of some differences, they were closely related. (J.A.M.A. 171(17): 117/2353.) C. I. Bliss and D. L. Blevins made a study in which they claimed that the attack rate of measles in susceptible Baltimore children during the first 31 years of this century shows a characteristic seasonal pattern when the rates are transformed to logarithms; its equation is a two-term Fourier curve with a maximum at the end of April and a minimum less than 5 months later in mid-September, the two differing by 30-fold. (Am. J. Hygiene, Vol. 70 (3): 328-334, 1959.)

Smallpox

Smallpox along with Roman strength defeated ancient Carthage. Smallpox ravaged Rome during the 2nd century A.D., killing also Marcus Aurelius. A negro in Cortez’s band of Conquistadores (long since immune) gave smallpox to the susceptive Amerinds, killing half of them and demoralizing the rest at a critical time. The epidemic plus Spanish arms and valor conquered the S. American continent.

Captain Bartholomew Gosnold explored the New England coast in 1602, naming Martha’s Vineyard, and found “the people of a perfect constitution of body, active, strong, healthful, and very witty.” A few years later, measles, scarlet fever, tuberculosis, other infections, alcoholism and especially smallpox had reduced the Indians from Narragansett to Penobscot from 9000 to a few hundred. The Puritans arriving in 1620 found their unburied bones. The Massachusetts tribe was reduced by infection from 30,000 to 300 in a short period. The pious English in 17th century N. America rejoiced openly as the Lord sent his “Avenging Angels to destroy the heathen.” When the Europeans realized that smallpox was as an effective weapon against Indians, they intentionally spread the infection among them with contaminated blankets on the self righteous pretext that smallpox helped to destroy the enemies of the faith (an example of applied “Puritanism”). Thus God was marshalled (ordered) onto the side of the lethal microbe. But the Spanish missionaries were worried that the conversion of S. American Indians to Christianity so often proved a death warrant for the Amerinds.

According to a report before the Pan American Health Organization there were 18,352 cases of smallpox in the Americas in 1948; in 1958 there were only 4,311 cases, a fourfold drop in ten years. But smallpox remains a major public health problem in this hemisphere since during this decade, of the total 103,491 cases reported in 15 countries and other areas, there were at least 16,000 deaths. The Pan American Sanitary Conference of 1958, held at San Juan, Puerto Rico, called for measures to eradicate the disease from the hemisphere.

Vaccination and Ignorance

With reference to the questionable efficacy of smallpox vaccination in comparison with the measures of sanitation prophylaxis, we add the comment of Sir William Creighton, one of the greatest of all epidemiologists, who declared that smallpox vaccination was a grotesque superstition.

Dr. Snow, Health Officer of Providence, R. I., reported in the Boston Medical and Surgical Journal that he had treated all the cases of smallpox, which had prevailed endemically in that city, without a particle of medicine, and that all of the cases–some of which were very grave ones–recovered.

Maybe such observations are responsible for the statement of Professor J. W. Carson, of the New York University Medical School: “We do not know whether our patients recover because we give medicines, or because Nature cures them.” In a similar vein Professor H. G. Cox of New York Medical College says: “The fewer remedies you employ in any disease, the better for your patient.” Professor Joseph M. Smith of New York College of Physicians and Surgeons says: “All medicines which enter the circulation poison the blood in the same manner as do the poisons that produce disease.” Professor Alonzo Clark of the New York College of Physicians and Surgeons says: “All of our curative agents are poisons, and as a consequence, every dose diminishes the patient’s vitality.” Professor St. John of the New York Medical College says: “All medicines are poisonous.” And Professor Martin Paine of New York University Medical School says in his Institutes of Medicine: “Remedial agents are essentially morbific in their operations.” And so Benjamin Franklin a long time ago was very modern and essentially correct when he observed: “It is the best physician who gives the least medicine. Drug physicians are quacks.” Even the late Dr. Oliver Wendell Holmes had to cry out: “If all drugs were thrown into the sea, it would be so much better for man, but so much worse for the fishes.” This is little different from the earlier statement of Voltaire: “Doctors are men who cram drugs of which they know little into bodies of which they know less, for diseases of which they know nothing at all.” Professor Gross says: “Of the essence of disease very little is known.” Professor Clark says: “Physicians have hurried thousands to their graves who would have recovered if left to Nature.” Dr. Evans, Fellow of the Royal College, London says: “The medical practice of our days is, at the best, a most uncertain and unsatisfactory system; it has neither philosophy nor common sense to commend it to confidence.” Dr. John Abernethy (London physician), in The Good, says: “There has been a great increase of medical men of late, but, upon my life, diseases have increased in proportion.” Professor Gregory of Edinburgh, in his Theory and Practice of Physic, says: “Gentlemen ninety-nine out of every hundred medical facts are medical lies; and medical doctrines are, for the most part, stark, staring nonsense.” Dr Ramage, Fellow of the Royal College, London, says: “I fearlessly assert, that in most cases the sufferer would be safer without physician than with one.” Dr. John Forbes (Sir), F.R.S., says: “Some patients get well with the aid of medicine; more without it; and still more in spite of it.” Dr Frank (eminent author and practitioner) says: “Thousands are annually slaughtered in the quiet of the sick room. Governments should at once either banish medical men, and proscribe their blundering art, or they should adopt some better means to protect the lives of the people than at present prevail, when they look far less after the practice of this dangerous profession, and the murders committed in it, than after the lowest trades.” Dr. John Mason Good, F.R.S., author of Book of Nature, Study of Medicine, A System of Nosology, etc., says: “The science of medicine is a barbarous jargon, and the effects of our medicines on the human system in the highest degree uncertain; except, indeed, that they have destroyed more lives than war, pestilence, and famine combined.” Dr. Jas. Johnson, F.R.S., Editor of the Medico-Chiurgical Review, states: “I declare as my conscientious conviction, founded on long experience and reflection, that if there were not a single physician, surgeon, man midwife, chemist, apothecary, druggist, nor drug on the face of the earth, there would be less sickness and less mortality than now prevail.” Napoleon said: “Doctors will have more lives to answer for in the next world than even we generals.”

George Bernard Shaw called the medical system in England a “murderous absurdity” and stated that “…until the medical profession becomes a body of men trained and paid by the country to keep the country in health it will remain what it is at present: a conspiracy to exploit popular credulity and human suffering.” Prof.. A. H. Stevens said: “The older physicians grow, the more skeptical they become of the virtues of medicine, and the more disposed to trust to the powers of nature.” Alonzo Clark said: “Every dose of medicine diminishes the patient’s vitality. In the zeal to do good, physicians have done much harm. They have hurried thousands to the grave who would have recovered if left. to nature.” Prof. B. F. Parker states: “Instead of investigating for themselves, medical men copy the errors of their predecessors, and have thus retarded the progress of medical science and perpetuated error.” Dr. Benjamin Rush stated: “The art of healing is like an unroofed temple uncovered at the top and cracked at the foundation. I am incessantly led to make an apology for the instability of the theories and practice of physic. Dissections daily convince us of our ignorance of disease, and cause us to blush at our prescriptions. What mischief have we not done under the belief of false facts and false theories? We have assisted in multiplying diseases; we have done more we have increased their fatality.” In view of all the foregoing observations, it is pertinent to add the comment of Claude Bernard: “When we meet a fact which contradicts a prevailing theory, we must accept the fact and abandon the theory, even when the theory is supported by great names and generally accepted.” Dr. W. C. Abbott, founder of the drug company bearing his name, understood the situation and with his flexible mind could summarize as follows: “It has seemed that the higher the standing of the physician, the greater has been his contempt for drugs.” With respect to some medical practice at least, we may feel inclined to agree with the professor who said, “There seems to be a preponderance of diarrhea of expression and a constipation of thought.” And this was brought out again in an incident reported in the J.A.M.A. for Dec. 13, 1958 (vol. 168, no. 15), which reads: “Some ten years ago the medical profession in Britain became involved in a debate on which position the body found most beneficial to lie in for sleep. It was agreed by the majority that the most restful position was to lie facing south!”

Drug Exploitation

Dr. Arthur Dale Console, former medical research director for a pharmaceutical house, told the Senate Antitrust Subcommittee that many drugs of high price but of low medicinal value are being foisted on physicians and patients by drug houses. He declared: “The incidence of disease cannot be manipulated, so increased sales volume must depend at least in part on the use of drugs…improperly prescribed.” He noted that the drug industry wears a cloak of “self-proclaimed virtue” for its costly research activities, stressing “that there are many failures for each successful drug.” He charged: “the problem is that they market so many of their failures.” Under present law, a new drug may be marketed, “if it cannot be shown that it probably will kill too many people.” Dr. Chauncey D. Leake, professor of pharmacology at Ohio State University, and president of the American Association for the Advancement of Science said the drug companies treat the nation’s physicians as “simpletons” by flooding them with “flamboyant, exaggerated advertisements” which “conceal for commercial reasons what is really essential for physicians to know.”

Those who take comfort in thinking that some of the contemplation in medicine is done more at the lower end’of the spinal cord than in the brain, will be gratefully reminded of that thoughtful dinosaur,

“…Famous in prehistoric lore,
Not only for his power and strength,
But for his intellectual length.
You will observe by these remains,
The creature had two sets of brains–
One in his head (the usual place),
The other at his spinal base.
Thus he could reason a priori,
As well as a posteriori.
No problem bothered him a bit,
He made both head and tail of it.
So wise was he, so wise and solemn,
Each thought filled just a spinal column.
If one brain found the pressure strong,
It passed a few ideas along.
If something slipped his forward mind,
Twas rescued by the one behind.
And if in error he was caught,
He had a saving afterthought.
As he thought twice before he spoke,
He had no judgment to revoke.
Thus he could think without congestion,
Upon both sides of every question…”

—Bert Leston Talor

Hope

Dr. Vannevar Bush in an article entitled “Professional collaboration” (Science, Vol. 125, 11 Jan. 1957, p. 49-54) strikes a hopeful note as follows: “A fascinating future surely lies before us, provided that we can escape certain perils, and the most heartening potentialities lie in the field of medicine and in the sciences adjacent to it. The time is coming when the practice of medicine will rest securely upon a firm scientific foundation, upon a systematic understanding of the life-processes in all their complexity, and no longer upon the insecure and shifting basis which partially supports it today, with clear understanding in part, but with a great mass of uncoordinated, empirical data necessarily as the main reliance.”

Typhus

Typhus was probably the plague of Athens which in 430 B.C. killed one-third of the city’s population, including Pericles. If this was not plague, it was measles, although other guesses have been yellow fever, scarlet fever, smallpox, typhoid fever, and dysentery. The Old Testament Job had typhus plague, the same that smashed the Philistines when they captured from the Israelites, the Ark of the Covenant. Plague devastated the 6th century (A.D.) Roman world for 50 years, hastening its end; although afflicted by it, the Emperor Justinian recovered. Plague killed one-half or two-thirds of the citizens of certain parts of the Roman world during the Justinian era, including those of certain English cities. The contemporary Byzantine historian Procopius wrote of the plague “that spread over the entire earth, afflicting without mercy both sexes and every age. It began in Egypt, passed to Palestine and thence everywhere else.”

Typhus plague struck Europe several devastating blows between the 14th and 17th centuries and remained rampant until the middle of the 19th century. This “Black Death” is reported to have killed one-fourth of the 14th century population, completely wiping out some towns and villages. England had repeated epidemics from the 14th to 17th centuries, culminating in the London disaster of 1664-65. Manpower became so short that grazing replaced land cultivation; the copyholder replaced the tenant farmer, and the enclosure movement spread over the land.

Typhus, dysentery and leptospirosis contracted by Napoleon’s march thru Poland and Russia, contributed to the disasters of 1812, along with Russian resistance and the winter hardships.

Typhus in Serbia, dysentery in Gallipoli, trench fever and influenza on the Western Front, all played their roles in World War I campaigns.

Typhoid

Dysentery and typhoid in World War II at times paralyzed the Italian army in Libya. Infectious hepatitis raised havoc with Rommel’s Afrika Korps, and also afflicted other elements of the German army. Typhus plague is highly fatal to Western World rats, but the plague bacillus, ubiquitous among Bombay rats, causes in them a mild inapparent infection, due to natural selective mechanisms. But whole populations of man or animals can be decimated by pathogens with which they had little previous contact. Today plague bacilli may be handled by controlling rodents which harbor the fleas carrying the bacilli, by eliminating the fleas, by vaccination, and by treating the affected with antimicrobial drugs. But sunspot cycles affect the weather; weather affects the crops; crops affect rodent abundance; rodents affect flea abundance; fleas affect plague bacilli abundance; plague bacilli affect plague incidence! So runs this cosmic unity.

Pneumonic plague exercised a tremendous killing power in Manchuria a half century back, introduced by Chinese hunting tarabazan (Manchurian marmot) for their pelts. These hunters gave the plague to Manchurians in the inns.

Influenza

Influenza in 1918 and 1919 in several consecutive waves killed about 20 millions of people (many more than from unrestricted global warfare). The “flu” virus may also have mutated to acquire the destructive potential of new invaders.

It has been experimentally demonstrated in mice that severe influenza virus infections of the mother may adversely affect the developing young by causing death. Mild infections may produce abnormalities of the fetus. In experiments with chick embryos, dilutions of influenza-A virus antiserum as high as 1:800 completely protected all embryos against both lethal and teratogenic effects following infection after mixture with the virus in vitro. Optimum protection was afforded when antiserus was administered before virus inoculation; the protective effect progressively fell off when immune serum was given from one to eight hours after virus injection (all lost by eighth hour). Controls not protected suffered 100% incidence of anomalies and death.

K. Bakos and co-workers at the Swedish Institute of Veterinary Medicine showed that the virus of influenza in cattle was identical with that causing parainfluenza-3 in human beings. The cattle disease in Sweden appeared in two forms, one with intestinal, the other with respiratory symptoms. (J.A.M.A. 171(17): 116/2352–117/2353.)

Tuberculosis

In a paper which Robert Koch read before the Berlin Physiological Society on March 24, 1882, he demonstrated the association of the tubercle bacillus with T.B. The low tuberculosis mortality in the West today is due, in part at least, to the result of the selective process effected by the great 19th century epidemic of T.B. which weeded out susceptible stock. This epidemic was effective only before and during the reproductive age, and not in old age. Adults are usually resistant to childhood diseases because they have overcome the disease during youth. This process of nature may be cruel and expensive, but it is more effective than medical procedures in the long run. The surviving population is endowed with a significant degree of natural resistance to T.B. Today man attempts to substitute for the natural mechanisms of biological adaptation sanitary procedures and immunization. There is convincing evidence (rabbit myxomatosis) that epidemics spontaneously decrease in severity through symbiotic adaptive changes affecting both host and parasite. Man takes pride in the illusion that medical practices have been THE factors of significance in the control of leprosy, measles, scarlet fever, syphilis, tuberculosis, etc. Fact is, some of the cataclysmic epidemics of history are traced to circumstances in which the evolution of the adaptive mechanism had no opportunity to operate.

In 20th century France, mortality from T. B. dropped 89% from 1919 to 1958. The greatest drop, 27.8% occurred in 1952 with the introduction of Isoniazid. Tuberculous meningitis dropped 87% from 1951 to 1958, whereas pulmonary tuberculosis dropped only 57.5% during this time, since treatment is often interrupted. The decrease in death rate is greater in the progressively younger people. T.B. is more deadly to the male since the elimination of high death rates of young women dying of galloping consumption and of pregnant women dying of tuberculosis cavitations.

The annual report of the National Tuberculosis Association states that some 55 millions of people are infected with the tubercle bacillus, according to estimates based on skin sensitivity tests, and that the statistical odds are that approximately 5 per cent of these, or 2.75 millions of people, will break down with active tuberculosis during their lifetimes if the development of active disease among the infected continues at the present rate. (Science, Vol. 126, 18 October 1957, p. 743.)

In 1945 T.B. mortality in Europe and N. America was about 500 per 100,000 population; by 1900 it had fallen to 200, and by 1945, it was 50, a ten-fold decrease. No drug therapy was available, and no vaccination practiced. The mere introduction of a microbe does not establish an epidemic. T.B. was described at length in the literature of the crowded cities of ancient India, Greece, and Rome, but not given reference, in the lore of pastoral peoples (viz., Bible peoples). The way of living is critical, so also social history and economic revolutions, which shift people from country to city. Long work hours, exhausting labor, dark factories, damp offices, suffocating atmospheres of coal mines, filth, crowding, slums, child labor, stress, gin and vice, are all important factors in epidemics.

Epidemic mortality soars to its highest peak shortly after the shift from rural to industrial economy, and as prosperity spreads, epidemics lose their acute character and mortality falls. This decline is partly due to biological and social forces quite independent of the introduction of specific therapeutic measures. England and America first became industrialized and first recovered from epidemics; Latin America and Asia, yet in the initial stages of industrialization are experiencing epidemics in their full devastation.

TB and Renaissance

Tuberculosis was common in the Renaissance urban society of Italy. The Florentine beauty, Sinonetta Catanea Vespucci (1459-75) died at an early age of consumption. She was Queen of Beauty in a tournament and Lorenzo de’ Medici admired her; she sat often for the artist Botticelli and her physical type remained the artistic type after her death. Botticelli’s models had the consumptive stigmata: long slender neck, sunken cheeks, and steep sloping shoulders. The wives of Dante Gabriel Rossetti and William Morris were artists’ models for the English pre-Raphaelite schools of painting. G. B. Shaw saw these as the “long, cadaverous women with sensuous lips.” Nineteenth-century T.B. inspired Keats to write: “Youth grows pale, spectre thin and dies.” Artists like Nicolo’ Paganini, “pallid and corpse-like,” and Rachel the divine actress, “white like alabaster,” had their dramatic effectiveness on the stage heightened by tuberculosis. T.B. was so common that good health came to be regarded as a sign of vulgar taste, and consumption was regarded as endowing its victims with creative genius and a peculiar spiritual quality. The Russian wonder child Marie Bashkirtseva, maintained in her diary that T.B. added to her charm: “I cough continually! But for a wonder, far from making me look ugly, this gives me an air of languor that is very becoming.”

To the Style

In his memoirs of 1823 and 1824, Alexander Dumas writes that “it was the fashion to suffer from the lungs; everybody was consumptive, poets especially; it was good form to spit blood after each emotion that was at all sensational, and to die before reaching the age of thirty.” The poet Byron once said: “I should like to die of a consumption because the ladies would all say, ‘Look at that poor Byron, how interesting he looks in dying!'” This perverted sentimental attitude to disease–a form of spiritualization of the being, an aristocratic decline of humans, resulting in an ethereal release of the soul, rather than a potent killer and effective producer of destitution and desolation–remained to the end of the 19th century, when the public came to scorn “the infirmerie litteraire,” the “sad, the leprous, the languorous elegies,” that the “lyric poet would weight no more than 99 pounds,” and now considered that “the man of genius must be obese.” In Samuel Butler’s Erewhon (1872), illness is a crime in utopia. “Whether your being in a consumption is your fault or not, it is a fault in you…you may say that it is your misfortune to be a criminal; I say that it is your crime to be unfortunate.”

The man of the Western World is dismayed because in some parts of the world syphilis, malaria, yaws, intestinal disorders, etc., are regarded not as diseases, being so common; yet he accepts as essentially normal for himself, poor vision, chronic sinusitis, allergy, baldness (some monkeys have genetic baldness also in the male), and other defects which may well be regarded as handicaps or repulsive traits in other cultural contexts.

Syphilis

Syphilis first struck Italy February, 1495 when the French army entered Naples, and since Columbus returned from Hispaniola March 4, 1493, the Amerinds were blamed for giving it to the returning Europeans. Syphilis brought by the French army to Italy, struck with acute and terrifying effects. The Italians called syphilis the “maladia francese,” and the French returned the compliment by calling it the “maladie Napolitaine.” Syphilis spread, caused loss of hair and the general use of the ruff and the wigs as part of the male’s costume. The Roman public baths were considered a source of infection and so rapidly abandoned. A terrible outbreak of syphilis occurred in 1495-1520 at the peak of the Renaissance. Even a pope contemporaneous with Martin Luther had it and befouled the air. It is common knowledge that syphilis cannot be contracted by contact with syphilis-contaminated plumbing. How then a celibate pope could have contracted syphilis, remains a profound and unsolved mystery. (The contemporary Paracelsus characterized both the pope and Luther as two harlots discussing chastity.) The disease was widespread throughout all social classes. Indians of the East Indies in the 16th century had syphilis but it caused them little trouble. Ulrich von Hutten described the lesions of syphilis, and Jacques de Bethencourt, a Rouen physician, referred to syphilis in 1527. By 1548, syphilis was a much milder disease in Europe (as in our own times), and Fracastoro so described it in his poem, “Syphilis sive Morbus Gallicus,” published in Verona, 1530.

Renaissance religious sermons “proved” venereal disease a sign of God’s anger and that sex was an ally of sin. Even in 1920 a German magazine made the claim that if syphilis, “the punishment inflicted by nature on vicious men,” should ever become curable, then both morality and society would come to suffer from a “moral syphilization even worse than that of the body.” The hero Adrian in Thomas Mann’s Doctor Faustus (1947) is talked into believing that “The act of procreation, esthetically disgusting, is the expression and the vehicle of original sin,” and he deliberately embraces a prostitute who has warned him of her syphilis. D. H. Lawrence thinks that the knowledge of the consequences of syphilis gave a “great blow to the Spanish psyche” and conditioned the Puritan attitude in England and America. The common oath of Elizabethans was—”pox on you!”

Too Costly

Samuel Pepys entered the following for Dec. 14, 1762 in his diary: “Have been in London several weeks without ever enjoying the delightful sex…Many-fold are the reasons for this my present wonderful continence…I have suffered severely from the loathsome distemper, and therefore shudder at the thoughts of running any risk of having it again. Besides, the surgeon’s fees in this city come very high.”

Reference is made to gonorrhea in the Bible, and the disease is described by both Greeks and Romans. Gonorrhea of Galen’s day was spermatorrhea, rather than the contagious urethritis of gonococcus which he also knew. In 1378 John of Ardenne in England published a reference to gonorrhea, and from the 15th century on, European literature dealt with the “burning” or “clap.” Shakespeare described gonorrhea, and so also Andrew Boord in 1546. Today, both syphilis and gonorrhea are readily amenable to penicillin.

Eli Lilly had on the market in 1898 a plant extract called “succus alternans,” the secret of which was taken from the Indians who used it as a remedy for syphilis. It may be that this extract was rich in vitamin C, and it might also be that this vitamin is effective in syphilis.

In New York City there was a nine-year decline in syphilis following the 1946 postwar peak, from an incidence of 78.7 per 100,000 of population to an incidence of only 7.7 per 100,000 of population. The chemical synthesis of penicillin was achieved finally, by John C. Sheehan, in 1957, at MIT, where he is professor of chemistry; he was assisted by K. R. Henry-Logan in the achievement of this baffling problem, wherein 39 other World War II laboratories in the U.S. and Great Britain failed.

The Colorado State Department of Public Health reported that the 10-to-19-year-old age group has consistently accounted for about 20% of all gonorrhea cases reported in the state. In the infectious syphilis cases, however, this group represented a little over 10% of the total. Until last year (1959) they accounted for 22% of all early infectious syphilis cases reported in the state. In 1958 for ages 10-19, there were 11 cases of infectious syphilis reported, or 12.36% of the total for all ages of 89 cases. (J.A.M.A., 172(14): 128/1532, 1960.)

Antibiotics of various kinds are produced in nature by molds, algae, bracket fungi, toadstools, Gorgonian coral polyps (or their associated algae?), mountain ash, onions, some conifers, etc. The broadening spectrum of antibiotics has now extended to include inhibition of various large particle viruses (trachoma, psittacosis, lymphogranuloma), phages, rickettsiae, bacteria, yeasts, molds, algae, protozoa and neoplastic tumors. Antibiotics are used not only for the chemotherapy of infectious diseases, but also in the nutrition of domesticated animals, in crop protection and in food preservation.

Adeno Virus

The sweating sickness (today masquerading perhaps as an attenuated influenza or adeno virus), ran a short but extremely acute course in Tudor times, never again to return in any recognizable form. From 1485-1551 several outbreaks afflicted England and the Continent somewhat. In England it paled into insignificance even the dreaded plague.

Poliomyelitis

Paralytic poliomyelitis afflicted King Siptah of the 19th Egyptian dynasty as seen from sculptures, paintings and x-ray photos of mummies.

Poliomyelitis raised havoc among Greenland Eskimos a few years ago, having acquired the virus from innocent American and European visitors. As long as polio virus was widely distributed and so infected every child after birth when the immunity conferred by maternal blood was at a high level, paralytic polio was extremely rare. But sanitary policies present new problems, since first contact with the virus is delayed and infection is acquired later when maternally conferred immunity has disappeared, resulting in increasing paralytic and fatal polio in both young and adults. Accordingly, the increase in incidence and severity of polio is noted principally in the most sanitary nations–the reward of a combination of impoverished foods, effective plumbing and social hygiene!

In the U.S. there were in 1958, 5987 cases of polio (85 during the last week alone), of which 3090 were paralytic. Texas ranked first with 530 cases, and New York State second with 523 cases. In 1959 there were 8531 cases of polio, 5661 of which were paralytic. (JAMA 172(3): 26, 1960.)

The incidence of poliomyelitis dropped thru the last weeks of September and October 1959 in the USA, after an upsurge in early September which followed a previous decline. In Germany (1959), inoculation with poliomyelitis vaccine is not yet generally accepted in wide segments of the population, due as it was explained, to the diminishing incidence of the disease. Also in Germany, the Salk vaccine was not entirely satisfactory, since paralytic cases occurred, and in the United States, some patients died after three injections.

Salk Vaccine

Here are some of the nervous complications associated with vaccination against poliomyelitis. One girl aged 2 years, and 5 boys aged 1.5-12 years, after vaccination against poliomyelitis with the Salk vaccine, developed nervous manifestations in the course of one week after the first and second injections, which included flaccid pareses, spasms, obnubilation, disturbances of swallowing and respiration, as well as febrile reactions, sore throat, rash and bouts of eczema. The nervous reactions were allergic in five of them, being radicular, myelitic and encephalic. In the 2-year-old boy, allergic vaccinal complication could not be excluded in the light of his symptoms: extensive paresis of lower limbs, high fever on the 6th day after the first injection, somnolence, complete paralysis except for head and face muscles; his respiration was superficial and his cough weak. In two days there was further deterioration, since he could not turn his head and there was pronounced respiratory insufficiency, difficulty in swallowing, high fever and obnubilation. After ten weeks the boy was essentially recovered except for mild weakness in legs and feet. Thus we are told to expect disturbances of the central nervous system which are not always mild, along with local reactions like sore throat, urticaria, gastrointestinal disturbances and anaphylactic shock.

K. A. Brownless, professor of statistics, of the U. of Chicago faculty, stated that 59% of the 1954 polio serum test was worthless because of inadequate controls.

Dr. Herbert Ratner, Health Commissioner of Oak Park, Ill. stated: “Finally, we should recognize that only one side of the ledger is being presented by the promoters of this vaccine. The price that has been paid and the risks that have been taken for the dubious results that have been obtained are not mentioned. The price that we have paid, and are continuing to pay, goes far beyond those known vaccinated children who have come down with poliomyelitis”…”The Chicago mass immunization program in 1956 was not only an unequivocal failure, but in addition the vaccine provoked paralysis. The evidence for this has been disregarded by public health officials. By August 2, 1956, one out of every two cases of polio reported in Chicago was in a vaccinated child. In spite of more rigorous diagnostic standards than those employed in former years, last year Chicago had the second highest incidence of polio in its history. One-third of the polio cases (349) were in Salk-vaccinated children and 212 of these were paralytic. Evidence that indicates the epidemic was caused by the vaccine has not been considered or ruled out by authorities.”…”In making these charges I am not unmindful that I risk my position and my professional future. But if our profession and each individual professional man is not dedicated to the search for truth and to the welfare of patients entrusted to his care, then ours does not deserve to be called a profession and we should recognize ourselves for what we are in danger of becoming—automatons, robots, slave technicians.”

According to Dr. Morris Greenberg, director of the bureau of preventable diseases of the New York City Department of Health, in his talk to the AAAS audience Dec. 27, 1956, in New York State poliomyelitis fatalities among children under fifteen decreased by 75 to 90 per cent in the period from 1915 to 1955. This he attributed to a drop in the rate of the paralytic type of polio. Using these figures as a base, he then forecast that for those children born from 1950 through 1954, the expected mortality rate will be 0.2 to 0.8 in each 100,000 by the age of fifteen, and this without the aid of the Salk vaccine. The Salk vaccine, or any similar polio vaccine will according to Dr. Greenberg, have to prove itself by bringing about “a more rapid reduction in mortality.” (New York Herald Tribune, Friday, December 28, 1956.)

Yellow Fever

Yellow fever remains a problem in Trinidad, Venezuela, Colombia, Honduras, Central America, Caribbean ports, Union of S. Africa, Egypt, India, Pakistan, Curacao, Aruba and Dutch possessions. For travel to these areas, immunization against yellow fever is required. Since the French neurotropic yellow fever strain of virus given by scarification causes too high a rate of encephalitis reactions, the 17D yellow fever vaccine is recommended which usually gives only a headache and muscular pains in the back and extremities after ten days—general reactions from a live virus and generally mild and occurring in only 10% of patients.

In the Western World, the 14th century had leprosy; the 15th had plague and sweating sickness; the 16th had sweating sickness, gonorrhea, and syphilis; the 17th and 18th had smallpox; the 19th had scarlet fever, typhus, dysentery, leptospirosis, measles, tuberculosis (the 19th century has been called the GLORIOUS CENTURY!); and the 20th had typhus, dysentery, trench fever, pneumonic plague and influenza.

Thus the infectious diseases replace one another. In 1803 Malthus (Essay on Population) wrote: “I feel not the slightest doubt that, if the introduction of cowpox should extirpate the smallpox, we shall find…increased mortality of some other disease.” Sixty years later, William Farr wrote (annual letter to Registrar General, London): “The infectious diseases replace one another, and when one is rooted out it is apt to be replaced by others which ravage the human race indifferently, whenever the conditions of healthy life are wanting. They have this property in common with weeds and other forms of life, as one species recedes another advances.” —And so, Farr was borne out by the typhoid and influenza that followed during the next half century.

Paleopathology

The records of paleopathology attest to the extremely ancient occurrence of well-known microbial and organic disorders in man and other animals.

Aortic arteriosclerosis affected Merneptah, Pharaoh of the Exodus, 1200 B.C., and other Egyptians of the 18th-20th dynasty, as well as later Greeks and Coptics (evidence from mummies found).

Mummies demonstrate the presence of silicosis, pneumonia, pleurisy, kidney stones, sinusitis, gallstones, liver cirrhosis, mastoiditis, appendicitis, meningitis, smallpox, leprosy, malaria, T.B., and congenital liver atrophy.

Schistosomiasis was a parasitic disease in Egypt 2000 years ago. Egyptians were plagued by lice and the ancient Peruvians by sand fleas (to wit, the lesions on the soles of their feet).

Rickets, due to insufficient insolation, has been identified in neolithic bones of Denmark and Norway.

Arthritic disease occurred in Neanderthal man, in the neolithic caves of France, in ancient Egypt, and in ancient Peru, in dinosaurs (arthritis deformans), in Eocene and Pleistocene mammals, in Miocene crocodiles, in Pliocene camels, in extinct cave bears (“cave gout,” or Hohlengicht of Virchow).

Malignant bone tumors are uncommon in prehistoric man and other animals, but they have been found in Egyptian mummies of 3400 B.C., in human remains in Peru, N. America, France, fossil horses and in cave bears.

Scurvy helped to defeat the Crusaders and gave failure to many sea and land explorations.

The Confederate army was so short on protein (ate corn and molasses) that on many occasions they lacked the strength to pursue and exploit to complete victory, military advantages gained early in the day over the Northern meat and dairy-product eating armies.

The undernutrition consequent to the Allied blockade contributed to the military defeat of Germany in World War I.

Dental Disease

Dental disease is found in very few fossil animals but neolithic human skulls in France had a 3-4% caries incidence, so also the skulls in the prehistoric site of Tepe Hissar in Iran 4000-2000 B.C. Despite common belief, caries afflicted man long before the advent of candy and soft foods. Caries were rare in predynastic Egypt but with developing civilization, every form of dental disease struck the favored class rather than the poor who are on coarse, uncooked diets. Today’s African tribes attest similarly. Luo children, which live in towns and eat manufactured foods, have a 28% caries rate; Banyaruanda are poor and can ill afford sugar and tea and their children have only an 11% caries rate. Australian aborigines eat the tough and rubbery kangaroo meat; they have healthy periodontal tissues, few caries, and can greatly exceed in force, the bite of more civilized man.

In 1960 America and Europe, as well as in many other civilized areas, dental disease is practically everybody’s disease. The annual American dental bill is $1,700,000,000 and represents more than one-sixth of America’s total expenditure for “health.” In spite of 100,000 dentists in the U. S., only one-third of all tooth damage is being repaired. The backlog of unfilled dental cavities in the U. S. has been estimated to be about 700 millions, and to eliminate this, it would require about 250,000 dentists working for a period of ten years. In addition to the money involved, how much shall we allow as the money-value of the working-time lost, cut in productivity, and the pain endured, as well as the inconvenience? R. F. Sognnaes, in an article in Science (Dec. 18, 1959) and entitled “Dentistry at its centennial crossroads” states: “It is a century now since organized dentistry became established in the United States, in 1859….Dentistry has arrived at a point where the modern dentist can all but improve upon nature.” The rhesus monkey of India has beautifully calcified dentin, and the wild chimpanzee of central Africa has some faulty granular calcification of the dentin, but Homo sapiens, including the prehistoric cave-dwellers of Mt. Carmel in Palestine, has interglobular spaces in the dentin completely uncalcified, a defect particularly widespread in modern civilized man. In comparing teeth attacked by dental caries in Primitive and in Modernized groups of people, for Primitives it is only 1%, but for Moderns it is 33 % (J. Appl. Nutr. 12(4), 1959).

The dental goal must move away from extraction and restoration, to control and better yet, prevention. As Bacon said, “He that will not apply new remedies must expect new evils.”

Fluoridation

For the benefit of the misguided, who are victims of the fluoridation fad, Richard Launt Maurer and Harry Gilbert Day, published the following in the Journal of Nutrition, volume 62, number 4, in August 1957, in an article entitled: “The non-essentiality of fluorine in nutrition.” Their findings are here summarized in their own words: “By means of exhaustive purification procedures it was possible to prepare a diet which proved to be nutritionally adequate for the maintenance of experimental rats through three generations and the beginning of the 4th generation when the experiment was terminated. The diet was estimated to contain no more than 0.007 ppm of utilizable fluorine. Rats maintained on this diet, but receiving 2 ppm of fluoride in their drinking water, did not show significant improvements in health or weight gain over similar animals receiving the same diet and redistilled water to drink. Alkaline and acid phosphatase determinations on the kidneys, livers and bones of deficient and supplemented animals showed no differences which could be attributed to the fluorine supplementation. The teeth of both supplemented and deficient animals appeared to be sound and without gross evidences of decay or defects. The investigation has demonstrated that under the rigorous experimental conditions employed, fluorine is not a dietary essential.”

Also, the late K. K. Paluev, engineer of General Electric, and member of the national ad hoc committee for the evaluation of fluoridation, proved by the U. S. Public Health Service’s own figures, that at Grand Rapids and Newburgh, the pilot demonstrations of what fluoridation would do, that there was no prevention of tooth decay in the children but rather a delay of some 18 to 24 months. The U. of New Mexico reported that 1 part of sodium fluoride in 15 millions in water inhibited vital enzymes as much as 50%; thus sodium fluoride is a potent poison and is officially recognized as such.

Drs. F. B. Exner and G. L. Waldbott, in their book, The American Fluoridation Experiment, have documented the arguments against fluoridation; they also unleash a devastating indictment against certain officials of the Public Health Service who should know better, and who in their efforts to “put over” fluoridation, “have deliberately falsified, distorted and suppressed evidence” through their “official opinions” and actions.

The Public Health Service notes that the trend is away from new fluoridation programs for community water supplies. During the past three years the increase in the number of persons drinking fluoridated water has lagged substantially behind the growth in urban population. During this three year period, the number of persons not benefiting from fluoridated water has increased from 73,500,000 to 76,800,000. Since 1956 the number of communities taking positive action on fluoridation has declined steadily, dropping to a low of 97 in 1959 compared with 233 in 1956. The PHS complains as follows: “If this trend continues, a rapidly increasing number of children in this country will be deprived of safe, effective, and inexpensive protection against one of the most widespread diseases–tooth decay.” (J.A.M.A. 172 (2): 28, 1959.)

As in so many things, so also in the fluoridation issue, the remark of Mark Twain is most pertinent: “The trouble with people is that they know too many things that ain’t so.”

The bulk of our health education effort in America is devoted to specious propaganda about disease, not health. And we do indeed belabor the American public about the individual’s chances of falling victim to this or to that affliction, disease or plague. We must return to the original and realistic view of public health which was and still remains that particular public discipline which in the realm of health, does for the people as a group, what the people cannot do for themselves individually.

IV. Explanation of Current Status of Man With Respect to Infectious Disease, Victory Over Which is Far From Complete

Notwithstanding the widespread and dominant medical and official pervading opinion, it is neither medical practice nor exact laboratory science which provided modern man with his current status with respect to infectious disease, but rather the techniques to avoid disease arising from social measures aimed at correcting the ugly injustices introduced with industrialization. Huge populations were crowded in factory and tenement of mushrooming cities during the Industrial Revolution, and people lived in squalor and with mental and physical misery, social and health problems became acute, and reform movements arose all over Europe and became intensified into the 1850-1900 period. Public health practices produced spectacular improvements in both the nutritional and sanitary state of the Western World. This achievement is not to be credited to medical or laboratory science, but to the conviction of 19th century reformers that since disease was invariably associated with the pollution, filth and want of the industrialized world, health could be restored by a return to the simples of pure food, pure water, pure air, and wholesome surroundings, all of which they reasoned were the inherent qualities of a life in contact with nature herself. Thus the improvement in health during the second half of the 19th century began long before the modern era of clinical medicine was introduced with the advent of the germ hypothesis of disease causation.

Recent work by H. M. Edwards, Jr., H. L. Fuller and S. W. Hess along these lines is to the effect that chickens grown in contaminated quarters have a much higher requirement for certain nutrients than do chicks grown in fumigated quarters (J. Nutr., 70 (3): 302-306, 1960).

Technology Dominates

Both modern clinical medicine and laboratory science are only 11th hour factors in a campaign against disease that was started a century and a half ago. But now both of these occupy the center of the “health” stage everywhere. Even so, their role has not been either so unique or completely effective as is commonly claimed, because the monstrous infectious specters of leprosy, typhus, plague, the sweating sickness, etc., had become enfeebled shadows of their former virulence, or all but disappeared from Europe long before the advent of the germ theory, and still longer before the advent of serums, vaccines and drugs for combat with microbes. Even the general state of nutrition began to improve, and the size of the labor class children began to increase before 1900 in N. America and in most of Europe. Thus modern clinical medicine and science are “come-latelys” in helping to clean up the debris emerging from industrial and urban civilization, since the job of catharsis had been carried far toward the finish by both the humanitarians and social reformers of the 19th century. The biological and economic forces introduced in the second half of the 19th century increased the resistance of the social body to infection before the introduction of control measures inspired by the germ theory of disease.

Rheumatic fever was a supreme killer of children a few decades ago. The decline is world wide, and in 30 years more, rheumatic fever may be as rare as typhoid today. In the 1920’s, eight out of 100 died within a year after the first attack of this fever, and sixteen died within 2-5 years. In the 1950’s, only one died during the first year out of 100, and only two out of 100 in 2-5 years. In the 1920’s (decade), only 15 out of 100 escaped permanent enlargement of the heart from rheumatic fever. In the 1950’s (decade), 28 out of 100 escaped. This change to the better has been due to several factors: overall improvement in the standard of living for the urban poor, the isolation of streptococcus carriers; the protection of infected patients; sulfa; penicillin; and the probable natural mutation of the disease in a favorable direction as a result of both more resistant hosts (children) and less vigorous streptococcal bacteria.

The Better Approach

Even though we grant the obvious usefulness of sanitation, immunology, and antimicrobial drugs, it does not necessarily follow that microbe destruction is the only approach to infectious disease problems, or necessarily the best approach. No longer do we believe that the only good Indian is a dead Indian; both whites and Indians can and do coexist peacefully and gain mutually. Unfortunately for us, the view that some form of ecological equilibrium can be and should be maintained between microbe and potential victim, has not been popular with medical scientists and physicians. All men including the so-called healthy Americans, become infected with a multitude of parasites of diverse and sundry types–staphylococcus, streptococcus, tubercle bacilli, influenza virus, intestinal disorder viruses, paralytic virus, worms, protozoans, etc. Thus the presence of pathogens can produce a diseased state, but usually does NOT. Many become a little tuberculous and live normal, creative lives. Many millions of young folks acquire the polio virus yet suffer no harm from the infection.

We are apt to be struck by the dramatic episodes of microbial conflict rather than by the more common fact that infection can and does occur without producing disease.

Hygeia Neglected

Health and fitness are considered the normal state and therefore unnoticed and so the cult of Hygeia tends to be neglected and the skills of Aesculapius loom large and bright in the mind of man. For the same reason today the school of public health plays second fiddle to the school of medicine.

Originally the viruses of poliomyelitis and of German measles were of very trivial importance, but are becoming increasingly grave threats in the West following improved sanitary practices.

Max von Pettenkofer, who regarded hygiene as an all-embracing philosophy of life, persuaded the city fathers of Munich to bring in clear water from the mountains, and to dilute the city sewage downstream in the Isar. With the clean-up, typhoid mortality fell From 72 per million in 1880, to 14 in 1898. Munich became one of the healthiest of European cities, thanks to Pettenkofer, a man entirely uninfluenced by and unconvinced of the germ theory of disease. Similar programs in Europe and N. America during the second half of the 19th century removed yellow fever from Barcelona and Alicante, and typhus morbidity and mortality decreased wherever sanitation prevailed. The boards of health who introduced anti-filth campaigns did not believe in contagion, let alone in the germ theory of disease. So also, T.B., the Great White Plague, was forced to recede by good and healthful living.

Since after 1900, death rate decreases appeared obvious to all, scientific medicine and the germ theory in particular have been given all the credit for the improvement in general health. —Even now, our generation goes further and believes that infectious disease control dates from the widespread use of anti-bacterial drugs! The truth is this: Mortality from infection had begun to recede in W. Europe and N. America long before the introduction of specific therapy methods, and even before the demonstration of the germ theory of disease.

The overemphasis on eternal life and other mystical values of medieval Christian faith, led to the neglect of sanitation without necessarily decreasing sensual enjoyment among normal men and women. St. Hildegarde believed God did not abide in healthy bodies, although the ancient Greeks believed health was the greatest of gifts. Today technology is a dominant force as it displaces religious and philosophical values in determining human fate. Eating habits may even be determined by acquired tastes and current social conventions and innovations in preference to nutritional requirements, and the physical acts of love may be performed for pleasure rather than for procreation. We may engage change for the sake of change, and so in 1957, 40,000 adults in Michigan alone registered to go hunting with bows and arrows!

Miracle Drugs

The sulfonamides of 1935 are now regarded as antiquated drug store items. The therapies of the pre-1930 era receive only lip service in the dusty volumes on library shelves. Antibodies can stop otherwise fatal subacute endocarditis and some forms of bacterial meningitis, and can interrupt the acute infectious process of streptococcus, pneumococcal pneumonia, bacillary dysentery, gonorrhea, and syphilis, make sepsis a rare occurrence, and so extend surgical skills. Modern chemotherapy may change the pattern of disease in the West, but it is not achieving a CONQUEST of microbial disease. Mortality from infections is at an all-time low, but the amount of infectious disease still remains very high. Drugs are effective in dramatically acute conditions which are relatively rare, but are less effective in the myriad of chronic ailments which afflict so much misery in daily life. Antibacterial drugs at best are but a drop in the bucket in wearing down infection-induced mortality in the West. Microbial diseases have not been conquered. For a relative protection from them, we pay a great ransom in terms of days lost from pleasure and work, in sums paid for drugs, hospitals and medical fees.

Gonorrhea in man has been readily amenable to antibiotic therapy since 1935; the gonococcus microbe is very vulnerable to penicillin. Yet gonorrhea has not been wiped out in any land or social group. Its control involves other factors which are physiological and social, not amenable to drug treatment. The incidence of gonorrhea is rising. The socioeconomic factors are complex, but the influence of alcohol and prostitution is clear. The major causes of failure at control lie in the asymptomatic nature of this infection in the female along with the persistence of a reservoir of gonorrhea in a small promiscuous section of the female population. There is also the threat of penicillin resistance.

Dr. William A. Albrecht had this to say: “The tremendous amounts of antibiotics now being used in fighting bacteria point to the desperation with which man is grasping at the self-protecting biotics in the very lowest level of life forms. He has not fostered development of self-protection by his own body through guided nutrition.”

Artificially maintained germ-free animals appear and function normally, reproducing themselves also. But when exposed in less esoteric environments, they fall prey to the omnipresent microbes and soon die of infection in the open world. They are deficient in lymphoid tissue which is operative in antibody resistance to infection, and this tissue is normally produced as an adaptive and protective response to microorganisms, as in newborn babies.

Germ Free Animals

Speaking of animals grown under germ-free circumstances, Dr. William Albrecht points out a number of facts as follows: “One of those is the fact that if the germ-free chick’s diet is compounded to be ‘deficient in a single vitamin’ (like riboflavin, or niacin, or thiamin, or folic acid), ‘the germ-free chick will show deficiency symptoms much sooner than the normal chick.'” (“Worlds without germs.” The Laboratory. Fischer Scientific Co., 27: 130. 1959) “Another is the fact that scholars in these germ-free researches are astounded by the incredible natural phenomenon in that both the germ-free and the conventional chick will excrete the very vitamins omitted by their diets. The amounts excreted are such that would save their lives if taken orally. This second and outstanding fact emphasizes the natural contribution to health and survival of the animal’s instincts, or choices, which are exhibited, for example, by the experimental rat when it indulges in what is scientifically termed ‘coprophagy’ or eating of feces.” (J. Appl. Nutr., 12(4), 1959.)

Bernard Wostmann and Edith Bruckner-Kardoss, working at the Lobund Institute at Notre Dame, noted the development of cecal distention in germ-free baby rats, and concluded that the absence of stimulation by a microbial flora, rather than a nutritional deficiency due to sterilization of the diet is the prime etiological factor in this phenomenon. (Am. J. Physiol., 197(6): 1345-1346, 1959.)

The greatest strides in health improvement were achieved in areas of disease responding to social and economic reforms after industrialization. Overall better nutrition was one of the measures, sanitation another, and general raising of living standards still another.

Degenerative Diseases

But cancer, vascular disease, and mental disease, not affected by the sanitary movement, remained, and are today without a solution in sight. We must reform aspects of our physical and social environment which perpetuate disease peculiar to our times. Stress, air pollution, chemical agents and defective nutritional regimens are implicated in these diseases. Treating diabetes with insulin does not prevent vascular disorders, and also tends to increase diabetic incidence thru improving chances for inheritance of the disorder.

According to the specialist in the cardiovascular system, Joseph B. Wolffe, after 30 years of clinical work, no less than 70% of cardiovascular disease is caused by the environmental stress of a status-seeking society, in which the artificially generated urge to keep up with the Joneses is too great to bear with equanimity.

According to Dr. Finland, et al, physicians who are overconfident of germ-killing drugs are living in a fool’s paradise wherein their patients may die. Deaths caused by bacterial infections in the bloodstream dropped steadily beginning in 1937 with the introduction of the first antibiotics (sulfa drugs), and continued to do so until 1947, whereafter the rate remained low or dropped further for deaths caused by pneumococci and the dreaded streptococci organisms most vulnerable to sulfas and antibiotics. But during the same 12 years, there has been an absolute increase in deaths from other bacteria. Optimists who think it old-fashioned nonsense to talk about fatal “blood-poisoning” are wrong since there are now more deaths from septicemia than there were before the antibiotic age. Among the worst offenders is Pseudomonas aeruginosa, or the blue-pus organism which today crops up more frequently and with greater virulence; also Aerobacter, found naturally on many food plants, in water and milk and in man’s digestive tract, once rated almost harmless, is now a killer.

According to the JAMA, up to 1955, in addition to many bad. reactions, antibiotics administered were responsible for 282 deaths in the USA due to anaphylactic shock, aplastic anemia and induced virulent infections. Clearly, at least one-half of these died from unnecessary antibiotic administration; such activity is a threat to medical standards. (JAMA 158 (14): 1330, 6 Aug. 1955). And for drugs in general, the JAMA records 107 fatalities in 5 years between Dec. 1946 and Sept. 1951, in the USA. (JAMA 147 (5): 377-379.)

According to T. G. Johnston and A. G. Gazort, in an article entitled “Prevention of deaths from penicillin” (J. Ark. Med. Soc., Nov. 1959), penicillin causes more deaths than any other drug, and deaths from immediate reactions to penicillin continue to occur. In 1956 Feinberg and Feinberg had estimated that more than 1,000 deaths had already occurred from penicillin. In anaphylaxis, death comes quickly, and aqueous epinephrine (1:1,000) stands alone as the only drug acting quickly enough and effectively enough to save a life from the penicillin reaction. (JAMA 172(11): 92/1126, 1960.)

According to Stevens and to Slanetz, some antibiotics can diminish the antibody production to antigens, in experimental animals, and it is known clinically that antimicrobial drugs can suppress both the development of measurable antibodies and of active immunity, as in infections with salmonella and rickettsiae. Chloramphenicol only suppresses salmonella growth and clinical symptoms, but does not eradicate this infection.

Antibiotics can also increase host susceptibility to infection through the suppression of normal flora, thus permitting the multiplication of undesirable organisms. Thus streptomycin may enhance susceptibility to streptomycin-resistant salmonella; the same applies to tetracycline.

Ionizing Radiation

Ionizing radiation can severely impair antimicrobial defenses in the host and cause animals or people to die from a bacteremia caused by otherwise normal intestinal organisms. Irradiation knocks out the host defenses against Gram negative bacilli. When we forget the role played by the host in infection, the result is a gross distortion of the chemotherapeutic approach. We must support the natural defenses and recuperative powers of the host, and this means non-specific support of the host. Infection creates a tissue deficiency; a tissue deficiency predisposes to infection. In a paper by B. W. Zweifach, E. Kivy-Rosenberg and A. L. Nagler, and entitled “Resistance to whole-body x-irradiation in rats made tolerant to bacterial endotoxins,” rats were treated with three conditioning agents (bacterial endotoxins, zymosan and compound 48/80) known to produce tolerance to other forms of stress, as at means of determining the importance of the reticulo-endothelial system in the response to whole body irradiation. Effective protection was provided by tolerance induced by lipo-polysaccharide extracts of E. coli bacteria. Some protection was also afforded by conditioning with 48/80 for several days. These agents were active only when administered before exposure to x-rays. Treatment post x-ray broke down the induced resistance. Blood platelet levels remained high in conditioned animals exposed to whole body irradiation. The authors suggest that a relationship exists between the priming or conditioning of the reticuloendothelial system and the maintenance of satisfactory blood platelet levels in adapted animals. receiving whole body irradiation.

Even now, chronic bronchitis is clearly epidemic in some areas of Northeastern Europe, and England it rates with arteriosclerotic heart disease as a cause of death and causes 15% of premature retirement from work due to ill health. In 1951, bronchitis caused a loss of 26.6 millions of days of work in England, and killed 30,000 people, affecting chiefly adults and older folks, like lung cancer and heart disease. Bronchitis, lung cancer and heart disease are ominous to the contemporary male. Bronchitis is related to air pollution by industrial and domestic smokes. The 4% day London smog of late Dec. 1952 killed 5,000 persons along with the prize cattle in the sanitary stalls of the Smithfield Show. Other cattle standing in barnyard manure, emanating ammonia, escaped because this gas presumably neutralized the irritating sulphuric and sulphur dioxide gases in the smog. The smog is “the pestilence that walketh in darkness,” and California knows about this also. Today, no antimicrobial drug or vaccine can give prophylaxis or control bronchitis, or sinusitis—TV ads to the contrary notwithstanding!

The U. S. Public Health Service in its weekly report on morbidity and mortality, for October 30, 1959, stated that in 1958 there was an increase of about 9% in the number of cases of infectious hepatitis (16,294 cases) over the 1957 figure (14,922 cases). Infection is still a big problem.

When in 1855 Southwood Smith lectured that “Epidemics are now under our control….We have banished the most formidable,” he was brash. It is true that cholera, plague, remittent fever, malaria and typhus had all but vanished in London following the anti-filth campaign, a change in social pattern, like others such as swamp drainage, shortened working hours, introduction of inexpensive cotton undergarments easy to launder, and of transparent glass to bring light to the humblest dwellings. A century later, in 1955, we heard many lecture that the conquest of disease had been effected by the use of antimicrobial drugs, whereas those drugs were not then in existence!

Negative Approach

Medical planners of today conjure up a universal gray state of health, corresponding to the absence of disease, rather than to positive health filled with creative, full and joyful living.

Success in medicine today (as in religion always), depends in large measure on inspiring faith, no longer in the healing powers of the ground-losing ancient gods, but in a modernized cult of mystery. Men have been indoctrinated to worship at the altar of current medical technology, and to believe in the “miracle” drugs of its priesthood, and its spectacular surgical feats. These produce the “evidence” and the “validity” for unproven hypotheses, and give to current medical practice, the mysterious air of authority of a priesthood whose aura and magic have come to substitute for the allurement of the less rational ancient mysteries, and also remain profitable. To the modern physician, health is a negative state meaning the absence of disease. By training and social tradition medicine has to do with disease and not with health. The maintenance of health and the prevention of diseases are cultural problems.

Population Increase

Despite common belief, the fivefold population increase in the world since the 17th century has occurred quite independently of disease control. In 1650 the world population was 450 millions; today it is 2.5 billions, and the increase began 300 years before and continued even thru the great epidemics in even those countries not enjoying the benefits of modern medicine. A medical utopia must be taken “cum grano salis.” We may say of physicians what Napoleon Bonaparte said about coquettes, and of men of wisdom: “It pays to see them, to converse with them, but it is usually unwise to select a wife or a cabinet minister from among them.”

In 1949 Americans spent 11 billions of dollars on medical and institutional care of disease, equal to more than 5% of the national income in 1949; add to this another 2% by reason of disability to be employed. In 1952, a million families spent 50% of their entire family income on medical care; of these 8 millions were in debt because of medical expense.

According to the Health Insurance Institute, the average American spent $95 on health care in 1958; the total bill was a new peak of $16.7 billions, or $1 billion more than in 1957. Physician of fees amounted to $4.8 billions ($1.3 billions covered by insurance), hospital costs were $4.5 billions ($2.6 billions covered by insurance), medicines and appliances cost $4.4 billions; another $1.3 billions went to osteopaths, chiropractors, eye-glass fitters, private duty nurses, and nursing homes ($20 millions). Health and hospitalization premiums cost $5.9 to billions, and benefits amounted to $4.7 billions. The total does not include $5 billions spent by federal, state, and local governments for health. Insurance covered 123 million people for hospital expenses, 111 millions for surgical expense, and 17 millions for major medical services. Hospital admissions in the U. S. exceed 20 millions annually, and the next few years will bring increasing demands for hospital facilities.

In 1955, over 50% of the hospital beds were filled with persons mentally ill, at an annual cost of $2,867,877,311 and no sense. Along with the sorrow and tragedy there was a total loss in man hours that year of 1,000,000. There is also the continuing problem of marginal mental ability, which reminds me of what a husband said to his wife: “I took an aptitude test this afternoon; it’s a good thing I own the company.”

A Nation of Invalids

These figures reflect an alarming trend. Our culture claims the highest health standards in history but also compels itself to spend ever-increasing funds for disease control. Now really, are we the healthiest nation on earth, if not among the worst off? Do we enjoy the advent of a millenium of good health? We seem to be suffering from new viruses, from poison contamination of foods and drink, from food impoverishment, from overstuffing with foodless foods, from smog, from pulverized rubber and motor exhaust, from man-made radiation, and from industrial chemicals like benzene with its leukemogenic action. We need a new crusade for pure air, pure water, and pure food–I say a militant offensive in behalf of these for the sake of humanity. We can launch and sustain the attack, and render printed stamps of approval on successful measures. We require bold amateurs and professions with humanitarian, philosophical and aesthetic knowledge and belief. Knowledge is power.

Large spurts in population during historical times have also been coincidental with new agricultural practices, new trade policies and the like that improved the quantity and distribution of food. The bean, sheep, goats, corn, sweet potatoes, peanuts, and white potatoes, have all played their part in various sectors of the world. Benjamin Franklin in his essay (Observations concerning the increase of mankind and the peopling of countries), believed that in 100 years, there would be more Englishmen west of the Atlantic than east of it, and regarded immigration and emigration both of little significance in affecting population size. He said: “If you have room and subsistence enough…you may of one make ten nations…or rather increase a nation ten fold in numbers and strength.”

But other factors like certain religious ethics, need for family labor, fondness of children, efforts to save children’s lives—all help to “up” the population even with food shortage, as in Asia today.

The use of DDT in Ceylon reduced malaria and infant diarrhea. At the same time this public health measure cut the overall death rate in half and raised the birth rate to such an extent that the Ceylon population rose rapidly. In Ceylon, after World War II, the spraying of once malarial areas with DDT produced a 33 per cent population increase from 6.8 millions to 9.1 millions within little more than a decade. Wars and epidemics have, in general, only transient effects on population trends. The Justinian and Renaissance era plagues, and the more recent influenza era losses were made up in a few decades by population increases in each case.

A medical investment of 14 cents per person has been known to cut a country’s death rate in Latin America, Africa and Asia by 50% and sent rates of population increase soaring even when birth rates stayed steady.

In Washington’s Commerce Department building a light atop the “U.S. Population Clock” flashed every 11 seconds to mark the birth of another American; but a world population clock would have been flashing 3 times per second! The United Nations Department of Economic and Social Affairs says: “With the present rate of increase, it can be calculated that in 600 years the number of human beings on earth will be such that there will be only one square meter for each to live on. It goes without saying that this can never take place; something will happen to prevent it.”

A new genealogical book published in Germany says that religious reformer Martin Luther, who was born 476 years ago (1483-1546), now has 1,834 descendants.

Constant Population

From the end of the Roman Empire until the 16th century, human numbers remained constant at an estimated half-billion, but fluctuating with war, disease, famine and favorable conditions. During the 17th, 18th and 19th centuries, the world population doubled to 1 billion. During the 19th century it doubled again to 2 billions. Since 1900, the increase is accelerated along a course whose steepening curve would, in any other form of life being studied, clearly indicate that it must level off or run into disaster. Paul B. Sears puts it this way: “Whether we consult the physics of dynamic particles, the observations of laboratory and field, or the lessons of human history, certain conclusions are plain. Stress and sacrifice of freedom increase with crowding. They also increase when energy is added to the system, as is happening to human society with its extravagant use of fossil fuels and internal combustion engines. One evidence of this lies in an annual highway death toll exceeding our nation’s battle fatalities in World War I. Another lies in the tragic increase of personality disturbances, while present international tensions doubtless owe as much to terrestrial crowding in a technological era as to that perennial scapegoat, the innate perversity of human nature.” Sir Charles Darwin, grandson of the father of Organic Evolution says that, with or without birth control programs, humanity is going to breed itself into chaos, and if the present rate continues, the time will come when there will be “standing room only” signs all over the earth.

All around demands are on the increase. “Robert is six months old. When he is 16 years our nation must have…tens of thousands of miles of new highway, almost double our present water supply, double our school facilities, 20 millions of new homes, 20% of our present housing rebuilt, 2½ times more oil, 60% more lumber production and double today’s pulpwood production, 55% more metal ores, soil conservation on 1,159,000,000 acres, 123,300 new dams, many miles of levees, double our present hospital facilities, and triple our electric power.”

Conservation

All these considerations give grave concern to the conservationist. We can summarize the arguments about world population problems and available resources by quoting from Prof. Kenneth Boulding of the University of Michigan, in a Princeton seminar on “Limits of Earth” in 1955.

“A Conservationist’s Lament:
The world is finite, resources are scarce,
Things are bad and will be worse….
Fire will rage with man to fan it,
Soon we’ll have a plundered planet.
People breed like fertile rabbits,
People have disgusting habits….”

On the other side of the ledger are additional considerations. Gordon Wrigley said in 1957, that 10% of the earth’s land area that is cropped, produces 90% of the world’s food supply; and the 20% of the earth’s land area that is covered with grassland, produces the remaining 10% of the world’s food. Herbicides amount to 35 millions of dollars in sales annually in the U.S.A. One chemical plant worker producing 2,4-D is equivalent in toil to 4,000 farmers armed with hoes to control weeds. Weed killers can control unwanted growth in onion patches at one-tenth the cost of hand weeding which runs about $60.00 per acre. The difference in the superior agricultural productivity of the Japanese in comparison with that of India, it is explained, lies in the Japanese farmer’s use of insecticides, better seed, and vastly more chemical fertilizer. And the United States, surfeited with food, has put 22.5 millions of acres of once productive land into its soil bank. It has been said that one day, industrial and agricultural technology could make it possible to feed ten to fifty billions of people, four to twenty times the present 2.5 billions in the world today.

In view of the more optimistic statements, there comes the following reply to the lamenting conservationist:

“The Technologist’s Reply:
Man’s potential is quite terrific,
You can’t go back to the Neolithic.
The cream is there for us to skim it,
Knowledge is power and the sky’s the limit…”

Life Expectancy

Much credit is claimed by modern clinical and laboratory science for the current and century-long increase in life expectancy in the Western World. This assumption is gratuitous and fallacious in the light of the fact that increased life-expectancy is not due so much to better health in adult years of life, as it is to the spectacular decrease in infant mortality from childhood microbial diseases, which in turn resulted far less from new drugs than from better nutrition coupled with practices of sanitation. Very little progress of a practical and applicable nature has been made in controlling diseases not dealt with by the 19th century Sanitary Revolution, that is, ailments of adult life and old age. While infectious disease is markedly submerged, degenerative disease remains and increases. This gives some point to the humorous comment that while most Americans are “dead” at 30, they are buried at 60, the intervening 30 years of life sustained by reduced activity, and by physical, medical and mental crutches. Modern man, although no wiser, is assuredly more conceited in his scientific knowledge and medical technology, in taking credit for a change to the better which was effected before ever he came on the scene, and which would have occurred in spite of him, if he had been there earlier.

In spite of his self-deluding boasts, the life expectancy of an American past age 45 is hardly greater (according to Dubos) than it was several decades ago, and is even now shorter than that of many current-generation Europeans. Americans die like flies from No. 1 killer, cardiovascular disease, and from No. 2 killer, cancer. Heart disease, cancer, strokes, and accident accounted for 71 per cent of all deaths in 1958, according to final data on 1958 mortality that have been released by the Public Health Service’s National Office of Vital Statistics. The 1,647,886 deaths that occurred in 1958 constituted a national death rate of 9.5 per 1000 population, compared to a rate of 9.6 in 1957. The number of deaths and the rate per 10,000 population (figure in parentheses) for each of the four leading causes of death in 1958 are: Heart disease, 637,246 (367.9); Malignant neoplasms or cancer, 254,426 (146.9); Vascular lesions, chiefly strokes, 190,758 (110.1); all forms of accidents, 90,604 (52.3), of which motor vehicle accidents constituted 36,981 (21.3). In Pennsylvania alone there were 18,856 fatal cancer cases in 1958, or 169.9 per 100,000 population. This is 11% higher than in 1950 when it was but 155.3 per 100,000. One-fourth of all American citizens spend months or years in a mental asylum, and not ALL of this could be due to TV advertising!

Strategy of Desire

Since advertising has engaged the services of behavioral science, the public mind is being molded into any shape like soft putty even to the belief in Living Modern, with a Thinking’s Man’s Filter in a Cancerette, or a Thinking Man’s Oil Filter in the automobile! It is pertinent to add the comment of Dr. Samuel Johnson in 1700: “The trade of advertising is now so near perfection that it is not easy to propose any improvements, but as every art ought to be exercised in due subordination to the public good, I cannot but propose it as a moral question to those masters of the public character whether they do not sometime play too wantonly with our passions.”

America’s 58 million smokers smoked 465.9 billions of cigarettes in 1959, amounting to a pack per day or more, thus burning up $6 billions worth of worthless tobacco. If all “goes well” and the incidence of lung cancer continues to rise, tobacco production will jump by 18% by 1965 and by 53% by 1975. Weak Willed characters, including some medics and others who ought and may know better, have gone so far as to rationalize the miniature bonfire habit by laying claim to the healthful nature of smoking in reducing high blood pressure!

A study of Carl C. Seltzer of Harvard University claims that the “Weakness of the masculine component is significantly more frequent in smokers than in nonsmokers and most frequent in the heavier smokers.”

Smoking during pregnancy substantially retards fetal growth. It may be that tobacco has a direct pharmacological action on the fetus, since the fetal heart rate increases when a pregnant woman smokes a cigarette. An even more credible explanation is that smoking limits the blood supply to the fetus. (JAMA 171(15): 185/2127—Small babies for mothers who smoke.)

Dr. J. A. Nadel at the Cardiovascular Research Institute, University of California, says that the free passage of air in and out of the lungs is cut by 50% for about an hour by 10 inhalations of cigarette smoke. This airway resistance occurs without being noticeable to patient or physician. Smoking a pipe, cigar or cigarette without inhaling did not affect airway resistance. He thinks that the inhalation of very fine particles, rather than any chemical in the smoke, causes narrowing of the smaller airways of the human respiratory system.

It is also known that cigarettes high in tar and nicotine also rank high in flavor, and that filters and mild tobacco mean reduced flavor. The tobacco industry research committee has recently released information to the effect that smoking taxes damaged hearts, and that tobacco users absorb 90% of the nicotine to which they are exposed.

“Tobago”

The word tobacco comes to us from the Caribbean Indian name for the primitive pipe, the “tobago” in which they smoked tobacco (Nicotiana tabacum). The Scottish physician, William Barclay in 1614, and so also Sir Walter Raleigh, Sir Francis Drake, and Jean Nicot (whence the word nicotine), popularized tobacco by saying that it was good for the health.

There were other views on tobacco. King James I of Great Britain said that tobacco was “the lively image and pattern of hell,” and so found an excuse for slapping a big import tax on this plant material. Louis XIII of France, and Czar Michael I, decreed penalties for smoking ranging from death to something even worse–Castration! Pope Urban VIII threatened excommunication for anyone found smoking in church or on church grounds and premises. Dr. Benjamin Rush (signer of Declaration of Independence, and after whom Rush Medical School in Chicago is named), attacked tobacco on grounds of health. Both Henry Ford and Thomas Edison vowed they would not knowingly even hire anyone who smoked. In 1918 Billy Sunday the evangelist said: “Prohibition is won; now for tobacco!” Some psychologists have stressed that one of the biggest elements in smoking is oral gratification, an unconscious return to the breast. But psychiatrist Sigmund Freud, holding a big black cigar before his class, said: “Just remember, it is not always a symbol–sometimes it’s just a cigar.”

In view of the multiple threat of tobacco smoking to health, it is understandable that health-minded physicians do not smoke (at least not in principle!). They realize that more can be taught by their own example, than by precept.

Mismanagement

Western man, misled by a blind medical philosophy, refuses to recognize, and much less to correct, the gross, intense, and prolonged mismanagement of his daily life. His pretense to health, even to superior health, is a national mental aberration verging on a self-blinding obsession. He thinks the present state of “health” is the best in world history, while at the same time increasing numbers of persons depend on medical aid in meeting ordinary simple daily problems. He spends 10% of his income for medical care. Hospitals cannot be built fast enough to accommodate the ailing. The need for hospitals is supported by the cry that 98.6% of all our people are sick or defective. But in defense of our retarded health system the cry goes out that we are the healthiest nation on earth! These contradictions are possible only since the mouth has two sides from which to utter statements of convenience.

In 1635 there lived in Shropshire, England, a man named Thomas Parr, said to be 152 years old at the time. Although he remarried at the age of 119, the results were not fatal. He had lived quietly, but when the Constable of England heard of him and ordered him to London where he was presented to the King, wined and dined, he promptly died. William Harvey autopsied him and found his vitals normal and healthy, no arteriosclerotic calcification, no anatomical cause of death, and so was said to have died of surfeit, and was buried in Westminster Abbey.

Unusual in America is the long life, 117 years, of Walter Washington Williams, last Confederate veteran of the Civil War. He died at last on Saturday, Dec. 19, 1959, because “he just quit breathing,” but contributing factors were the blood clot in the brain vessel, several attacks of pneumonia during this year, and senile malnourishment.

George Douglas, born in Sweden, married at age 85, had eight children, and died at age 120.

John Tyler, our tenth president, married at 75 and fathered a talented daughter. (This phenomenon did not require the good neighbor policy.)

Uncle Mark Thrash of Chattanooga, Tenn., passed his 122nd birthday.

Henry Jenkins is reported to have swam rivers at age 100 and died at 190. This is proof positive that swimming too many rivers will eventually kill.

In the early 1920’s a baggage-porter of Constantinople, Turkey, had a verified age of 154 years and was going strong.

Ripley reported on Kamdar, “India’s Oldest Man,” age 135 years.

A Chinaman, Li Chung Yun, of Los Angeles was reported to be 256 years old and still living at the time.

Between the ages of 75 and 83, Commodore Vanderbilt added 100 millions of dollars to his fortune.

At age 74, Kant wrote his philosophical masterpiece.

Tintoretto painted his biggest and most famous canvas when he was 75.

Verdi was 85 when he wrote “Ave Maria.”

Cato decided to study Greek when he was aged 80, and Goethe was also 80 when he finished Faust.

Titian painted his historic “The Battle of Lepanto” when he was 98 years young!

While the expectation of life at birth has increased by more than 20 years since the turn of the century, this has been almost entirely due to prolonging the lives of persons who formerly would have died in infancy, childhood or young adulthood. This has resulted largely from the control of infectious diseases. But there has been no significant change in the average lifetime remaining to those who have reached age 65 or 70. Thus there has been no increased longevity, but only an increased life-expectancy upward to the age of 70 or thereabouts. This is in agreement with the 1951 release from the Federal Security Agency. Decline of mortality from communicable diseases has led to a shift in the ages when most deaths occur. The Public Health Service says that deaths at ages under 45 dropped from 57% of all deaths in 1900, to 17% in 1958. But deaths among persons over 65 years rose from 24% of all deaths in 1900, to 58% in 1958.

Infant Mortality

The annual loss of life in early infancy is still very high in the U.S., more than 76,000 babies dying each year within one month of birth. And the so-called degenerative conditions, cardiovascular disease and cancer, now cause more deaths among children of school age in the U.S. than all the infectious and parasitic diseases combined. (JAMA 155(8): 739, June 19, 1954; JAMA 147 (15): Dec. 8, 1951.)

Life expectancy in Caesar’s Rome was about 22 years; in Medieval Europe, it was about 33 years. In India between 1921 and 1931, expectation of life at birth was about 27 years, less than half of that of the U.S. at the same time. For the world as a whole in pre-World War II days, average length of life was determined to be about 35 years.

A dog lives about 10-15 years, a monkey about 30, a horse 40-50, and turtles from 200-300. Predictions for maximum life expectancy for humans vary from 105 to 150 years, but the average is something else as the following table will show. These figures do not represent average old age attained, but rather the average age of death when infants and children are included, and they do suggest a high infant mortality.

17th century man in Breslau had an average life expectancy of 33.5 years.
18th century man in Sweden had an average life expectancy of 41.5 years.
1850-1900 man in Sweden had an average life expectancy of 44.6 years.
1890 citizen in the U.S.A. had an average life expectancy of 40.0 years.
1900 citizen in the U.S.A. had an average life expectancy of 50.0 years.
1920 citizen in the U.S.A. had an average life expectancy of 56.0 years.
1940 citizen in the U.S.A. had an average life expectancy of 64.0 years.

According to the Metropolitan Life Insurance Company, the expectation at birth, of length of life in the U. S. was in 1859, 42 years (three-fifths of that in 1957), in 1900, 49.3 years, in 1947, 66.8 years, in 1954, 69.6 years, in 1956, 69.6 years, the highest of all so far, since in 1957 it fell to 69.3 years due to Asian Influenza and other upper respiratory infections during the late months of 1957. Credit for this 70-year expectancy must go in part to improved diets, skillful surgery, increased public health measures, general rise in the standards of living, and better medication. It is said that 1.5 millions of lives were saved between the years of 1937 and 1952 by the chemotherapy of sulfa and antibiotics, but very likely most if not all of these could have been saved more simply and inexpensively by proper attention to the bolstering and support of the normal immune mechanisms of the body, very important in which would be a complete and wholesome diet including adequate amounts of vitamin C and other pertinent metabolites.

On April 7, 1960 the Russians claimed still another triumph over capitalism. Presumably they also invented longevity. The Russian republic claims to have nearly three times as many men and women over 100 years of age as the United States. The Russians claim 81 centenarians per million population as compared with only 30 centenarians per million in the United States. There are supposed to be 9500 Russians 100 years of age or over, including more than 100 citizens ranging from 120 to 156 years of age.

Eating When Old

With respect to nutrition in old age, the scars of the past may not be eradicated, but at least the progress of deterioration may be allowed to halt or even brought to a halt. Without constructive changes in our ways of life, we pay a penalty for increasing life expectancy through the degenerative diseases. Much of what we have previously accepted as normal aging is in part at least, accumulated deficiencies; such senile changes can be reversed by optimum nutrition with emphasis on protein.

V. Natural Mechanisms of Immunity and Role of Nutrition in Immunity to Infectious Disease

Bacteria susceptible to bacteriophage via lysis, swell and disintegrate by bursting following markedly increased bacterial metabolism and hydrolysis of cytoplasm. The highly hydrated ions of highly diffusible urea penetrate the bacterial cells and so accomplish this transfer of water.

There is the Properdin system, discovered by Pillemer, and which consists of the serum protein properdin, magnesium ions, and four components of complement (JAMA 170(4): 158/502. May 23, 1959).

It was the Prussian army surgeon, Emil von Behring who discovered the Humoral mechanism of immunity. According to Talmage, unique combinations of natural globulins provide an alternative to the classical concept of immunological specificity, which requires unique globulin molecules for each possible antigen. He says: “Many hitherto separate facets of the antibody response such as antibody diversity, cross reactions, natural antibodies, increased mitoses in lymphatic tissue, the anamnestic response, and immune tolerance may be related through the general thesis that antibody production is not a unique biological phenomenon but a highly specialized example of certain general cellular processes.”

According to a review article in the JAMA 140:784, 1949, it is the lymphocyte which produces antibodies, residing in alpha, beta and gamma globulins endowed with immune properties.

And Axelrod points out that available evidence indicates that certain B-vitamins, notably pyridoxine, pantothenic acid and pteroylglutamic acid, play a significant role in antibody synthesis.

Joshua Lederberg in discussing the relation of genes to antibodies, has discussed in Science, the question which he raised: “Do antigens bear instructions for antibody specificity or do they select cell lines that arise by mutation?”

Along similar lines, Jack Schultz in discussing antigens and antibodies as cell types, asks and discusses the question: “How does cell heredity change when hostgraft relations are altered or antibody formation is stimulated?”

Metchnikoff over 50 years ago formulated the cellular theory of resistance to infection, stressing the role of polymorphonuclear leukocytes (solidist theory of immunity) in eliminating microorganisms from animal tissues. Today we know of three other factors in these leukocytes, (a) lysozyme, a low molecular weight protein which enzymatically degrades the aminopolysaccharides of the cell wall of Gram-positive microorganisms and so kills them, (b) phagocytin, a protein which alters the cell wall of susceptible microorganisms such as various Gram-negative enteric bacilli, and so destroys them intracellularly and (c) local accumulations of organic acids giving a pH near 4.5 within the leukocyte which either acting alone, or in conjunction with phagocytin or lysozyme, is lethal or inhibitory to many microorganisms ingested by the leukocyte.

Other factors which inhibit multiplication of bacilli in tissues include organic amines in the tissues such as spermine and spermidine, oxygen deprivation, high carbon dioxide tension, acidic pH in necrotic foci and accumulation of several organic acids.

Inflammation

Inflammation may be one of nature’s defenses against virus infection, since inflammation raises local acidity by increasing the carbon dioxide, glycolysis and lactic acid production. Along this line it is pertinent to refer to the work of G. T. Barry and W. F. Goebel of the Rockefeller Institute for Medical Research, New York, who reported in a recent issue of Nature. They refer to a chemical, colominic acid, found in a strain of colon bacillus. This is the first time that an acid of this type has been discovered in bacterial cells. This is a new type of acidic carbohydrate and is very rich in a.substance resembling sialic acid. When combined in its native state with protein and other sugars, the sialic acid-containing complex interferes with the adherence of certain viruses, such as the influenza virus, to living cells. (Science, Vol. 125, 5 April 1957, page 639.)

Goebel (’57) et al have demonstrated that the symbiotic Escherichia coli in the intestine have the ability to kill specifically certain other strains of enteric bacilli by excreting into the medium, colicine K, a lipo-carbohydrate protein complex, presumed to be related to bacteriophage yet differing in that it cannot be transmitted by serial passage.

Fever

There is much evidence that fever is another of the organism’s natural defenses against virus multiplication. A French microbiologist demonstrated that when the temperature of a subject is raised from the normal of 98.6 degrees Fahrenheit, to 104 degrees, there is a decrease in the rate of polio virus multiplication by 250 times. When mouse temperature is raised from 98.6 to 102.2 with the external temperature at 96 degrees, no animals died of Coxsackie virus and no virus was demonstrated after two days. But if the external temperature is dropped to 39.2 degrees, all animals die following inoculation with Coxsackie virus. When Dr. Andre Iwoff (Pasteur Institute) kept his mice inoculated with many times the lethal dose of virus, at an outside temperature of 68 degrees, they all died within ten days, but at an environmental temperature of 97.7 degrees, they were all alive after 15 days. But when the temperature was brought down to 68 degrees Fahrenheit, all animals died.

In a similar vein, Dr. Wolfgang-Dietrich Muller (Bielefeld) regards the increased fluid secretion by the nasal mucosa as one of the body’s defenses against viral invasion. Drying up the mucosa (usually with antihistamines), may simply prolong the battle. The fever that results from many virus infections is also widely regarded as a major defense mechanism, and might therefore best be allowed to run its course. (Time, 22 Feb. 1960, p. 60; a report based on an article in the February 15th issue, 1960 of Munich’s Medizinische Wochenschrift.)

Studies in experimental fever, with reference to the pathogenic role and chemical properties of leukocytic pyrogen, suggests that endotoxin fever is produced by the following mechanisms: intravenous injection of bacterial endotoxin is followed by interaction of endotoxin with circulating leukocytes; then follows a release of leukocytic pyrogen into the blood stream; there occurs then the action of leukocytic pyrogen upon the thermoregulatory centers of the brain; then follows the well known fever. (W. B. Wood, Jr., D. L. Bornstein and G. W. Rafter, Science 131, 29 April 1960, p. 131.)

The “shock attack” on the autonomic nervous system provides a salutary stimulus, because as a result, the regulatory processes of the organism are stimulated into action and established anew.

D. E. Rogers in an article entitled, “Observations on the nature of Staphylococci infections” (Bull. N. Y. Acad. Med., Jan. 1959) attempts to explain the survival and protection of staphylococci from substances present in the extracellular fluids and which would ordinarily destroy them. It is his current thinking that intra-cellular residence protects the bacteria. Staphylococci surviving within polymorphonuclear leukocytes may play a role in this surprising persistence of microorganisms within the blood stream. (JAMA 171(15): 126/2068, 1959.)

Resistance

It is pertinent here to introduce the comments of Parish on inherited immunity, or innate non susceptibility to infection: “Different animal species vary in their resistance to bacterial parasites and toxins. Thus, for example, man is resistant to canine distemper and rinderpest, and the dog and cat do not get measles, poliomyelitis, typhoid fever and cholera.

Sometimes the differences between species are not complete or absolute, as in the above instances, but partial or relative. The mouse is relatively insusceptible to diphtheria toxin—relatively, that is, to the susceptibility of the guinea pig. The dog and goat are rarely infected with tetanus, and the man seldom develops avian tuberculosis. The frog is unaffected by tetanus toxin in the cold, but succumbs on warming. The fowl is naturally immune to anthrax, but on exposure to low temperature contracts the disease and dies.”

Dr. H. A. Schneider (Rockefeller Institute, N. Y.) reports on work which shows that animals can have an inherited resistance to infectious invaders, or an inherited susceptibility, or as is usually the case, be randomly bred with no particular selected inheritance. Thus animals are not too resistant or too susceptible. Thus in the natural world, nutritional forces are important in determining the outcome of infections. Man is a product of random breeding and this being so, gives us great control over our health and makes the search for optimal nutrition most rewarding and of paramount importance. Adopting the ecological view, we can understand how healthy animals make short shrift with invaders. But malnourished animals are likely to develop infectious symptoms and even succumb.

In an article in the Aug. 8 issue of This Week, 1954 (reprint of article in Reader’s Digest, Nov. 1954), Dr. Eugene Payne discovered two villages “in Brazil where cases of malaria were unknown although in towns less than 100 miles away almost every inhabitant was a victim of the disease. In another section of Brazil, Dr. Payne reported a complete absence of tooth decay while tests of the drinking water in the area failed to show any trace of fluorine used artificially in many United States cities to reduce tooth decay.” “His travels in Peru took him through a mountain valley where the natives enjoyed a natural immunity to intestinal parasites or hookworm, the most common infection in neighboring regions. Back in the Brazilian states it was cancer which had failed to penetrate the mysterious wall of immunity although cases of malaria and hookworm numbered in the thousands. A Bolivian island of immunity showed that instances of mental illnesses occurred at such rare intervals that the native vocabulary lacked a word for insanity.” (Marquette Alumnus, Nov. 1954, p. 5) Thus he found islands of immunity to cancer, heart disease, malaria, tooth decay, hookworm and insanity.

Antibodies—Immunity

Just because there may be high titres of antibody or antitoxin in the blood, it does not necessarily follow that this is identical with immunity. For example (JAMA 146(1): 100, Sept. 1951), an article in the JAMA discusses immunity against diphtheria and says: “There is far too much tendency to confuse antitoxin in the blood stream with immunity and to use the two terms interchangeably. That antitoxin in the blood does not necessarily confer immunity is shown by the development of diphtheria in persons receiving antitoxin a short time before onset. The immunity to diphtheria that follows the natural disease is far more effective than that which follows injections of bacillus-free toxoid because the patient develops tissue resistance as a result of contact with the bacilli, as well as antitoxin resulting from contact with toxin. Thus authentic second attacks of diphtheria are rare.”

Bush sickness in Australia occurs in sheep pastured on soils deficient in cobalt, a metal required by bacteria which normally synthesize vitamin B-12 in the gut, and B-12 is a nutritional requirement for sheep. This is a nutritional relationship between animals and the world of microbes. Microorganisms in the intestine manufacture B-vitamins essential to the nutrition of the host organism.

Milk

The intestine of breast-fed infants contains almost exclusively the Lactobacillus bifidus bacteria, very different from the more common bacteria predominating when the diet consists of cow’s milk. And so the Lactobacillus plays an important role in the greater resistance of breast-fed infants to enteritis during early infancy.

It still remains to be proved (if possible at all), that pasteurized milk in a paraffined carton has any advantage over the ripened caseins of natural cheese, since lactic acid fermentation greatly interferes with the multiplication of disease-producing bacteria in milk. Incidentally, the beneficial Doderlein bacillus of the female genital tract, has been recently declared to be identical with the Lactobacillus!

B. Campbell, M. Sarwar and W. E. Petersen of the University of Minnesota studied diathelic immunization, a maternal-offspring relationship involving milk antibodies. A report of this work appeared in Science 125, 10 May 1957, pp. 932, 933. I quote from it as follows: “The extraordinary speed with which the mammary gland returns specific antibody upon direct immunization with bacterial antigens has led us to experiments testing the hypothesis that in intercurrent infections of the young, injection of the antigen through the teat orifice during the act of nursing may lead to the return of specifically immune milk.” Tests with cows showed the agglutination test positive in the front experimental quarter in 4 hours, in the rear experimental quarter in 6 hours. “The mammary gland functions as an exocrine reticuloendothelial gland. This status is made more meaningful by the delineation of the process whereby the act of sucking can inject organisms into the gland and thus cause an outpouring of specific antibody in subsequent feedings. We suggest the term diathelic immunization for this phenomenon and the term diathelic immunity for the state induced. Augmenting the well-known transmission of maternal immunity to the young via colostrum, and in some species via the placenta, this hitherto unsuspected relationship puts at the disposal of the offspring a large amount of antibody forming tissue at the time at which its own reticuloendothelial organs are inadequate.”

Normal body microbes are involved in protective mechanisms, and patients treated with antimicrobial drugs may lose this protection and suffer from pathological disorders (even unexpected and dangerous consequences) resulting from a spontaneous replacement with a virulent microbial population. It is always risky to tamper with the natural balance of forces in nature.

Vitamins

Vitamin deficiencies may invite a disastrous multiplication of bacteria while before the deficiencies, there was no disease; by environmental control of diet, there may be no detectable germs in the animal tissues at all. We cannot overemphasize the dependence of susceptibility to infection, upon the physiological status of the host. Disease may evolve when the host parasite equilibrium is upset. Dubos says: “Of particular interest is the fact that cortisone treatment can cause animals to develop a fatal disease owing to the multiplication of microorganisms which they normally carry in their tissues in the form of an inapparent infection.” Infection in many instances is the normal state, and the disease is the abnormal state. Disease may result from a state of malnutrition, from exogenous and endogenous poisoning, from stress, and from environmental abnormalities rather than through accidental encounters with microorganisms. This view contrasts with that of narrow orthodox medical science which insists that viruses, germs, etc., are the basic causes of disease by themselves.

An article in Science, Vol. 123, pages 932 ff, and entitled “Factors in human milk interfering with influenza-virus activities,” states the following: “Muco-proteins interfering with hemagglutination by influenza virus or exhibiting other antiviral activity have been previously found in various biological materials. In a recent report from our laboratory, fractions obtained from human milk were described as showing activity against the multiplication of influenza viruses in the chorioallantoic cavity of the chick embryo.”

Vaishwanar found the levels of blood ascorbic acid about two times as high in children with no history of influenza, as in children who had the disease. On the basis of figures available before the epidemic, he concludes that the difference in ascorbic acid levels was the result, and not the cause, of the infection, and that if the ascorbic acid level played any part in determining resistance to infection, it must have been small.

On the basis of experimental evidence with animals, Dubos and Schaedler have demonstrated that “the resistance of young growing animals to bacterial infections is controlled by nutritional factors different from those involved in weight gain”; and this observation explains much of the disease, especially infection, among the children of the underprivileged parts of the world whose protein nutrition is grossly inadequate.

B12

In Vitamin B-12 deficiency there is a severe reduction in the number of leukocytes both in the blood and migrating in inflamed areas. In exudates of such animals there is granulocytopenia and consequent lymphocytosis.

In folic acid deficient animals there is a decrease in polymorphonuclear cells and an increase in the mononuclear cells. In exudates and in the bone marrow, there is a reduction in the relative number of myelocytes and segmenters, and an increase in reticulocytes.

The leukocyte count is kept within the normal range and a continuous high rate of production and elimination is assured by two mechanisms: an elimination regulator which controls to levels much lower than the normal circulatory levels, and a production regulator which controls at levels much higher than normal.

Sir Robert McCarrison (Nutrition and National Health) said: “I know of nothing so potent in maintaining good health in laboratory animals as perfectly constituted food. I know of nothing so potent in producing ill health as improperly constituted food. This too, is the experience of stock breeders. Is man an exception to a rule so universally applicable to the higher animals?” From this observation, those bakers who constantly point out that if one eats a good mixed diet he does not need the best in foods (such as bread), can take learning. The obvious answer to these bakers is that if one then heeds their advice and selects a high quality diet in other respects, one then does not need any such impoverished breads! Realistic people realize that few of us make the best possible choices in our foods, and so we must urge ourselves to procure the best in all foods, including the best in flours and breads.

Survivorship of mice infected with Salmonella typhimurium has been arranged by potent, naturally occurring nutritional factors. The experiment lends “heuristic argument in favor of the Salmonella phenotypic adaptation hypothesis.”

Malnutrition

The 16th century Montaigne recorded how women ruined their stomachs by swallowing sand, in order to acquire a pale complexion and make themselves “attractively” anemic! At romantic dinners in the 19th century, it was the fashion to affect and feign an indifference to food. Young ladies drank vinegar and lemon juice to destroy the appetite. All this was done to lead men to pretend a passion for a languid, ethereal, transient, evanescent, spirit-like, ghostly, and alas, ghastly womanhood! The pale-faced starch-eating females were considered to have an interesting and seductive look! Iconographic and literary sources demonstrate that the possession of a goitre was a highly desirable attribute of women in parts of the 16th century Europe, and as such, the goitre expressed loveliness and exerted an emotional appeal, especially in religious images. The pathological goitre even served as a basis of sexual selection in the increased incidence of goitre.

In various guises, malnutrition is nearly as common in the midst of plenty as is undernutrition in times of famine. Nerissa in “The Merchant of Venice” said, “They are as sick that surfeit too much, as they that starve with nothing.”

Rickets was so prevalent in the 17th century England as to pass as a normal state, and even Charles I was rachitic. The swaddling of infants originated in the prevalence of rickets (“…and they wrapped Him in swaddling clothes and laid him in a manger.”).

Museum armor and costumes attest that medieval knights and the aristocracy which came in their wake, were much smaller than present Europeans or the American soldier of World War II; and the 18th century belle was a diminutive in comparison with today’s lassies and debutantes. The regimens of nutrition in the past seldom allowed growth to maximal size in men and women even in the more opulent groups. Today there are no seasonal interruptions in the flow and availability of sufficient food (except in reservation Indians). With dairy milk and other concentrated whole pattern proteins and other foods, man is today able through technology and nutritional knowledge, to make rapid gain in both weight and height, but it remains to be seen whether such fed babies are also the best in health and longevity.

Size

According to Russell Markert who sized 9,000 to 12,000 potential Rockettes during the past 30 years, the girls’ shoe sizes increased from a range of 2½ to 4½ to a range of 4½ to 8 ½ or even 9. In height the girls rose from the five-foot four, to five feet six and five feet eight inches. Ten per cent of American women now fall into the five foot eight inch (or taller) category. Bust and waist (21 inches) measurements changed little, but the hips have, and what’s below the waist often rules them out, although for this latter item no figures were given! One can surmise that the height of men has also increased somewhat because, when skirts are shorter, men look longer! But maximum shortness has been achieved in the bathing suit, so much so that a horrified policeman approaching a teenager on the beach and dressed in the scantiest of bathing suits, said: “What would your mother say if she saw you in that suit?” “She’d say plenty,” said the teenager, “it’s her suit.”

In 1900, only one out of every 25 American men measured 6 feet; today one out of every 5 (in 20-29 age bracket) is 6 feet tall. The foot of the American male is getting bigger, growing an additional third of an inch every 20 years. His average shoe size today is 10; it was 7 some 75 years ago (1885). The average suit for men now sold ranges between sizes 41 and 42; 30 years ago (1930) the average size was 38.

Delinquency

Delinquency among overfed teenagers may arise from unspent creative energy. Man wants to prove at any cost that he is more than an organ-stop. The antisocial sniveling hero in Dostoevsky’s Letters from the Underworld could not stand the comfort of the “Crystal Palace.” Says he: “Well, gentlemen, what about giving all this commonsense a mighty kick…simply to send all these logarithms to the devil so that we can again live according to our foolish will?” Dostoevsky writes: “All man wants, is an absolutely FREE choice, however dear that freedom may cost him and whereever it may lead him.” The law of human spirit demands that the human race, never static, must grow in the midst of ever new dangers and challenges.

Sir Ernest Shackleton put this advertisement in a London newspaper: “Men wanted for hazardous journey, small wages, bitter cold, long months of complete darkness, constant danger, safe return doubtful. Honor and recognition in case of success.” People scoffed when this “ad” appeared in the paper. Who would answer? Thousands did! Risking life in the Antarctic or facing the thorny problems of life elsewhere, man will always respond to challenges.

But again with reference to delinquency and behavioral problems, it is of interest to note that the new international (U.S.-Canadian) commission, has been authorized to review what is known about alcoholism, to review what is being done in treatment, education and research, and to seek answers to the question as to what had better be done concerning alcoholism over the next 20 years or so. This commission is backed with a million dollar grant from the U.S. Government. (JAMA 172(4): 133/1537, 1960.) It is also notable that physicians have not only the highest rate of narcotics addiction of any occupational group, but also the highest recovery rate. The physician soon realizes his precarious position, and with proper treatment he can break the habit. He knows the discomfort and the anguish of withdrawal treatment, and the threat of recidivism. (JAMA 172(14): 121/1525, 1960—The duty of discipline.)

In 1960 there were in Oregon, 1241 births to unwed mothers. One of every 30 live births was to an unwed mother, compared to one in 54 a decade ago (1950). The new figure for 1960 is 11% higher than that for 1958 (1091 illegitimates). Forty-two per cent (510) of the 1959 unwed mothers were teenagers; of these 13 were less than 15 years of age. Some of these unwed mothers had as many as four previous pregnancies, but for 87.9%, it was the first child. In 1956, there were about 193,000 illegitimates born in the whole of the United States, 19 per 1000 among whites, 204 per 1000 among non-whites.

Even the fast may find some justification by allowing the opportunity for built-in normal mechanisms of defense and regeneration to come into play. Overnutrition can be a form of malnutrition and diminish life expectancy, as in Imperial Rome. In this vein Lucretius wrote in his 5th book (De Rerum Naturas): “In the old days, lack of food gave languishing limbs to Lethe; contrariwise today surfeit of things stifles us.” In the West history repeats itself and men dig their early graves with overstuffing and obesity, the warnings of life insurance companies notwithstanding.

VI. Health and Happiness

Katherine Mansfield (in her journal) concluded: “By health, I mean the power to live a full, adult, living, breathing life in close contact with what I love—the earth and the wonders thereof—the sea—the sun…I want to be all that I am capable of being, so that I may be—there’s only one phrase that will do—a child of the sun.”

Health and happiness are not to be equated with solving the problems of disease. Health is not recovery from disease, but disease is a departure, a defection, or a compromise from the normal state of affairs, namely wholeness and health. The latter are the expressions of individual response to the changing challenges of daily life.

The very belief in the former existence of an idyllic golden age or of a paradise lost, implies the conviction that happiness, perfect health and longevity, are the essential birthrights of all mankind.

A philosopher observed: “With health everything is a source of pleasure. Without it, nothing else, whatever it may be, is enjoyable. Even the other personal blessings of a great mind, a happy temperament—are degraded and dwarfed, for want of it. It follows from all this, that the greatest of all follies is to sacrifice health for any other kind of happiness, whether it be for gain, advancement, learning or fame. Everything should be made secondary to health.” Similarly, Martial in 43 A.D. noted: “Life is not living, but living in good health.”

 

VII. Supporting Bibliography

1. Adams, J.M., H.D. Heath, D.T. Imagawa et al. 1956. “Viral infections in the embryo.” A.M.A.J., Dis. Child., 92:109-114. Aug. (Abstract in JAMA 162(10): 1011-1012.)
2. Axelrod, A.E. 1953. “Role of the vitamins in antibody production.” J. Immunol., 71(1):5.
3. Bagdassarov, A.A., R.A. Rutberg, I.L. Chertkov et al. 1958. “The study of the properdin system of the body.” Prob. Hematol. and Blood Transfus. 3(2):69-73. Trans. from Russian. New York. J.A.M.A. 170(4):158/502. May 23.
4. Bronfenbrenner, J. (Bowman-Gray Medical School) 1952. “Mechanism of lysis of bacteria by bacteriophage.” Science 116:517. November 14.
5. Brownless, K.A. 1955. “Statistics of the 1954 polio vaccine trials.” J. Am. Statistical Assn., 50:1005-1013.
6. Burkholder, Paul R. 1959. “Antibiotics. The exploitation of microbial antagonisms is having a challenging impact on medicine and society.” Science 129 (3361):1457-1465. May 29.
7. Dubos, Rene J. 1959. Mirage of Health, Harper and Bros., Publ., N.Y.
8. Dubos, Rene J. and Russell W. Schaedler 1957. “Protein intake and resistance to infection.” Science 126:1230. December 13.
9. Dubos, Rene J. 1954. Biochemical Determinants of Microbial Diseases. Harvard University Press.
10. Fed. Security Agency, Public Health Service, Washington 25, D.C. FSA-D6, Friday, October 19, 1951, Release.
11. Galdston, Iago 1954. “Beyond The Germ Theory. The roles of deprivation and stress in health and disease.” New York Academy of Medicine, publ. by Health Education Council, New York, Minneapolis.
12. Goebel, Walther F., Guy T. Barry, and Tsunehisa Amano. 1957. “Colicine K.” Science 126:1231. December 13.
13. Hanna, L., P. Thygeson, E. Jawetz and C. Dawson. 1959. “Elementary-body virus isolated from clinical trachoma in California.” Science 130:1339-1340. Nov. 13.
14. Hirsch, James G. 1957. “Bactericidal substances in white blood cells.” Science 126:1231-2. December 13.
15. JAMA 1959. 171 (13):166/1860. “Poliomyelitis vaccine.” 1959 München. med. Wehnschr. 101:1177. Kleinschmidt, H.
16. JAMA 171(8):30. Oct. 24. “Cases of poliomyelitis decrease.”
17. JAMA 1959. 170 (18):142/2246-143/2247. Graser, F. and G. Fortong. Monatsschr. Kinderh. 107:227-230. April. Berlin. “Nervous complications associated with vaccination against poliomyelitis.”
18. JAMA 1959. 171(13):143/1837. Horsfall, Frank L., Jr. The J. Burns Amberson Lecture, The American Review, September, 1959. “Viruses as causes of disease in man.”
19. JAMA 1959. 171(12):206/1730. “Epidemiology of the future.”
20. JAMA 157(8):661. Feb. 19, 1955. “Immunization against yellow fever for international travel.”
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22. JAMA 1959. 171(13):163/1857-164/1858. Foreign letters, France. “Deaths from tuberculosis.”
23. JAMA 1959. 171(10):198/1374. “Smallpox declining in the Americas.”
24. JAMA 171(7):104/868, 1959. “Statistical effects of Asian Influenza.” (Statistical Bulletin, July 1959, Metropolitan Life Insurance Company).
25. Jawetz, Ernest. 1957. “Antimicrobial chemotherapy.” Ann. Rev. Microbiol., 10:85-114.
26. Lamanna, Carl. 1959. “The most poisonous poison. What do we know about the toxin of botulism? What are the problems to be solved?” Science 130:763-772. September 25.
27. Lederberg, Joshua. 1959. “Genes and antibodies. Do antigens bear instructions for antibody specificity or do they select cell lines that arise by mutation?” Science 129:1649-1653. June 19.
28. Quan, S.F., A.G. McManus and H. von Fintel. 1956. “Infectivity of tularemia applied to intact skin and ingested in drinking water.” Science 123:942-943. May 25.
29. Ratner, Herbert. 1956. “Poliomyelitis vaccine.” J.A.M.A. 160(3): Jan. 21.
30. Ratner, Herbert. 1957. “Stalking the Salk.” GP 15(5): May.
31. Schneider, Howard A. 1957. “Structure of pathogen populations and problems of natural resistance to infection.” Science 126:1235. December 13.
32. Schultz, Jack. 1959. “Antigens and antibodies as cell phenotypes. How does cell heredity change when host-graft relations are altered or antibody formation is stimulated?” Science 129 (3354):937-943. April 10.
33. Science 129:1490 ff. May 29, 1959. “Transmission of rabies to laboratory animals by bite of a naturally infected bat.”
34. Seltzer, Carl C. 1959. “Masculinity and smoking.” December 18. Science 130:1706-1707.
35. Sognnaes, Reidar F. 1959. “Dentistry at its centennial crossroads. Prevention is the only rational solution to dental health; basic science, the only hopeful approach.” Science 130(3390):1681-1688. December 18.
36. Talmage, David W. 1959. “Immunological Specificity. Unique combinations of selected natural globulins provide an alternative to the classical concept.” Science 129(3364):1643-1648. June 19.
37. Time, May 18, 1959. “Medicine. Mixed blessing,” pages 94-95 (A report on the work of Drs. Maxwell Finland and Wilfred F. Jones, Jr. and of Research Technioian, Mildred W. Barnes, in Boston City Hospital).
38. Vaishwanar, P.S. 1959. “Ascorbic acid levels and influenza.” JAMA 171(9).

 

Editor’s note: Since the era in which this article was written, society’s understanding of respectful terminology when referring to ethnic and cultural groups has evolved, and some readers may be offended by references to “primitive” people and other out-of-date terminology. However, this article has been archived as a historical document, and so we have chosen to use the author’s exact words in the interest of authenticity.  No disrespect to any cultural or ethnic group is intended.