Orthodox Medicine, Interventionism and Symptom Suppression

This article is divided into the following subsections. Each section can be accessed directly by clicking the title link below, or by scrolling through the article. 

Why has Orthodox Medicine Failed?

Interventionism or Vitalism - who is the healer?

Symptom Suppression - the science of concealing illness

Nutrition is for the Birds

Links and References

Why has Orthodox Medicine Failed?

Amongst the most important reasons for the failure of orthodox medicine are the following.

• Based on interventionism not vitalism
• Symptom based
• Does not accept importance of nutrition
• Changing definition of scientific evidence
• Not based upon science

Most of these reasons are consequences of reductionism and avoidance of the whole truth. I will consider these various aspects below and the evidence which supports them.

Interventionism or Vitalism - who is the healer?

Whereas holistic medicine is inherently supportive and therefore possesses a certain gentleness and friendliness ( 1, 2, 3, 5, 6, 7, 8 ), orthodox medicine on the other hand, is fundamentally interventionist ( 1, 2, 3, 5, 6, 7, 8 ). That is, orthodox medicine seeks not to support nature and the body's inbuilt healing system, but rather, it seeks to actively intervene in the patient's illness so that it may be perceived to be actively fixing the problem. Doctors it seems, "emphasise somatic intervention with curative intent, and talking with, comforting, guiding, and educating patients of lesser importance - something to do until the injection is ready" ( 8 ). Orthodox medicine seeks to fix or repair, and not to support. It refuses to acknowledge the part played by the patient in healing and resistance to disease in spite of the fact that one of the fundamental truths of healing is that all healing is performed by the patient. Inability to recognise or accept this simple fact is one of the fundamental flaws of reductionist orthodox medicine. 

A doctor can perform surgery, stitch up a wound, kill an infection, or put a broken limb in plaster, but all healing is performed by the patient. If the bone refuses to knit or if the immune system is severely compromised, all the doctors treatments will be useless ( 9 ). Because of this interventionist approach, the doctor may be seen as "a warrior confronting disease" ( 3 ), and modern medicine maybe described as conducting "lethal chemical warfare" ( 1 ).  As a result of this approach, patients are considered to be "passive recipients" ( 5 ) who "often find themselves surrounded by a bewildering array of charts, monitors and tubes, being spoken about rather than to, and witnessing their body as the object of debate among strangers, in an incomprehensible scientific language ( 2 )."

The ability of the body to resist disease and heal is said to be due to the body's own innate vitality, vital energy, vital force, vis medicatrix naturae ( 5, 7, 9, 12, 35 ), or the inherent "wisdom of the body" ( 12 ). The existence of this inner vitality, which was noted by Hippocrates more than 2,000 years ago ( 35 ) still forms a fundamental part of holistic healing systems throughout the world. In China, it is described as Qi ( 3 ), and as I have previously noted (see CFS page ), there is an amazing similarity between Qi and the innate vitality or adaptive energy which was described by Selye ( 35 ).

The effects of vital energy are obvious. Who has not wondered why people heal from similar illnesses, trauma, or surgery at varying rates? Not only do the young generally recover more quickly than the aged, but even within the same age group there will be variations which cannot be explained by orthodox medicine. Although groups of people may be medically identical (ie. normal ), they will recover at varying rates.

Resistance to infections also varies enormously between medically normal people ( 9 ). Most people would know of someone who rarely succumbs to any infection. Such a person can go for 10 or 20 years without even catching a cold even though his/her associates or friends may repeatedly catch infections. The question here is not so much why is this so, but rather, why is it orthodox medicine cannot scientifically explain this dramatic difference between people? In this age of over reliance on antibiotics it is amazing that research into these differences is not the number one priority of modern medicine.

One of the major problems here for orthodox medicine is that vital energy, or a person's healing ability, is an inherent part of nature. Because of the interventionist nature of orthodox medicine, whereby doctors like to feel that they can actually do something to the patient in order to fix his or her problems, doctors not only do not support nature, they are frequently in competition with it ( 5, 7, 9 ). According to Whitelegg ( 5 ), while alternative medicine regards nature as a "force which one works with rather than against", orthodox medicine on the other hand regards nature as something which must be "categorized and controlled" ( 5 ). Given this background it is hardly surprising that doctors claim that the concept of vital energy is unscientific because it "cannot be measured by scientific methods" ( 10, 11 ). Of course the assumption here, is that since science cannot measure vital energy today, this will always be the case. Basic wisdom, logic, and common sense dictates that things do in fact exist which science still cannot measure. As has been noted by Kothari and Mehta ( 12 ) "most human diseases and death" are "beyond science". 

Various problems result from the inability of medical practitioners to understand and respect nature, which of course has not been scientifically proven, and the inbuilt healing ability of the body. Firstly, natural warning signs (ie. symptoms) may be indiscriminately suppressed with absolutely no concern about consequences. Since there is little or no respect for natural healing processes, symptoms which occur as part of the healing or resolution of an illness may also be inappropriately suppressed. 

Secondly, disinterest in natural healing processes means that there will also be a disinterest in nutrition. Since nutritional therapy aims to support and assist the body in its ability to heal and resist disease, such therapy is probably perceived by doctors to be in competition with their interventionist role. Reductionist practitioners seem to find it rather difficult to accept what they may consider a secondary healing role, namely, supporting mother nature in the healing process.

It is the lack of respect for nature, and therefore the patient, which permits the reductionist to resort to potentially injurious and hazardous treatments in an effort to actively intervene in a patient's illness. This approach which has been described as the "violence" of medicine ( 12 ), is responsible for the thousands who die annually from medical treatment. At a time when there is so much concern about environmental pollution, it is amazing how little thought is given to internal pollution of the body by a huge number of chemicals and prescribed drugs ( 7 ). Ironically, it seems that it is the practitioners of orthodox medicine, our primary health care providers, who are least concerned about this internal pollution.

In an interesting consideration of medical violence, Kothari and Mehta ( 12 ) note that the term violence implies "interference that smacks of righteousness" or "thoughtlessness". Kothari and Mehta continue: "but violence is also transgression of what Einstein called self-evident truth". The "heartlessness" of modern medicine, according to Kothari and Mehta ( 12 ), "can be directly trace to its calculated myopia". 

Because holistic medicine is based upon vital energy and the ability of the body to heal itself there are three areas in which such therapies may be ineffective and inappropriate. Firstly, any condition which involves a degree of irreversible tissue damage or constitutional imbalance, whether from a disease, genetic cause or injury, may not be effectively treated by vitalistic techniques. Secondly, since vitalistic techniques depend upon optimum cellular nutrition, any disorder which interferes with the nutrient delivery system, from digestion and absorption through to transport into cells and mitochondria, may require a more orthodox interventionist approach. Finally, any acute or life threatening condition may also require an orthodox interventionist approach.

Realization that the patient is actually the healer necessitates that any effective health care system must be fundamentally supportive rather than interventionist. Compared to the widespread applicability of supportive vitalistic techniques, interventionism has a rather narrow field of application which is confined to emergency medicine, trauma, life threatening illness and other illnesses where there is irreversible tissue damage. It is only in such areas of application that the violent nature of interventionism could in any way be justified. Even in such areas, the use of interventionist techniques does not justify the total abandonment of vitalism. 

Symptom Suppression - the science of concealing illness

In keeping with the desire of holistic medicine to respect and support the normal restorative processes of the body, this form of medicine has traditionally regarded symptoms as nature's vitally important warning signs. Any system of medicine which lacks this understanding and respect for normal body processes will regard these warning signs as something which must be suppressed, controlled, or concealed. While concealing or controlling warning signs remains the ultimate objective of orthodox medicine, holistic medicine on the other hand, strives for the much higher ideal of the attainment and maintenance of optimum health.

The starting point for any cause based system of health care is the study of the state of normality or optimum health. By studying health rather than disease ( 4, 9 ) preference will be given to ensuring there is the correct balance of those factors which contribute to this condition of optimum health rather than merely the absence of symptoms of clinical disease. Such factors include our glandular make up or constitution and the nutritional building blocks upon which every cell in our body depends.

Since the starting point for orthodox medicine is not the study of normality or optimum health (11 ) but rather the study of disease ( 9 ), this form of medicine could not be considered to be fundamentally cause based. In fact, according to Kothari and Mehta ( 12 ), the inability of medicine to understand or define normality, is the "saddest part of medical science." Preoccupation with the symptoms of disease ( ie. the result) rather than the actual deviation from normality which the disease involves, ensures that orthodox medicine is fundamentally symptom based. A cause based health care system must consider first and foremost those requirements or fundamental building blocks which are necessary for production and maintenance of optimum health and vitality.

Although both orthodox medicine and holistic medicine regard symptoms as indications of the presence of an abnormality or disease condition, the interpretation of symptoms is vitally different in a reductionist interventionist setting, as opposed to a holistic setting. From a reductionist perspective the importance of symptoms is commonly confined to their ability to indicate the presence of, or confirm the diagnosis of, a predefined disease, which itself is just a symptom of a more fundamental metabolic disturbance or illness. Since the goal of orthodox medicine is simply to remove symptoms of disease rather than attain a condition of optimum health, the elimination of symptoms becomes an end in itself rather than a means of identifying and correcting the underlying cause of disease. In this setting, there is little incentive to search for causes.

From the holistic viewpoint, since symptoms are considered a means by which the fundamental cause of an illness or metabolic disturbance may be identified and treated, they have much deeper significance than they do in orthodox medicine. In view of the fact that holistic medicine regards disease as being caused by a disturbance or discrepancy in those factors which comprise or influence the fundamental building blocks of the body, symptoms are considered a valuable means of identifying underlying nutritional or constitutional factors. It is this use of symptoms to identify fundamental causative factors rather than the presence of a predefined disease, which further distinguishes holistic medicine from orthodox medicine. To illustrate, whereas the holistic practitioner will utilise symptoms to identify such basic causative factors as nutritional disturbances or constitutional imbalance, the medical practitioner on the other hand, will normally see symptoms as being totally unrelated to any disturbance or inadequacy of such basic human requirements.

There is also a very serious time factor involved here, since any health care system which must wait for the emergence of a predefined disease state before diagnosis and treatment is possible, has little or no relevance for prevention, early diagnosis, or the treatment of subclinical disease ( 8,12,13,14 ). It is in this area, the area of prevention and treatment of subclinical disease where orthodox medicine has been most inept. As has been noted by Kothari and Mehta (12 ), most diseases may be "silent" in the body for a considerable period of time before they actually become diagnosable. This period of "silence" of course, represents the subclinical stage of disease which has been all but abandoned by orthodox medicine ( 8,12,13,14 ). This is the stage of illness between the condition of optimum health and the emergence of definite signs of clinical disease, a stage which is impossible to diagnose when the state of optimum health is neither accepted nor understood. The importance of recognising the early stages of illness of course, stems from the fact that it is at this point that the condition is most easily reversed.

Although this initial subclinical stage of illness may not be accepted by orthodox medicine because of a lack of clinical signs, to the holistic practitioner who seeks to identify any deviation from the condition of optimum health, there may be numerous signs. It is tragic that this early most treatable stage of illness, which also represents a stage of disease consolidation within the body, has been abandoned by modern medicine.

The symptom suppressing nature of modern medicine also makes it generally unsuitable for the treatment of conditions which are characterised by chronic toxemia. Such conditions include various types of chronic drug intoxications, chronic food poisonings such as ciguatera, and post viral syndromes which may be characterised by the persistence of microbial toxins within the body. These include post hepatitis syndrome, post giardia syndrome, CFS and other related disorders. Treatment of these disorders requires an understanding of the body's restorative mechanisms and an ability to to support the elimination and detoxification processes of the body. It also requires an ability to distinguish between disease symptoms and recovery symptoms and hence determine in which direction an illness is progressing.

While naturopaths and holistic practitioners strive to deliberately bring about an exacerbation of symptoms referred to as a "healing crisis" ( 13a, 13b, 13c, 13d, 13e, 13f ), orthodox medicine on the other hand, which regards symptoms as bad, seeks to suppress symptoms at any cost. Unlike the various holistic healing traditions which have had a thorough understanding of recovery or healing symptoms for thousands of years, orthodox medicine on the other hand, has absolutely no understanding of such phenomena and will usually seek to prevent such symptoms. While holistic practitioners possess a fundamental respect and concern for the normal restorative processes of the body which makes the mechanisms behind symptom causation of the utmost importance, to the medical practitioner such mechanisms are unimportant. To the holistic practitioner, symptoms which occur as part of the healing process reflect the body's attempts to detoxify and restore normality and therefore should be encouraged, certainly not prevented, as is the case with orthodox medicine. 

It is this ability to understand and support normal processes of elimination which makes holistic medicine particularly suitable for treatment of chronic toxemic conditions. According to holistic medicine, the desire of orthodox medicine to suppress healing symptoms will exacerbate the disease and cause it to become more chronic.

The ultimate aim of orthodox medicine then, is not to achieve a condition of optimum health, but rather to suppress or remove the symptoms of recognisable diseases with little or no consideration of the underlying cause (1, 9, 12, 13, 14, 15, 16, ). In fact, the structure of medicine is such that it is biased against the discovery of disease causation ( 16a ). The fact that alternative medicine strives for much higher goals, namely the elimination of causes and the attainment of optimum health, than does orthodox medicine, has probably resulted in the low level of expectation of medical treatments, doctors often warning that any suggestion of the possibility of curative treatments could only be quackery ( 12 ). Preoccupation with symptomatic treatment of chronic illness is a sign of medical mediocrity and the abandonment of curative ideals.

The whole issue of the expectation of the general community when it comes to science and medicine is of such importance that it is worth digressing at this point to consider this matter in a little more detail. While community expectations should be realistic, unnecessarily lowered expectations could perpetuate medical mediocrity.

Prominent medical scientists are concerned that the public simply expects too much of modern medicine ( 96 ), even going so far as to suggest that this excessive expectation is the cause of both the current increase in medical litigation and the increasing popularity of alternative medicine ( 96 ). Most people it seems, know "too little of science" ( 96 ) and they "cannot understand why scientific medicine still has no cures for many diseases" ( 96 ). As far as the patient is concerned therefore, it seems that increasing knowledge of science will result in increasing awareness of the inability of science to cure their illness. Scientific knowledge is apparently synonymous with reduced expectations and the acceptance of the incurability of illness.

I must admit I find this type of reasoning most disturbing as it appears to be simply an attempt to justify, and get the community to accept, the ongoing failures of science. After all, such criticisms could also be applied to the patient who pursues litigation because he had the wrong limb amputated, the incorrect operation performed, or the incorrect drugs administered. The patient should hardly be blamed for such events. 

Similarly, is it possible to take seriously anyone who suggests an unsuccessfully medically treated victim of chronic illness ( or, even worse, iatrogenic illness ) should accept the failure of medical treatment and therefore the inevitability of their illness and refrain from seeking alternative treatments? Is it really better to be totally negative and do nothing rather than try something else? The bottom line here, and a vitally important lesson for all scientists to learn, is that patients resort to alternative therapies, not because of "excessive expectations" ( 96 ), but rather simply because they dislike being sick and wish to become well. Has it really got to the point where the desire to obtain health is regarded as being unscientific? I suspect that even eminent scientists, if faced with the prospect of a medically incurable illness, may be tempted to explore the advantages of alternative treatments.

The other point that should be made here is that alternative treatments are limited by human experience, knowledge and common sense, all of which encompass a much broader range of therapies than is accepted by reductionist science. The deliberate imposing of restrictions upon human knowledge by virtue of the inherent restrictiveness of reductionism is hardly the fault of the patient. There are many effective therapies which are beyond science in that they are intrinsically natural, holistic and experiential in nature and patients should therefore be encouraged to pursue such alternative therapies and not confine themselves to the restrictiveness of modern science. By doing so, the incurable may be cured and the unscientific may ultimately become scientific.

Irrespective of the expectations of the community, the suppression of symptoms of chronic diseases can have rather serious consequences. When it is considered that a symptom is actually an outward warning sign or readily perceived effect of an underlying disease or illness, it is hardly surprising that any healing system which seeks to remove such warning signs without addressing the fundamental cause may, in fact, exacerbate or prolong the underlying illness. The practitioner has a responsibility to ascertain with some certainty that the fundamental disease process is being addressed, and not just the more easily perceived symptoms of an ongoing internal disease. This matter is of vital importance since any practitioner who suppresses symptoms but fails to address their cause is, by removing warning signs, encouraging the development of the underlying illness with minimal awareness by the patient ( or practitioner ), perhaps even until a point of irreversibility is reached.

Symptomatic treatment not only "cannot restore well being" (14 ) but further, by masking the symptoms may "complicate the physicians job by erasing valuable clues to the real source of the trouble" ( 9 ). Not only may symptomatic treatment make disease "more difficult to detect and treat" ( 15 ) and therefore aggravate the long term prognosis ( 13, 15, 16 ), but furthermore, the disappearance of symptoms may be falsely interpreted as an improvement in the underlying illness. Preoccupation with symptomatic treatment also coincided with increasing reliance upon sophisticated medical tests as doctors sought to avoid the difficulty of interpreting nature's warning signs ( 38 ). According to Rudolfer and Harrison in this regard ( 38 ): "a simultaneous development of investigative apparatus relieved the physician of the laborious task of interpreting nature's signals, and provided him with the facility to treat a series of laboratory data quite divorced from the patient and his surroundings."

It should be noted however, that the above comments apply predominantly to chronic diseases where symptomatic treatment only serves to conceal an ongoing illness. When it comes to the treatment of acute illnesses or trauma, which represent the strengths of orthodox medicine, symptom suppression may be absolutely essential. It should not however, be used as a total substitute for cause based therapies.

When it comes to diseases which have a genetic component then the risks of symptomatic treatment may be considerable. With diabetes and asthma for instance, both of which are claimed to be "controlled" by orthodox medicine, what happens when the underlying cause of these disorders is ignored? The prevalence of both disorders is increasing and medical authorities question why this is so. But is there any reason to expect otherwise when the underlying cause of both disorders remains untreated? It has been claimed that this is true of heart disease also, with succeeding generations experiencing the same disease because the cause remains untreated (16 ).

In view of the fact that, according to naturopathy and holistic medicine, suppression of disease symptoms will cause disease to become chronic, it is indeed interesting to observe the astonishing increase in the incidence of chronic diseases which have occurred during the 20th century, a period characterised by an absolute obsession with suppression of symptoms by the use of toxic drugs. This period has resulted in increases in heart disease and cancer death rates of more than 200%-300% ( see Health Trends page ). As a percentage of total deaths, deaths from these two causes has increased from 500%-600% during 1900-2000 ( see Health Trends page ). If we combine these figures with those for other chronic diseases such as arthritis, diabetes and asthma, it is clear that there has been an unprecedented increase in chronic diseases during the 20th century, a fact which, given the consequences of symptom suppression, is entirely consistent with the expectations of holistic medicine.

The lack of scientific justification for blindly suppressing symptoms and the consequences of concealing nature's warning signs must be acknowledged as a matter deserving our most urgent attention. Preoccupation with concealing warning signs is a feature of medical myopia.

There are many obvious examples of symptom suppression within modern medicine. Analgesic and antiinflammatory arthritis treatments for instance, remove the patient's awareness of the ongoing underlying disease by removing the symptoms, perhaps even making the underlying cause worse (17a ). The same is true of most other chronic diseases including asthma, diabetes, and heart disease. Medical treatments for these disorders are not aimed at correcting the underlying cause, but rather, the "control" or "management" of symptoms. If the underlying disease is completely concealed by the suppression of symptoms, then the disease may be regarded as being correctly "managed". By definition, any treatment which does not seek to address the underlying cause is merely symptomatic. This also includes antibiotic treatment for infectious illnesses if the infection is caused by lack of resistance or vital energy rather than being solely caused by exposure to the offending microrganism.

A cause based approach to health care is intrinsically linked to nutrition. Nutritional supplements, which are generally perceived to have a supportive effect in the body and participate in normal restorative processes, are generally considered by orthodox medicine, which evaluates treatments by their ability to suppress symptoms, as having little or no "therapeutic" potential. In view of these facts, and notwithstanding the "therapeutic" effects of massive amounts of vitamin D or nicotinic acid ( see B Vitamins ), the clinical effectiveness of nutritional supplements in the treatment of various disease conditions suggests that they play a causative role in these conditions. In other words, effective nutritional treatments are more likely curative, certainly not symptom suppressing. There is no evidence to suggest that nutritional treatments possess a significant symptom suppressing potential. Especially since they lack the capacity to intervene at a superficial symptomatic level, it is vitally important that we understand the holistic mechanisms by which nutritional supplements have their positive effects.

Clearly, any evidence pertaining to the effectiveness of nutritional supplements in the treatment of specific diseases is of vital importance, particularly from a cause based point of view. Reports of the effectiveness of nutritional supplements for the treatment of asthma and various mental disorders ( see B vitamins ) deserve much more extensive research, especially given the failure of symptomatic medical treatments. Similarly, accumulating evidence that diabetes and heart disease may be treated nutritionally ( see But What About Efficacy? and Nutrition is for the Birds ) also warrants urgent attention. Recent acknowledgement of the effectiveness of nutritional supplements for treatment or prevention of heart disease, cancer, and birth defects ( 132, 133 ) are also of vital importance.

For the most part much of this evidence is not new, it has simply been rejected by orthodox medicine in the past because of its anti-nutrition bias and its reductionist symptomatic perspective. What is new is that some sections of the medical profession are reconsidering this evidence in light of a more open minded attitude towards nutrition and natural therapies. The effectiveness of nutritional supplements, either for disease treatment or prevention, must be seen within the context of their potential for cure, as distinct from symptom suppression. For those who are more familiar with symptomatic treatments this may be a totally foreign concept. 

Another difficulty which may arise from the indiscriminate suppression of symptoms stems from the fact that some symptoms, as I have stated previously, are considered desirable due to the fact that they indicate a resolution of the underlying illness. Such recovery symptoms may result from elimination or detoxification or other metabolic processes. For instance, indiscriminate and unnecessary lowering of "fever" conditions, which are a normal response by the body to assist the fight against infections (12 ), may have adverse effects upon the immune system (12 ). The widespread use of antiinflammatory drugs for diseases like arthritis may also conceal the onset of acute infections by virtue of their fever lowering and antiinflammatory effects. Inappropriate use of cough suppressants may also cause or aggravate lung disease by preventing the natural discharge of mucus.

When prominent medical experts are sufficiently concerned to warn that "the
mindless craze for gadgets and chemicals leads medical men to create a modern medical police state where symptoms are suppressed and signs are erased" (12 ), then clearly the general community should express some alarm.

Since modern symptom suppressing drugs may render the patient completely unaware of an ongoing underlying disease process it is vitally important that this is fully explained to the patient before treatment is initiated. The patient should be informed that there is a very significant risk that the underlying disease condition may re-emerge later in life in a much more severe and perhaps untreatable form. It must be emphasised to patients that masking of symptoms may conceal any deterioration in the underlying disease process. Patients certainly should not be deceived into believing that the suppression of symptoms will do anything to resolve or cure the illness in the longer term. This should be part of the normal communication between doctor and patient. Informing the patient of this risk gives him/her the ability to make an informed choice and perhaps pursue a more cause based therapy.

Symptom suppression merely amounts to an attempt to conceal the effects of an ongoing disease which modern medicine can neither cure nor understand. In other words, if the patient is not clearly informed about the symptomatic nature of the treatment, then, unbeknown to the patient, it is only their awareness of the disease which is being treated, not the disease itself. If the practitioner can completely remove the patient's awareness of the disease process while permitting the underlying cause to continue, then this is usually regarded as a successful treatment outcome.

Nutrition is for the Birds

The reductionist era has brought with it many strange, unscientific and dangerous beliefs. This is perhaps best illustrated by the commonly held reductionist belief that nutrition has little or nothing to do with health ( 4, 9, 97a, 98 ). In fact, according to Frankle ( 97a ), the relationship between nutrition and health was only accepted after this link was confirmed by various studies, although even in spite of this the medical bias against nutrition continued ( see the Medical Bias page ). This type of contemptuous disinterest in nutrition has resulted in the belief, formerly promoted by medical practitioners, that the nutritional status of a pregnant woman would have no effect upon the health of the newborn baby ( 109 ). Even worse, women were actually advised that if they wanted an easier birth, then they should ensure they have a small baby by practising semi-starvation during pregnancy (109 ). 

It must be stated most emphatically, that such dangerous beliefs are only possible within the realms of a reductionist system.

It was only a few decades ago also, that hospital patients frequently suffered from what has been termed "iatrogenic malnutrition" ( 97a, 99 ) because doctors did not believe that nutrition was necessary for their recovery ( 97a, 98 ). "A great many patients in hospitals became malnourished" ( 98 ) and even suffered from "starvation" ( 98 ) as a result of their hospital stay.

Sadly, but not surprisingly, this same contemptuous disinterest in nutrition is widely prevalent amongst reductionist practitioners today. Attempts to correct this situation while maintaining an underlying tunnel vision reductionist philosophy are likely to meet with limited success ( see Medical Bias page ).

To the general community however, it is probably fair to say, the recognition of the importance of nutrition for the maintenance of optimum health and freedom from disease, is simply common sense. In stark contrast, the scientific community generally seems to regard vitamins and minerals as being unnecessary unless they are specifically shown to be essential by a double blind study. Even today, many members of the medical profession reject nutritional therapy as quackery ( 56, 63, 64, 85 ). Ironically, there is a very real danger here that the medical profession will be the last section of the community to realise the importance of nutrition ( 8, 14 ).

For hundreds of years doctors have argued about the importance of nutrition. They have gone to extraordinary lengths to contradict accumulating scientific evidence regarding the connection between nutrition and health ( 8 , 9 ). Although beri beri ( deficiency of vitamin B1 ) for instance, was first encountered in the 17th century (18 ), doctors argued about the nutritional basis of this disease for more than 200 years ( 18 ). Even in the early 20th century doctors continued to argue that beri beri had nothing to do with nutrition but rather was caused by an infection ( 9, 18, 19, ). Unconvinced, even after 200 years of evidence, doctors continued to try and prove the infectious nature of beri beri by unsuccessfully attempting to deliberately transmit the disease (19 ).

The history of pellagra is also similar to that of beri beri. In the early 20th century medical scientists were also convinced that pellagra was caused by an infection ( 20, 21, 97 ). Although Goldberger, in 1915, produced pellagra by feeding a "corn based diet" to volunteers ( 97, 109 ), the medical community remained unconvinced about the nutritional basis of this disorder, suggesting instead that it was an infectious disease which was spread by mosquitoes ( 97 ). Subsequently, to further prove the non infectious nature of pellagra, Goldberger obtained volunteers to consume the "blood, faeces, urine, and infectious skin secretions from people with pellagra" ( 97 ). When, after six months, no one developed pellagra, the infectious theory was finally discredited. 

Although there is now an extensive amount of scientific evidence relating to both the widespread prevalence of nutritional deficiencies in the general community ( 22, 23, 24, 100, see also the B Vitamins page ), and also the positive effects of nutritional therapy ( 8, 14, 25, 27, 28, 29, 30, 31, 32, 33, 34, 36, 37, 39, 40, 99, 100, 101 ), the medical profession generally fails to accept this evidence. In fact, most patients who present to a medical practitioner with a non life threatening chronic illness will be prescribed toxic drugs as a first line of treatment, irrespective of any scientific evidence. There will generally be a determination to avoid the use of dietary analyses or nutritional tests.

It is astonishing that nutritional therapies have been shown to be effective for the treatment or prevention of common disorders such as diabetes ( 25, 26a, 36, 100 ), heart disease ( 26b, 28, 29, 30, 31, 32, 100 ), asthma ( 33, 34, 36, d ), kidney stones ( 27, 36, 100 ) and depression ( 34, 36, 99, 101 ), and yet such therapies tend to be ignored by all except a small number of holistic medical practitioners. Patients it seems, have "outstripped the medical profession" (14 ) in applying effective natural therapies for their various illnesses.

There has been much publicity given to the relatively recent 'discovery' that folic acid deficiency during pregnancy could cause spina bifida and other birth defects ( 41, 42, 43, 44 ). Although doctors did not officially accept the importance of folic acid for preventing birth defects until 1992 - 93 ( 43, 103 ), it seems that this was known, but not medically accepted, 30 years earlier (17b , 42, 103 ). Roger Williams, who concentrated and named folic acid ( 45 ), reported in 1971 ( 9 ) that folic acid deficiency could cause many types of gross birth defects and warned that even minor deficiencies of this vitamin during pregnancy might produce subtle abnormalities which would not become apparent until later in life. Quillan ( 102 ) has noted that the evidence implicating folic acid deficiency as a cause of birth defects was so overwhelming in the 1980's that women began to refuse to participate in trials. Although these women decided to err on the side of safety by taking folic acid supplements, doctors responded with "hostility" ( 146 ) to evidence of the importance of folic acid. In spite of all this evidence doctors still preferred to expose the newborn to the risk of birth defects until more evidence had accumulated. The importance of the 'discovery' about folic acid was such that in 1996 the US government moved to enforce fortification of foods with this vitamin (46 ). This was not successful however, and subsequently folic acid supplements were recommended (44, 47 ).

As has been pointed out by Hoffer ( 146 ), a ten year delay in endorsing the use of folic acid during pregnancy resulted in the birth of 250,000 children with spina bifida in the US alone at a total cost of 10 billion dollars over ten years. Hoffer continues ( 146 ): "How many babies could have been saved by such a simple solution? Even if the original findings had been wrong, what harm would it have done to have advised them immediately about this very important finding? I was astonished in 1981 at the vehemence of the reaction by physicians and nutritionists, and I am still astonished."

History shows quite clearly, that when it comes to the use of nutritional supplements, if we wait for medical approval there will be a considerable amount of unnecessary suffering ( 20 ).

Clinical vitamin deficiencies, such as scurvy, beri beri, and pellagra, are, according to many experts, only the tip of the deficiency iceberg ( 20, 22, 37, 48 ). For every case of clinical vitamin deficiency caused by dietary inadequacy there may be many others which are subclinical or are caused by an increased need for certain vitamins in particular individuals. In such cases it may be impossible to obtain sufficient amounts from the diet ( see the B Vitamins page ).

Subclinical disorders, including vitamin deficiencies, are somewhat of an Achilles heel for orthodox medicine ( 8 ) which, as I have previously indicated, is clearly structured so as to favour intervention at later more acute stages of disease. The focus of orthodox medicine upon disease rather than health, creates a situation in which no nutritional deficiency is believed to exist until a precisely predefined disease becomes manifest. Patients who complain of illness before reaching this acceptable level of disease are commonly diagnosed as being depressed, neurotic, hypochondriacs, or "somatizers" ( See "Is Illness Holistic" ).

Unfortunately, since it fails to recognise the initial stages of disease, this system of medicine usually considers the end stages of a disease to actually be the beginning of the illness. Heart attacks and cancer for instance, represent the final stages of disease. Interestingly, Kothari ( 13 ) makes the point that, even with modern technology, early cancer diagnosis is impossible since cancer is not detectable until it has been in the body for years and already contains billions of cancer cells.

The early or subclinical stage of vitamin deficiencies are therefore generally ignored by orthodox medicine which tends to regard fully developed scurvy and pellagra as the "first signs of vitamin deficiency, not the last signs before death" ( 20 ). As is noted by Challem ( 20 ), many doctors still cling to this false belief. Although pioneers like Roger Williams and Linus Pauling developed the concept of subclinical nutritional deficiencies and biochemical individuality in the 1950's and 1960's (  9, 20, 49, 99 ), these concepts are only now beginning to be accepted by the more progressive members of the medical community ( 14, 63 ). While the nutritional therapies promoted by Linus Pauling were initially dismissed by a medical profession obsessed with drugs as being quackery, it seems that Pauling has now come to be regarded as a genius ( 8, 86a ).

Perhaps the area of greatest potential for nutritional therapy is the area of orthomolecular nutrition ( 8, 20, 49, 86, 87, 99, 100, see also the B Vitamins page ) which is based upon the concept of biochemical individuality which was pioneered by Roger Williams ( 104 ). Williams claimed that people are all different and therefore have a unique pattern of nutritional needs. Whereas the position of orthodox medicine has traditionally been that virtually everyone in the world of the same sex and age group requires exactly the same amount of each nutrient in order to maintain health, Williams rejected this view claiming that optimum nutrition is "for real people" while "statistical people are of  little interest" ( 86 ). In the words of Hoffer ( 99 ), "they adopt a statistical point of view in which all human uniqueness vanishes."

Although the orthodox viewpoint continues to be based upon the unscientific assumption ( 20 ) that everyone has perfect utilisation and metabolism of each and every nutrient, Williams claimed that individual differences in absorption, assimilation, metabolism, and excretion of particular nutrients ( 104 ) determined the amount of each nutrient that is required by a specific individual. The aim was to ensure that optimal amounts of every nutrient reached their destination in all the cells of the body where they are required ( see "Is Illness Holistic" ).

This concept of individuality in nutritional needs was further developed by Linus Pauling and others and came to be known as orthomolecular medicine ( 18, 20, 39,  49, 99 ). Since the goal of orthomolecular medicine was the attainment and maintenance of optimum health, and not just freedom from disease ( 99 ), there was a conflict with the orthodox viewpoint which, as I have previously discussed, rejected the concept of optimum health. The orthodox position simply required that people take the minimum amount of nutrients necessary to prevent the appearance of major nutritional diseases in a statistically average person ( 99, 144, 145 ). To achieve this, the Recommended Dietary Allowances (RDA) were developed.

The misuse of the RDA system to justify the common reductionist assumption that everyone who eats a normal diet cannot possibly suffer from nutritional deficiencies is unfortunate and unscientific. There are two basic reasons for the misunderstanding and misusing of the RDA's. Firstly, it must be realised that the RDA's do not specify the amount of nutrients which are necessary for the maintenance of optimum health, but rather "only the estimated amount that for most people would prevent death or serious illness from overt vitamin deficiency" ( 99  ). The Food and Nutrition Board of the National Academy of Sciences has admitted that the RDA's "are not recommendations for the ideal diet" ( 99 ). The term "recommended allowance" was deliberately chosen "to avoid any implication of finality or............ optimal requirements" ( 99 ). The RDA system makes no allowance for individuality in nutritional needs and inefficiencies in nutrient utilisation. It assumes universal perfection in nutrient utilisation. It is just as scientifically baseless to suggest that everyone in the world needs exactly the same dose of a drug as it is for vitamins.

The second problem with the RDA system is that these allowances only refer to a statistically average person who in fact, may not even exist. The Australian Dietary allowances in 1977 for example, only applied to the following "reference" person ( 105 ).

"The reference man is twenty five years of age. He is healthy, that is, he is free from disease and exhibits a 'normal degree of physical fitness. He weighs 71 kg and lives in the warm temperate zone at a mean external annual temperature of 18 C. He consumes an adequate well balanced diet; he neither gains nor loses weight. His activity is exemplified by the following average weekly schedule. On each working day, 8 hours of the physical work of the type referred to below; 4 hours of 'sedentary' activity; walking slowly on the level for 2 hours and at least 2 hours out of door: on each non-working day, the active pursuit of exercise and sport not of the extremely strenuous variety. The degree of activity involved in occupation in light-industry or , general laboratory work would represent approximately his working activity."

It is obvious from this description that it would be difficult to find anyone at all who the RDA's apply to. Not surprisingly, the RDA system has become increasingly irrelevant as more experts realise the health benefits of taking vitamins in doses many times the RDA's ( 144, 145 ).

In a groundbreaking vindication of Williams' research into biochemical individuality and the considerable limitations of the RDA system, Hathcock of the Council for Responsible Nutrition recently made the following announcement ( 142 ):

The history of nutrition is indeed disturbing. The practical implementation of nutritional research, both at the curricular level and the clinical level, has traditionally been opposed by medical authorities. This opposition to nutrition is not scientifically based (8, 20 ) but rather depends upon bias ( 17c ) and a "tunnel vision" approach ( 20 ). In fact, the consistent misuse of the RDA system by medical authorities is the result of  attempts to justify the anti-nutrition bias of orthodox medicine. While new drugs are generally welcomed enthusiastically by medical authorities, nutritional discoveries made by eminent scientists are usually contradicted and rejected, frequently for decades ( see Medical Bias page ). When science subsequently reveals however, that the new drug is dangerous, and the nutritional discovery is correct, no one is called to account and the "mistakes" continue.

Given the longstanding antagonistic attitude of orthodox medicine to orthomolecular nutrition and the mere existence of subclinical vitamin deficiency conditions it is indeed gratifying to see recent reports ( 132, 133, 142, 143 ) linking "suboptimal" vitamin status with various chronic diseases including heart disease and cancer. In fact there is now accumulating evidence that subclinical non-diet related vitamin deficiencies are extremely common throughout modern society. Fletcher and Fairfield ( 133 ) for instance, conclude that suboptimal vitamin status is so common that a "large proportion of the population needs supplements of more than one vitamin."

There are four vitally important facts which emerge from this new research. Firstly, the occurrence of vitamin deficiencies is extremely common and is not necessarily related to dietary intake. This observation of course, is consistent with the principles of biochemical individuality and the fact that some people require an increased vitamin intake if they are to avoid a deficiency condition. Secondly, although these vitamin deficiencies are mild or subclinical they are nevertheless capable of causing very serious diseases. While acute severe vitamin deficiencies may cause the classical vitamin deficiency diseases, now we have increasing evidence that mild chronic deficiencies may also cause serious chronic diseases. Thirdly, since these deficiencies are relatively "mild" they cannot be reliably detected by medical tests. This fact has enormous implications for nutritional surveys, the establishment of "normal ranges" and the use of "control" subjects in research studies. Unfortunately, many doctors today are completely satisfied if test results are "normal", they are considerably less concerned about the patient.

Finally, increasing evidence that diseases such as heart disease, cancer, and asthma may be caused by nutritional deficiencies emphasises the need for a completely new approach to health care. If for instance, heart disease is caused by deficiencies of folate or vitamin B6 ( see Health Trends or B Vitamins ), then the effectiveness of traditional medical therapies for heart disease must depend upon their ability to suppress signs and symptoms of these deficiencies. How many patients are there who have been suffering from heart disease because of nutritional deficiencies but who, instead of receiving appropriate cause based nutritional treatment, have had their symptoms masked by drugs or surgery until the damage has become irreversible? While the symptomatic nature of modern medicine has long been acknowledged and accepted, the possibility that toxic drugs and invasive surgical procedures are being utilised to conceal symptoms of nutritional deficiencies suggests an intolerable abuse of modern medical science. Preoccupation with symptomatic treatments must inevitably invite this type of "mistake".

In the years to come we will undoubtedly continue to find other nutritional diseases which modern medicine traditionally treats by masking of symptoms. There is no reason to think that heart disease is unique in this regard. There is already considerable evidence for instance, that asthma and various mental disorders also have a nutritional basis ( see B Vitamins ). There is also evidence of nutritional involvement in arthritis, diabetes, and some forms of cancer. Like heart disease, modern medicine treats all these disorders by masking of symptoms. The possibility that the underlying cause that is being masked is in fact nutritional, has not been positively eliminated. More importantly, there seems to be very little concern about the consequences of deliberately encouraging chronic disease to invisibly deteriorate by masking nature's warning signs. The future will continue to reveal the foolishness of such an approach.

It is clear that some sections of the medical profession are attempting to move forward, to abandon the longstanding anti-nutrition bias which has plagued the profession. This is a welcome trend indeed. Sadly however, anti-nutrition bias is still very prevalent. For instance, in spite of the above facts the Australian Institute of Health and Welfare ( AIHW ) have recently stated that ( 134 ) "nutritional deficiency is uncommon among the Australian population in general." This statement is heavily dependent upon two very bold and unscientific assumptions.

Firstly, it assumes perfection in nutritional testing procedures. It denies the existence of scientific evidence which reveals that subclinical vitamin deficiencies, which cannot be reliably detected by medical tests, are in fact very common, as has recently been noted by Calvaresi and Bryan of the CSIRO ( 147 ). It also fails to recognise the fact that people suffering from chronic subclinical vitamin deficiencies or vitamin dependencies do not display symptoms which would be recognised as typical vitamin deficiency symptoms. Secondly, it also assumes universal perfection in nutrient utilisation and denies the existence of extensive scientific evidence pertaining to biochemical individuality. It is curious that comments made by the AIHW are so at odds with the scientific facts as confirmed by the CSIRO.

Remarkably, in direct contradiction of their above statement, the AIHW also state, in regard to the importance of folate for women of childbearing age ( 134 ), "only 1% of women aged 15-49 years consumed the recommended amount."

The AIHW have a responsibility to ensure their statements are accurate, consistent with the available evidence, and do not mislead the public. They have clearly failed, not just in their statement about the prevalence of nutritional deficiencies, but also in their claim that Australians are becoming healthier, a claim which is not supported by scientific evidence ( see Health Trends ). The continuing refusal of the Institute to highlight the current increasing incidence of CDV and the dramatic increase in heart disease and cancer death rates which have occurred over the past 100 years is also cause for concern ( see Health Trends ). The AIHW have also failed to highlight the astonishing increase in iatrogenic diseases ( see Holistic Medicine Sets the Standard for Safety ).

Health authorities such as the AIHW should be at the forefront of nutritional research. The reality is very different however. The public at large will have been experiencing the benefits of nutritional supplements for many years before health authorities like the AIHW even become aware of the prevalence and health consequences of nutritional deficiencies. There is nothing new about this. As I have previously indicated, women began using folate supplements when medical authorities were still trying to discourage such supplements, long before their use was officially endorsed. The public has also generally recognised the importance of diet and natural foods even when health authorities claimed this was quackery.

Instead of leading the way, health authorities like the AIHW traditionally lag well behind public opinion, scientific evidence and common sense. History shows however, that eventually they will catch up.

Since vitamins and minerals form the fundamental building blocks of every tissue in the body, including DNA ( 20 ), nutritional medicine has the unique potential to intervene at the most fundamental causative level of the disease process. This fact has led Challem ( 20 ) to criticise genetic scientists who, although dedicated to DNA research, are not interested in the nutritional building blocks of DNA. Challem states in this respect ( 20 ): "In a sense, these doctors are the charlatans who victimise people by offering the distant hope that some day scientists will fabricate replacement genes to prevent and cure these diseases."

At a time when the world is faced with a spiralling increase in diseases which modern medicine can neither cure nor understand, it is tragic and inexcusable that the field of nutrition still remains largely unexplored. It makes absolutely no sense to say, as medical authorities seem to persist in doing, that nutrition is definitely not the answer, but we have absolutely no idea what the answer is. While we know for certain that a deficiency of valium does not cause any disease, we are still counting the number of diseases which are caused by nutritional deficiencies. The direction in which scientific research should be proceeding is abundantly clear, the fact that it is not doing so has more to do with commercial considerations than with health. The future of nutrition, as has been noted by Challem ( 20 ), has "wondrous possibilities".

To continue to the final part of this section, including, "Science Today.... Quackery Tomorrow" and "Medical Evidence or Medical Ignorance?", click here. To access the concluding part of this article go to the Integrated Medicine page.

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