The developer of Functional Technique, Harold V. Hoover DO used the term ‘dynamic neutral’ to describe what it was that was being achieved as disturbed tissues were positioned in a state of ‘ease’.¹

As we examine the mechanisms of what is taking place when tissues are placed in a balanced state the terms ‘ease’ and ‘bind’ will frequently be used to describe the extremes of restriction and freedom of movement.

It was Lawrence Jones DO who first developed an approach to joint and soft tissue dysfunction which he termed ‘Strain and Counterstrain’ (SCS).²

Walther Describes Jones Discovery³

‘Jones’ initial observation of the efficacy of counterstrain was with a patient who was unresponsive to treatment. The patient had been unable to sleep because of pain. Jones attempted to find a comfortable position for the patient to aid him in sleeping. After twenty minutes of trial and error, a position was finally achieved in which the patient’s pain was relieved. Leaving the patient in this position for a short time, Jones was astonished when the patient came out of the position and was able to stand comfortably erect. The relief of pain was lasting and the patient made an uneventful recovery.’

The position of ‘ease’ which Jones found for this patient was an exaggeration of the position in which spasm was holding him, which provided Jones with an insight into the mechanisms involved.
Many hospitalised patients have been treated for their current pain and discomfort, without leaving their beds, using these methods.⁴

SCS requires verbal feedback from the patient as to pain in a ‘tender’ point, being palpated by the operator as a monitor while a position of ease is sought.

Where there is a language barrier, or someone has lost the ability to speak, or is too young to cooperate a need exists for a method which allowed the operator to achieve the same ends without words, in which the operator determines a position of ease by means of palpation alone, assessing for a state of ‘ease’ in the tissues.

1. Exaggeration of Distortion

This is an element of SCS methodology.

Consider the example of someone bent forward in psoas spasm/’lumbago’ in considerable discomfort or pain. The person would be posturally distorted – bent into flexion,together with rotation and sidebending.

Any attempt to straighten towards a more physiologically normal posture, pushing through the ‘barrier of resistance’ would produce pain.

However moving the area away from the restriction barrier (in this case bending forwards more), increasing the degree of distortion displayed would normally be easy and painless. After 60 to 90 seconds in such a position of ease, a slow return to neutral will commonly leave the patient somewhat or completely relieved of pain and spasm.

2. Replication of Position of Strain.

This is another element of SCS methodology.

If as someone bending they slip or their load shifts they might remain locked into a distorted position as in example 1.

If, as SCS suggests, the position of ease equals the position of strain – then they need return to flexion in slow motion until tenderness vanishes from the monitor/tender point and/or a sense of ‘ease’ is perceived in the hypertonic tissues. By adding ‘fine-tuning’ positioning to the position of ease achieved by flexion, greater reduction in pain can usually be achieved. This position is held for 60 to 90 seconds before slowly returning to neutral at which time a some resolution of hypertonicity and pain should be felt.

The position of strain is often an exact duplication of the position of exaggeration of distortion – as in example 1.

Limited Value

These two elements of SCS are described as examples only, since it is not a frequent occurrence to have patients describe precisely in which way there symptoms developed. Nor is obvious spasm such as torticollis or ‘lumbago’ the norm. Ways other than ‘exaggerated distortion’ and ‘replication of position of strain’ are needed to enable identification of positions of ease.

3. Jones’ Tender Points⁵

Through years of clinical experience Jones compiled lists of tender point areas relating to strain of most of the joints and muscles of the body. These ‘proven'(by clinical experience) points are usually found in tissues shortened at the time of strain, rather than those which were stretched.

New points are periodically reported – for example recent sacral foramen points relating to sacroiliac strains.⁶

Jones provided directions for achieving ease tender points being palpated involving maintenance of pressure on the tender point, or periodically probing it, as a position is achieved in which:
a/ there is no additional pain, and

b/ the monitor point pain reduces by at least 75%.

This is then held for an appropriate length of time (90 seconds according to Jones, however there ways of reducing this).

The person with acute low back pain, locked in flexion,will have a tender point in the abdominal muscles short at the time of strain (when the patient was in flexion). The position which removes tenderness from this will, as in previous examples, require flexion and probably some rotation and/or side-bending.

The problem with Jones’ formulaic approach is that the mechanics of the particular strain with which the operator is confronted may not always coincide with Jones’ guidelines. An operator relying on Jones’ formulae may find difficulty in handling a situation in which the prescription fails to produce results. It is suggested that a reliance on palpation skills and other positional release variations offers a more rounded approach to dealing with strain and pain.

4. Goodheart’s Approach^7,8

George Goodheart D.C. (the developer of Applied Kinesiology) has described an almost universally applicable formula which relies more on the individual features displayed by the patient, and less on rigid formulae as used in Jones’ approach.

Goodheart suggests that a tender point be sought in the tissues opposite those ‘working’ when pain or restriction is noted. If pain or restriction is reported or is apparent on any given movement, the antagonist muscles to those operating at the time pain is noted will be those that house the tender point(s).

In examples 1 and 2, of a person locked in forward bending with acute pain and spasm, using Goodheart’s approach, pain and restriction would be experienced as the person moved into extension from their position of enforced flexion.

Irrespective of where the pain is noted when trying to straighten from this position, the tender point would be sought (and subsequently treated by being taken to a state of ease) in the muscles opposite those working when pain was experienced – i.e. it would lie in the flexor muscles (probably psoas) in this example.

Tender points which are going to be used as ‘monitors’ during the positioning phase of this approach are not sought in the muscles opposite those where pain is noted, but in the muscles opposite those which are actively moving the patient or area when pain or restriction is noted.
Goodheart has added various refinement which reduce the amount of time the position of ease needs to be maintained, from 90 seconds to 30 seconds.

5. Functional Technique^9,10

Osteopathic functional technique ignores pain as its guide to the position of ease and relies instead on a reduction in palpated tone in stressed (hypertonic/spasm) tissues as the body (or part) is being positioned or fine-tuned in relation to all available directions of movement in a given region.

One hand palpates the affected tissues (moulded to them, without invasive pressure). This ‘listening’ hand assesses changes in tone as the operator’s other hand guides the patient or part through a sequence of positions which are aimed at enhancing ‘ease’ and reducing ‘bind’.

A sequence of evaluations is carried out, each involving different directions of movement (flexion/extension, rotation right and left, sidebending right and left etc) with each evaluation starting at the point of maximum ease discovered during the previous evaluation, or at the combined position of ease of a number of previous evaluations. In this way one position of ease is ‘stacked’ on to another until all directions of movement have been assessed for ease.

Were the same patient with low back problems(examples 1, 2) being treated using Functional Technique the tense tissues in the low back would be palpated. A sequence of flexion/extension, sidebending and rotation in each direction, translation right and left, translation anterior and posterior, and compression/ distraction, would be painlessly attempted, involving all available directions of movement of the area, until a position of maximum ease is arrived at and held for 30 to 90 seconds. This produces a release of hypertonicity and reduction in pain.

The precise sequence in which the various directions of motion are evaluated is irrelevant, as long as all possibilities are included. Only very limited range of motion would be available in some directions during this assessment and the whole procedure would be performed very slowly.

The position of palpated maximum ease (reduced tone) in the distressed tissues should correspond with the position which would have been found were pain being used as a guide, as in either Jones’ or Goodheart’s approach, or using the more basic ‘exaggeration of distortion’ or ‘replication of position of strain’.

6. Any Painful Point as a Starting Place for SCS.

All areas which palpate as painful are responding to, or are associated with, some degree of imbalance, dysfunction or reflexive activity which may well involve acute or chronic strain (see March, April and June articles in this series).

We might therefore consider that any painful point found during soft tissue evaluation, massage or palpation, including a search for trigger points, could be treated by positional release, whether we know what strain produced them or not, and whether the problem is acute or chronic.

The response to positional release of a chronically fibrosed area will be less dramatic than from tissues held in simple spasm or hypertonicity. Nevertheless, even in chronic settings, a degree of release and ease can be produced, allowing for easier access to the deeper fibrosis.

Treatment of painful tissue using positional release, is possible whether using reducing levels of pain in the palpated point as a guide or whether the concept of assessing a reduction in tone in the tissues is being used (as in example 5 above).

Anything from 20 to 60 seconds are suggested for holding the painless position of ease.

7. Facilitated Positional Release (FPR)¹¹

This involves the positioning of the distressed area into the direction of its greatest freedom of movement starting from a position of ‘neutral’.

The seated patient’s sagittal posture would be modified to take the body or the part (neck for example) into a more ‘neutral’ position – a balance between flexion and extension – following which an application of a facilitating force would be introduced. No pain monitor is used but rather a palpating/ listening hand is applied (as in Functional technique) which senses for changes in tone in distressed tissues as positioning is performed. The final ‘crowding’ of the tissues, to encourage a ‘slackening’ of local tension, is the facilitating aspect of the process. ‘Crowding’ might involve compression applied through the long axis of a limb, or directly downwards through the spine via cranially applied pressure.

The position of ease is usually suggested at just 5 seconds.

8. Induration Technique¹²

Marsh Morrison DC suggested very light palpation, using extremely light touch, as a means of the feeling a ‘drag’ sensation (see March issue of JACM) alongside the spine (as lateral as the tips of the transverse processes). Drag results from hydrosis, the physiological response to increased sympathetic activity, an invariable factor in skin overlying trigger and other forms of reflexively active myofascial areas. Once drag is noted pressure into the tissues normally identifies pain.

The operator stands on the side of the prone patient opposite the side in which pain has been discovered in paraspinal tissues.The point is held by firm thumb pressure while, with the soft thenar eminence of the other hand, the tip of the spinous process most adjacent to the pain-point is very gently eased towards the pain (ounces of pressure only) crowding and slackening the tissues being palpated, until pain reduces by at least 75%.

Somewhere within an arc involving a half circle, an angle of push towards the pain will be found to abolish the pain,lessening any palpated tension. This is held for 20 seconds after which the next point is treated. A full spinal treatment is possible using this extremely gentle approach which incorporates the same principles as SCS and Functional technique.

9. Integrated Neuromuscular Inhibition Technique¹³

INIT involves using the position of ease as part of a sequence which commences with the location of a tender/pain/trigger point, followed by application of ischemic compression (this is optional and is avoided if pain is too intense or the patient too fragile or sensitive) followed by the introduction of positional release (as in number 6 above).After an appropriate length of time during which the tissues are held in ‘ease’ the patient is asked to introduce an isometric contraction into the affected tissues for 7 to 10 seconds after which these are stretched (or they may be stretched at the same time as the contraction – if fibrotic tissue calls for such attention).

10. Fascial Release

Soft tissues are gently moved towards the direction of their greatest ease until ‘release’ occurs. The process is repeated until there exists symmetry of motion in all directions of possible motion.

11. Cranial Methods (applicable anywhere on the body)¹⁴

Restricted structures/tissues are taken towards their direction of greatest ease of motion, at which time this position is held until there is a sense of an attempt by them to return towards the direction from which they have come. This is gently resisted for a short time. Subsequently the barrier usually retreats and the tissues can be taken into greater ease in previously restricted directions, and the process is repeated.

Summary

All methods require positioning to be performed slowly without introducing any additional pain to the patient.

In all variations a slow return to neutral is advised following the holding of the position of ease.

Most of the positional release methods involve movement towards ease, away from bind, using a slackening or crowding of dysfunctional tissues in order to facilitate muscle spindle resetting and improved function.

Despite the gentleness of the methods there is almost always a reaction involving stiffness and possibly discomfort on the day following treatment, as tissues adjust to new their situation and adaptation processes accommodate to these changes.

References

1. Hoover H Collected Papers Academy of Applied Osteopathy Year Book 1969

2. Jones L Strain and Counterstrain Academy of Applied Osteopathy Colorado Springs 1981

3. Walther D Applied Kinesiology Synopsis Systems DC Pueblo Colorado 1988

4. Schwartz H The Use of Counterstrain in an acutely ill in-hospital population J. American Osteopathic Association 86(7)pp433-442 1986

5. Jones L op cit

6. Ramirez M et al Low Back Pain – Diagnosis by six newly discovered sacral tender points and treatment with counterstrain technique J American Osteopathic Association 89(7) pp905-913 1989

7. Goodheart G Applied Kinesiology Workshop Procedure Manual 21st Edition (Detroit – privately published) 1984

8. Walther D Applied Kinesiology Synopsis Systems DC Pueblo Colorado 1988

9. Hoover H op cit

10. Bowles C Functional Technique – a modern perspective J American Osteopathic Association 80(3)pp326-331 1981

11. Schiowitz S Facilitated Positional Release J American Osteopathic Association 90(2)pp145-156 1990

12. Morrison M Lecture Notes presentation/seminar Research Society for Naturopathy, London 1969

13. Chaitow L Integrated Neuromuscular Inhibition Technique British Journal of Osteopathy Vol13 1994 p17-20

14. Upledger J & Vredevoogd J Craniosacral Therapy Eastland Press Seattle 1983

Leon Chaitow DO, former editor of JACM, practices at The Hale Clinic London (0171-631-0156). He teaches widely in the UK, Europe and the USA, and is author of major textbooks including ‘Soft tissue Manipulation’ . He is a senior lecturer on the University of Westminster’s MA in Therapeutic Bodywork course.

Take the simple action of a firm dragging action of a digit or the thumb across an area of skin, in which hyperaemia is produced – a ‘red reaction’.

It is fascinating to go back through the history of bodywork and to find how many ways this simple method has been utilised.

Many researchers and clinicians have described an assortment of responses in the form of such ‘lines’, variously coloured from red to white and even blue-black, after application of local skin dragging friction, with a finger or probe.

In the early days of osteopathy in the 19th Century the phenomenon was already in use.

Carl McConnell D.O.stated the following in 1899:

‘I begin at the first dorsal and examine the spinal column down to the sacrum by placing my middle fingers over the spinous processes and standing directly back of the patient draw the flat surfaces of these two fingers over the spinous processes from the upper dorsal to the sacrum in such a manner that the spines of the vertebrae pass tightly between the two fingers; thus leaving a red streak where the cutaneous vessels press upon the spines of the vertebrae. In this manner slight deviations of the vertebrae laterally can be told with the greatest accuracy by observing the red line. When a vertebra or section of vertebrae are too posterior a heavy red streak is noticed and when a vertebra or section of vertebrae are too anterior the streak is not so noticeable’.

Much more recently, Marshall Hoag D.O. writes as follows regarding examination of the spinal area using skin friction:

‘With firm but moderate pressure the pads of the fingers are repeatedly rubbed over the surface of the skin, preferably with extensive longitudinal strokes along the paraspinal area. The blunt end of an instrument or of a pen may be used to apply friction, since the purpose is simply to detect colour change, but care must be taken to avoid abrading the skin. The appearance of less intense and rapidly fading colour in certain areas as compared with the general reaction is ascribed to increased vasoconstriction in that area, indicating a disturbance in autonomic reflex activity. The significance of this red reaction and other evidence of altered reflex activity in relation to (osteopathic) lesions has been examined in research. Others give significance to an increased degree of erythema or a prolonged lingering of the red line response’.

John Upledger D.O. writes of this phenomenon:

‘Skin texture changes produced by a facilitated segment [localised areas of hyper-irritability in the soft tissues involving neural sensitisation to long term stress] are palpable as you lightly drag your fingers over the nearby paravertebral area of the back. I usually do skin drag evaluation moving from the top of the neck to the sacral area in one motion. Where your fingertips drag on the skin you will probably find a facilitated segment. After several repetitions, with increased force, the affected area will appear redder than nearby areas. This is the ‘red reflex’. Muscles and connective tissues at this level will:

1. have a ‘shotty’ feel (like BBs under the skin);
   
2. be more tender to palpation;
   
3. be tight, and tend to restrict vertebral motion; and
   
4. exhibit tenderness of the spinous processes when tapped by fingers or a rubber hammer’.
   

Roger Newman Turner N.D., D.O. describes the research of another osteopath/naturopath, Keith Lamont N.D., D.O., who first described the ‘black line’ phenomenon:

‘It is a common observation of osteopaths who use a spinal meter, to detect the most active lesions, that pressure on either side of the spine with a hemispherical probe of approximately 0.5 cm diameter, will, in some patients, illicit a dark blue or black line. The pressure of the probe is usually very light since it is intended to register variations in skin resistance, but it has a pinching-off effect on the arterioles and venules of the capillary network beneath the skin. Local engorgement of the capillary bed with deoxygenated venous blood causes the appearance of the line which slowly fades as the circulation returns.’

This is considered to relate to a nutrient deficit in those patients in whom this sign is seen:
Keith Lamont, who first drew attention to the Black Line Phenomenon, has found that administration of vitamin E, bioflavonoid complex and homoeopathic ferum phosphate will correct this deficiency.

Bertrand DeJarnette D.C. the developer of sacrocranial technique, writes extensively on the subject of the ‘red reaction’-

He describes how he initially makes assessments of patients (partly based on blood pressure readings) into various categories, during which process he has them treated in order to alter the relative oxygenation levels which are assumed on the basis of these categories. None of these methods are pertinent to this survey of skin reactions, but are a necessary preamble to his descriptions, which would be confusing otherwise. In a ‘type 1’ patient, who has received the appropriate preliminary attention as outlined (‘carbon dioxide elimination technic’):

‘Sit or stand immediately behind the patient facing the patient’s back. Have the patient bend slightly forward. Be sure the light is even on the patient’s back to avoid shadows. Place the index and middle fingers of your right hand upon the 7th cervical vertebra, having the two fingers about an inch lateral from the spine of the 7th cervical vertebra. Keep the fingers evenly spaced as you go down the spine, so each line is as straight as possible. For the ‘Type 1’ patient (normal BP after appropriate techniques) use a light touch. To produce an even pressure of both fingers on the back they may be fortified by placing the fingers of the left hand over them. As you go down the spine, your pressure will be just hard enough to cause the fingers to dent the skin.

Now draw your fingers down the spine very quickly ending at the coccyx. Step back and watch the reaction. A red line will usually appear all the way down the spine. This soon starts to fade and the fading is what you must watch. The area that appears Reddest as this fading starts, is the major [lesion] for this patient and should be marked with a skin pencil. You will often notice on this type of patient that the major area is much wider than any other area of your lines down the back. This is caused by tissue infiltration’.

The ‘Type 2’ category patient will have slightly high blood pressure after DeJarnette’s preliminary treatment. After adopting the same starting position:

‘Making a firm pressure, draw fingers down the spine, with a fairly slow motion. You should be able to count to 15 while drawing the fingers from the 7th cervical to the coccyx, by counting steadily. With a good light on the back, the results should show a line which becomes red, some portions brighter and some very faintly coloured. Now watch the lines fade. The area which shows the Whitest is marked as the major [lesions] for this is the most anaemic spinal muscle area. It will be paler than any portion of skin on the patient’s body.’

Moving next to the final category which interests us in this survey, (patients with high blood pressure) DeJarnette asks that you adopt the same start position and then:
‘Making heavy pressure, come down the spine slowly, counting 20 as you go from 7th cervical to coccyx. Now watch the reaction. The line that shows the Whitest is the major [lesion]. In this type the blood pressure is over 180 (systolic) the whitest area shows a waxy, pale colour and may persist for several minutes.’

Professor Irvin Korr, writing of his years of osteopathic research described how this red reflex phenomenon was shown to correspond well with areas of lowered electrical resistance, which themselves correspond accurately to regions of lowered pain threshold and areas of cutaneous and deep tenderness.

He cautions:

‘You must not look for perfect correspondence between the skin resistance (or the red reflex) and the distribution of deeper pathologic disturbance, because an area of skin which is segmentally related to a particular muscle does not necessarily overlie that muscle. With the latissimus dorsi, for example, the myofascial disturbance might be over the hip but the reflex manifestations would be in much higher dermatomes because this muscle has its innervation from the cervical part of the cord.’

By use of a mechanical instrument which quantified the pressure applied at a constant speed, followed by measurement of the duration of the redness resulting from the action of the frictional stimulator on the skin, Korr could detect areas of intense vasoconstriction which corresponded well with dysfunction elicited by manual clinical examination.

It could be said that the opportunity to ‘feel’ the tissues was being ignored during all these ‘strokes’, and ‘drawing’ of the fingers down the spinal musculature.

This thought was not lost on Marsh Morrison D.C. who describes his views as follows:

‘Run your fingers longitudinally down alongside the dorsal and lumbar vertebrae (anywhere from the spinous processes extending laterally up to two inches) and stop at any spot of tissue which seems ‘harder’ or different from normal tissue. These thickened areas, stringy ligaments, bunched muscle bounds, all represent indurated tissue; they are usually protective and indicate irritation and dysfunction. Once these indurated areas are palpated press down and almost always they will be sensitive, indicating a need for treatment.’

Morrison used a technique for easing such contractions similar to that later described by Lawrence Jones D.O. in his Strain/ counterstrain system.

Osteopathic researchers, Doctors, Cox, Gorbis, Dick and Rogers, writing in 1983 (regarding their work on identification of palpable musculoskeletal findings in coronary artery disease describe their use of the ‘red reflex’ as part of their examination procedures (other methods included range of motion testing of spinal segments and ribs, assessment of local pain on palpation, and altered soft tissue texture). In this study the most sensitive parameters, which were found to be significant predictors for coronary stenosis, were limitation in range of motion and altered soft tissue texture.

‘Red reflex’ cutaneous stimulation was applied digitally in both paraspinal areas [T4 and T9-11] simultaneously briskly stroking the skin in a caudad direction. Patients were divided arbitrarily into three groups.

• a/ Grade 1 – erythema of the spinal tissues lasting less than 15 seconds after cutaneous stimulation.
  
• b/ Grade 2 – erythema persisting for 15 to 30 seconds after stimulation
  
• c/ Grade 3 – erythema persisting longer than 30 seconds after stimulation.
  

In this context the Grade 3 – maintained erythema – is seen to represent the most dysfunctional response.

Making Sense of the Red Reaction

Clearly there is a good deal to learn from and about the simple procedure of stroking the paraspinal muscles. Whether or not DeJarnette’s preliminary methods are validated does not alter the possible wisdom of his subsequent observations, employing as it does variable pressures and looking as it does at the fading of redness, rather than the initial red reaction itself, for evidence of altered function.

Similarly, Lamont’s nutritional observations would need verification, something which does not alter the fact that some patients demonstrate this unusual ‘black streak’. As with so much in palpation there is little question of ‘something’ being ‘felt’ or observed. It is the interpretation of what it means that excites debate.

The simpler observations of Upledger, Hoag, Morrison and McConnell are readily applicable, and should be tested against known dysfunction to assess the usefulness of these methods during assessment.

The research of Cox et al indicates that one musculoskeletal assessment method alone is probably not sufficiently reliable to be diagnostic, however when for example tissue texture, changes in range of motion, pain and the ‘red reaction’ are all used, a finding of the presence of several of these is a good indication of underlying dysfunction which may involve the process of facilitation.

A Simpler Use for the Reaction

A less complex use of the red reaction is to go back a century to McConnell’s method, described earlier in this special topic note, in order to highlight spinal deviations. By creating erythema paraspinally you can stand back and visualise the general contours of the spine as well as any local deviations in the pattern created by application of your firm digital strokes.

Question:

How do you know whether your palpating fingers or thumbs are applying equal pressure bilaterally during such assessments, or when palpating elsewhere, bilaterally?

A useful guide to the uniformity of pressure can be obtained by comparing the relative blanching of your nail beds; are they equally white, pink, red?

References

1. McConnell C The Practice of Osteopathy 1899

2. Hoag M Osteopathic Medicine McGraw Hill, 1969.

3 Upledger J. Vredevoogd W. Craniosacral Therapy, Eastland Press, Seattle 1983

4. Newman Turner R Naturopathic Medicine Thorsons, Wellingborough UK, 1984

5. DeJarnette B Reflex Pain (Nebraska,1934)

6. Korr I The Physiological Basis of Osteopathic Medicine, Postgraduate Institute of Osteopathic Medicine and Surgery, N.Y. 1970

7. Morrison M Lecture Notes, London 1969

8. Cox, Gorbis, Dick and Rogers Journal American Osteopathic Association vol.82 No.11 1983

Benefits of fasting

1. Fasting provides the body with the opportunity for a ‘physiological rest’ which allows the speeding up of detoxification and healing processes. A demonstration of this was provided by fasting treatment in Japan of people poisoned by toxic cooking oil, in which ‘dramatic’ relief was seen after seven to ten day fasts (American Journal of Industrial Medicine (1984) 5:10-53), and also by treatment of acute pancreatitis where fasting was found to be preferable to drugs or other therapy (Digestion (1984) 30:224-30).
   

   
   

2. Fasting enhances irarnune function. We saw evidence of this in treatment of auto immune diseases such as glomerulonephritis, where fasting shortened its early stages and improved the chances of recovery (Lances (1958) i:760-3). The conclusion of the doctors involved was that ‘all patients with acute glomerulonephritis should fast’. In another auto immune condition, rheumatoid arthritis, patients who fasted showed significant improvement in their ability to grip, in reduction of pain and of swellings, lowered erythrocyte sedimentation rate and improved general functional ability, after a seven day fast (Clinical Ecology (1984) 2:3:137 44). These benefits were confirmed by the one year Norwegian study referred to in Chapter 4.
   

   
   

3. Fasting stimulates production of growth hormone (see Chapter 7) which is of particular significance to life extension. This phenomenon is not as obvious in people who are very much overweight.
   

John Mann, writing in Secrets of Life Extension (Harbor, San Francisco, 1980) said: ‘The effectiveness of fasting as a life extension measure is fairly well backed by experimental evidence.’ He describes one research study in which rats were made to fast on one day out of three throughout their lives (normal eating on the other days). They achieved a 20 per cent increase in life span compared with non-fasted rats. This has nothing to do with calorie restriction, according to Mann, who cites enhanced general function and growth hormone stimulation as more likely factors.

Naturopathic medicine

Fasting for health has been an integral part of naturopathic medicine for a century or more, and practicing naturopaths in Europe, Australia, New Zealand, India, South Africa and North America will have experience of these methods, as will medical doctors who use the methods of treating allergy called Clinical Ecology, since they use five day fasts as a normal measure to investigate and treat chronic allergy.

So how should you go about achieving some of the benefits of fasting, since spending one day in three on water for the rest of your life may well be unappealing! Guidance and advice from such a practitioner as mentioned above is advised should there be any reason (see below) why short fasts should not be conducted on your own, or if you require the support of someone experienced in the method when you first start.

Cautions

1. First, this is not something to do for anything more than a short period (defined as 48 hours) unless you are under the supervision of a health professional who understands the physiology of fasting. Even short one and two day fasts require guidance and this is provided below.
   

   
   

2. No-one who has a serious health problem should fast unsupervised unless they have experience of the process. This includes anyone who is diabetic or pregnant (not that fasting is contraindicated, only that it requires expert guidance under these circumstances).
   

   
   

3. No-one who is currently taking prescription medication should fast unless under the supervision of an expert.
   

   
   

4. No-one who has a history of eating disorders such as anorexia or bulimia should fast unless under supervision.
   

Technique for a short fast

Important note: The fasting methods outlined here are not aimed at treating anything. Therapeutic fasting, while a health problem is being addressed by this method, calls for personal evaluation by a suitably qualified practitioner who would then prescribe a particular fasting pattern, as well as ensuring that some guidance and supervision were available. The fasting which is being described is preventive, and aimed at enhancing already existing well-being, not as a treatment.

1. The ideal way to start a fast is to have a light meal the night before the first day of the fast, say a small bowl of natural yogurt, or a light vegetable or chicken soup.
   

   
   

2. In modern life a weekend is the perfect time for most people to apply fasting, since it interferes least with normal life, especially if they are working during the week (working and fasting are not a good idea at the same time!). You should ensure that you have available a means of contacting a health expert, ideally having warned them that you might contact them if problems or anxieties should occur during your fast (highly unlikely).
   

   
   

3. If you feel ready, then start the fast by having only a bowl of yogurt or soup on Friday night.
   

   
   

4. On Saturday your forward planning should have kept the day clear of any obligation to get involved in anything physical, and you should avoid the need to drive. Arrange to have some light reading or some pleasant music to listen to. Keep the day free of any social or work obligations.
   

   
   

5. Take the day slowly, drinking water (it’s a good idea to add a mere touch of lemon juice to freshen your mouth) whenever thirsty and ensuring that through the day you drink no less than a litre and no more than three litres of water.
   

   
   Some people prefer to fast on diluted juices. Strictly speaking this is no longer a fast, since the sugars in the juice prevent the physiological changes of a fast from progressing (ketotic metabolism).- A sense of hunger rapidly disappears on a fast but is maintained far longer when juices are being used. Juice days (‘restricted diet’) are, however, sometimes useful before and after a fast, and are used as appropriate during a long fast if this is considered necessary by a practitioner. On a short (24 to 48 hours) fast, juice is best avoided, apart from that small squeeze of lemon juice in the water you drink.
   

   
   

6. Expect that on this first day you might develop a headache, a sense of nausea, a furred tongue, and possibly a sense of anxiety and restlessness. More likely though will be a feeling of tiredness and unnatural coldness of your extremities. None of these signs and symptoms is unusual or a cause for any concern. The headache/nausealfurred tongue are all signs of detoxification starting, with some degree of liver overload. They wi11 pass, requiring no treatment, and will, with subsequent fasts and the overall dietary improvement, become less and less obvious as the need for deta~afication reduces and your liver becomes more efflcient.
   

   
   You can clean your teeth or rinse your mouth out whenever the taste becomes unpleasant (a usual occurrence at the beginning of a fast).
   

   
   The symptoms of anxiety/restlessness might indicate that withdrawal signs are appearing in relation to a chronic food allergy. This happens because we literally become addicted to substances to which we are allergic if we have them frequently in our diet. The frequency of exposure prevents them producing obvious allergy symptoms, but produces chronic symptoms (called a ‘masked’ allergy) which you might never relate to allergy. If these symptoms of edginess, anxiety and restlessness do not pass within 24 hours, break the fast (see below for how to do this) and consult an expert (naturopath, clinical ecologist etc.) for further guidance.
   

   
   No medication or supplementation should be taken during a fast, and if you are on a course of such treatment you should clear with whoever prescribed it that you can abandon it for the duration of the fast. If you cannot stop the medication do not fast without supervision. No smoking of any sort should be allowed during a fast.
   

   
   

7. If you do have any detoxification symptoms, avoid at all costs any use of medication to treat this, since the body reacts unpredictably when fasting. A far simpler means of getting rid of the symptoms, if you can’t face continuing with the fast and its early and short-lived symptoms, is to break it (see below). Usually, though, all that is needed is patience and rest to allow the body to take care of itself. All social and business obligations should be put on hold, and stress avoided if at all possible. This is a time for physiological and mental rest.
   

   
   

8. Your bowel function may stop during the fast, and this is not something about which you should be concerned. If a fairly high intake of vegetables (raw) and fruit was achieved on the day before the fast, then a bowel movement should occur during it. If not there is no reason to resort to enemas or other methods of making the bowels open, as they will take care of this function on their own in the fullness of time. Do not be concerned, and do not take anything to reverse the situation, if the bowels do not work for a day or so after the fast (or even if a degree of diarrhea is noticed).
   

   
   

9. Avoid exercise during the fast, although some fresh air and a little walking are fine. It is highly desirable that some exposure to sunshine be achieved (not sunbathing) if possible.
   

   
   

10. As indicated, you might feel a little cold, so dress more warmly than usual (one extra layer of clothing) and rest in pleasant surroundings as much as you can. This is not a social time, but best reserved for sleep, rest and contemplation. Even reading might be too much of an effort in the early stages.
    

    
    

11. By Sunday afternoon you should be feeling comfortable, without apparent hunger, the headache and nausea should have eased, and you should have slept more peacefully than for many years. Your mental function should have a clarity you had forgotten existed. It is time to break the short fast (the same procedure is used for a short and a long fast).
    

    
    

12. Around mid-afternoon on Sunday (assuming you started on Friday night with the small meal recommended) take one of the following:
    
    
    
    1. An apple, either raw or baked in the oven, or lightly stewed (no sweetening) or
       
       
    2. a small bunch of grapes or
       
       
    3. a few prunes or
       
    4. a small bowl of live yogurt or
       
    5. a small bowl (mug) of thin homemade vegetable broth/soup.
    
    

    
    Whichever of these you have, try to make each mouthful a meal in itself, chewing it thoroughly, even when in a liquid state. Take a long time eating this first ‘meal’, and then rest. An hour or so later have another of the choices offered on the list, in a slightly larger quantity.
    

Say that so far you have had some stewed apple at 4 pm, and a bowl of yogurt at 5:30 pm. Now, at around 7:30 to 8 pm have a slightly more substantial intake of food, but only if you feel like it. If you are hungry have either a small mixed salad with cottage cheese, or a lightly boiled egg, or a slightly more substantial (thicker) soup. As before, chew each mouthful for as long as you can. If you are not hungry, wait until breakfast the next morning, at which time resume your normal food intake, although you will probably want a little less than usual.

How often should you fast?

It is an excellent idea to introduce a two day fast as a quarterly part of your programme. Two days of fasting, every three months, is not going to place any great strain on your leisure or social time, and offers a magnificent method of regularly ‘spring cleaning’ yourself.

Some people increase their frequency of fasting to every six weeks, and this is a matter of personal choice. The truth is that the more often you fast, within reason, the less obvious are the symptoms of nausea etc. and the greater are the benefits of clarity of mind and sense of abundant energy and well-being which follow.

What about one day fasts?

A 24 hour fast achieves something, but not nearly as much as the 48 hour version, and the benefits from a one day fast take a lot longer to show. Nevertheless, 24 hour fasts are better than no fasts at all, and they can certainly be applied on a six-weekly or even monthly basis. All other guidelines are the same as for the 48 hour fast given above.

Monodiets

A variation of the fasting technique is the introduction of periodic days, or several days at a time, on one food only – a monodiet. The foods involved are open to personal taste, and among those most successful and popular are grape diet (a period during which grapes only are eaten), rice diet (said to be ideal for helping reduce high blood pressure) and potato diet (like the rice diet, often used for specific health purposes, such as treatment of rheumatic disorders). However, for the purposes of our life extension programme the monodiet is not being suggested as a therapeutic measure, but as an alternative to complete fasting aimed at encouraging general well-being, and preventing health problems rather than trying to deal with them.

If a monodiet is decided on, then all the same rules apply as for fasting. A weekend is ideal, following the monodiet for 48 hours. Less care is needed in breaking the monodiet than would be the case for a fast, so that in a weekend setting the Sunday evening meal could simply revert to a normal one, rather than
going through the various gentle stages required to safely break a fast.

Effects such as headache etc. are possible on a monodiet, but less intensely so than on a fast. Monodiets are recommended for people who wish to avoid the rigours of fasting but who want to increase the detoxification/health enhancing effects which fasting offers. They achieve the same thing as fasting but very much more slowly.

When eating whatever food has been selected, a small amount (say 6 or 7 grapes, or an ounce or two of cooked rice) should be very well chewed whenever hunger is felt, which could be seven or eight times during the day. The total amount eaten should be small (no more than a pound of cooked rice or a pound of grapes through the day). In between, drink water as required.

Raw food

In Chapter 4 the methods used by Dr Bircher-Benner were described, showing some of the remarkable results he obtained in Switzerland and at the Royal Free Hospital, London, using raw food as the only method of treatment of chronic disease such as rheumatoid arthritis. The rich source of enzymes available through eating raw foods makes them a highly suitable addition to the calorie restriction diet, in terms of prevention and enhanced well-being. Raw food days or meals, though, should not be thought of as a treatment for anything in our particular purpose.

The menus discussed in the previous chapter offer the chance to include at least one raw meal daily as a main meal (salad or fruit) and such an approach is highly recommended. It is also possible to further boost the benefits of raw food eating by allotting a day a week to raw food only (a day a week is only a suggestion; it could just as easily be a day a fortnight, or a weekend a month, or any odd day that the mood takes you, whatever is easiest for you). On such days, increase the intake of vegetables and fruits so that you meet your calorie requirements mainly from these sources, with protein and fat being derived from fresh nuts and seeds, or as a single exception to the raw food theme, by a small amount of pulses/grains (say a rice and lentil savoury).

As long as you are getting fairly dose to your calorie, protein and fat requirements (the exact meeting of all needs is not something to become obsessed about) the benefits of raw food eating will be felt, and will add appreciably to the value of the programme. Some people follow raw food eating all the time, and feel nothing but good results. The social difficulties of this might create stress, however, so the suggestion offered is that raw foods should be the main part of at least one meal daily, and that a day every now and then (weekly, fortnightly etc.) should be allotted to raw food only. Raw food patterns are not an alternative to fasting but an addition.

Chelation therapy

In Chapter 8 I described the potential that free radicals have for creating cellular damage and havoc. In the next chapter one of the additional life extension health promotion strategies which will be outlined will be the use of antioxidant supplements which can assist the calorie restriction diet to keep free radicals under better control.

Another method is also available. This is not as a self-help measure, however, but one which has powerful anti-free radical potential. It is chelation therapy, and it uses an artificial amino acid called EDIA. EDTA was first developed to treat people suffering from heavy metal toxicity in industry, such as lead poisoning in shipyards following the painting of ships with leadbased paints. EDTA was used to chelate (chemically bind) with the lead, allowing its elimination from the body. Other benefits were observed after its use, and Elmer Cranton, writing in The Journal of Holistic Medicine (1984 6:21) states the case as follows:

EDTA can reduce the production of free radicals by a millionfold. It is not possible for free radical pathology to take place or be accelerated by metaUic ions in the presence of E1~A. Traces of unbound metallic ions are necessary for uncontrolled proliferation of free radicals in living tissues. EDTA binds ionic metal catalysts, making them chemically inert and removing them from the body.

He goes on to describe an important finding in Switzerland:

Free radical inhibition by EDTA may explain the recently
published observation of Blumer in Switzerland, who reported a 90 per cent reduction in deaths from cancer in a large group of chelated patients (they had all been chelated
following a lead toxicity scare in their area) who had been
carefully followed over an 18 year period. When compared
with a statistically matched control group (who had received
no chelation therapy) Blumer reported a ten times greater
death rate from cancer in the untreated group, compared to the
death rate of the patients who had been treated with EDTA.
A greatly reduced incidence of cardiovascular disease was also
observed.

Here then were people, all living in similar city environments, of the same age and sex, and eating roughly the same diets, who had a 10-fold difference in incidence of cancer, with the only difference between them being that some had received chelation therapy some 20 years earlier, and others had not.

As described earlier, it is now largely a matter of accepted medical fact that free radical damage plays a major part in the onset of cancer and in developing the scene for cardiovascular disease, and EDIA removes this risk dramatically by chelating surplus ionic metals from the system. Elmer Cranton has documented the benefits of EDIA therapy to people suffering cardiovascular and other diseases in his book Bypassing Bypass, and I have given my explanation of its value in my 1991 book Chelation Therapy. Chelation therapy’s only drawback is its cost, since it is generally only available privately unless you are suffering from obvious heavy metal toxicity.

Chelation therapy involves a series of infusions of EDIA in a solution into a vein, a process which takes up to 90 minutes, and which needs to be repeated as much as 20 times over a three month period in order to get maximum benefits. If you wish to learn more about this remarkable and useful approach to switching off free radical pathology you are referred to one of the books just mentioned.

In the next chapter I deal with the usefulness of additional supplementation to augment and support the calorie restriction programme.

Allergic conditions such as asthma have increased by many hundreds of percent over the past forty years in the United Kingdom, where a child born today is six times more likely to develop eczema and three times more likely to develop asthma compared to a child born in the mid-1940s.

Allergy is an over-enthusiastic reaction of the immune (defence) system of the body to any substance it considers to be dangerous. The substance could have entered the body by any route, through being eaten, breathed or absorbed from the skin, and resulting in a typical chain-reaction of biochemical alterations starting in the immune system, which can be easily monitored medically.

The person who suffers from an allergy will usually produce physical symptoms such as skin reactions, digestive disturbances, headache or breathing difficulties in response to the particular substances to which they are allergic, and all too frequently there are also mental and emotional disturbances accompanying these reactions.

However when such a reaction occurs to something consumed, contacted or inhaled, which does not involve a ‘true’ allergic response, it is known as an intolerance or sensitivity which can produce many of the same symptoms as a true allergy.

Intolerance commonly causes symptoms such as joint pain, arthritis-like changes, chronic fatigue and a host of emotional states involving an inability to concentrate, feeling `spaced-out` and woolly-minded, irritable, anxious or depressed?

Although the symptoms of intolerance may be indistinguishable from those which occur in allergy a problem may arise for the patient because the biochemical changes in the blood-stream, which are always present with allergy will not be found, so that the reality of their condition may be questioned by medical personnel, with the condition frequently being labelled `psychosomatic`.

Why are Allergies and Intolerances Increasing?

There seem to be a great many answers to this question, with no two people having quite the same pattern of causes. These might include deficiencies, toxicities, stress factors, various forms of infection, immune depression as well of course as inherited features.

Where food allergy and intolerance is the problem there is often a background in which early feeding patterns seem to be implicated.

At weaning, when solid foods are first introduced to a child, there often occurs a degree of indigestion (colic, loose bowel etc) or behaviourial change (crying, restlessness etc) or catarrhal symptoms (cough, wheezing, runny nose, earache etc) or a skin reaction (redness, eczema etc) or any combination of these, none of which would necessarily be considered by the parents to involve allergy at the time, who often think of these symptoms resulting from infection or `teething`.

These symptoms may be evidence of the infant being allergic/intolerant to one or other of the foods to which (s)he is being exposed for the first time.
By repeated exposure, eating that same food daily or even more frequently (cows’ milk, wheat, citrus etc) the acute response to the food/substance(s) would usually diminish, leaving a background, so-called `masked`, reaction which produces no obvious symptoms for a long time.

In time though, often following some additional stress factor such as an infection (or the antibiotic treatment of an infection), or vaccination, far more obvious symptoms might appear, such as asthma or eczema.

New Zealand Study Confirms This Scenario

Recently a report emerged from New Zealand of a study 1265 children were evaluated for 10 years.

The findings show that children who were introduced to four or more types of solid foods before the age of four months were nearly 300% more likely to develop recurrent eczema than were those children not exposed to early solid feeding.

(Fergusson D Early Solid Feeding and recurrent childhood eczema: a 10 year longitudinal study. Pediatrics 86, 541-546 1990)

Toxicity as Well

In addition to coping with an intolerance or masked allergy the infant in today`s world will be having to handle an increased toxic load in the air it breathes, the things it is in contact with (synthetic carpet for example as well as wall coverings, clothing etc) the water it drinks as well as the presence of pesticides and other toxic products in much of the food it eats.

To cap all this we now know that some of the protective `friendly bacteria` (mainly bifidobacteria infantis) which populate the infant digestive tract have in recent years been severely damaged by among other things the universal presence in breast milk of toxic substances such as dioxin.

This startling finding does not mean that breast milk is dangerous, all alternatives are still infinitely more undesirable, but that we can begin to understand why babies today who are breast fed show the same levels of allergic problems and susceptibility to infection previously only seen in non-breast-fed babies. Until between 25 and 40 years ago babies who were breast fed were far more resistant to infection and had far less allergy than babies who were fed from birth on cow’s milk or formula meals.

One solution to this drastic compromising of infant digestive tract protection is to supplement babies with special cultures of these important friendly bacteria (never supplement a baby with adult forms of bacterial flora). A number of brands are available with Natren’s Life-Start being recommended.

To understand this vital subject more deeply see my book `Probiotics` (co-authored with Natasha Trenev and published by Thorsons).

Chronic Allergies

As the years go by a masked allergy may not be producing many obvious symptoms but will probably be an underlying factor in a host of health problems which seem ‘normal’ (they only seem normal because they are so common !) such as general lethargy, odd aches and pains, intermittent headaches and digestive problems, palpitations, PMT, tendency to fluid retention, chronic sniffles, sinus problems and post-nasal drip, mouth ulcers, bladder irritation and many more.

Unmasking Allergies

One way of establishing the presence of a masked allergy or intolerance is to look at those foods and food families which you consume the most.

• What foods do you actually crave?
  

  
  

• Is it wheat products, sugary foods, soya products, citrus fruit, cow’s milk products, eggs?
  

By removing all or any of these from the diet in a controlled way, one by one, and observing the reaction of the body/symptom pattern, a lot can be learned.
If there is a masked allergy and the offending food is eliminated for at least five days (to allow it to flush completely from the system) symptoms will start to vanish over the next few days.

Warning: There can be severe withdrawal symptoms when such foods are removed from the diet, just as occur when alcohol is removed from the intake of an alcoholic and this sort of approach is best monitored by a naturopath or a doctor who is well-versed in nutrition (ideally a clinical ecologist).

It is usually possible by careful use of supplements and/or homoeopathic medicines to minimise these withdrawal symptoms.

While symptoms of masked allergy in an adult usually disappear after a week or so of avoiding the food in question it can take some weeks for the symptoms to ease in a child with masked allergy.

Rotation of Foods

A food is identified as an allergen when symptoms disappear following removal of the food from diet. It is possible to confirm this link between it and the symptoms by `challenging` the body once more (i.e. eating or drinking the suspected food) ideally within a few weeks of its elimination while the system is still sensitive.

To perform this test the suspect food should be consumed in reasonable amounts, twice in one day, after not having consumed it for some weeks. If symptoms reappear the test is positive and that food should not be consumed again for many months.

The longer it is kept out of the diet the more likely will it be that at a later stage it will be safe to reintroduce without problems, once the sensitivity to it has vanished (months and sometimes years need to pass for this to happen in some cases).

On the other hand it may be possible to resume eating particular foods fairly soon after its elimination as a regular part of the diet but no more often than once in five days. This is the so-called `rotation` pattern of eating.

Other Factors in Dietary Allergy/Intolerance

Many experts believe that it is largely due to an incomplete breakdown of foods that allergies occur. They point out for example that almost all children with asthma have a marked lack of digestive (stomach) acids and that supplementation with Betaine Hydrochloride with meals can have a great effect on reducing symptoms of the condition.

In addition the use of suitable enzyme supplements can improve digestion and minimise allergic symptoms.

Candida and Allergy

The increased use of refined sugars, and the widespread (over)use of antibiotics along with a number of other factors such as the use of the contraceptive pill have allowed a yeast, living in all of us, to escape from its usual limited habitat and to spread to areas previously inhabited by our friendly bowel flora, notably bifidobacteria in the colon and lactobacillus acidophilus in the small intestine.

Once the yeast spreads into these regions and the friendly bacteria no longer produce adequate quantities of the B vitamin biotin the yeast alters into a more aggressive mycelial form which can actually produce rootlets which damage the mucous lining of the bowel. This allows for a degree of malabsorption from the intestines of partially digested food particles and yeast waste products, triggering a defensive reaction in the bloodstream and other tissues affected.

Such Candida albicans activity can be a major contributing factor in many allergy conditions, and requires a specific dietary effort to control the yeast and to repopulate the bowel with strong and healthy micro-organisms.
This yeast involvement is more probable if allergic symptoms started soon after a course of antibiotics (the infection for which it was given often gets the blame rather than the treatment).

William Crook’s book `The Yeast connection` and my shorter description of a similar non-drug treatment programme `Candida Albicans – Could Yeast be your problem? (both available from most health food stores) outline the best way of dealing with this insidious and widespread problem naturally and effectively.

Holistic Approaches to Allergy

Avoidance of contact with whatever it is to which you are allergic deals with one side of the problem, and in many cases allows the body to regain its ability to tolerate the substance(s). The other side of the picture is your body, and if it can be made less toxic, more `hardy`, then it will be better able to cope with substances which might otherwise create allergic problems.

This calls for general health enhancement involving consideration of the whole person, including:

• a balancing of the diet
  

  
  

• taking note of the needs of your body in terms of adequate rest and exercise
  

  
  

• application of detoxification methods (controlled fasting, elimination diets, hydrotherapy methods, herbal and homoeopathic treatment for example) as appropriate (detoxification is covered in depth in my book `Clear Body, Clear Mind` – distributed by Thorsons).
  

  
  

• stress reduction approaches (relaxation and meditation, massage, aromatherapy and reflexology for example)
  

  
  

• and immune enhancement (appropriate supplementation, use of specific herbal products, dealing with candidiasis if present, guided imagery, acupuncture etc).
  

Emphasis on only one side of the equation, avoiding the allergen, will produce inadequate results, it is necessary to deal with both the allergen and the person who is allergic.

Recent Studies Confirm Natural Approaches

In the last few years reports have emerged from some of London`s major teaching hospitals confirming herbal approaches to some forms of allergy. At the Hospital for Sick Children, Royal Free Hospital, University College and Middlesex School of Medicine and Kings College Hospital) tests have been conducted in which traditional Chinese herbal medication has been successfully used in treating atopic dermatitis (eczema) which had previously failed to respond usual to medical methods.

A report states that, ‘In the patients known to us who have taken this treatment we have seen a response rate of 80-90%, and this exceeds the capability of conventional therapy in our hands. Furthermore many patients enjoy a persistent benefit after discontinuation of treatment.’

The doctors admit that they were concerned in case there would be any toxicity, and report, `We have investigated 70 children before and after long-term treatment and can report that full blood counts, urea and electrolytes, liver function tests and creatinine clearance remain normal throughout treatment.’

They have formulated a standardised mixture which they believe will be useful in the majority of cases of eczema.

(Atherton D et al Chinese herbs for eczema The Lancet November 17 1990 p1254)

Success for Homoeopathic and Herbal Treatment of Asthma

A combination of herbal and homoeopathic treatment was recently found to produce excellent results in 86.2% of the 29 asthmatic patients.

The treatment protocol was based on constitutional (i.e. unique to the patient) prescribing of homoeopathic medication, the most common ones employed being Pulsatilla nigricans, Arsenicum album and Kali carbonicum.

Herbal medication used included Bromelaine (pineapple plant extract containing powerful anti-inflammatory and digestive enzymes); Ephedra compound and a combination herbal elixir.

In all cases adults received bromelaine and Ephedra and children the elixir.
(Malave R Mixed modality outcome study of adult and paediatric asthma. Journal of [American] Naturopathic Medicine Volume 2 No.1 pp43-44 1991)

Allergy is increasing because we are seeing the result of a progressive over-burdening of our defence mechanisms.

We can do much to increase the effective functioning of our detoxification and immune functions and to lower exposure to and protect against the effects of undesirable substances, naturally.

For example in cases where the allergen is mainly an inhaled substance, especially if this a volatile (possibly petrocarbon based) substance, protection is often possible by mens of supplementation with anti-oxidants such as beta carotene (for Vitamin A) and vitamins C and E in particular. Also frequently helpful in such cases are amino acids such as cysteine and methionine and minerals such as selenium.

A general supportive programme combining detoxification, overall lifestyle reform for health enhancement, sound nutrition and the help of herbal, homoeopathic and acupuncture methods as needed, offers the safest key to allergy elimination.

Leon Chaitow may be contacted through The Hale Clinic, London W1 (071-631-0156)

2. Techniques Which Can Be Used When Pain is Present Include:

Rest, support, hydrotherapy (including ice), massage, exercise, manipulation, pain killing injections or medication, electrotherapy (including TENS), acupuncture, sclerosing injections for hypo-mobile structures, surgery.
All may benefit from re-education employing stretching exercises, relaxation exercises, stress reducing measures etc.

The safest self-help measures include:

• a/ Muscle energy techniques
  

  
  

• b/ Strain/counterstrain techniques
  

  
  

• c/ Acupressure or neuromuscular techniques
  

These will be all demonstrated and are described in detail in Osteopathic Self Treatment (published by HarperCollins)

3. Good Habits for the Back (Prevention):

• Postural integrity and use of self is main preventive measure. Stand tall as Head/neck relationship is primary (Alexander approach will explain this further)
  

  
  

• Avoid one-legged standing for any length of time.
  

  
  

• Avoid bending from waist, use hips and knees to raise and lower body and weights.
  

  
  

• Try to organise working heights ergonomically (height of tables, desks, working surfaces etc)
  
  Correct height for work surface is judged by standing alongside it wit h arms relaxed. If worktop height is correct it will match level of wrist. Better high than low.
  

  
  

• Sit well back into chair, with adequate support. Ensure that when seated for any length of time knees are at least on same level as hips. If not use small support for feet.
  
  Swedish designed ‘Balans’ chairs in which individual kneels are best, but expensive.
  

  
  

• WHEN LIFTING HAVE WEIGHT CLOSE TO TRUNK, ARMS CLOSE TO SIDES, AND BACK AS STRAIGHT AS POSSIBLE.
  

  
  

• Avoid lifting and twisting at same time especially when back is bent.
  

  
  

• Arch back when sneezing and coughing.
  

  
  

• Try to balance carrying such as shopping bags or suitcases to avoid one sided stress.
  

  
  

• When lifting avoid heavy objects, rather try to lift more frequently with lesser loads each time.
  

  
  

• When placing items into boot of car use knees and hips, and/or spread legs to lower yourself to correct height, all the while keeping back straight. Same for bed making. Better to kneel for this than bend.
  

  
  

• When gardening ensure long-handled tools to avoid stooping action. Use kneeling stool with arms to help getting up and down for lengthy jobs such as weeding.
  

  
  

• Reduce stress levels so that what is being done with muscular action does not involve excessive effort. In other words avoid overuse.
  

  
  

• Sleep on firm surface, sidelying best (face down is harmful to neck and back) using one medium cushion to support space between neck and shoulders.
  

4. What to Do in Sudden Attack of Backache.

Use ice pack (frozen peas!), bed-rest, possible first aid support using strapping or corset type support.

Avoid anything which hurts the area. Stay still. Get advice.

5. When to Call In or Visit an Osteopath or Chiropractor

All chronic back conditions can be helped to some extent, once serious pathology has been ruled out.

Acute back pain where no organic disease is present usually benefits.
Recent studies show chiropractic/osteopathic methods speed up recovery compared with rest of other methods, such as those used in physiotherapy.

6a. Where to Find an Osteopath/Chiropractor

Obtain names of local MROs or MBCAs from registering authority. General Council and Register of Osteopaths, 56 London Street, Reading, Berks. (0734-576585)

Ensure osteopath is member of Register as this guarantees 4 year full-time training or MD training plus osteopathy. Look in Yellow pages for box of MROs or members of British Chiropractic Association. MCOs are members of college of Osteopaths and will have had a six year part time training which is also very sound.

6b. When Should MD be Called First?

If in any doubt as to nature of problem see a doctor or consult a registered osteopath. If the problem is not the result of active degenerative disease (arthritis, osteoporosis etc) an osteopathic practitioner will help to some extent, and will be trained to know what not to treat and when to refer to MD specialist.

6c. What Conditions Should be Suspected in Back Pain Which is Not Clearly of Mechanical Origin?

Pain of mechanical origin will usually cause pain related to movement (not normally painful at rest).

If mechanical pain is severe it may continue at rest but adoption of new position will usually ease it. If pain is persistent at rest suspect deeper pathology or structural damage. Mechanical pain is usually intermittent.

If pain is noted when a joint is actively moved in one direction and passively moved in another then soft tissue involvement is probable.

If joint pain is noted on active and passive motion in same direction then internal joint dysfunction is likely.

7. What Osteopaths Do, What Chiropractors Do.

Methods of joint mobilisation and structural reintegration will be discussed and demonstrated. Basically osteopaths mobilise restrictions with due attention to soft tissues and to total mechanism. Chiropractors tend to deal more with local problem and to use very specific high velocity low amplitude adjustment techniques, usually based on interpretation of x-rays of the area.

In general osteopaths use less invasive (gentler) approaches.

8. Exercises to Help Back Problems.

• Lying on back, light ‘flattening’ of back to bed/floor while alternately, and slowly, stretching heel away from body. Repeat five times each side.
  

  
  

• Lying on back always have knees slightly flexed over cushion/ bolster. Exercise to ease low back tension/disc conditions involves bringing one knee up towards chest, held at knee by same side hand, and then bringing other leg up similarly. Lie holding knees in this curled position (usually painless, stop and abandon if painful). As exhalation occurs ease knees towards shoulders, hold for a second or two and slowly return to starting position on inhalation. Repeat for several minutes (20 cycles or so) Do this every hour or two when in pain.
  

  
  

• Apply ice pack when inflamed for up to 15 minutes at a time. If heat (hot towels are best) ever used always finish with short cold application (half a minute).
  

  
  Ideal to use warmth before exercise and ice after.
  

  
  

• If not completely bedridden SLOWLY perform gentle flexion, extension, rotation and side bending in seated position. Note which movements do not hurt and which do. Perform the painless exercises every two hours for a series of repetitions taking up to five minutes overall and cease any movement which causes more than mild discomfort.
  

  
  Recheck after a few days and reevaluate painful and painless movements and only do painless movements.
  

  
  

• Sit on dining room type seat and ease forwards so that one hand grasps front leg of chair on same side, and to slowly flex forwards running hand down chair leg. Do same other side, then down back one leg of chair and then other. Abandon any movement which is painful. Seated hanging forward breathe deeply and relax for a minute or so before stretching further forward (painlessly).
  

Repeat several times during day.

9. Other Problems:

Osteoporosis, post-natal conditions,

Osteoporosis often involves ‘splinting’, especially in spinal regions. Do nothing physical, apart from ice massage!

Post-natal conditions require evaluation as to type of dysfunction. The sooner an osteopath/chiropractor can be consulted the better.

Trigger point pain. Many back and head/neck pains relate to trigger point (myofascial triggers) activity, which can be safely treated using methods of soft tissue manipulation.

Self stretching and self-massage (tennis ball massage!) can be effective and safe. All self-help measures carry two warnings:

• If it doesn’t rapidly resolve the condition get professional advice and
  

  
  

• If it hurts more than a little stop doing it.
  

All chronic pain conditions require attention to your belief system, with modification if necessary of the attitude to the pain and your understanding of the pain process.

Introduction of element of ‘control’, as well as using safe self-help measures (hydrotherapy, ice massage, self-massage, TENS etc) as well as general dietary guidance and awareness of nature and causes of pain allows for better coping skills to be gained.

10. Pain Reduction via Diet.

Inflammatory processes depend upon presence of substances called leukotrienes.

The main metabolic source of these in the body is from animal fat derived arachdonic acid.

Reduction of meat and dairy fats reduces levels of arachdonic acid and therefore of leukotrienes, thus reducing intensity of inflammation.

This is further helped by addition of fish derived oils (eicosapentenoic acid or EPA) which is found mainly in cold water fish such as herring, sardines and salmon. EPA capsules are available at health stores and pharmacies (and on prescription if your doctor is amenable).

Inflammatory pain processes can be further helped by taking enzyme rich substances such as pineapple bromelaine (Larkhall Laboratories. These proteolytic enzymes should be taken between meals in doses of 500 to 1000mgs daily while inflammation is present.

Further Reading:

Osteopathic Self-Treatment: Leon Chaitow (HarperCollins-Thorsons)

The Back: Relief from Pain Dr.Alan Stoddard (Martin Dunitz)

Feelings of shame, embarrassment, low self-esteem, isolation, frustration, anxiety and depression are extremely common where B.O. is present.

Although sufferers and their families have been shown to gain considerable benefit from sympathetic counseling, and while learning to deal with the stress this condition causes is certainly important – long-term strategies and approaches which deal with underlying causes of increased body odor are probably a lot more important.

Certainly the answer does not lie in antiperspirant and deodorant sprays which at best only mask the problem, although safe forms of these might well prove useful in the short-term – as long as they are not adding to the person’s problem – for example by increasing exposure to and absorption of aluminum – now implicated in Alzheimer’s disease.

Many Causes

The reason why some people smell offensively can have various causes – some easily remedied others not – and it is these which need to be dealt with:

• When B.O. is simply a result of inadequate bathing (and/or cleaning/washing of clothes) the solutions are equally simple – better hygiene, regular bathing/showering as well as the regular washing of clothes – which should ideally always be of natural fibre such as cotton.
• Much B.O. is caused by skin bacterial activity on sweat which has dried on the skin – and this makes people who sweat excessively more likely to be affected. In some people (the excitable ‘greyhound/racehorse’ types) the sympathetic aspect of the nervous system is dominant and they tend to sweat more, whereas in others (the calmer ‘bulldog/carthorse’ type) the parasympathetic aspect dominates and they tend to stay calmer. So keeping stress levels low is important for people who sweat a lot.
• Tactics such as learning relaxation methods and stress coping techniques along with improved nutritional balance, all help to reduce this tendency.
• In women menstruation and stress often dramatically increases the degree of body odor experienced and careful attention to personal hygiene and dietary excellence is called for.
• The efficiency or otherwise of our internal detoxification processes are commonly affected by nutrient imbalances – for example the micro-element zinc has been reported by Professor Derek Bryce-Smith, of Reading University, England, as being deficient in people with body odor.
• A thorough review of nutritional status of anyone with B.O. should be undertaken by a suitable professional nutritional adviser.
• B.O. is sometimes associated with specific health problems including liver dysfunction, diabetes, digestive problems (parasites etc) and yeast infections and these conditions require professional attention and advice.
• Some people with systemic yeast conditions (Candida) carry a ‘beer’ smell – since yeast can turn sugar into alcohol in their body’s very rapidly. Fortunately safe natural anti-yeast dietary and herbal methods exist which can bring such conditions under control.
• Medical tests at Imperial College in London2 has shown that some people with B.O. have imbalances affecting the ‘friendly bacteria’ which live inside all of our digestive systems. If these vital micro-organisms are unbalanced through use of medication (antibiotics and steroids in particular) or a high fat, high sugar, high red-meat, low fibre diet the vital role they play in detoxification of the bowel and in manufacturing important nutrients is impaired and this can lead to aggravation of B.O., as well as to numerous other health problems.
• In such cases ‘repopulation’ of the intestines with healthy friendly bacteria as well as regular short detoxification efforts can be extremely are helpful in both helping to help normalize intestinal flora and to remove toxic debris from the system.

Anyone with B.O. – of any type – should supplement daily with good quality Lactobacillus acidophilus and Bifidobacteria in order to boost their intestinal flora quality.

In addition detoxification via a one day juice or water or fruit only day, two or three times a month (all day Saturday for example) is a useful strategy (but not for people on prescription medication, diabetics or people with eating disorders without supervision by a qualified health care professional).

A balanced diet is also called for if B.O. is a problem, ideally one in which 20% of the diet comes from protein (fish, poultry or vegetarian combinations of pulses and grains), 20% of the diet can come from oils and fats (avoiding animal fats as much as possible) with the balance from vegetables, fruit, pulses and grains.

This should be supported by a daily high potency multivitamin /multi-mineral supplement.

• Some people (about 7% of people complaining of body odor) do not completely digest particular foods because of in-born enzyme deficiencies, or due to acquired digestive problems, and this leads to a body odor in which a strong ‘fishy’ smell is noted -especially around period time (or when the contraceptive pill is being used). The substance which causes this smell is called trimethylamine.2

Dietary changes – particularly reducing foods rich in the amino acids carnitine and lysine and more importantly foods rich in lecithin and choline – can reduce the intensity of the problem in these severe cases.

Researchers emphasize that apart from diet this form of B.O. will be aggravated during menstruation, when there is a fever or when the person is under stress.

When B.O. has this fish-like smell increased care is needed over food selection because studies in London2 have shown that diet irritates this usually inherited condition.

Foods rich in the amino acid carnitine are known to leave residues in the intestines which have to be worked on by the natural flora (friendly bacteria). If very specific enzymes (known as flavin monooxygenases) which break the residues down to an odorless state ready for excretion are in poor supply or are missing (or if the bowel flora are disturbed) the characteristic fish-like odor appears.

For people with this particular ‘fish odor’ form of B.O. the following foods which are rich in lecithin or choline or carnitine/lysine should be avoided or kept to a small part of the daily diet.

These include:

• Chocolate, peanuts, nuts, raisins, cereals. (carnitine/lysine)
  Eggs, soya products, corn, wheatgerm. (choline/lecithin)

Instead of these there needs to be greater emphasis on eating vegetables, rice and fruit – with fish or poultry as protein sources for non-vegetarians.

Although true ‘Fish Odor Syndrome’ is probably the worst sort of B.O. – it fortunately affects a relatively small number of people – and the strategies outlined above can usually deal with its worst aspects.

References

• Bryce-Smith D Hodgkinson L The Zinc Solution Century Arrow 1986
• Ayesh R et al The Fish Odour Syndrome : Biochemical, familial and clinical aspects. British Medical Journal 1993;307pp655-657
• 3. Chaitow L Trenev N PROBIOTICS HarperSanFrancisco 1990

Because of the accumulation in the fatty tissues of almost everyone on the planet of toxic debris from petrocarbons to dioxin and DDT fasting may not be such a safe option any longer, or at least lengthy fasts which produce an uncontrolled delivery of the toxic debris into the bloodstream may no longer be safe unless under strict supervision.

There are arguably only three broad strategies which can offer a beneficial change to the inevitable decline in health caused by biochemical, mechanical (posture etc) and emotional stressors impacting anyone’s defense systems:

1. Removal of causes (improved nutrition, exercise patterns, relaxation) so reducing the demands being made on the adaptive, repair and defense capabilities of the body.
   
2. Improvement of the adaptive, repair and defense capabilities of the body by methods which enhance immune and repair functions.
   
3. Treatment of the symptoms – either in a way which causes no new problems (the ideal) or in ways which mask symptoms and actually create new problems, depending upon which model of health care you follow.
   

This is sometimes referred to as ‘vis medicatrix naturae’ or the ‘healing power of nature’. In German texts it is often referred to as ‘awakening the physician within’, and in more scientific terminology as ‘enhancing homeostasis’.

Such methods appear to work by allowing space, giving a healing opportunity and doing the opposite of forcing a solution, which may offer only short term benefits.

Fasting sits at the centre of such approaches, along with relaxation and meditation methods, the use of relaxing hydrotherapy methods (such as the ‘neutral bath’), the use of non-specific bodywork (‘wellness massage’ and aromatherapy relaxation methods for example) and employment of techniques which have a balancing, harmonising, normalising influence – including some herbal and acupuncture methods. None of these methods, in themselves, is ‘curative’, but all allow a healing potential to operate more efficiently because they offer the body-mind complex physiological rest,essential time, space and reduced demands which encourages normalisation and recovery, irrespective of whatever is wrong.

This is not to say that such methods can produce absolute remedies in all cases, since in many instances pathology will have created so much change, so much damage, that the best that can be hoped for is that matters do not get worse, or that there is a marginal improvement. This is nevertheless an infinitely better outcome than a steady decline into ever more ill health.

Trevor Salloum ND describes the benefits of fasting,

“Decreased weight, clearer skin, increased elimination, tissue repair, decreased pain and inflammation, increased concentration, relaxation, plus spare time and savings in the cost of food.Perhaps the greatest benefit is the satisfaction that you are taking a major role in improving your health.”(1)

The Aging Arocess – and Fasting’s Anti-aging Potential

There are a number of competing theories as to just what constitutes the mechanics of the aging process, but there is an increasing agreement that it is probably a combination of interacting elements – all happening at the same time. This was neatly summarised in Newsweek (March 5 1990) by journalists Sharon Begley and Mary Hager,

“One theory holds that the changes that accompany aging are the inevitable result of life itself. DNA, the molecule of heredity, occasionally makes mistakes as it goes about its business of synthesising proteins; metabolism produces toxic avengers (free radials) that turn lipids [fats] in our cells rancid and proteins ‘rusty’. This damage accumulates until the organism falls apart like an old jalopy….The other theory argues that aging is genetic, programmed into the organism like puberty. there is evidence for both sides.”

So we either gradually start to malfunction and fall apart because of wear and tear and the effects of accumulated toxic materials, and/or the whole process is as inevitable as growth, puberty and the menopause – it is preprogrammed in our cells.

Research into how to slow down this inevitable process has been focusing ever greater attention on to what has been termed ‘calorie restriction’ as a means of successfully reversing (or at least slowing) the decline into decrepitude and death.

The principle researchers in this field are Americans Richard Weindruch PhD and Roy Walford MD. (2)
I have summarised their work and added other evidence to support the value of ‘calorie restriction’ (which includes the use of fasting, monodiets and exclusion/elimination diets) in my own books on the subject, Natural Life Extension and my detoxification text Body Tonic (formerly published by GAIA as Clear Body Clear Mind)(4)

Short Fasts? Long Fasts?

Fasting for longer than two days can hardly ever cause harm, although some short-term symptoms might be noted, as will be discussed later.

Some experts say that up to five days of unsupervised fasting is acceptable – however I disagree and insist that no-one fasts for longer than four days without the advice and potential for supervision from a health care professional who is qualified to give advice, in case symptoms of an unpredictable nature start during a fast.

And What Are The Risks?

In the medical literature up to 1985, involving thousands of cases of fasting, usually involving severely ill patients often with life-threatening conditions, there are only 7 cases of death reported and in five of these drugs were administered during their fast, something which is quite definitely contraindicated. (4), (5), (6), (7), (8)

As Joel Fuhrman MD explains,

“If we look at the details of these cases we can clearly see that the individuals were fasted improperly, using multiple drugs during the fast, in patients who had heart failure and kidney disease prior to the fast…..[some of] these patients drank unrestricted amounts of coffee, tea, and fruit juice during the fast and were given digoxin, diuretics and anticoagulants. These were not total fasts, and might more appropriately be called coffee and fruit juice feasts.”

Contraindications to Extended (beyond 48 hours) Fasting

1. Emaciation. Anyone who is severely underweight, for any reason should not fast for long periods. However controlled short fasts can assist in normalising reasons for the emaciation in some cases (malabsorption problems for example).
   If emaciation is due to advanced cancer, TB or AIDS or to an eating disorder such as anorexia, then fasting of any sort should not be undertaken.

2. Fasting during pregnancy. There exists danger to the foetus in some instances – especially if the woman is also diabetic. Any fasting of a pregnant woman should be under strictly controlled and supervised conditions and for a clearly defined reason. Fasting is contraindicated when breast feeding since milk flow is likely to cease and will be difficult to start again.

3. Type l diabetics should not be fasted according to many experts, however some allow fasting as long as glucose levels are tested frequently and insulin intake adjusted according to lowered needs during a fast. Type ll diabetics should also be checked regularly, and they will probably find that sugar levels are normalised during the fast.

4. Infants should not be fasted for longer than two days, and they seldom need even that length to respond well to this method of health promotion. There is seldom any reason for avoiding a short fast (36 to 48 hours) in a child of any age, should this be indicated (infection, digestive upset, skin reaction, etc.)

5. Kidney failure is thought to be a sound reason for avoiding fasting since the process makes excessive demands on remaining kidney function. However under controlled conditions short fasts can be helpful in such cases.

6. Medium-Chain Acyl-CoA Dehydrogenase (MCAD) deficiency is a very rare enzyme defect which makes it difficult for the body to process fatty acids which are mobilised during a fast. In such cases urine may appear light in colour which is unusual during a fast when great deal of waste (ketones) are being processed.Extreme lethargy and vomiting are early signs. Such problems would only present a danger on a long fast, and not during a short (48 hour) fast because the mobilisation of fats would not be advanced until some days of fasting.

7. Long fasts are contraindicated in anyone with severe liver disease or severe anaemia, however repetitive short fasts may be beneficial as part of an overall strategy to assist or normalise such problems.

8. There are strong contraindications to even short-term fasting for anyone who is taking prescription drugs. If a health condition is such as to warrant regular intake of such medication then the condition should be treated in such a way as to avoid long fasts or unpredictable reactions could occur. This is particularly true of anyone taking steroid medication, or who has taken steroid medication in the past for long periods. A similar caution is required regarding anyone taking forms of hormone replacement, such as in cases of underactive thyroid.
   

   
   In all such cases (where steroid – hormone medication is current of has been prolonged) supervision of the fast is essential, in a controlled environment – clinic, hospital etc. whether or not weaning from the medication has been possible prior to the fast.
   

   
   Physician Joel Fuhrman MD explains his approach to patients on medication if he wishes to have them fast,
   

   
   

   
   “Normally, I taper medication as the patient adopts a healthy diet and postpone the fast until it is safe to discontinue most medication…….If patients cannot reduce their dependency on such agents [toxic drugs which combined with fasting can cause toxic insult to the kidneys] through dietary and nutritional management prior to the fast, they are not suitable candidates for a fast.”(10)

   
   

   
   Among the forms of prescription medication which indicate that fasting should be avoided would be the current use of antidepressants, non-steroidal-anti-inflammatory drugs, aspirin, oral hypoglycaemic drugs, anti-coagulant drugs, chemotherapeutic drugs, anti-hypertensive medication.
   Once these have been safely stopped, with a physicians approval, fasting can commence, however if the fast is to last for more than 48 hours supervision is suggested.

9. Anyone habitually using ‘social’ drugs (alcohol, tobacco, street drugs etc) should be very carefully detoxified (as well as stopping the habit) before any long-term fasting is considered. All signs of withdrawal should be passed before fasting is used, and careful monitoring of their condition should be continued throughout long-fasts. Short fasts, interspersed with other detoxification method are preferable.

10. No-one who is afraid of the idea of fasting should be asked to do so. There are gentler ways, including mono-diets which can start the process.
    

Common Side-effects of Fasting

Awareness of the likely side-effects of fasting is important for both the person undertaking the fast and anyone supervising or looking after them. Such ‘side-effects’ are usually relatively mild and are rarely serious, and include:

• Headaches (usually lasting less than a day – and common at the start of a fast). Cold compresses, warm foot baths and neck massage should help.

• Insomnia is not uncommon at the start of a fast. A ‘neutral bath’ is often helpful as are the use of essential oils.

• Nausea and a coated tongue are usual on a fast. Scraping the tongue and use of a herbal mouth-wash can help reduce these symptoms. Gentle acupressure on the ‘anti-nausea’ point (P6) on the wrist should help minimise this symptom.

• Dizziness, lightheadedness and palpitations are common early symptoms and highlight the need for rest and for no driving or use of machinery requiring strength or concentration during a fast. Relaxation and slow deep breathing exercises are suggested to assist in the normalisation of these transient symptoms.

• Increased body odour, skin rashes and dry skin may appear during a fast. Regular warm but not hot showers or aromatherapy baths using appropriate oils are suggested. All such symptoms decrease as regular short fasts are undertaken.

• Increased discharge from mucous membranes (nasal, vaginal etc) often occurs and this should be allowed to happen unchecked.

• Aching limbs and muscles may occur and can be minimised by use of aromatherapy oils in a neutral bath, massage and doing light stretching exercises.

• It is normal to feel colder than usual during a fast so the individual should dress more warmly than usual and add an extra blanket to the bed.

• As a rule hunger vanishes after the first day of a fast.

• Bed-rest is not essential or even desirable unless the physical condition demands it. Fresh air and a little gentle exercise are helpful but excessive exercising (aerobic) and sunbathing should be avoided to conserve energy and prevent dehydration.

• The bowels may stop functioning during fasting and this is not a concern. In long fasts if there is a history of a toxic bowel an enema or colonic irrigation may be suggested, although this is seldom necessary.
  

Possible (rare) Side Effects During Long Fasts

• If serious symptoms occur on a long fast, such as a sudden drop in blood pressure, or a feeling of extreme cold which persists, or a prolonged, rapid and weak pulse, or extreme weakness, or difficulty in breathing then the fast should be stopped. These symptoms are unlikely to occur on short fasts, but are possible on long-fasts which highlights the need for supervision and the regular checking of vital signs.

• If vomiting and/or diarrhoea occur and are persistent then expert advice should be sought. It is essential to maintain liquid intake at an optimum level.

• If acute anxiety and emotional distress are experienced then the fast should be carefully broken (vegetable broth, yogurt, steamed fruit etc).

• If there are signs of hepatic or renal problems the fast should be terminated.

• Uric acid levels in the bloodstream rise during a fast and if there is a history of gout caution is required. High levels of fluid intake can ensure that gout is an unlikely outcome of fasting even if uric acid levels become relatively high.
  

Lab Tests During Long-term Fasting (more than 4 days)

• Salloum, Burton and Fuhrman as well as many other experts suggest that during a supervised long fast there should be daily assessment of vital signs (heart, blood pressure etc) and weekly evaluation of electrolyte levels and reserves (which should be repeated if vomiting and/or diarrhoea or sudden weakness are noted)

• Before a long fast is started liver and kidney tests should be performed. A long fast should be ruled out if the liver or kidneys are in a distressed state.

• No specific patterns of laboratory results are predictable during a fast, with individual characteristics being evident depending upon overall health status and any concurrent medical problems.

• Liver enzyme levels may rise, with or without liver disease being present.

• Cholesterol and triglyceride levels usually rise as fat stores are mobilised and uric acid levels rise (they should all fall after the fast).

• Blood glucose levels decline in most fasting individuals (and normalise subsequent to the fast).

• Erythrocyte Sedimentation Rate (ESR) usually decreases during a fast while most aspects of complete blood count remain stable if hydration is adequate.

• Increased specific gravity of urine usually indicates inadequate hydration. A variety of unusual products are commonly found in urine during a long fast.

• Insulin and thyroid hormone levels usually drop during a fast, while growth hormone increases (except in obese patients). Other increases usually include serum melatonin (assisting sleep and stress reduction), glucagon, cortisol, plasma norepinephrine.

• Blood pressure is likely to drop as is weight and pulse rate.

• A marked improvement occurs in immune function, especially during the first 36 hours of a fast. There may be raised levels of T-lymphocytes and lymphokines, decreased complement factors, decreased antigen-antibody complexes, increased immunoglobulin levels, enhanced natural killer cell activity, heightened monocyte killing and bactericidal activity and marked increase in resistance to infection in the post-fast period.
  

1. Salloum, T. Fasting – Patient Guidelines Textbook of Natural Medicine (eds Pizzorno J Murray M) Bastyr University, Seattle WA. 1987.

2. Weindruch, R. & Walford R The Retardation of Aging by dietary restriction. Charles Thomas Springfield Illinois. 1988.

3. Chaitow, L. Natural Life Extension Thorsons 1992 & Clear Body Clear Mind GAIA London. 1991.

4. Burton, A. Fasting too long Health Science 2:144-146. 1979.

5. Cubberley, P. et al Lactic acidosis and death after treatment of obesity by fasting New England Journal of Medicine 272:628-630. 1965.

6. Norbury, F. Contraindications to long-term fasting JAMA 188-88 1964.

7. Kahan, A. Death after therapeutic starvation The Lancet i:1378-1379 1968.

8. Salloum, T. Burton A Therapeutic fasting Textbook of Natural Medicine (eds Pizzorno, J.; Murray, M.) Bastyr University, Seattle WA. 1987.

9. Stewart, W. Fragmentation of cardiac myofibrils after therapeutic starvation Lancet i:1154. 1969.

10. Fuhrman, J. MD Fasting and Eating for Health St. Martin’s Press NY. 1995.
    

In a different way the soft tissue techniques which have evolved out of osteopathy allow a further expansion of the range of conditions which massage therapists and aromatherapist can successfully address.

Osteopathy has gradually moved (and continues to move) away from the traditional means of joint mobilisation (high velocity thrusts for example) towards increased use of methods which accepts that most dysfunction in joints is the result of soft tissue dysfunction. Techniques for normalisation are therefore less invasive and aggressive.

These methods which include what are generally called ‘muscle energy’ techniques as well as functional methods (including Strain/counterstrain) and Neuromuscular Techniques (which address local soft tissue dysfunctions including trigger points) are loosely combined under the heading of soft tissue manipulation.

Many osteopaths now find that by using such approaches they can deal more effectively than previously with joint restrictions and pain, in less time, with less effort, and far more safely.

From the perspective of the massage therapist and aromatherapist this opens a treasure chest of technique possibilities.

The only factor retarding aromatherapists and massage therapists seems to be a significant (in some cases) lack of knowledge of anatomy and physiology, something which can be remedied by additional study….after which the availability in workshop settings of training in use of these safe and powerful soft tissue methods can allow a significant widening of the scope of what can be successfully treated.

Assessment

In order to adequately deal with soft tissue dysfunction the therapist needs to be able to assess and identify what is dysfunctional. The questions which need answering include:

• Which muscle groups have shortened and contracted?
  

  
  

• Which have become significantly weaker?
  

  
  

• What ‘chain reactions’ of imbalance have occurred as one muscle group (because of its excessive contraction) has inhibited and weakened its antagonist?
  

  
  

• What postural stresses have such changes produced and how is this further stressing the body as a whole, affecting its energy levels and function?
  

  
  

• Within particular muscle areas which are stressed how can we rapidly (using at least five different palpatory method) identify local soft tissue dysfunction such as trigger points?
  

In other words what palpable, measurable, identifiable evidence is there which relates to the symptoms (pain, restriction, fatigue etc) of this patient ?
And what can be done to remedy the situation, safely, effectively and quickly.
These are the questions and answers which the methodology of soft tissue manipulation offers.

Different Muscles Respond Differently to Stress

One of the most exciting revelations over the past decade has come from research which shows without question that particular muscles will shorten when stressed while others will not shorten but become increasingly weak (see reference 1 in particular).

The stress can result from poor posture, occupational patterns, repetitive movement, injury, emotional or other stress factors.

The muscles which shorten are the primarily postural ones and it is possible to learn to conduct, in a short space of time (ten minutes or so) a diagnostic sequence of simple tests in which these can be identified as being short/contracted or normal.

Postural Muscles

Those muscles which respond to stress by shortening comprise the following :
Gastrocnemius, soleus, medial hamstrings, short adductors of the thigh, hamstrings, psoas, piriformis, tensor fascia lata, quadratus lumborum, erector spinae muscles, latissimus dorsi, upper trapezius, scalenes, sternomastoid, levator scapulae, pectoralis major and the flexors of the arms.

Once any of these is identified as being short (as mentioned, a rapid screening of all is possible and desirable) there exist a powerful range of easily applied methods which allows them to be painlessly stretched back to a more normal state.

This is called ‘Muscle Energy Technique’.

Muscle Energy Methods

The following methods are suggested for use in any shortened soft tissue as long as the starting point is at the restriction barrier (for acute conditions) or short of it (for more chronic conditions).

Note: Restriction barrier in this and all other instances is defined as the first signs of resistance as the muscle is taken towards its end of range, not the furthest position obtainable.

Starting from the appropriate position, based on degree of acuteness or chronicity, the patient is asked to exert a small effort AWAY from the restriction barrier (20% of available strength say) towards an unyielding resistance provided by the operator’s hands.

This effectively isometrically contracts the shortened muscle(s) and this contraction is held for 7 to 10 seconds (longer, up to 30 seconds, if the condition is chronic) together with a held breath (if appropriate).

On slow release of the contraction the shortened muscle is taken (painlessly) to its new restriction barrier if acute or slightly and painlessly beyond the new barrier if chronic (and if chronic, held there for 7 to 10 seconds in slight stretch).

This pattern is repeated until no further gain in length is achieved.
Alternatively the antagonists to the short muscles can be used by introducing a resisted effort TOWARDS the restriction barrier followed by a painless stretch to the new barrier (acute) or beyond it (chronic).

Use of antagonists in this way is less effective than use of agonist but may be a useful strategy of trauma has taken place.

Example: PSOAS

As an example of what one ‘trouble-maker’ postural muscle can do we can examine psoas.

• Psoas has a powerful reciprocal agonist-antagonist relationship with rectus abdominus with important postural implications since as psoas shortens it results in ever increasing weakness of the abdominal muscles.
  

  
  

• Lewit tells us in addition that Psoas spasm causes abdominal pain, flexion of the hip and typical antalgesic (stooped) posture. Problems in psoas can profoundly influence thoraco-lumbar stability.
  

  
  

• If you see or palpate the abdomen ‘falling back’ rather than mounding when the patient bends forwards this indicates normal psoas function. Similarly when lying supine if the patient flexes knees and ‘drags’ heels towards buttocks (keeping them together) the abdomen should remain flat or ‘fall back’.
  

  
  If the abdomen mounds or the small of the back arches, psoas is incompetent.
  

• If the supine patient raises both legs into the air and the belly mounds it shows that the recti and psoas are out of balance. Psoas should be able to raise the legs to at least 30 degrees without any help from the abdominals.
  

  
  

• Goodheart points out that there exists an intimate link between psoas behaviour and sternomastoid behaviour (a psoas in spasm will influence SCM on the opposite side of the body and vice versa. Increased tonus in one will produce similar increase in tonus in the other).
  

  
  

• Psoas fibres merge with (become ‘consolidated’ with) the diaphragm and it therefore influences respiratory function directly (as does quadratus lumborum).
  

  
  If the lumbar erector spinae group of muscles is in a weakened state then bilateral psoas contraction/spasm/shortening will result in a loss of the lumbar curve, or even a reversal of it.
  

  
  If however the erector group are hypertonic then similar psoas problems will produce an increase in lumbar lordosis.
  

  
  

• It is useful to assess changes in psoas length when treating by periodic comparison of apparent arm length.
  

  
  Patient lies supine arms extended above head, palms together so that length can be compared. A shortness will commonly be observed in the arm on the side of the shortened psoas, and this should normalise after successful treatment.
  

  
  

• Basmajian informs us that the psoas is THE MOST IMPORTANT postural muscle.
  If it is hypertonic the abdominals will weaken and a chain reaction of imbalance will result.
  

Treatment of Shortened PSOAS

1. Psoas can be treated with the patient lying face down. The operator lifts with one hand the thigh (knee bent or straight) to its EASY resistance barrier (no force). The other hand stabilises the sacrum to prevent arching of the back.

The patient takes the thigh towards the table with a slight effort for 7 to 10 seconds and the releases and relaxes. as the leg is extended through the resistance barrier for a short stretch. This is repeated until no further gain is possible.

2. A better position is to treat from the supine position, in which the patient is at the very end of the table, non-treated leg flexed at hip and knee and held in that state by the patient.

The leg which is to be treated hangs down.

If the condition is acute the leg is allowed to commence treatment from the restriction barrier, whereas if chronic it is taken into a somewhat more flexed position to be in the mid-range.

The patient’s effort is to lift against resistance.

After the isometric contraction, using effort suitable to the degree of acuteness/chronicity, the thigh should either be taken to the new restriction barrier, without force, if acute, or through that barrier with slight, painless, force if chronic and held there for 10 seconds or so. Repeat until no further gain is achieved.

Note: Direct inhibitory pressure techniques onto the origin of psoas, through the mid-line is an effective alternative approach.

Conclusion

Massage therapists / Aromatherapists have in Soft Tissue Manipulation a powerful additional set of methods combined with simple and accurate diagnostic methods.

References

1. Karel Lewit Manipulative Therapy in Rehabilitation of the Locomotor System Butterworth Heinemann 1992

2. Irvin Korr Neurobiological Mechanisms in Manipulation Plenum Press 1980

3. J. Basmajian Muscles Alive Williams and Wilkins 1978

4. Leon Chaitow Soft Tissue Manipulation Thorsons/Harper
Collins 1989

5. Leon Chaitow Palpatory Literacy Thorsons/Harper Collins 1991

6. David Simons and Janet Travell The Trigger Point Manual William and Wilkins 1983

These are treatment systems which also offer a basic philosophy for living, which if followed is claimed to prevent much of the illhealth which afflicts modern humans.

Quite simply naturopathy is a system which is concerned with the whole person, rather than just the problems afflicting his/her various organs and systems. Naturopathy recognizes and uses the fact that the body is a self-healing organism, working with the knowledge that if the right environment and opportunity for self-healing can be created repair, recovery and good health will result, spontaneously and illhealth will be prevented.

Homoeostasis
Most forms of illness are self-limiting.

Cuts heal, breaks mend, infections are controlled, digestive upsets settle and emotional upsets resolve themselves … as a general rule.

The mechanisms which achieve these resolutions are together known as homoeostasis.

This is the self-balancing, self repairing process achieved by efficient working of the immune system and other defence mechanisms in action.

Naturally enough when these self-repair systems become overwhelmed or deficient they may require assistance, and this is where treatment comes into the picture.

What is essential from a naturopathic (and logical) point of view is that whatever treatment is used it should not make matters worse. Ideally treatment should encourage the self-healing mechanisms rather than dictating to them or forcing them into particular actions.

Top Symptom Treatments and Alternatives

A recent survey of UK medical prescribing trends showed that far and away the most costly and common conditions treated by drugs are those related to ulcers and high blood pressure (each of these problems cost the NHS many hundreds of millions of pounds annually!).

The causes of peptic ulcers and high blood pressure have much in common, and these can be summarised as a combination of nutritional imbalances, poor stress coping abilities and (often) undesirable habits such as smoking (all interacting with certain predisposing, inborn, characteristics in many cases).

To take medication to control these conditions, except when the condition threatens life itself, does not address the real needs of the sick person, it just controls and masks the problem.

Naturopathic methods to both conditions would include:

• reform of the person’s diet as well, where indicated, as the use of specific supplementation
  

  
  

• the possible use of periods of detoxification (including short fasts if necessary, during which time remarkable degrees of self-repair occur)
  

  
  

• the use of structural normalisation (using osteopathy and various soft tissue techniques for example) to help the general function of the body as a whole and to reduce mechanical stress factors
  

  
  

• the introduction of appropriate forms of stress reducing methods including breathing and relaxation techniques
  

  
  

• help (perhaps using supplements and/or acupuncture) in breaking old habits such as smoking
  

  
  

• the use of homoeopathic and/or herbal substances to assist in the healing process but not to suppress the symptoms.
  

Here then naturopathy would offer a fully comprehensive approach to the patient with the problem (whether it be peptic ulcer,hypertension or anything else) and not an attack on the symptoms alone.

Which approach, drugs or these holistic methods, seem to you to be addressing the real needs of the sick person?

Fever: Leave it Alone or Treat it?

Naturopathy believes that not only should symptoms not be the main focus of treatment, they should often be recognised as being the very expression of self-healing in action, and allowed to run their course.

When you have a fever for example this is evidence of your body’s defence systems dealing with something out of the ordinary, perhaps an infection by a bacteria or virus.

In 9 cases out of 10 this will resolve itself without any treatment at all (especially if you are well nourished and cope well with stress) and only needs to be helped by adequate rest and suitable nourishment (liquids only for the first 24 hours of a fever has been shown to enhance immune function dramatically).

When however a fever is met by an instant attempt to suppress it (`the child has a temperature, we must get this down!` syndrome) what is being done is in direct conflict with the real needs of the person, unless the fever is actually life-threatening, which is rare indeed, and in which case appropriate medical care is essential.

Naturopaths recognise that fever is usually an expression of self-healing, a heightened degree of immune system activity. Naturopathic care would aim to help the immune system to do its job efficiently, initially by dietary modification and/or controlled fasting.

In addition it would use methods which would make life more comfortable while these necessary internal processes are doing their job (massage and osteopathic manipulative techniques can for example assist in the drainage of lymph, the fluid which carries debris away from the site of infection).

Some naturopaths would assist the healing process further by judicious use of herbs or homoeopathic medication, neither of which would be aimed at suppressing the fever but which would support the body’s efforts.

Similarly hydrotherapy or acupuncture might be used to reduce discomfort and assist the self-healing work of the body.

Contrast the happy outcome of such a naturopathic effort with the result of the use of drugs to bring down the temperature, leaving the underlying condition unresolved and a frustrated immune system denied its opportunity to act on the invader.

So important as a healing aid do naturopaths see elevated temperature to be that in some conditions of on-going infection (as occurs in AIDS and in some instances of chronic fatigue) an artificial temperature is created by careful use of hydrotherapy (a method called hyperthermia, in which the person’s body temperature is slowly raised by immersion in hot water).

This has no long-term side effects (but needs to be expertly supervised) unlike the long-term overuse of antibiotics which has resulted in a massive rise in the number of resistant bacteria as well as doing untold damage to the health of many people’s digestive tracts where `friendly` bacteria (upon which our health depends to a large extent) have been severely compromised.

Arthritis as Another Example

Arthritis too can be superbly treated by naturopathic means.

Contrast the difference between methods used in orthodox medicine which directs attention towards reducing the inflammatory process involved in arthritis, with little understanding of the ways in which the condition can be more safely treated by attention to causes, unlike naturopathic medicine.

Opren, and the widespread use of other anti-inflammatory drugs, resulted in most people who used them for any length of time actually having worse arthritis in later years than did those people who had no treatment at all (not to mention digestive systems which had been well and truly damaged).

Why should this be?

Because as with a fever, inflammation is part of the self-repair mechanism on which our health depends.

If the reasons for the inflammation can be dealt with the condition improves spontaneously. Even if it can’t fully resolve itself the inflammatory process leads ultimately to a degree of self-healing which is superior to what happens if inflammation is chronically suppressed.

Naturopathic approaches to both osteo- and rheumatoid arthritis have now been vindicated by recent studies in Norway (published in the Lancet 12 October 1991) which show that fasting and a vegetarian based diet have a major impact on the levels of pain, stiffness and disability in people with arthritis.

This together with the ‘new’ medical findings that meat, citrus fruits and certain other foods are harmful in arthritis has been known by naturopaths for 100 years or more and yet the medical studies which prove the value are only just being recognised.

Modification of diet together with some basic naturopathic therapies (focusing on both mind and physical structures) offers the safest and most effective approach to arthritis, because causes are being dealt with and not just symptoms.

Working With the Body

Naturopathy encourages the self-healing potential by a combination of the removal of obstacles to its efficient working alongside active involvement/treatment which assists it through one form of therapy or another.

Holistic Thinking Started with Naturopathy

The idea of looking at the person with a health problem, at the overall condition of health or ill-health, in the context of the person’s lifestyle, dietary pattern, stress levels, attitudes and beliefs, habits, relationships, environment and social background, is essentially naturopathic and is the foundation thinking which has now been adopted by doctors who believe in holistic principles.

Individuality

The study of emotional (psychological), structural and biochemical (diet, toxicity, deficiency) factors as they interact with the unique individuality (biochemical, structural, emotional and genetic) of each of us, to create a formula for health or ill-health, is the naturopathic way of understanding the complex influences affecting everyone, and has its roots in classical Greek medicine as practised by Hippocrates.

This way of looking at health and disease is essential to unravelling the causes and therefore the solutions to health problem according to naturopaths, since it relates all those attributes which we inherit from our parents to all that has happened (and is happening) to us in life, up to this point in time, to our current health status.

However naturopathy is far more than this logical, rounded, way of understanding the human condition as it relates to health and disease, it is also a revolutionary way of approaching the treatment and indeed the prevention of illhealth.

Disease is seen as an imbalance in the harmony of body/mind function which, by attention to predisposing features, most ill-health can be prevented and much removed once it exists.

Definitions

Definitions are slippery things, and attempts to nail down just what the word naturopathy means have resulted in the term having different meanings in different countries, and even having various meanings within the same country, to different groups.

In Germany, where naturopathy is practised within the national health service, practitioners using it are known as `heilpraktikers` – health practitioners.

They use the main methods of naturopaths everywhere : nutrition, controlled fasting, stress reduction methods and counselling, hydrotherapy (often including colonic irrigation methods), exercise and lifestyle changes as basic ways of influencing their patient’s conditions. However they go further and incorporate into their methods of treatment the use of herbal and homoeopathic medicines, physical methods such as massage and manipulation as well, in many instances, as the use of acupuncture and other Oriental methods of treatment.

This eclectic approach to healing is the same as that used by naturopaths in the US, Australia, India, South Africa and Israel.

In America and Israel there are major naturopathic colleges which provide no less than four years of full time education in naturopathic medicine (the Israeli course runs to just under 5500 hours) and include all of the methods and systems mentioned above as well as training in mid-wifery.

Sadly in the UK naturopathy is far less comprehensive, and is in fact divided into two forms. A relatively narrow one which insists that alteration of diet and lifestyle and modification of habits plus a degree of psychological counselling can achieve all that is desired in terms of healing, with little or no treatment advocated; and another form which lies somewhere between that narrow formula (often called ‘straight nature-cure’ or natural hygiene) and the German/US version of naturopathy.

The main UK college of naturopathy (British College of Naturopathy and Osteopathy) has in recent years focused its attention more on the osteopathic content of its four year course, with the naturopathic training offered being largely related to nutrition and lifestyle influences on health.

The naturopathic component of the six year part-time osteopathic course offered by the College of Osteopaths is at least as comprehensive as that taught by the BCNO, which also now hosts a short (under 100 hours) post graduate course produced by the British Naturopathic Association for suitably qualified practitioners (chiropractors, doctors etc).

The abbreviated content (as evidenced by the time involved) of this BNOA course highlights the enormous philosophical differences between the US, Germany, Israel and the UK as to just what naturopathy is and is not, and many question just how much naturopathy can be learned in this short time-scale.

Fortunately many British naturopaths have adopted an eclectic approach to healing and incorporate methods such as homoeopathy, herbal medication and acupuncture which they have learned separately from their naturopathic training.

If you want to consult a naturopath in the UK you should contact a member of one of the following organisations, but before booking an appointment check whether the practitioner uses eclectic (many modalities) or ‘straight’ naturopathy, and select according to your feelings on this subject.

The British Naturopathic and Osteopathic Association,

6 Netherhall Gardens, London NW3 5RR

The College of Osteopaths Practitioners Association,

110 Thornhill Road, Thames Ditton, Surrey KT7 OUW

Incorporated Society of Naturopaths

1 Albermale Road, The Mount, York YO2 1EN

The Natural Hygiene Society

College Contacts : BCNO as BNOA address above
College of Osteopaths : as per address above

The Israeli College of Natural Health Sciences
16 Beit Hillel Street, Tel Aviv 67017

Bastyr University
144 N.E.54th, Seattle, Washington 98105 USA

National College of Naturopathic Medicine
11231 S.E. Market Street, Portland, Oregon 97216 USA

Further Reading:

Naturopathic Medicine by Roger Newman Turner (Thorsons)

Before looking at the amazing things they do for us we should reflect on just how many of them we house.

There are several thousand billion in each of us (more than all the cells in your body!) divided into over 400 species, most of them living in your digestive tract.

If they were all placed together the total weight of the of friendly bacteria would come to nearly four pounds weight and in fact about a third of the faecal matter (water removed) which you pass consists of dead or viable bacteria.¹

What Do They Do?

These bacteria are not parasites. They do not just take up residence and do nothing in return…indeed they pay their way handsomely. We live in true symbiosis with them.

As long as you are providing them with a reasonable diet (and the foods that are good for you are the ones that are good for them) and as long as they remain in good health they provide excellent service in return.

However not all of the friendly bacteria do the same things, some being far more useful and plentiful than others and it is on these that we will concentrate.

Among the most important of their proven roles are some functions which help maintain our good health while others have a definite value in helping us regain health once this has been upset.

These dual roles (protective and therapeutic) help explain why the word ‘probiotics’ was coined since it means ‘for life’.

1. They manufacture some of the B-vitamins including niacin (B3), pyridoxine (B6), folic acid and biotin.²
   

   
   

2. They manufacture the milk-digesting enzyme lactase which helps you digest calcium-rich dairy products.³
   

   
   

3. They actively produce anti-bacterial substances which kill or deactivate hostile disease-causing bacteria. They do this by changing the local levels of acidity or by depriving pathogenic bacteria of their nutrients or by actually producing their own antibiotic substances which can kill invading bacteria, viruses and yeasts.^4,5
   
   Naturally enough they are doing this to preserve ‘their’ territory, not because they love you!
   

   
   

4. Some (such as the bifidobacteria and acidophilus) have been shown to have powerful anti-carcinogenic features which are active against certain tumours.⁶
   

   
   

5. They improve the efficiency of the digestive tract and when they are weakened bowel function is poor.⁷
   

   
   

6. They effectively help to reduce cholesterol levels when this is high.⁸
   

   
   

7. They play an important part of the development of a baby’s digestive function and immune system. Bifidobacteria infantis is acquired from breast-milk and when it is in poor supply allergies and malabsorption problems are more common.⁹
   

   
   

8. They help protect against radiation damage as well as deactivating many toxic pollutants.¹⁰
   

   
   

9. They help to recycle oestrogen (one of the female hormones) which reduces the likelihood of menopausal symptoms and osteoporosis.¹¹
   

   
   

10. Therapeutically they have been shown to be useful in treatment of acne, psoriasis, eczema, allergies, migraine, gout (by reducing uric acid levels), rheumatic and arthritic conditions, cystitis, candidiasis, colitis and irritable bowel syndrome and some forms of cancer!¹²
    

Meet the Cast

Some of the friendly bacteria which help you most are residents, others are transient visitors, staying in your digestive tract for a few weeks before passing on.

The key players in this drama of life and death, territorial demands and ferocious battles involving villains of great power and heroes with surprising weapon systems, are as follows:¹³

• Lactobacillus acidophilus: This is the main inhabitant of your small intestine in humans and animals. It is also found in the mouth and vagina.
  

  
  Acidophilus manufactures lactase to digest milk sugar and produces lactic acid which suppresses undesirable bacteria and yeasts. Some strains produce natural antibiotics. They also lower cholesterol levels and kill Candida yeasts.
  

  
  They are very susceptible to poor diet and stress conditions (pollution, antibiotics such as penicillin).
  

• Lactobacillus bulgaricus: This is a transient but very important bacteria. Together with Streptococcus thermophilus it makes yogurt. Some strains of bulgaricus and thermophilus also produce antibiotics which kill harmful bacteria.
  

  
  By manufacturing lactic acid these encourage a good environment for the resident bacteria such as acidophilus and the Bifidobacteria.
  

  
  

• Bifidobacterium bifidum and B.longum: These is a the main inhabitants of your large intestine. Bifidum is also found in the vagina and the lower part of the small intestine.
  

  
  In breast-fed infants and adolescents these make up 99% of the entire flora of the bowel. There is strong evidence that the numbers and efficient working of these bacteria decline as we age and with any decline in our health status.
  

  
  They produce a number of specialised acids and use these to prevent colonization of the large intestine by invading bacteria, yeasts and some viruses.(see Box)
  

  
  They help infants retain nitrogen thus increasing their weight and they prevent potential toxicity from nitrites in your food; manufacture B vitamins for you as well as helping detoxify bile from which they recycle oestrogen in women.
  

  
  

• Bifidobacteria infantis: This is the main inhabitant of every infant’s intestines and is found in small amounts in the vagina. Its functions are very much the same as the other Bifidobacteria.In a freeze-dried form it is the only probiotic product which should be supplemented to infants without professional guidance (see Box)
  

What Damages the Friendly Bacteria?

Many factors influence just how healthy the flora are. While the type of friendly bacteria living in a region may seem much the same in health and disease, the tasks they perform change according to circumstances.

For example when Bifidobacteria are in a good state of health they will detoxify pollutants and carcinogens as well as manufacturing the various B vitamins as listed above. When in a poor state of health however they just cannot do these jobs as well or at all.

So what makes them function less efficiently?

• The level of local acidity is one major influence and this is affected by your diet and digestive function and most importantly by any stress you are under.¹⁴
  

  
  

• Another important influence is the wave-like contraction of the intestines (called peristalsis) which moves food along the intestines.
  

  
  If it is too rapid (as in diarrhoea or irritable bowel syndrome or colitis) this severely reduces the efficiency of the flora.
  

  
  If it is too slow (as in atonic or spastic constipation) this too causes changes in their function.
  

  
  

• The type of diet you eat is a major influence on bacterial health.
  

  
  They are healthier on a diet rich in complex carbohydrates (vegetables, whole grains, pulses) and low in animal fats, fatty meat and sugars. They also love cultured dairy products (especially ‘live’ yogurt and cottage cheese).¹⁵
  

  
  So not surprisingly the diet which is good for you is also ideal for them!
  

  
  

• They are also influenced to a major extent by the degree of infection by yeasts and bacteria to which ‘their’ territory (your bowels) are subjected.
  

  
  

• And they are severely upset by certain drugs especially antibiotics (penicillin will kill a friendly bacteria just as efficiently as it will kill a disease-causing bacteria).¹⁶
  

Steroids (hormonal drugs such as cortisone, ACTH, prednisilone and ‘the Pill’) also cause great damage to the bowel flora.

How can they regain health and efficiency once damaged?

By dealing with any of the factors listed above which you can, especially your diet and by stress reduction, and by supplementing with good quality freeze-dried bacteria.

How can you be sure of the quality of supplemental friendly bacteria?

There are many undesirable products on the market, and it is only by insisting on the best that these can be eliminated.

• For example we have seen what the main inhabitants of the intestines are, and which transient bacteria are most helpful to them and these are the ones which should be supplemented (bifido, acidophilus and bulgaricus).
  

  
  

• Some products carry ‘cocktails’ of bacteria which should not be together in a container and which are only minutely a part of the total flora picture, such as Bacillus laterosporus and Streptococcus faecium.
  These should be avoided.
  

  
  

• Even cocktails of the best friendly bacteria should not be found in the same container since they are destined to inhabit different regions of the digestive tract and will damage each other if confined together.
  

The way products are made is very important:

• When being separated from the ‘soup’ (supernatent) in which they are cultured some manufacturers spin the bacteria (in a centrifuge). This damages the delicate chains of bacteria, something which does not happen when a slower (and therefore more expensive) filtration process is used.
  This information should be on the container.
  

  
  

• Similar damage can occur if the bacteria are encapsulated or tableted, which means they are best found as a powder in a dark glass (never plastic) container.
  

  
  

• Viable cultures of strains of the particular bacteria you want, which are capable of re-colonising the intestines need as a rule to be refrigerated after the opening of their container and should be taken away from meal times so avoiding the extreme acidity of the stomach when it has food in it.
  

  
  

• All good products should carry guarantee of numbers of viable colonising bacteria up to a specific expiry date.
  

  
  

• If you look for such information on the container of friendly bacteria you will find that very few meet all the requirements listed. One manufacturer which does guarantee ALL the above is Natren of California and these are recommended.
  

When to Use Probiotic Products:

Under professional guidance if their are chronic bowel problems or on-going infections such as Candidiasis.



As a preventive against food poisoning when travelling (Bifidobacteria and Acidophilus kill most food-poisoning bacteria)



After (and during) any period when antibiotics are taken.



B.infantis should be given to all babies.



By all premenopausal and menopausal women to reduce chances of osteoporosis.



By anyone with high cholesterol problems



By anyone with chronic health problems (acne, skin problems, allergies, arthritis, cancer, etc) under professional guidance.



By anyone receiving radiation treatment.



By anyone having recurrent vaginal or bladder infections (thrush or cystitis)

Box/Panel

Two major health problems, Rheumatoid arthritis (Rh.A) and Ankylosing spondylitis (A.K.) have been found to be associated with overgrowth in the intestines of particular harmful bacteria, proteus and klebsiella respectively.¹⁷

Both of these can be controlled by healthy bowel flora. The natural antibiotics manufactured by L.bulgaricus, L.acidophilus and the bifidobacteria ALL kill both of these bacteria.¹⁸

British research has shown benefits to people with A.K. if they go onto a diet low in fat and sugar and high in complex carbohydrates – the very diet the friendly bacteria enjoy and which allows them to do their job efficiently.
Rh.A patients have been shown to benefit in recent Norwegian trials, from a vegetarian diet, something which also dramatically improves the health and function of the friendly bacteria.

Which Bacteria can the Friendly Flora Control?

Many studies prove the antibiotic effects of the friendly bacteria.

In 19 cases of non-specific infection of the vagina treated with acidophilus (Doderlein bacillus strain) 95% were cured.

In 25 cases of Monilia vaginitis 88% were cured and 12% relieved of symptoms.

In 444 cases of Trichomonas vaginitis 92% were cured and remained infection free up to a year later.¹⁹

The acidophilin antibiotic which L.acidophilus produces will kill 50% of 27 different disease causing bacteria.²⁰

16 Children with salmonella poisoning and 15 with shigella infections were cleared of all symptoms using acidophilus. B.bifidum effectively kills or controls E.coli, S.aureus (cause of toxic shock syndrome) and shigella. Acidophilus can also control viruses such as herpes.²¹

Box/Panel

German research has shown that the state of the intestinal flora (measuring both numbers and quality of colonies) of most breast-fed babies today is similar to that of formula (bottle) fed babies 40 years ago, leading to malabsorption and food sensitivity problems as well as increase in allergies and susceptibility to infection.²²

Further research has pointed to contamination of breast milk, world-wide, with pollutants such as DDT and dioxin.²³

This suggests that supplementation of all babies with Bifidobacteria infantis would be a helpful strategy (available as Life-start from Natren of California)

References

1. Leon Chaitow Natasha Trenev: Probiotics; Thomas Harper Collins 1990

2. Alm L. et al: Effect of Fermentation on B Vitamin Content of Milk in Sweden; Journal of Dairy Sciences 65:353-359

3. Alm L.: Journal of Dairy Sciences; 64(4)509-514

4. Friend B. Shahani, K.: Nutritional and Therapeutic Aspects of Lactobacilli; Journal of Applied Nutrition 36, 125-153

5. Hamdan I.: Acidolin and Antibiotic Produced by Acidophilus; Journal of Antibiotics 8, 631-636

6. Reddy G.: Antitumour Activity of Yogurt Components; Journal of Food Protection 46, 8-11 1983

7. Shehani K.: Role of Dietary Lactobacilli in Gastointestinal Microecology; American Journal of Clinical Nutrition 33, 2248-2257

8. Mott G.: Lowering of Serum Cholesterol by Intestinal Bacteria Lipids 8,428-431 1973

9. Rasic J.: Bifidobacteria and There Role; Birkhauser Verlag Boston 1983

10. Simon G.: Intestinal Flora in Health and Disease Physiology of the Intestinal Tract (ED.Johnson L) pp1361-1380 Raven Press New York 1981

11. Speck M.: Interactions Among Lactobaccilli and Man; Journal of Dairy Sciences 59,338-343

12. Chaitow L. Trenev N.: Probiotics; Thorsons/Harper Collins 1990

13. Microbial Ecology of Intestinal Tract; Old Herborn Universty, Herborn, Germany as Seminar Monograph 1987

14. Giannella R. et al: Gastric Acid Barrier T Ingested Microorganisms in Man; Gut 13,251-256

15. Henteges D.: Effect of High-Beef Diet on Bacterial Flora of Humans; Cancer Research 37,568-571

16. Finegold S.: Effect or Broad Spectrum Antibiotics on Normal Bowel Flora; Annals of New York Academy of Sciences 145, 269-281

17. Chaitow L. Trenev N.: Probiotics; Thorsons/Harper Collins 1990

18. Shahani K.: Natural Antibiotic Activity of L.acidophilus and Bulgaricus; Cultured Dairy Products Journal 12(2)8-11

19. Butler B.: Bacterial Flora in Vaginitis; American Journal of Obstetrics and Gynaecology 79, 432-440

20. Fernandes C. et al: Control of Diarrhoea by Lactobacilli; Journal of Applied Nutrition 40,32-42 1988

21. Weekes D.: Management of Herpes Simplex with Virostatic Bacterial Agent; EENT Digest 25 1983

22. Grutte F.: Human Gastrointestinal Microflora pp39-44 J. Barth Verlag Leipzig 1980

23. Scecter A. Health Hazard Assessment of Chlorinated Dioxin and Dibenzflurans in Human Milk; Chemosphere 16,2147-2154