The word “fever” is taken from the Latin word favere which means “to warm”. In adults, the normal body temperature is considered to be 98.6 F (37C), with young children being slightly higher. While the onset of a fever may be frightening , it is not caused by a breakdown of the body’s temperature-regulating mechanism as in heat stroke. Rather, it is the bodies normal self-preserving mechanism of “hyper-functional repair”. In other words, a fever is a normally occurring body process that destroys the infecting agent or toxemia and repairs the damage done by these agents. It acts to preserve the status quo of the healthy body.

Fever may occur for a variety of reasons. It is most often a response to a bacterial or viral infection that has occurred because of the body having a lowered resistance. But fever may also occur when toxic wastes have accumulated in the body, the increased temperature serves to neutralize and eliminate the toxemia. In response to the offending agent’s influence, an elevated temperature acts to increase resistance to disease and restore the body to health. Fever has been shown in research to elevate the white blood cell count. White blood cells act to bind toxic materials and engulf microorganisms, aiding in their removal from the body. In addition there occurs an elevation in the heart and respiration rates which aid to spread oxygenated blood to the site of infection. Microorganisms do not tolerate high oxygen environments well and are less likely to multiply. In addition, the body’s metabolic rate increases, causing elimination of toxic wastes from the infection site. While enhancing these normal body mechanisms to fight disease, fever also acts to lessen microbe growth. Most microorganisms that cause harm to the body are only able to live within a narrow temperature range. A higher temperature destroys these organisms by restricting their growth and allowing the white blood cells to get the upper hand.

In the wholistic view, an elevated body temperature is the organism’s way of correcting an imbalance between its own “vital force” and the external environment. Viruses and bacteria prevalent in the air, soil and water around us cause infections when a persons “vital force” is no longer able to oppose it. When we are in good health, exposure to these infective agents can occur without the person getting sick. This is why some people get a “flu bug” that is going around while others are unaffected.

Welcome Companion to Disease

It is important in therapy to support a fever, allowing it to do its work by eliminating the infective agent or toxin and building the immune system. If not allowed to complete its natural progression, the body will become progressively weaker, unable to mount the reactive power to overcome disease. Administering agents that block the ability to mount a fever is similar to teaching a child to tie their shoes then never allowing them to do so because someone finishes it for them. When the time comes to do it on their own, they are not able to do a good job as they have not been able to practice and are not well prepared.

Fever then should be a welcome companion to any disease process. It signifies that the body is attempting to eliminate the disease and toxic influences upon it. The process can be enhanced by following a few simple guidelines.

1. Rest – decrease all unnecessary activity, take the day off from work or keep the child home from school. Take the time to keep warm and read a good book, or if your body tells you, sleep.
2. Increase fluids – drink at least 6-8, eight ounce glasses of water a day for an adult and slightly less for a child. If you feel the need for more, then do so. Decrease all foods, taking only soups and broths for nourishment.
3. Medicines – take only those that enhance fevers and sweating. Teas such as Yarrow, Chamomille or Cat Nip enhance this mechanism and also help to calm the person. Other immune stimulating herbs or homeopathic medicines are excellent for this process, and may be used along with hydrotherapy techniques which enhance their action.
4. Monitor the temperature frequently – especially in a child. Rectal temperatures run 0.5 F above oral temperatures and those taken under the arm will be 0.5-1.0 F below the oral value. The new electronic digital thermometers (battery operated), are felt to be slightly inaccurate compared to the standard mercury ones. This should be kept in mind if the temperature starts to approach 105 F. The skin temperature measuring strips are good only as a screening test and a more accurate measure is needed to obtain a true value.
5. Observe – for changes in behavior, levels of consciousness or onset of convulsions and dehydration. Most parents have little problem with this as “parental intuition” plays a role. Your “feeling” should be listened to as it may prevent a fever or illness from getting out of hand. Dehydration may be assessed by pinching and feeling the skin on the face and hands for turgor (does the skin bounce back to its normal position) and dryness and observing the tongue for moisture. In newborns, retraction of the fontenells is a sign of dehydration as well. If in doubt, contact your physician.
6. Let the person know – you are there for them and that you care. This is felt to be one of the main therapeutic values of “chicken soup”. Often times this is all it takes to ally fears and anxiety, which will aid in the healing process. Fear and anxiety have been shown in studies to depress the immune system.

Science Discovers Fevers

In studies done with animals, it has been discovered that with the first onset of fever, they will seek out a warm place in which to lie quietly. They refuse all food and take fluids only as necessary to maintain that which is lost with perspiration. Children and most adults, respond to fever much like animals. A child will often find a warm place to lie down or cling to an adult and insist on being held tight. They usually do not wish to eat their most favorite foods (even ice cream), and tend to drink fluids sparingly, or if perspiring. As time goes by, they tend to become more quiet and less likely to tell you what is wrong unless they are uncomfortable.This commonly observed behavior has been termed “adaptive withdrawal” and serves to concentrate the body’s efforts on fighting the disease process.
Some children however, may not show any discomfort with fevers below 102F (39 C) and, in fact, may wish to continue to be active and play. This may not hold true for infants, but refusal to breast or bottle feed and easy or unexplained irritability may be a sign of illness and fever.

Elderly persons do not often manifest temperatures like children or adults do, as they generally develop a lower temperature for a similar condition. In general, the elderly have a narrower tolerance range than adults or children and so a fever in an elderly person should be viewed as being serious and the reason for its occurrence should be sought.

Body Responses to Infection

When infection occurs, there may be a gradual or sudden onset of fever. Frequently it is of a gradual nature, but is more noticeable when it announces its presence with sudden chilling and shivering. When this happens, the body’s thermostat receptors in the brain, spinal cord, and in other parts of the body suddenly reset themselves at a higher mark. Vasoconstriction (flushed face and coldness of the hands and feet) and shivering occur. The heart and respiration rates increase and the person affected may become lethargic and wish to sleep or excitable, alert and restless. As the blood pours into the body’s central core for warming, the skin will often feel hot and dry while the hands and feet may feel cold. Pyrogens, given off by white blood cells, serve to increase temperature by acting with the body’s prostaglandins to reset the thermostat. Aspirin, which will reduce a fever, inhibits prostaglandin synthesis. Association of aspirin usage in children with fevers and the onset of Reyes Syndrome (inflammation of the brain), has made this type of therapy less popular in recent years.

After the body has reached a sufficient temperature to overcome the infection, its “thermostat” resets at a lower temperature and sweating occurs. The fever is said to have “broken” and it is a sign that the crises has now passed. The person affected will begin to feel better after resting.

As the person recovers, sweating may occur periodically as the body attempts to cool things down to keep the temperature from getting higher. For this reason, the fluid intake should be monitored, particularly in children, because fluid replacement is essential if prolonged sweating occurs. One of the values of “chicken soup” lies in its fluid and electrolyte (sodium, potassium, chloride and other mineral salts) content which helps replenish body fluid stores. If fever is accompanied by vomiting, then they may be given by enema in order to rehydrate. If diarrhea is present, then intravenous fluid replacement is necessary if the condition is prolonged.

Fevers above 106 F should be controlled as brain damage may take place. While a core body temperature of 105 F to 106 F will not cause damage, the brain is comprised of much more delicate tissue than other organs and convulsions may occur. Convulsions are one of the first signs, along with extreme lethargy and unresponsiveness, that a fever is too high and should be brought down to a manageable 102 F to 104 F. Cold compresses to the neck and scalp will help decrease the temperature as will rubbing with alcohol or a Brand (decreasing temperature) bath. Anytime convulsions are present, the person should be seen by a physician immediately, especially if it is a child.

Fever without sweating is of concern, because elimination of toxins through the skin is important to temperature regulation and the body’s ability to maintain optimal metabolic function. A fever can go on for a longer period of time provided it is accompanied by sweating. A high fever with no perspiration is cause for concern especially if the person is uncomfortable and unresponsive. In general, a fever can last anywhere from 1-4 days at temperatures between 101 F and 104 F and are higher in the morning and lower in the afternoon.

The duration of a fever is as important as how high it is. A high fever for a short period of time is tolerated better than a high fever for a longer period because there is less depletion of body energy reserves. The longer a fever goes, the less stamina a person has. While this varies from person to person, a person with a fever running longer than 4 days with no changes, should see a physician.

How one tolerates a fever then, depends upon how high it goes, how long it lasts, if there is sweating, and how much energy reserve a person has. In general, if the person eats well, tends to have few illnesses, and when they do, illnesses of short duration, and are fairly alert and oriented; they undoubtedly have a strong constitution and will be better able to handle the effects of a fever. They also tend to mount a fever quickly, a sign of a strong immune system.

By contrast the person who is frequently or chronically ill, has poor eating habits or eats poor quality food, and tends to be low energy when not ill is less likely to weather the effects of a fever. He or she will not spike the high temperatures needed to overcome the infection but will tend to have lower fevers which “hold the line” against infective agents but are unable to overcome them. Elderly persons are often in this group as a result of the ageing process, narrow tolerance ranges and generally poor diets.

Ideal Fever

Ideally a fever will follow a pattern somewhat like this. There is a period of incubation when the infective agent or toxin has taken hold. This is where we first notice that we are getting a cold or flu and are feeling a bit “under the weather”. Next, there is an aggravation period when temperature elevation occurs. The person tends to go into “adaptive withdrawal” as chilling often occurs. The destruction period is marked by a sustained high temperature to eliminate the infective agent and toxins. Next is the abatement stage which is characterized by sweating to bring down the fever; as mentioned previously, the fever is said to have “broken” and the person begins to feel better. The reconstruction period is the time when one wants to rest, as the body uses this time to restore its strength and resources.

For the most part fevers follow this pattern. There are exceptions however and different types of fever patterns can point to various infective agents.
Fevers in adults tend to show up differently than in children because “grown ups” often do not allow their body’s to fight the infection the way it was designed to. More often than not, adults continue to work and not rest, eat meals even though they may be nauseated or not hungry, take medications to “get rid” of symptoms and, in general, ignore the process. Continuing to ignore the condition will only prolong it and in the long run, make it worse.

It is interesting to note that many of the elderly will undertake actions that act to enhance the body’s healing mechanisms similar to those discussed earlier in children. Perhaps this is due to lifestyle patterns learned in early childhood when there were fewer medicines available to counteract fever symptoms. It is also possibly due to instinctual patterns inherent in our body’s which are now heeded, as the effects of illness can be much more serious in this age group.

Only through supporting the body and its natural ally, fever, will it be able to overcome the disease or toxic process and simultaneously strengthen the vital force. In the long run it will make for less illness and a longer, healthier life.

The US Environmental Protection Agency (EPA) became concerned about PFOA after removing PFOS (perfluorooctanic sulphonates) – the active ingredient in Scotchgard – from the market in 2000. PFOA belongs to the same class of environmentally hazardous, carcinogenic chemicals.

PTFE has been around for a good 50 years, but we’re only beginning to understand the health consequences of this prevalent polymer. Once again, the manufacturers (in this case, DuPont) have served up decades of scientific spin. In fact, the EPA is currently suing DuPont for failing to report information concerning PFOA.

In the meantime, these are the most pressing health hazards we know of so far.

Cholesterol

A series of studies point to an increased risk of heart attack and stroke in workers exposed to PFOA. In 2001, onetime PFOA manufacturer 3M (who made Scotchgard) published its own study showing that workers consistently exposed to Teflon® for five to 10 years had a risk of fatal stroke that was 15 times higher than that of non-exposed workers (www.ewg.org/issues/pfcs/20041216/index.php).

More recently, DuPont released its own study linking PFOA to higher levels of cholesterol. According to a January 2005 DuPont press release, analysis of the blood and urine of 62 workers exposed to PFOA showed “an approximate 10 per cent increase in total cholesterol (most of which was in the LDL fraction) and a rise in triglycerides among some individuals having PFOA levels of greater than 1000 parts per billion”, which are levels at least 200 times higher than that found in the general population (www2.dupont.com/Media_Center/en_US/assets/downloads/pfoa/nr01_11_05a.pdf).

Polymer fume fever

PFOA isn’t the only Teflon® chemical of concern. A report by the Environmental Working Group (EWG), a Washington, DC-based non-profit research and advocacy organisation, showed that PTFE can break down when heated for as little as two to five minutes or, in one case, to just 396º F (202.2º C). The higher the temperature, the more chemicals are released. In addition to PFOA, these include global pollutants such as: TFE, a potential carcinogen; PFIB, an extremely toxic chemical warfare agent; and MFA, which is fatal at low doses. These fumes produce a flu-like illness (‘polymer fume fever’) as well as more severe conditions such as pulmonary oedema, pneumonitis and even death (Acta Astronaut, 1992; 27: 257-9). This can easily happen in any household if an unfilled PTFE-coated saucepan is heated or when such a pan boils dry, and is more likely to occur if the coating is worn or scratched. Considering that PTFE is heated daily in most kitchens (see box, page 21), this is very bad news. It’s even worse news for birds, which are even more susceptible than humans.

In days of yore, that was why canaries were placed in coalmines. Given their small size and high metabolic rates, birds are extremely efficient in exchanging gases and delivering oxygen. However, this also makes them more susceptible to airborne toxins. In one case report, five cockatiels died within 30 minutes of a PTFE-coated frying pan being accidentally overheated. And within an hour, their owner developed symptoms of polymer fume fever (Vet Rec, 1975; 96: 175-8). In another report, 264 broiler chicks, out of a flock of 2400, developed pulmonary oedema due to breathing a noxious gas – found to be emanating from PTFE-coated heat-lamp bulbs – and died over a six-week period of exposure. In another similar flock, 96 chicks died within just 24 hours of such exposure (Avian Dis, 2000; 44: 449-53).

Polymer fume fever (see box below) usually resolves itself within 48 hours but, in some people, it’s not so benign. In one instance, textile workers exposed to PTFE experienced recurring polymer fume fever that eventually led to permanent lung damage (J Occup Med, 1994; 36: 75-8). In a similar incident but in a domestic situation, a 26-year-old woman suffered respiratory distress for a month after exposure to a defective and melting PTFE microwave-oven part (Thorax, 1993; 48: 300-2). And, in a more recent report, three workers in a plastics factory suffered acute pulmonary oedema after inhaling heated PTFE, one of whom died as a result (Eur Respir J, 1997; 10: 1408-11). An epidemiological study of workers exposed to PFOA for 10 years revealed a more than threefold increase in prostate cancer mortality compared with workers not exposed (J Occup Med, 1993; 35: 950-4; J Occup Health, 2004; 46: 49-59). In rats, PFOA caused malignant pancreatic, testicular and liver tumours (Toxicol Appl Pharmacol, 1991; 111: 530-7; Toxicol Sci, 2001; 60: 44-55; Dis Markers, 2003-2004; 19: 19-25), although this may not necessarily apply to people.

Symptoms of polymer fume fever
* Chest tightness
* Difficulty breathing
* Dry, irritating cough
* Chills
* Fever
* Headaches
* Nausea and vomiting
* Sore throat
* Malaise
* A 100-104° F (37.8-40° C) temperature

Nevertheless, the EPA recently dubbed the chemical a ‘likely human carcinogen’ – a good example of understatement, given that PFOA meets the agency’s own criteria for labelling as a human carcinogen. For some reason, the EPA appears to be dragging its feet in fully condemning PFOA.

PTFE has also been shown to cause cancer of the liver and kidneys as well as leukaemia – but again, in rodents (Natl Toxicol Program Tech Rep Ser, 1997; 450: 1-321; Toxicol Pathol, 2004; 32: 222-8). However, based on this evidence, it is “reasonably anticipated to be a human carcinogen”, according to the US Department of Health and Human Services National Toxicology Program Report on Carcinogens (11th edition).

Birth defects

The EWG recently unearthed a decades-old internal DuPont company-research memo stating that PFOA had been found in the umbilical cord blood of an infant born to a company worker, and in the blood of another worker’s baby. In the same memo, serious birth defects in two of seven babies born to female Teflon®-plant workers were also recorded. According to the memo, one baby was born with “one nostril and eye defect”; the other had an “unconfirmed eye and tear duct defect”.

According to the EWG, DuPont did remove women from the plant, but these findings were never reported to the EPA. This revelation sparked off an EPA review of DuPont company practices concerning PFOA, including the potential contamination of the Lubeck, West Virginia, and Little Hocking, Ohio, tap-water systems for at least 17 years (www.ewg.org/issues/pfcs/20040617/index.php?print_ version=1).

Kim Wallace

There are two types of rhinitis: perennial; and seasonal (hayfever), a pollen sensitivity during late May to early August. Patients with rhinitis in early spring usually react to various wind-pollinated trees, weeds, shrubs or grasses.

Perennial rhinitis occurs all-year round and is like a cold that lasts forever.

Perennial rhinitis and sinusitis are frequent co-passengers, as the mucous membranes of the nasal passages and sinuses flow together. The continual allergic or fungal attack on these membranes often causes them to proliferate, leading to polyps, usually in the nasal passages. These polyps, in turn, make the problem worse by causing a physical obstruction in an already blocked nose.

What doctors tell you
The usual treatments for rhinitis are various drugs that only suppress the problem, such as antihistamines, which block the effects of histamine, a chemical released during an allergic reaction. Histamine is mainly responsible for the inflammation, sneezing and itching symptoms of rhinitis. Although antihistamines may be well tolerated, they commonly cause a dry mouth, nose and eyes, and drowsiness. The latest ‘second-generation’ drugs, such as Allegra and Clarityn, despite their claims, still come with a range of side-effects. Long-term use of topical steroid sprays, such as Beconase or Rhinocort, offers all the dangers of ordinary steroids.

The only conventional treatment of polyps is surgery, or a polypectomy. Although this can improve matters, it’s often only for a few months until the polyps recur because the underlying cause has not been addressed. Some of my patients have undergone as many as 10 polypectomies.

Perennial rhinitis has at least four main causes:
* inhalant allergies, such as housedust, dust mites, moulds, animals and feathers
* food allergies or intolerance
* fungal/yeast problems
* magnesium deficiency, which can worsen any or all of the above causes.

You will know you have this problem if you are worse:
*in dusty environments or first thing in the morning
* in August or September, especially on humid days before thunderstorms. In the hours before a thunderstorm, there is a marked increase in mould counts and a marked increase in hospital admissions for asthma
* after sweeping up mould-ridden leaves or turning over a compost heap
* in any damp, musty dwelling, indicating a reaction to indoor moulds.
Another clue is if you are better in hot dry climates, such as the Algarve or Greek islands. Dust mites don’t survive in high heat and are extremely thirsty for water, and can’t live in desert-like environments. If you don’t improve in these situations, suspect a food sensitivity or a fungal/yeast problem.

You can also test for inhalant sensitivity with prick tests and radioallergosorbent test (RAST; a blood test measuring immunoglobulin E reactivity).

Foods play a large part in perennial rhinitis. Milk sensitivity is very common and frequently described as ‘mucus-forming’, but any food can be implicated. Suspect a food sensitivity if you have:
* no history of inhalant sensitivity and a negative response to skin inhalant tests
* a history of food cravings
* abdominal distention after food, or puffy swelling of the ankles and fingers
* occasional bouts of a rapid heartbeat or sweating for no apparent reason
* weight problems and sudden, dramatic weight fluctuations from day to day.

Don’t discount alcoholic drinks. Scotch whisky, for example, comprises wheat, corn, yeast and sugar. If you’re sensitive to any of these, you’ll notice an increase in rhinitis after drinking it. As alcohol is absorbed incredibly quickly, the response is more obvious than if ingested as food.

Food intolerance usually involves several food groups, so excluding only milk and cereals, for example, rarely succeed, as only part of the problem is addressed.

The role of fungus
If the problem isn’t due to inhalants or food, it could be due to a fungus – fungal rhinitis (if it affects just the nose) or rhinosinusitis (affecting both the nose and sinuses).

Dr Jens Ponikau et al. reported on a new technique for collecting and testing mucus that showed that 202 of 210 patients with chronic rhinosinusitis had fungi in their mucus (Mayo Clin Proc, 1999; 74/9: 87784). They also detected eosinophils (a type of white blood cell commonly found in an allergic response) in the nasal tissues of nearly all of these fungal patients. Interestingly, most of these patients, however, were not sensitive to immunoglobulin E, suggesting that the rhinitis/sinusitis resulted from the body’s immune response to fungi. Such a non-allergic response may explain why many patients fail to respond to antihistamines.

Three years later, the same team reported the results of fungal treatment for their patients (Immunology, 2002; 110: 862-6). Amphotericin B was applied intranasally (at a dose of 20 mL of a 100 mcg/mL solution) twice a day. Sinusitis symptoms improved in 75 per cent of the patients and almost half of these were shown, by endoscopic examination, to be totally disease-free. Other studies have reported similar findings.

As the source of these yeasts or fungi lies in the gut, further improvements may result from the more fundamental approach of restoring balance to the gut flora using an anti-Candida regime.

Magnesium deficiency
Don’t forget the role of magnesium. A deficiency of this mineral can lead to instability of mast cells, which release histamine during an allergic response, thereby causing the symptoms of rhinitis. This was shown in animal experiments (using rats) carried out at Brigham Young University in Utah (J Am Coll Nutr, 1990; 9/6: 616-22).

The study concluded that both the blood and urine histamine levels of severely magnesium-deficient rats were significantly higher than those of other rats throughout the study, particularly after specific antigen challenges. The amount of antigen used in the challenges also had the effect of exacerbating the magnesium deficiencies in the blood and urine.

Although animal studies don’t always apply to humans, similar findings were made in clinical trials at the University of Turin (Allergy, 1987; 42: 186-8). These results suggest that a magnesium deficiency can aggravate diseases that are caused by abnormal histamine release as a result of allergic responses to inhaled or food allergens.

Dr John Mansfield
Dr Mansfield runs the Burghwood Clinic (see http://www.burghwoodclinic.co.uk) and specialises in environmental and nutritional medicine.

* Traumeel, a homoeopathic combination product, available as oral drops, tablets and gel (see http://www.heel.com/products)

* Oils. Aromatherapy preparations such as lavender, chamomile and peppermint have analgesic properties (Complement Nurs Ther, 1997; 3: 16-20). Peppermint oil applied to the forehead and temples can work as well as paracetamol for pain relief (Cephalalgia, 1997; 17: 446). Other menthol oils can also increase blood flow, which may reduce inflammation (Am J Phys Med Rehabil, 1991; 70: 29-33; Nippon Yakurigaku Zasshi, 1984; 83: 219-26)

* Tiger Balm (SSL International, tel: 08701 222 689), the Chinese version of Deep Heat. In one study, Tiger Balm worked as well as paracetamol for severe tension headache, but has to be reapplied after three hours (Aust Fam Physician, 1996; 25: 216-20).

* Herbs. Feverfew (Tanacetum parthenium) and Ginkgo biloba have some evidence of easing migraines.

* Fish oils. Anti-inflammatory fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have an effect on prostaglandins, the hormone-like substances involved in pain and inflammation. Take 1 g/4.5 kg (10 lb) of body weight (Am J Clin Nutr, 1985; 41: 874; Am J Clin Nutr, 1986; 43: 710).

* Avoid food allergies, which have been implicated in headaches. This includes amines, found in fermented, pickled or marinated foods as well as in avocados, bananas, caffeinated drinks, chicken liver, monosodium glutamate (MSG), chocolate, citrus fruits, nuts, processed meats, raisins, red wine, ripened cheese, onions and lentils (Lancet, 1983; ii: 865-9; Ann Allergy, 1985; 55: 28-32).

* Avoid excitotoxins such as aspartame and MSG, which can trigger headaches (Headache, 1988; 28: 10-3; N Engl J Med, 1988; 318: 1200-1).

Readers: What else has helped your headaches? Write in to WDDTY at info@wddty.co.uk.

1. Backache. Research demonstrates that for most cases of lower back pain, chiropractic or osteopathy works far better than anything medicine has to offer (WDDTY vol 4 no 8).

2. Ear ache. In most cases, time, mullein oil, a woolly hat or a hot water bottle works far better than antibiotics in curing ear ache, according to numerous studies (Alternatives,WDDTY vol 5 no 12).

3. Fever. Fever is your body’s extremely clever method of killing foreign bugs of all varieties and shouldn’t be suppressed. Rather than worrying about the exact degrees, its more important to determine whether the problem is serious say, meningitis. Fevers for ordinary viral and bacterial infections won’t exceed 105 degrees, which isn’t dangerous.

4. Infection. For common or garden infections, first try working with a herbalist, who will prescribe echinacea or berberis, rather than antibiotics.

5. Just in case checkups, particularly if you are over 50. If you have nothing blatantly wrong with you, going to a doctor won’t necessarily protect you but is likely to unleash the entire arsenal of his testing apparatus.

6. Menopause. Unless you are among the very small percentage of women who don’t respond to other measures, holistic measures (diet, homeopathy, herbs) will help you through the change in a safer way than any doctor.

7. Chronic but not life threatening diseases. Eczema, psoriasis, non life threatening asthma all respond better to alternative measures than drugs, which only suppress symptoms (The Guide to Asthma and Eczema; PROOF! vol 1 no 3).

8. Slimming. All a doctor usually has to offer is drugs, and numerous slimming drugs have been found to be life threatening. Allergies are one of the major causes of overweight, as are calorie poor slimming diets (WDDTY vol 6 no 5 and Allergy Handbook).

9. Colds and flu. Unless you are elderly and your immune system is compromised in some way, there is nothing your doctor can give you or your child that will improve a cold or flu. Bed rest, plenty of fluids, lemon and honey drinks and homoeopathy help; antibiotics cannot.

10. Acne. Again, all your doctor has is drugs with horrendous side effects to offer you. Try diet and allergy treatment first (The Allergy Handbook).

Government policiy for travellers abroad appears to be a case of massive overkill. A handful of vaccines are urged and sometimes even forced on you anytime you venture much beyond our shores. If you were to listen to the UK Department of Health’s recommendations “Health Advice for Travellers” or the Center for Disease Control and Prevention in the US, you’d get vaccinated against polio every time you stepped foot outside Europe, North America or Australia, even though the disease is virtually non existent in many of these recommended areas.The problem with this “just in case” mindset is not only that it creates a paranoic view of the world, but also that it offers travellers a false assurance that a simple jab can take the place of careful precaution when heading off to remote areas. Furthermore, it rests on the assumption that these jabs actually work. Of all the vaccines, travel vaccines have the poorest record of success. The old cholera vaccine has such a dismal track record that it may be one reason the World Health Organization (WHO) has dropped it from the list of required immunizations and no country requires it anymore.

With malaria there is not only no vaccine, but a dangerous and growing resistance to the drugs used to treat it.

With travel vaccines, more than any other, it’s vital to find out how necessary, how safe and how effective each one is, even before you make your travel plans, particularly to less well trod areas. Here, in the first of two parts, are the available studies to date about malaria, cholera, typhoid and yellow fever.

Malaria

Of all infectious diseases abroad, malaria is perhaps your greatest risk. WHO estimates that there are 300-500m people infected with malaria, the parasitic disease carried by the Anopheles mosquito (JAMA, 1996; 275 (3): 230-233). Each year in Britain, 2000 people contract malaria and 12 people die, a higher figure than from any other tropical disease. (In America, where presumably fewer people travel to Asia and Africa, several hundred patients contract it every year.) There is no reliable vaccine for malaria, so the rationale has been that taking the drugs which treat malaria as prophylaxis (just in case measure) before, during and after your stay in the infected area will also somehow ward off the disease.

Several synthetic drugs developed during World War II to be taken against malaria used to be effective. The problem is that most strains of the disease have developed active resistance to the drugs. Few tropical countries are now unaffected by strains resistant to chloroquine, often used with proguanil (Paludrine), the former drugs of choice; resistance to quinine, an earlier favourite, is also now increasing. Consequently, doctors and even tropical vaccine experts are finding it difficult to tell patients which types of drugs work where any more. They tend to rely on a quick change scheme of swapping schedules of drugs frequently in the hope of outwitting resistant strains. The same applies to patients who return with malaria; the choice of treatment depends on the parasite’s resistance to the drug in the area where you got the infection (New Eng J Med, 1996; 800-6).

The general rule of thumb at the moment is to use combinations of drugs in areas where resistance is known not to be high (BMJ,1993; 307: 1041; New Eng J of Med, 996; 335: 800-6).

There is also the fragile balance which must be maintained between the risk of the disease and the risk of the drugs. There are a number of toxic effects with all these drugs, such as nausea, vomiting, severe gastrointestinal disturbances, and even psychotic reactions. Chloroquine can cause bone marrow suppression, heart problems, a neuropsychiatric syndrome and brain dysfunction. The British Compendium of Data Sheets 1996-7 also lists skin eruptions, itching, hair loss and skin depigmentation. Prolonged high doses of chloroquine can lead to damage to the retina of the eyes, ringing of the ears or convulsions. One doctor reported that his 6 year old son had a grand mal seizure after taking the drug (BMJ, 1996; 312: 1421).

Other sulphur drugs such as sulphadoxine purimethamine are effective but also cause rapid development of resistant strains (The Lancet, 1996; 347: 244-8).

The natural compound quinine, made from cinchona bark, remains more than 85 per cent effective nearly everywhere and has been a mainstay of malaria treatment for three centuries. Nevertheless, it is starting to lose its effectiveness in Southeast Asia.

It also can be toxic, causing dysphoria, tinnitus and high tone deafness, hypoglycemia and even serious cardiovascular or nervous system effects (New Eng J Med, 1996; 335: 69-75 and 800-6).

As drug resistance grew, so tropical disease experts turned to mefloquine, marketed as Lariam by Swiss pharmaceutical giant Hoffman-La Roche. Besides its effectiveness, this once a week anti malarial quickly became popular because of its convenience (The Lancet, 1996; 348: 344). However, because it tends to stay in the system for a long time, the potential for adverse reactions also appears heightened (see box below). And now holfantrine is being looked at as a possible new drug, although there is evidence of toxicity of the heart (Lancet, 1993; 341-1044-49).

Another problem is the potential for drug interactions between the drugs, particularly as more than one are often taken (New Eng J Med, 1996; 335: 800-6).

Many hopes had been pinned on trials of SPf66, a new vaccine developed by a team in Colombia. After a series of studies, protectiveness was found to be only 31 per cent, but was nevertheless considered encouraging (The Lancet, 1994; 344: 1172-3). However, a later randomized double blind trial study of infants in the Gambia showed that the vaccine was useless, as did a study of children in northwestern Thailand (Lancet, 1995; 346: 462-7 and 1996; 348: 701-7).

Thechances of getting malaria varies a great deal from area to area, and it also depends on when and how you travel.

Travellers to Africa are at risk in most rural and many urban areas, particularly during the evening. Most travellers to Asia and South America, however, spend most of their time in towns or resorts where there is limited, if any, risk of exposure, and they travel to rural areas mainly during daylight hours when there is also limited risk of infection.

Cholera

Cholera (Vibrio cholerae) infection is caught from contaminated food or water and usually results from poor sanitation. In a 1991 epidemic in Peru of over 16,400 cases and 71 deaths, the epidemic was traced to drinking unboiled water, or water from a household water storage container (Lancet, 1992; 340: 28-33).

Cholera vaccination is no longer recommended for the current outbreak in South and Central America. There have been some instances in African countries where a vaccination certificate has been requested at the border, but this is not common. In any case, cholera doesn’t appear to pose a serious threat to Britons, since only about 30 contract it every year, according to the Public Health Laboratory Service. Risks are higher in America, with its proximity to South America, where 10 cases were reported in only three states, following the big epidemics in South and Central America in the early 1990s (JAMA, 1991; 265: 2658-9).

The main reason for dropping the recommendations could be tacit admission that there is no effective vaccine to date. The killed injected vaccine, which offered protection (if at all) for only a few months (Ind J Biochem & Biophys, 1994; 31: 441-8), is now being replaced by a number of whole cell and live vaccines. Some studies of the killed oral WC/rBS vaccine were promising, showing a protection of 85 per cent after six months, but largely among patients with type O blood (Lancet, 1994; 344: 1273-6). A 1993 Vietnamese trial of the killed oral cholera vaccine showed an effectiveness of only 60 per cent, leading doctors to experiment with a single dose of the live oral CVD vaccine. Nevertheless, experience demonstrated the vaccine only offers protection against certain strains (Lancet, 1997; 349: 957 and 1992; 340: 689-93). It’s known, for instance, that the vaccine doesn’t protect against a new strain, known as Bengal cholera, that has emerged in southern Asia.

In July 1994, in one of the worst cholera outbreaks in recent times, 12,000 Rwandan refugees died in Goma (eastern Zaire). This strain was also resistant to tetracycline and doxycycline, used to treat cholera (JAMA, 1996; 276 (5): 348). Other multiple drug resistant strains have emerged in Honduras (Lancet, 1997; 349: 924).

Besides fever, you can experience serious allergic reactions to this drug, nerve damage, and even mental problems (Infection & Immunity, June 1996; 64 (6): 2362-4). In one study, cholera vaccine may be responsible for transverse myelitis (J Royal Society of Med, 1990; 83; 653).

Other studies have shown pancreatitis (Br J Clin Pract, 1986; 40: 300-1); hepatitis B (Presse Medicale, 1986; 15: 1331); immune complex disease (Trans Royal Soc Trop Med & Hygiene, 1984; 78: 106-7); stroke (Lancet, 1985; 2: 1372); sudden death (Forensic Science Inter, 1984;

24: 95-8); myocarditis (Deutsche Med Wochenschrift, 1984; 109: 197-8); and psychiatric complications (Acta Neurological, 1974; 29: 520-33). Occasionally side effects are heightened when cholera has been given with typhoid vaccine (Beitrage zur Pathologie, 1976; 158: 212-24). The live (oral) form is purported to have fewer side effects (BMJ, 1993; 307: 1425).

Simply obeying certain hygiene rules, particularly concerning water and uncooked food, and replacing lost fluids may protect you against all forms of cholera; studies have shown that a healthy person can have more than a billion cholera bugs in their body without developing the disease (Times, June 3, 1993).

The most important element is to avoid the effects of severe diarrhea, which is what eventually kills you. A patient with cholera can lose virtually twice their weight in fluid in a single day (see Alternatives, p 6, for tips on rehydrating after diarrhea).

Some data has suggested that getting cholera and yellow fever vaccines simultaneously will decrease the response of both. Although this data is disputed, Wyeth-Ayerst, who produce the injected cholera vaccine, recommends that each be given in no less than a three week interval of the other.

Typhoid

Typhoid fever (caused by Salmonella typhi) is also spread by contaminated food and water. In Britain, some 200 people come home from holiday each year with typhoid. Typhoid vaccine is recommended for those travelling to areas where they may be exposed to contaminated food and/or water, particularly where the disease is common or sanitation particularly primitive. In practice, if you follow the lists put together by the Department of Health, you can end up getting shots even if you are heading off for a first class holiday in the Caribbean.

The heat phenol inactivated injected whole cell shot has an effectiveness rate of 65 per cent but causes severe adverse reactions in one quarter of patients (Infect Control & Hosp Epidemiology, 1991; 12: 168-72).

The typhoid vaccine should not be used in children under one year, and its harmful effects are worse in people over 35. The interaction of the fever (caused by the shots) and an underlying heart condition can cause shortness of breath, dehydration and fever (Washington Times, February 23, 1993).

Pasteur Merieux’s new live Typhim VI vaccine, a polysaccharide vaccine, is purported to work better and cause fewer side effects than previously available vaccines (Military Medicine, 1990; 155 (6): 272-4). In practice, this means an effectiveness rate of between 64 per cent and 81 per cent in countries where the disease is endemic (GP, May 22, 1992). The manufacturer warns that Typhim’s effectiveness could be lowered if you have an immune disorder or are already receiving treatment that lowers your immunity. As with any vaccine, if you’ve already had a severe reaction to Typhim VI you should not receive it again, and it shouldn’t be administered to children over 6 (Infec Con & Hosp Epid, March 1991; 12 (3): 168-172).

Side effects from the oral vaccine include abdominal discomfort, nausea, vomiting, fever, headache, and rash. The most common side effect from the injection is redness, hardening and tenderness in the skin, which occurs in most patients. Fever, nausea, headache and flu like symptoms have been reported in 8 per cent of patients. People who receive the shot have fewer side effects if it is given into the skin (ie, intradermally), rather than under it (J of App Phys, June 1992; 72 (6): 2322-8). Other reports of side effects include loss of consciousness, abdominal pain, vomiting, hypotension, arthralgia, kidney problems, neutropenia (lowering of blood cells) and allergic shock.

Yellow Fever

This is a well known disease that has plagued the tropics relentlessly. Yellow fever is a viral disease transmitted to humans by mosquitoes. You may not be able to avoid it if you are travelling to certain parts of Africa or South America, since you need a certificate of vaccination upon entry. The vaccine must be given at least 10 days before entering a country requiring it.

If you are dead set against the shot, it may be wise to avoid any areas requiring the certificate. Eastern and southern African states have hitherto been free of epidemic yellow fever, hence routine vaccination is not a policy in these countries.

On paper, the shot seems effective. In one study, the shot produced antibodies in 93 per cent of adults (J Biol Standards, 1986; 14: 289-95), although this fell to 60 per cent in babies (W Afr J Med, 1990; 9: 200-3).

This vaccine, which is given live, can cause encephalitis (inflammation of the brain), especially in children under nine months, although a four year trial among pregnant women and its effect on their newborn children showed no significant side effects (Transactions of the Royal Soc of Trop Med & Hyg, May-June 1993; 87 (3): 337-9).

The vaccine has also been shown to cause urticaria, bursitis, jaundice, neurititis, myalgia and low grade fever. About a quarter of patients react, and 11 per cent suffer post vaccine syndrome of multiple pains and fever (Bul Soc Path Exotique et de Ses Fil, 1986; 79: 772-6). In one African study, a number of patients developed gangrene of the arm just a few hours after being inoculated at Shaki, Nigeria in May, 1987 (Revue Roumaine de Virologie, Jan-Jun 1994; 45 (1-2): 25-30). Five went into a coma and died. Nevertheless it may have been that poor hygiene and possible contamination played a part.

After 1830 some 52 years ahead of Koch’s first isolation of the tubercle bacillus for the tuberculosis vaccine-nosodes (that is, homeopathic dilutions of the products of the illness in question given orally) were commonly used as just-in-case measures against a wide variety of diseases. According to government statistics, when homeopathy was a strong contender against orthodox medicine for medical dominance, the use of these homeopathic “vaccines” was accompanied by an amazing drop in the incidence of whooping cough, diphtheria, scarlet fever and measles in children. In all groups, the numbers of people of all ages contracting TB, dysentery, typhoid fever and Asiastic cholera plummeted (Gaier, Thorsons Encyclopaedic Dict of Hom, HarperCollins, London, 1991).

Although proof of the scientific benefit of the various “vaccines” are generally thin on the ground, a few published studies suggest the effectiveness of nosodes used as preventatives against specific diseases, including cancer.

One experimental study in the early part of this century investigated a strain of fruitfly (Drosophila melanogaster), in which 50 per cent of male offspring die from a genetically inherited tumour. In a large series of 218 larval cultures matched with 22 control groups, the death rate was reduced fourfold by giving the flies homeopathic potencies of a tumour nosode mixed with Arsenicum album and Mercurius nitricus (Hom Recorder, 1925; 40: 130; J Am Inst Hom, 1925; 18; 433: 790).

Chagas-Cruz disease, known as Brazilian trypanosomiasis, is a greatly feared South American insect-borne infectious disease affecting humans, rodents and armadillos. In a controlled study, a potentized homeopathic nosode, prepared from the blood of infected mice, was given to a group of mice 10 days before they (and a control group, not given the “vaccine”) were exposed to trypanosomal infection.

All the mice given the nosode survived, compared with no survivors among the control group. The nosode wasn’t found to be effective when given to treat the illness, once contracted (Annals Hom Fr, 1982; 24 (3): 253-64).

Another three studies demonstrated that pretreatment with this nosode raised protective antibodies to Trypanosoma cruzi (Transactions XLII Congress Liga Medicorum Homoeopathica Internationalis, Rio de Janeiro, 1986).

Although these are only animal studies against an arcane disease not encountered in the West, at least one large-scale homeopathic human trial exists. In 1974, more than 18,000 children were successfully “vaccinated” with the nosode “Menigococcinum 11CH” against meningitis (F X Eizayaga, Treatise on Homoeopathic Medicine, Buenos Aires: Ediciones Marcel, 1991).

Twenty years later, this trial not only shows how effective the treatment is, but also how safe. There wasn’t a single instance of side

effects.

Harald Gaier is a registered naturopath, osteopath and homeopath.

Researchers in Southampton found that warm sponging of feverish children reduces temperatures more quickly than does administering paracetamol, but most of the parents in the study were “not sure” about this form of treatment.

Most, however, were “very happy” about administering paracetamol, which was shown to have “no significant effect”.

The study (BMJ, 7 November 1992) looked at 52 children aged between three months and five years with fever temperatures of between 37.8 and 40 degrees centigrade. The most effective method of treatment was warm sponging.

In this method, parents were advised to sit their child in a bath or bowl containing a few inches of warm water, the temperature of which should be just below that of the child.

They should wet their child all over for 10 to 20 minutes, or as long as the child is comfortable. Then the child should be “unwrapped” into light clothing in a warm room and encouraged to take frequent cool drinks.

Wearing a copper bracelet helps. In one study of 240 RA patients, those wearing copper bracelets had a statistically significant improvement, compared to patients given a placebo bracelet (Agents’ Actions, 1976; 6: 454).

The reason the bracelets work is less mysterious than it seems. We know that the the worse the RA, the more elevated the blood levels of copper. Copper concentrations in the synovial fluid (found in the joints) in RA sufferers are also three times those of non sufferers. But the rise in these copper concentrations leads to a fall in levels of copper in the liver and other copper storing tissues. These localized copper deficiencies lead to an increase of iron in these tissues, which may help cause RA. Using copper bracelets restores some of this lost copper; in the study, each bracelet lost an average of 13 mg of copper while being worn.

The very low incidence of RA in pre industrial Europe has been put down to the use of copper cooking utensils and plates (K D Rainsford, in J R J Sorensen, Ed, Inflammatory Diseases and Copper, Humana Press, 1982).

Copper can also be used for pain relief. Anthroposophical medicine has had long success with a copper ointment used for pain in RA (Weleda, product code 6066).

Copper’s anti inflammatory effect is related to its ability to form selective anti oxidants (J Int Acad Prev Med, 1980; 7-21). This is why practitioners of nutritional medicine advocate replacing conventional medicine’s high dose aspirin therapy with a copper salicylate complex supplement.

In one study of over 1000 RA patients given this copper complex, 89 per cent showed better joint mobility, decreased joint swellings, and normalization of red blood cell levels for an average of three years (Inflammation, 1977; 2: 217-238).

In folk medicine, feverfew (Tanacetum parthenium) has been a stalwart of RA treatment.

However, its effectiveness depends on its containing at least 0.4 per cent of the active ingredient parthenolide. When tested, most of the 35 commercially available preparations of feverfew contained either no parthenolide or only minute traces of it (J Pharm Pharmacol, 1992; 122: 266-70).

If you decide to use Feverfew, check the parthenolide content first.

Test for low gastric acid production. About half the RA patients I see are suffering from a low acid levels, which very often leads to leaky gut, which, in turn, is known to lead to inflammatory joint disease (including RA) (Clin Exp Rheumatol, 1990; 8: 75-83). It’s important to check for a leaky gut at the same time.

Check out your allergies. Several medical anthropologists point out that, historically, the appearance of arthritis seems to have coincided with the farming of cattle or cereals like wheat, rye, barley and oats all known to be common allergens. In one study, nearly three quarters of the participating 44 RA patients felt their condition was “better” or “much better” once they’d eliminated suspected allergens from the diet (Lancet, 1986; i: 236-8).

Eat an avocado a day.

Dr John Heinerman, a medical anthropologist, reports he has not found a single case of RA among the Mayan Indians of the Yucatan Peninsula and Guatemala who regularly consume ripe avocado pears. The same is true of various native North West Amazon tribes who live in areas where wild avocados grow in abundance. Only when they give up avocados and start eating a Westernized diet do they start suffering from the disease (J Heinerman, Encyclopedia of Healing Juices, Parker Publishing, 1994).

!AHarald Gaier

Harald Gaier is a registered naturopath, homeopath and osteopath.

Researchers in Nottingham surveyed the vitamin E intake of a random sample of 2633 adults, aged 18 to 70. Each of the individuals supplied information on their intake of vitamins E and C, magnesium, polyunsaturated fats and other nutrients, via a food frequency questionnaire.

The participants also underwent measurements to determine their sensitivity to grass pollen, cat fur and other allergens, as well as to provide information on the nature of their asthma and hayfever.

On putting all of the information together, the researchers found that those with the highest daily intake of vitamin E were least likely to suffer from allergen sensitive atopic conditions such as asthma, rhinitis and hayfever.

In addition, none of the other nutrients measured appeared to have the same protective effects nor did vitamin E appear to be more effective in combination with any other nutrient (Lancet, 2000; 356: 1573-4).