Charles Lakerman was a 78-year-old retired businessman who had had rhinitis for the past thirty years and mild intermittent arthritis of the hands for almost a decade. In the fall of 1967, he had developed acute arthritis of the hands, followed by involvement of the right elbow, shoulders, knees, and right hip. Aspirin was the only medication he had received.

At the time of his hospitalization for environmental testing, his hands were red, swollen, and inflamed, with very little motion in the joints. He was barely able to eat and refused to shake hands.

Under the program of comprehensive environmental control, Lakerman’s arthritis became progressively better, without his suffering any withdrawal effects. All of his joints were comfortable at the end of five days of fasting, although some residual swelling of the hands persisted.

Individual food ingestion tests resulted in the following reactions:

Corn: 3 hours, nausea and abdominal distress followed by spontaneous diarrhea; 6 hours, recurrence of arthritic pains of hands and left shoulder

Wheat: 31/2 hours, watery eyes and running nose; 12 hours, painful right knee upon awakening

Beets and beet sugar: 13 hours, slight aching of ankle upon awakening: a

new joint involvement

All other commonly eaten foods were test-negative, nor did he react to the commercial forms of such foods.

Mr. Lakerman remained symptom-free at the time of his hospital discharge and experienced no evidence of reaction upon returning home to follow his new diet. After eight months of freedom from arthritis, he tolerated wheat when it was returned to his diet once in five days for several months. However, he experienced a gradual recurrence of mild arthritis of the knees and hands as he increased his intake of wheat to twice daily, corn to three times per week, and began the regular use of beet sugar. All symptoms subsided when he returned to his former diet restrictions, and he has remained free of arthritic pains ever since then.

Many cases of rheumatoid arthritis also have a coexisting muscle involvement referred to as allergic myalgia. This may start either before or following the onset of joint involvement. Allergic myalgia may be acute or chronic, localized or generalized. It tends to be characterized by painful, tender muscles and sometimes presents as cramps or muscle spasms. I first described this condition in 1951.4 Myalgia of ecologic origin also occurs frequently in the absence of arthritis, in association with headache and fatigue. The postural muscles of the nape, back, chest, and legs are most commonly involved.

Although the causative roles of foods in individually studied cases of rheumatoid arthritis and myalgia have been documented for thirty years, there has been practically no recognition of these findings as taught by rheumatologists in most medical centers. The record shows clearly that of 1,000 cases of rheumatoid arthritis studied during the past three decades, specific foods have been demonstrated in most of them and environmental chemicals in many of them.

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Kelly Johnson was a nine-year-old schoolgirl when she developed arthritis of the right ankle in the spring of 1970. This was followed by migration of the arthritis to both knees and ankles. Aspirin was the only treatment given until an operation (called a synovectomy) was performed on the right knee, in order to allow it to move more freely.

Four months later, the partially crippled child was hospitalized for food and chemical testing. Examination revealed swelling and limitation of motion in both knees, as well as a scar from the previous operation. Upon beginning the period of fasting, Kelly experienced nausea and headache as withdrawal effects. Progressive improvement occurred, however, so that after four days of fasting her joints were more mobile and less painful than they had been in many months.

Severe recurrences of arthritic pain, swelling, and other symptoms was associated with the ingestion of the following chemically less contaminated (organic) foods:

Rice: 2 hours, stomachache; 9 hours, itching

Chicken: 21/2 hours, pains in elbows and hands

Pork: 3 hours, stomachache; 14 hours, joint stiffness

Beef: 3 hours, chest pain and residual stiffness

Potato: 3 hours, right-shoulder pain

Wheat: 31/2 hours, itching

Corn: 5 hours, itching; 10 hours, swollen extremities

Milk: 91/2 hours, mild itching of skin only

Beet: 14 hours, swollen, stiff hands and feet

In contrast to some of the earlier cases, Kelly’s symptoms generally came on hours after the food ingestion test. Since another meal may have intervened between the ingestion of corn, milk, or beet and the development of symptoms, it was often necessary to repeat tests in order to make sure that a given food resulted in a given symptom. This is the kind of test which is extremely difficult to do outside a specialized hospital setting.

Other commonly eaten foods were all test-negative. Kelly went home in good condition and remained well on the diet we devised for her until the gas-fired furnace was turned on that fall. This was followed by a flare-up in her arthritis. She was therefore moved to an all-electric house. Since then, Kelly has remained symptom-free, adhering well to her dietary program. Other than some physiotherapy for pain in the operated knee, she needs no therapy— not even aspirin—at the present time.

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Patrick Wells, an architect, had a long history of medical problems, including running nose (rhinitis), coughing, headache, fatigue, mental confusion, and intermittent bouts of depression. Like many people in Chicago, he worked in the Loop and commuted by rail to a suburb west of the city. Under my care, he had already controlled various aspects of indoor air pollution in his home, yet many of his symptoms persisted. Suspecting that there was a relationship between the weather and his problems, he kept a log of all of his symptoms for each day, and of the weather conditions prevailing on that day. He carefully monitored this for a year, without missing a day. He also obtained data from the United States Weather Bureau concerning wind velocity and visibility on these days.

Wells found that he was, in effect, a “human barometer.” At both home and work, he remained symptom-free on those days when the wind blew from the west, northwest, and north (there is little industry in these regions). Invariably, however, his depression and other symptoms returned when the wind blew from the east, and particularly from the southeast. This, of course, is where the heavy industry is located, especially the refineries and largest industrial plants. Winds from the south and even the southwest were also troublesome.

It was particularly interesting that Wells had no trouble from any wind with a velocity of fifteen or more miles per hour. The pollution, apparently, had to drift slowly over the area at a leisurely three to seven miles per hour in order to affect him.

Wells’ observations were later confirmed by other chemically susceptible patients in Chicago. It was always the slow, southern winds that brought with them symptom-causing pollution. In particular, as Wells found, the severity of such effects could be correlated with the visibility factor (visibility being defined as the distance one is able to see spaced lights). The lesser the visibility, the greater the chance of chronic symptoms on any particular day.

Further incidents revealed the remarkable carrying power of these slowly drifting winds, and how they could bring pollution to the doorstep of unsuspecting people many miles away.

One day, in the Chicago area, a number of my chemically susceptible patients became acutely ill at the same time. Several of them claimed to smell refinery odors in the air, although they did not live near refineries. Plotting their homes on a map and studying weather patterns for that day, 1 concluded that these people were reacting to chemical “fallout” from the Joliet refineries, although they all lived in the northern suburbs of Chicago, forty to seventy-five miles away.

Many similar incidents have occurred over the years. Even the northernmost suburbs of Chicago, near the Wisconsin border, occasionally receive some of the air pollution from Chicago’s south side. In fact, there is no residential area within a fifty- to seventy-five-mile radius of the center of Chicago which is consistently free of air pollution from the city or its industrial locales. The same is true of many American cities.

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Few studies of public places have been as complete as this parents’ report from Wauconda. Similar findings would undoubtedly be made, however, at other schools, universities, laboratories, offices, and hospitals.

Each public place has its own potential dangers. Offices, for example, often contain a variety of possible irritants, including carbon paper, ink, mimeographing and duplicating devices, rubber cement, typewriters, typewriter pads, plastic lamps and fixtures, and perfumes and scents. The new type o? carbonless carbon paper is particularly troublesome to many patients. If the office is new, the odor of freshly chemicalized carpet is often strong. Some offices are adjacent to factories, warehouses, shops, and garages, and share a common heating and ventilation system with them. Many people who are susceptible to chemicals are also affected by tobacco smoke, which can reach heavy concentration in some offices.

Hospitals, on the other hand, have their own peculiar smells: deodorants, disinfectants, and cleansers; ether fumes and other anesthetics from the operating room; odors of drugs and rubbing alcohol; and the smell of rubber draw-sheets and plastic bedding material.

As I have pointed out, the air of supermarkets is often fouled by the odors of insecticides, disinfectants, deodorants, and the like. A peculiar odor often emanates from the freezer sections, sometimes as the result of leaking refrigerants. Ammonia is frequently used in cleaning refrigerators, often while customers are still in the store.

Even churches provide no sanctuary for the chemically susceptible. Gas is often detectable, coming from a well-hidden kitchen. There is also the odor of burning candles (in recent years, mainly petroleum-based rather than made of bees’ wax), incense, perfumes, and the mothball-like smell of furs and outer garments.

Finally, a word should be said about pollution inside factories, although this enormous topic falls outside the scope of this book. In factories, many of the already-mentioned pollutants are mixed with the special odors which arise from manufacturing and processing. The worst offenders tend to be solvents and their combustion products: rubber, plastic, resins, detergents, cutting and lubricating oils, sulfur, chlorine, and similar agents. Large-scale outbreaks of illness have already taken place in electronic plants and other plants where such materials are handled. While traditionalists have ascribed this to “mass psychogenic illness,” some environmental health experts have interpreted it as a sign of chemical susceptibility on the part of large numbers of workers.

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Food allergies – unusual reactions or increased sensitivities to food or drink – are more likely to occur in infants than in older children. The condition involves vomiting, diarrhea, and abdominal cramps and occurs from minutes to hours after the child has had certain foods, beverages, or medications. Non-pasteurized cow’s milk is the most common cause of food allergy, but eggs, wheat, soybean formulas, orange juice, tomatoes, chocolate, fish, berries, and melons may also be responsible.

A malabsorption syndrome, which occurs when the digestive system lacks certain natural chemicals to digest food, may produce symptoms similar to those of a food allergy. Normally, the body produces natural chemicals called enzymes that break down starches, fats, proteins, and sugars into forms that the body can use. In a malabsorption syndrome an enzyme is missing, which means that the child cannot digest certain foods. For example, a condition called celiac disease may interfere with the digestion of gluten (starch found in wheat and rye), and the disease cystic fibrosis may hamper the digestion of fats and proteins.

Signs and symptoms

Hives, eczema, runny nose, and asthma can all be signs of food allergy. Sometimes blood appears in the baby’s stool. If a particular food brings on abdominal cramps and diarrhea (with or without vomiting), a food allergy can be suspected. By changing the diet and observing your child’s reactions, you may be able to identify the problem. Often, however, specific and complex tests are required to diagnose a food allergy. If the child does not seem to tolerate several kinds of foods and is not doing well generally, the cause may be a malabsorption syndrome.

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Home care

The only danger in fainting is possible injury from falling. Try to catch the child before the fall or as the child goes down. Place the child flat on the back, raising the legs to return blood to the head. Although not required, the coolness from an open window or air conditioner may help. Keep your child lying down for five to ten minutes after consciousness returns.

If your child is not yet unconscious, but feels a faint coming on, have the child sit with his or her head between the knees. Place your hand on the back of the child’s head, and have the child push the head up slightly against your hand. This manoeuvre forces extra blood into the head.

Precautions

• Sometimes a first convulsion is mistaken for fainting. If fainting occurs often, or if there are any signs of epilepsy, see your doctor.

• If the child’s skin turns bluish during an apparent faint, or if your child is not completely well before and after fainting, consult your doctor. Extremely rare heart conditions might resemble fainting.

• Smelling salts are not necessary and are not always helpful. If you use smelling salts to revive your child, be careful not to burn the membranes inside the nose.

Medical treatment

If there is any question about the cause of your child’s fainting, the doctor will examine your child for various causes of unconsciousness. Your doctor may order an electrocardiogram, electroencephalogram, blood chemistries, or a chest X ray.

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