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Dubious Allergy-Related Practices:
Clinical Ecology and the Feingold Diet

William T. Jarvis, Ph.D.

Clinical ecology is a nonrecognized medical "specialty" centered around the notion that a wide array of common physical and psychological symptoms can be triggered in susceptible persons by low-level exposure to chemicals or foods. Patients are said to be suffering from "environmental illness," "multiple chemical sensitivity," "brain allergy," "food addiction," "ingestant intolerance," or total allergy syndrome," or are "allergic to the 20th Century," or "allergic to everything modern." In the mid-1980s, clinical ecologists began calling themselves "environmental medicine specialists." [1] In the mid-1990s, "multiple chemical sensitivity" became the most often used term to describe a syndrome of symptoms perceived by people who believe themselves to be adversely affected by a wide variety of substances. Kurt describes these in detail [2].

Clinical ecology was founded by Theron Randolph, M.D., who diagnosed "environmental illness" in himself and married one of his patients. Both believed that eating ordinary food would make them ill. The couple won a case brought against them by the Internal Revenue Service (IRS) for deducting $3,000 of their $6,000 food bill for the year (1971), which they had spent on "organically grown" foods to avoid adverse reactions [3].

In 1981, the California Medical Association (CMA) adopted the position that clinical ecology does not constitute a valid medical discipline and that scientific and clinical evidence to support the diagnosis of "environmental illness" and "cerebral allergy" or the concept of massive environmental allergy is lacking. As a result of requests from clinical ecologists to endorse their claims, the CMA appointed a task force in 1984 to review clinical ecology. The task force concluded:

In 1986, the American Academy of Allergy and Immunology concluded that "the diagnostic and therapeutic principles used to support the concept of clinical ecology indicates that it is an unproven and experimental methodology."[5] In 1989, the American College of Physicians also issued an unfavorable position paper [6].

Scientology, which potrays itself in part as an "alternative" approach to psychiatry and clinical psychology, has embraced the notion of environmental illness. Scientology operates HealthMed, some of whose physicians are clinical ecologists, and markets "Purification Rundown" (PR), a "detoxification" program created by Scientology's charismatic founder L. Ron Hubbard. Based on the idea that body loads of environmental poisons are at the root of many behavioral problems, PR is claimed to detoxify the body by megadoses of niacin for dilating blood vessels (i.e., the niacin blush), and sweating out poisons through steam baths and exercise. The method was popularized in a book, Diet for a Poisoned Planet, by David Steinman [7]. In 1990, the FDA issued a talk paper stating that Steinman's book misrepresented FDA data and pointing out PR's invalidity and potential hazards [8].

Benefits and Risks

Being able to blame factors outside of themselves for their internal or relationship problems appeals to many people. Many parents have found comfort in Benjamin Feingold, M.D.'s book Why Your Child is Hyperactive [9] and the views of groups organized around his theories. Well-designed studies have failed to confirm Feingold's hypotheses, but many parents became believers based upon their own subjective experiences. Indirect harm can occur because Feingold groups tend to attract purveyors of nutrition quackery. Raw milk, bee pollen, questionable herbs, megavitamins, and other potentially hazardous products have been promoted in lectures before such gatherings. Many of Feingold's followers become alienated scientific medicine and embrace "experts" who support their beliefs.

Some may argue that there are positive effects to misdiagnosing psychological problems as due to food allergies or environmental toxins. Parents who come to believe that their child's troubles are due to dietary factors rather than behavior patterns may get some relief by shifting blame away from the child to nasty ol' sugar or something similar. Likewise, parents may be able to assuage guilt about having failed in their childrearing by scapegoating "bad" foods. However, such theoretical benefits must be balanced against possible harms that might accrue from lifestyle and social restrictions. Children may have to forego important experiences needed for normal social development such as going to camp, sleeping over with friends, and going to birthday parties, because their parents fear that they will ingest forbidden food. Causing children to feel physically impaired can teach hypochondria and weaken self-confidence.

Most misdiagnoses involve false positives in which patients are told that they have allergies that do not actually exist. Overdiagnosing allergies can waste money and needlessly prolong suffering, but failing to diagnose a real allergy can have serious consequences. One case in which patients were told that they did not have an allergy when, in fact, they did, resulted in a near-fatal episode. The incident involved Irvine Allen Korman, M.D. a Canadian physician who practiced clinical ecology. The patient's mother, a dentist, brought her two children to Korman for treatment of allergy problems both had experienced from birth. Her boy had become worse since starting school.

Two dubious procedures were used to test the children. The first (sublingual provocative testing) involved placing several drops of a solution under the tongue, followed by ten minutes of observation for unusual behavior. The second test involved a variant of "applied kinesiology" in which the patient holds a closed glass container of a solution in one hand while the examiner tests the strength of the opposite outstretched arm. The mother did not understand the second test and questioned Korman about its reliability for assessing peanut sensitivity. Korman told her that he had absolute confidence in the test and assured her that it was safe for the children peanut butter. The mother purchased some organically grown peanut butter and gave each child a tiny amount on a piece of bread. According to the report:

A dramatic scene followed. Both children collapsed. The girl was terribly white-faced, regained consciousness, was given medication, vomited, developed huge hives, but continued to breathe. The boy kept struggling, could not open his eyes, was gasping for breath, was blue and choking. An ambulance took the family to the hospital where the children were given adrenaline and within a few hours were fine again, but naturally somewhat shaken [10].

Dr. Korman was given a recorded reprimand and had his license suspended for 60 days, with an additional 12-month suspension if he failed to complete a review with special attention to the areas of immunology, allergy, and nutrition [11]. Korman's license was revoked in 1990 for professional misconduct and incompetence. Korman's actions included testing a patient for allergies by swinging a quartz ball attached to a string, advising her to have her metal dental filings removed, and informing her that she was allergic to electricity. Several of Korman's patients testified in glowing terms of the doctor's success in treating their "environmental illnesses." [12]

Patients: Victims or Co-conspirators?

America is the birthplace of the voluntary health agency concept in which patients and others organize to raise funds for research and education about a community health problem. This began with the Anti-Tuberculosis Society of Philadelphia in 1892. Today over 100,000 voluntary health groups exist. However, when it comes to clinical ecology, there is a strange kind of patient activism. Psychiatrist Donna Stewart has noted that misdiagnosed somatization (bodily symptoms produced by stress) is unique in that patients organize into groups that oppose scientific study into their conditions rather than encourage research [12]. Some patients with misdiagnosed psychiatric problems actually become involved fighting doctors who practice scientific medicine. In November, 1990, a meeting of the American Academy of Allergy and Immunology was disrupted by clinical ecologists and their patients. As reported by John C. Selner, M.D.:

We arrived at our workshop to find a number of patients confined to wheelchairs with oxygen masks in place, or wearing filters, who were identifiable as patients with so-called environmental illness. Approximately four hours into the workshop, I was confronted by a CBS radio news reporter who interrupted my presentation to ask if I was aware of a public demonstration in front of the hotel. The reporter indicated that he had been informed by environmental activists that a demonstration would take place. A clinical ecologist (M.D.) accompanied the demonstrators as the forced their way into the workshop. When asked to leave they refused and the ecologist demanded to have access to the platform. The workshop was recessed and the speakers dispersed to reconvene after the demonstrators had been evicted by the security personnel and local police.

It would appear that any programs which might address issues surrounding the effects of unproven and controversial methods of diagnosis and treatment may be targeted for such demonstrations in the future.

Irony might be found in the fact that the message the co-moderators of this workshop were attempting to highlight for psychiatrists and psychologists was the importance of taking patients very seriously who present without objective signs of disease, but with the so-called environmental illness scenario, and to recognize that many of these patients may be able to be helped. Further, we were attempting to emphasize the importance of environmental chemicals in the induction of disease including psychological presentations [13].

This kind of patient behavior is probably what led Benjamin Franklin to remark: "There are no greater liars than quacks, except for their patients." Some somatists use their maladies as coping devices for everyday living, while others are litigants with a strong financial interest in being compensated for their pain and suffering by a "deep-pocket" entity whom they blame for their illnesses.

Peter Huber's book Galileo's Revenge [14] exposes the use of "junk science in the courtroom," wherein cranks and quacks have been allowed to pollute the legal process by appearing as expert witnesses. Huber points out that the 1975 Federal Rules of Evidence opened the doors to the testimony of pseudoscientific "experts" by discarding the previously recognized Frye rule requiring that expert testimony be founded on theories, methods and procedures "generally accepted" as valid among other scientists in the same field. Huber has also described the work of Bertram W. Carnow, M.D., of the University of Illinois School of Public Health:

Carnow obtained his medical degree in 1951 but hasn't practiced medicine for 20 years. He registered for the board certification in internal medicine in 1957, 1958, 1960, 1961, 1962, 1963, and 1964, but withdrew twice and failed five times. He has since testified, under oath, that he sat for board certification in internal medicine only once. "I had completely forgotten" the other tries, Carnow explained in a 1983 UPI story. Today Carnow heads Carnow, Conibear & Associates-the Conibear being Dr. Shirley Conibear, Carnow's fourth wife. (Third, testifies Carnow). The firm's best-known service is expert testimony [15].

Carnow's testimonial line extols the theory of clinical ecology. Huber writes that Carnow was backed up by Arthur C. Zahalsky, Ph.D., who teaches immunology to nursing undergraduates at Southern Illinois University, even though he never studied immunology in graduate school. The two helped plaintiffs obtain a $49.2 million verdict against a chemical company in Missouri. With such large sums of money at stake, and the inherent need somatists to deny psychiatric disorders, it is not surprising to discover patient organizations that lobby against the intrusion of objective science into the problem of allergy misdiagnosis.

References

  1. Discipline Committee, Report of Proceedings, The College of Physicians and Surgeons of Ontario, February, 1989, pp.9-10.
  2. Kurt TL. Multiple chemical sensitivities: A syndrome of pseudotoxicity manifest as exposure perceived symptoms. Clinical Toxicology 33:101-105, 1995.
  3. Block J. Questioning medical deductions. American Way, March, 1984, p.76.
  4. Clinical ecology: A critical appraisal. West Journal of Medicine 144:239-245, 1986.
  5. Anderson JA and others. Position statement on clinical ecology. Journal of Allergy and Clinical Immunology 78:269-270, 1986.
  6. American College of Physicians. Position paper: Clinical ecology, Annals of Internal Medicine 111:168-178, 1989.
  7. Steinman D. Diet for a Poisoned Planet. New York: Harmony Books, 1990.
  8. Food and Drug Administration. "Poisoned Planet" -- A Diet for the Wrong Reasons. FDA Talk Paper T90-48, October 15, 1990.
  9. Feingold B. Why Your Child is Hyperactive. New York: Random House, 1975.
  10. Discipline Committee, Report of Proceedings, The College of Physicians and Surgeons of Ontario, February, 1989, pp9-10.
  11. Stewart DE. Emotional disorders misdiagnosed as physical illness: environmental hypersensitivity, candidiasis hypersensitivity, and chronic fatigue syndrome. International Journal of Mental Health 19:56-68, 1990.
  12. Demonstrators disrupt allergy workshop, National Council Against Health Fraud Newsletter 14(1):1-2, 1991.
  13. Haliechuk R. MD who used quartz ball loses license. Toronto Star, October 19, 1990.
  14. Huber P. Galileo's Revenge: Junk Science in the Courtroom. New York: Basic Books, 1991.
  15. Huber P. Spiel of fortune: how bad science wins big judgments. Reason, October, 1991. pp.24-31.

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© 1998 National Council Against Health Fraud.
With proper citation, this article may be reproduced for noncommercial purposes

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This article was posted on August 31, 2001.