The Health Blog

The Ecology Unit (sometimes referred to as the Environmental Control Unit) plays an indispensable role in the diagnosis and treatment of allergies. This unit was established after many years of development.

I first started hospitalizing patients for the diagnosis of food allergy in 1950. I chose complicated patients, whose problems could not be worked out simply by testing with one food at a time in the office. (In those days I employed feedings of whole foods in the office, rather than provocative tests, as today.) These patients rarely ever achieved a “base line” of good health before any particular test against which their reaction could be measured. It was therefore impossible to tell to what extent a particular food, or other environmental exposure, was responsible for their symptoms.

At this same time, I had occasion to present some of my earliest patients with “mental” symptoms to the psychiatrists at the Milwaukee Sanitorium. Dr. Josef Kindwall, chief of staff at this well-respected institution, listened to my presentation and then suggested that I fast such patients, in order to clear the board, so to speak, of all preexisting symptoms.

Six patients were therefore hospitalized in separate rooms and fasted. Each patient soon complained of heightened symptoms and, being inexperienced, I was disturbed by their worsened condition and decided to cancel the tests. In fact, these heightened symptoms in the early part of a fast are now known to be normal withdrawal reactions to addicting foods. Thus the initial attempt to fast patients ended in failure.

In April, 1951, the chemical-susceptibility problem was first described, and so, in the winter of 1953, were the effects of natural gas on susceptible individuals. Considering these unexpected sources of reactions, it became even more obvious that in order to achieve a “base line” of health, it would be necessary to remove a patient to a sheltered environment, in which food and chemical exposures could be thoroughly controlled. This belief was reinforced by seeing an occasional patient who felt distinctly better in the chemically less contaminated environment of a hospital. Some doctors referred to this phenomenon as “hospitalitis,” an alleged “disease” in which an individual craves a protective environment, but I believed the reason lay in the effects of the nonpersonal environment on the patient’s health. In the meantime, I told Dr. Donald S. Mitchell of Montreal about my difficulties in fasting patients and about the need to do so, given the complexity of their problems. Dr. Mitchell, on his own initiative, attempted to confirm this and was able to fast patients for longer periods of time. He discovered that the withdrawal symptoms subsided by the third or fourth day and that after that, the patients generally felt better than they had in a long while.

In 1956, I therefore decided to attempt a hospital fasting program again. This time the experiment was a success, and certain food and chemical allergies were diagnosed which simply could not have been found through any of the office procedures used at that time.

This experience led to a new approach to the diagnosis of allergy-caused illnesses. Since that time, I have hospitalized, fasted, and tested over 10,000 individuals in this manner. Until 1975, such testing was done in separate hospital rooms of a general hospital. Patients did reasonably well in this environment. One problem, however, was that chemically susceptible patients were still exposed to tobacco smoke, perfumes, and other hospital fumes and odors, which interfered with the accuracy and validity of the testing. Sometimes night nurses might smoke in the nursing stations. At other times rooms were chemically disinfected and residues of such agents made certain rooms unavailable for use.

Since 1975, therefore, a separate Ecology Unit has been maintained as a section of a hospital in a Chicago suburb, and it is far more controlled than any ordinary hospital room or ward could be.1

The procedures in the Ecology Unit are an indispensable part of the treatment for allergy. Traditional diagnostic techniques are like a table with three legs. The first leg is the patient’s history, the second his physical examination, and the third his diagnostic tests. In the Ecology Unit, all three of these standard methods are employed, but in addition there is a fourth leg. Often it is this fourth diagnostic leg which provides the sound basis for an answer. Its value has been confirmed by many physicians, and about a dozen are now using this sort of hospitalization in their daily practice. Indeed, in the combined experience of clinical ecologists using these techniques in a hospital or environmentally controlled setting, approximately 20,000 patients have been observed under controlled conditions during the past three decades (see Appendix B for a list of clinical ecologists practicing in a controlled environmental hospital setting).

The basic idea of the Ecology Unit is control. For several weeks, all aspects of the patient’s physical environment are scientifically managed. The air he breathes, the food and water he consumes, and everything that might come into contact with, or enter, his body, is subjected to prior scrutiny.

This technique, in effect, borrows a page from the experimental scientist’s book. “It is a controlled clinical experiment,” Dr. Lawrence Dickey once wrote of the Ecology Unit, “using an individual patient, and has all the validity of a controlled laboratory experiment. Both require control of as many variables as possible.”

This may seem like a big job, and indeed it is. First of all, one must control what the patient brings into the hospital. Plastic suitcases, synthetic fabrics, cosmetics, and so forth must all be left behind. Patients can only wear garments made from natural fabrics, such as wool or cotton, and only those which have been washed many times or which were not originally treated with chemicals.

Patients are allowed visitors during their stay, which averages three weeks. But the visitors are warned at the door not to enter if they are wearing cosmetics or scent of any kind and not to bring in flowers, candies, or other substances that might make some patients sick or destroy the validity of the test reactions. Staff members, like patients and their visitors, are not allowed to wear any perfumes or scents.

Patients are then fasted on spring water for an average of five days. The purpose of the fast is to completely clear the digestive tract of all food, a process which is often facilitated by the use of milk of magnesia or alkali salts.

In fasting, the patient may experience withdrawal reactions in which his accustomed symptoms get worse for a few days before they get better. The arthritic patient’s joints may flare up. The person with a chronic headache problem may suffer a particularly bad attack. The moderately depressed may get a bad attack of the doldrums.

When the worst of the withdrawal reaction is over, however, the patient is tested blindly with several different waters. One of these is the local tap water, and the others are commercially available bottled water (only in glass bottles, never plastic). A new water is tested every three hours, if there has been no adverse reaction to the previous test sample. The patient rates the waters on a scale of zero to ten, without knowing which water he is receiving. He keeps a record of his reactions to the water samples, and the one he tolerates the best will be his compatible water for the remainder of his stay in the hospital. The compatible water is continued on first returning home.

After four or five days, the patient usually feels better; in fact, he may feel healthier than he has in months or years. For example, some patients who have been prostrated by fatigue are able to get up and bustle about. Others who have had pain find that they are virtually pain-free. If the symptoms do not go away, and sometimes they do not, then the fast is prolonged. There is ordinarily no hazard in this, provided that the patient does not have a medical condition which makes fasting dangerous. At all times, of course, the fast is carefully monitored by the medical and nursing staff.

Some fasts have lasted ten days or more. Of course, there are patients whose symptoms are apparently not the result of environmental exposure or for whom even the minimal exposures of the Ecology Unit are disturbing. Such patients may not improve. In the great majority of cases, however, the fast will eventually bring about a cessation of old, disturbing symptoms, and a new sense of well-being, sometimes bordering on the euphoric, will set in. Fasting breaks the addictive cycle of the sick person to the foods and other environmental substances making him ill.

The chemical environment in the Ecology Unit is particularly controlled. Just as there is an attempt to prevent the entry of potentially harmful materials from outside, so too-everything inside the unit is kept as innocuous as can be. This gives the unit a somewhat old-fashioned appearance. The couch in the lounge, for instance, is made of well-worn leather, and the chairs are fashioned from wood and metal, upholstered with cotton or felt, and covered with natural fabrics. All of the bedding is made of simple, untreated cotton, and such things as sponge-rubber pillows or mattresses, draw sheets, upholstered furniture, rug pads, or even tubing made with rubber, are forbidden.

Plastics have also been banished from the Ecology Unit. There are no mattresses with plasticized surfaces, no plastic covers on the pillows, no plastic furniture, shower curtains, drapes, slippers, or handbags.

Initially, there was a problem with the floors. Some of the patients simply did not lose their symptoms, even after a prolonged fast. We finally learned that before the Ecology Unit had taken over this particular space in the hospital, the baseboards had been sprayed with a chemical pesticide. It is virtually impossible to entirely eliminate such sprays. The baseboards and the old floor, therefore, had to go and new tile baseboards and flooring were put down. Since then, far fewer patients have failed to get rid of their symptoms on the fast.

In addition, the Ecology Unit has its own broom closet, and the cleaning personnel use only soap and water. Since there are odors and fumes emanating from other parts of the hospital, it has been necessary to seal off the stairwells, elevator shafts, laundry chutes, and ventilating systems to prevent leakage into the unit. Even the latch holes on the doors were plugged to keep out cigarette smoke. When it is time to paint, the entire floor is evacuated for a week. In addition, large and effective air purifiers are kept running most of the time, despite the fact that the Ecology Unit is located in one of Chicago’s least polluted suburbs.

Despite these precautions, chemical contaminants sometimes do get into the unit. Recently, for example, during the shooting of a film, a solvent-based marking pen was opened. Although the pen was not open for more than half a minute, at the next morning’s staff meeting one of the nurses reported that several chemically susceptible patients had gotten ill at the time of the shooting. The answer almost certainly lay in this marking pen. When the error was realized, the door and window of the room where the pen was had been foolishly thrown open, blowing the fumes across the hall and into the room opposite. The patients who had gotten ill were in this room. It is because of reactions such as this that great strictness is exercised in controlling chemical pollution of the Ecology Unit.

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Whereas the lectin found in raw or badly cooked kidney beans is damaging to almost everyone, other lectins are more selective – indeed, the word lectin comes from a Latin word meaning ‘choosing’. Each of us is slightly different in our chemical make-up, and one important way in which people vary is in the short carbohydrate molecules that sit on the surface of our body cells. It is mainly these carbohydrates to which the lectins bind, and they are highly specific for the individual sugars that make up the carbohydrate. Each type of lectin is specific for a particular sugar. (There is also a short carbohydrate chain in every antibody molecule, and it may well be that lectins trigger mast cells by binding to the carbohydrate component of IgE.)

It seems likely that individual differences in the carbohydrate chains (either on the cell surface, or in IgE molecules) could make some people susceptible to a particular lectin which has no adverse effect on the majority of the population. There is some evidence for this in coeliac disease. But if susceptibility to particular lectins causes false food allergy why is this

problem so rare? The answer must be that natural selection has weeded it out, because it would have been a serious disadvantage among our distant ancestors if an important element in the diet could not be eaten. Any individual who suffered such an affliction would probably have died early, without leaving any offspring. In this way, the genes that could make a person susceptible to false food allergy would have remained very rare. But even such damaging genes can survive if they are capable of being masked by other ‘healthy’ genes – this means that some people can carry the gene, without suffering any ill-effects, and pass it on to their children.

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Anaesthetising injections used in dental treatment are relatively simple chemicals given locally and reaction is rare. If you are concerned, try to avoid having injections unless absolutely essential. If sensitive to water and disinfectants, take your own water with you for rinsing your mouth.

Some people are affected by the mercury in amalgam fillings. Replacement or new fillings of material other than amalgam can be paid for under usual NHS funding if your dentist is willing to do it, but it requires a special letter from your doctor saying that the work is essential. Consult your dentist and doctor.

Other materials used in dental treatment very rarely cause problems, or are used only fleetingly (e.g. in making moulds for braces or dentures). If you think you have become sensitive to your dentures, try changing your denture cleaning material first. If you are sensitive to plastic materials, it is possible to have metal dentures made.

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Water distillers purify water by boiling water and cooling it again. Gases evaporate, bacteria and viruses are killed, and almost every other chemical salt,” mineral and contaminant is left in the boiling chamber. The condensed water is then passed through an activated carbon filter, which removes organic chemicals which have not been removed in the steam. The distilled water is collected in a storage chamber. The resulting water is extremely pure – comparable to reverse osmosis water.

Distillation units cost between £400 and £600. They can be plumbed in under a sink, or can be used on a worktop or table top. Apart from the de-mineralised taste, their other drawbacks include the expense of electricity costs, their low flow-rate, their need for regular cleaning, and their bulk. The resulting water is warm also, so usually needs cooling before drinking. Their major disadvantage for the chemically sensitive, however, is that the water, being de-ionised, absorbs chemicals very readily from its environment and, being usually stored or held initially in a plastic container, has been known to upset people sensitive to plastics. Although it is so pure, in practice chemically sensitive people often tolerate distilled water less well than other types of purified or filtered water.

If you do not want to instal a distiller but want to use distilled water, one company The Freshwater Company (address below) supplies distilled water in containers (plastic) in the London and Home Counties area for a cost of between 21p and 25p per litre (2 pints) at 1992 prices. Pharmacies also sell distilled water, usually in plastic containers. You need to check whether it has been distilled with an activated carbon filter distiller. Some distilled or de-mineralised water sold for steam irons or other uses has not been filtered with activated carbon and still contains organic solvents.

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If you need such a product because of chronic illness, you are not required to pay VAT. Vacuum cleaners can be supplied exempt of VAT if you sign a simple declaration form which the supplier will provide.

Remember to change bags and clean fabric filters regularly. If changing bags or cleaning filters upsets you, enlist someone to do it for you.

The Medivac is available from The Healthy House or direct from Medivac. The Nilfisk is available from Allerayde or direct from Nilfisk. All these suppliers offer a trial period. Other suppliers of allergy vacuum cleaners are BVC, AEG, Miele, Rainbow and Vorwerk. Addresses and telephone numbers below.

The Rainbow machine is worthy of particular mention since users report that they find it more effective than the Medivac or Nilfisk. Dusts and dirt are removed by passing through water and there are therefore no bags to change, or filters to clean. The main drawback is price – it’s about £900 (at 1992 prices).

If you absolutely cannot afford to buy such a cleaner, another option is to try exhaust filters, available from Allerayde. These are made of fabric which you tape over the exhaust of any conventional cylinder cleaner, and most hard cased upright cleaners. The fabric is thick synthetic wadding, but has not been reported to cause any reactions. These filters are not as effective as the filtration cleaners. Tests have shown that they are slightly less efficient at trapping particles, and they let out through slightly larger particles. But they still trap over 99 per cent of particles over 0.5 micron in size, which covers most important allergens.

The filters cost £20 for three filters, at 1992 prices, and last about 24 hours of vacuum use. For most people, this would mean replacing them every 12 weeks or so. This is a cheaper solution than buying a filtration cleaner over the long term, unless you use a vacuum cleaner very heavily. Drawbacks are, however, that you are exposed to dusts on changing niters and that it can be fiddly to fix the filters on properly. Again, enlist someone’s help to do it for you if you need to avoid dusts.

Using exhaust filters may be a help if you go away for some time – on holiday or on a prolonged visit.

They may also help to use for a trial period while you decide whether thorough vacuuming will be of benefit to you long term.

Hoover sell High Filtration dust bags for their Turbopower and Turbomaster upright cleaners, which are claimed to reduce the amount of dust passing. A Which? survey in 1991 found that ‘these gave only a small improvement over their other bags and that they still let through an unsatisfactory quantity of dust’.

Contact a local allergy support group, or a local group of a national charity, to see if they have members willing to lend you an allergy vacuum cleaner to try for a while.

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You are left, if you are sensitive to many things, with virtually no choice in contraception except natural methods. The most effective method of natural contraception is called the sympto-thermal method, combining the mucus method (also known as the ovulation or Billings method) with measuring temperature changes and other changes in bodily symptoms. Used correctly, the sympto-thermal method has a failure rate equivalent to a cap or diaphragm used with spermicide, a condom, or a coil, according to the Family Planning Service. Most women are fertile for only about seven days each month around ovulation. Learning to monitor the signs can help you identify the times when unprotected sexual intercourse will not result in pregnancy. The mucus produced by the cervix has characteristic changes on days prior to and just after ovulation. Body temperature also has identifiable changes around the time of ovulation. Other symptoms, such as abdominal pain, bloated tummy and breasts, and an increase in libido often accompany ovulation. During the few days each month when the woman is fertile, you can either abstain from intercourse, or use a method of contraception which you can tolerate in small amounts.

The drawbacks of this method are that it requires a lot of attention and monitoring, and that it is probably only possible for people who have a regular and co-operative partner, or who are in a stable relationship. Furthermore, for women who have an extremely irregular cycle, or do not menstruate, it can be impossible to detect the bodily changes.

A good family planning clinic or experienced doctor will be able to help you work out what to do. Try the Durex.

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Simple slatted beds of solid wood and metal are readily available. Mail order companies, such as Freemans, Littlewoods and Grattans, sell metal frame beds by post (addresses below). Habitat and IKAEA do not sell by post but have a choice of wooden, metal, glass and even marble furniture at reasonable prices. Contact them for details of local branches.

If you want to have upholstered furniture made for you, Multiyork will make chairs, stools and sofas upholstered in cotton wadding, on a beech frame. They will use a totally untreated cotton cover fabric if you supply it (>FABRICS for sources) over a pure cotton barrier interliner fabric to meet fire safety regulations. They have branches around the country or will take postal orders.

Alternatively, contact the Association of Master Upholsterers for local specialist upholsterers.

Treske will make solid wood furniture in any wood of your choice, with a varnish of your choice.

Directors’ chairs made of cotton canvas and varnished wood, are often well tolerated and comfortable. You can also use them to carry with you if you go on holiday, on a visit or if you have problems at work. They are widely available at Habitat, DIY stores and department stores. Also try folding chairs of wood and metal.

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DAY

PROTEINS
ONE

Beef Rabbit
TWO

Pork Eggs Venison
THREE

Lamb Fish
FOUR

Birds Turkey Chicken Duck
MILKS
Cow’s milk Cheese Butter Yogurt

Goat’s milk and cheese

Sheep’s milk and cheese

GRAINS AND STARCHES
Wheat

Oats

Rye
Tapioca
Rice Corn Millet
Buckwheat Sago
FRUIT
Apple

Berries

Grapes
Banana Melon
Pear

Apricot

Peach
Dates Kiwi

All Citrus Rhubarb
VEGETABLES PULSES AND BEANS
Carrot

Avocado

Parsnip

Onion

Garlic

Olive

Spinach

Mushroom
Sweet Potato Green Beans Peas

Courgettes Cucumber Soya Lentils
Sweetcorn

Cabbage

Broccoli

Sprouts

Watercress
Potato

Tomato

Lettuce
NUTS AND SEEDS
Nuts
Peanuts
Sesame
Sunflower
OII.S
Olive Oil Grapeseed Oil Nut Oils
Groundnut Soya
Com Sesame
Sunflower Palm Oil
SUGARS
Beet Sugar
Honey
Cane Sugar
Maple Sugar and Syrup
BEVERAGES
Chocolate
Tea
Coffee
Dandelion Coffee
HERBS AND SPICES
Bay Leaf

Cinnamon

Chives

Parsley

Ginger
Nutmeg Rosemary Oregano Basil
Allspice

Clove

Coriander

Cumin

Dill
Tarragon Mint Sage Thyme
MISCELLANEOUS
Yeast

Alcohol Vinegar

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No objective measure of chemical sensitivity exists, other than challenge tests (when individuals are ‘challenged’ with chemicals to provoke a reaction) in controlled conditions. Doctors are largely dependent for diagnosis on symptoms reported by patients, and because of this, many of them do not believe that it is a real disorder. Furthermore, because many of the symptoms people typically complain of are mental symptoms, many doctors commonly diagnose a psychiatric or psychosomatic illness, saying that the individual’s problems are all in his or her mind, that no-one can be made unwell by tiny doses of chemicals, that the illness is a stratagem, probably unconscious, for dealing with personal or psychiatric problems.

Psychosomatic illnesses clearly exist – the link between mind and body is strong – and there will be in the field of allergy and sensitivity, as in any other area of medicine, cases where underlying psychiatric disorder is a component, perhaps an important component, of the individual’s ill-health. However, the fact that psychosomatic illness exists should not lead to the common bias that people claiming that tiny doses of chemicals make them ill must be suffering from psychiatric problems.

The evidence from clinical practice of doctors who treat people who have positive results from controlled testing with chemicals is that the vast majority of their patients are average, happy, sane people whose abnormal symptoms (psychiatric or otherwise) appear when they are exposed to certain chemicals, and disappear when they are not. The level of improvement in symptoms in clinical practice is significantly above that expected from the placebo effect. (In medical trials, it has been found that, on average, one-third of patients – or more in the case of psychiatric patients – respond to being given dummy or inactive therapy or medication – a placebo. Only improvement in excess of expected placebo results is taken as serious evidence of the effectiveness of any therapy.)

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If your child is chemically sensitive, or has irritable eczema or asthma, avoid synthetics and wool. Pure cotton is generally better tolerated, although some unlucky children are sensitive to it, particularly flocky or knitted cotton. When choosing cottons, take care with fabric finishes and:

• wash poplin or denim very well before using to remove any finishes. If very sensitive, avoid altogether

• avoid winceyette, especially sleepwear

Look for clothes made of:

• cotton jersey

• cotton tracksuit fleece

• 100 per cent cotton corduroy

• brushed cotton

Wash everything very well before wearing at all.

The most difficult clothes to find for children in pure cotton are:

• school uniform

• knitwear

• socks and tights

• hats and scarves

• outerwear and waterproofs

School Uniform and Knitwear

Cotton On sell by post a range of school uniform clothes (trousers, shorts, shirts, jumpers, socks) in pure cotton, as well as a range of plain tracksuit tops and bottoms. These are formaldehyde and chlorine bleach-free. Cotton school cardigans and jumpers are available from Sheila Stewart. Angela Knitwear make school uniform, novelty and striped jumpers lor children in pure cotton.

Socks and Tights

Pex manufacture 100 per cent cotton socks for children. They are widely available. Cotton On (details above) sell pure cotton socks for children, and 100 per cent cotton tights for babies and children. Some of their socks are 98 per cent cotton, 2 per cent synthetic fibre, but no reports of reactions have been received. Schmidt Natural Clothing sell pure cotton socks and tights for children by mail order.

Hats and Scarves

Cotton On also sell warm, knitted cotton hats and scarves.

Outerwear and Waterproofs

It is virtually impossible to find warm, waterproof outerwear for children that does not contain some synthetics. One solution is to buy a waxed cotton jacket, and let it hang until the fumes from the new waxing have given off; these are then usually tolerated well, even by the chemically sensitive. Re-wax rarely. Another solution to achieve warmth is to make a coat or jacket liner out of cotton blankets and wear it under a waxed coat or corduroy jacket

The Cotswold Clothing Company make dry wax waterproof rainwear of pure cotton, with a brushed cotton lining. They also have a range of padded pure cotton corduroy and brushed cotton jackets. Next Directory sell soft cotton anoraks with polyester wadding. Joan Hollings makes Liberty cotton wadded jackets and waistcoats. Annie Jo Retail make pure cotton needlecord and poplin padded jackets. The wadding in each case is polyester, but encased so should not cause trouble. You can also try PVC raincoats. If rinsed through with water, and left to air for some time, the new plastic smell goes, and they can be tolerated reasonably well.

Sources clothing

Table 11 gives sources for children’s clothing, mostly mail order. Once again, check all details in catalogues and, if necessary, by telephone. For formaldehyde-free and chlorine bleach-free clothes, see Cotton On, and Schmidt Natural Clothing. Schmidt also make silk and silk blend underwear for children. The Green Catalogue sells unbleached cotton underwear for children.

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