Suppressed Inventions and Other Discoveries (4 page)

Dr. Horrobin presents many situations in which, through peer review, Organized Medicine has tried to suppress an innovative concept but failed. He shows how the use of peer review influences journals, conference choices and grant awards.

Pathologist Charles Harris has written editorials about the "Cult of Medical Science" in which he says pseudo-science in medicine is currently a cult which inhibits innovation and considers participation in clinical drug trials (which have been designed by statisticians) as the work of scientists because these trials reject so-called anecdotal evidence based on clinical observations alone. But this narrow attitude is not real science which leads to discovery. It is merely indoctrination and a pledge of allegiance to the flag of pseudoscience.

Harris also asserts that diagnosis, which is supposed to be the determination of the nature of disease either by examination or by exclusion, is not being practiced as it should be. Diagnosis today too often does not consist of examination, exclusion, clinical or therapeutic trials; rather, it often consists only of a rushed referral to a medical specialist under the guise of a diagnosis. The specialist may accept and act on the initial diagnosis which was not valid in the first place. The initial diagnosis serves to justify referral and satisfy the CPT code in order for the doctor to get reimbursed.

The New York Times, on March 26, 1991, carried an article by Philip J. Hilts entitled "How Investigation of Lab Fraud Grew Into a Cause Celebre" recounting how scientists turned a tangled dispute into a defense of science. This article is about a draft report which had been recently released by the newly-established Office of Scientific Integrity at the National Institute of Health. This office had been investigating the case of

Dr. Thereza Imanishi-Kari and a paper she published with Dr. David Baltimore in the April, 1986, issue of the scientific journal Cell about the basis of an immune reaction. Questions about the paper arose when Dr. Margot O'Toole, a post-doctoral fellow in Dr. Imanishi-Kari's laboratory, went to Dr. Baltimore (who was then at the Massachusetts Institute of Technology) and told him her reasons for doubting the authenticity of the data in the article. She alleged that the paper made false statements, a conclusion she reached after seeing seventeen pages of data that supposedly, but did not, support claims in the paper. She persisted in her accusations, and, as a result, two scientific reviews of the paper were conducted in 1986—one at MIT, where the work was done, and the other at Tufts University, where Imanishi-Kari was seeking employment. Both of these reviews found problems with the work but found no reason to believe misconduct was involved. Dr. O'Toole, who was eventually fired from her job at MIT, had been told by Dr. Baltimore that she could publish her objections to the paper, but that if she did he would also publish his views of it.

The matter lay dormant for two years after the initial scientific reviews conducted at MIT and Tufts, until Representative John D. Dingell, who heads the House Subcommittee on Oversight and Investigations, asked the Secret Service to examine Dr. Imanishi-Kari's notebooks for their authenticity. This action raised the hackles of the scientific community. Supporters of Dr. Baltimore criticized Dingell for prying into the notebooks of science and, described his panel as the "science police." Dingell revealed that his committee was soon buried in letters from scientists concerned with the subcommittee's actions, but he also said that in perhaps 50 percent or more of the letters the scientists included disclaimers, saying that they did not know the facts of the case. What had begun as a small dispute within Dr. Imanishi-Kari's laboratory had become a national debate, pitting Dr. Baltimore and his many supporters in the scientific community against Dingell's House Subcommittee and generating bitter controversy over a period of five years.

The controversy was eventually addressed by the National Institute of Health's Office of Scientific Integrity and put to rest by its draft report. In that report, the OSI concluded that Dr. O'Toole's actions were heroic and that Dr. Baltimore's response was troubling because he, instead of ending the matter within weeks of its beginning, allowed it to mushroom into a national debate. Dr. O'Toole's allegations were vindicated, and most of Dr. Baltimore's supporters have withdrawn their objections to the Congressional action after confronting the evidence uncovered by the OSI and presented in their draft report.

This case of scientific fraud illustrates the need for an office such as the Office of Scientific Integrity. Dr. David Goodstein, Vice-Provost of the California Institute of Technology, helped to write the rules for dealing with misconduct. He stated in regard to the Imanishi-Kari/Baltimore case, "The scientific community until recently was disposed to believe that fraud didn't exist. So, in the rare cases that it did come up, the community was not prepared for it."

Having established that fraud can exist in the scientific community and having acknowledged the need for an agency to investigate such fraud, we now need to address a disturbing question: What about fraud and deceit that is conducted by individuals who work for organizations such as the AMA and the FDA? Why doesn't the Office of Scientific Investigation inquire about what happened with the Koch reagents and how an injunction was issued by the FDA prohibiting interstate shipment and the making of any medical claims, without the FDA even investigating them? What about the recall by the FDA of all contaminated tryptophan products sold in health food stores while allowing the continued use of the contaminated product in infant formulas and in intravenous pharmaceutical preparations?

The statute of limitations has expired in the case of the Koch reagents, but it is arguable that there should be no statute of limitations in science, particularly regarding a therapeutically useful drug. In any case, the statute of limitations has not expired in the recent contaminated tryptophan case. Why is this case not investigated by the OSI? If their mandate is not to investigate cases like this, then what is it? Surely their mandate goes beyond an occasional nabbing of a cheating researcher. It appears that the Office of Scientific Integrity is prepared to investigate individual instances of fraud but not collusion and conspiracy within the ranks of the government itself.

The story of vitamin C and cancer was thoroughly researched by Dr. Evelleen Richards and published in "Social Studies of Science" in 1988. Her paper received much publicity. Dr. Richards documented in great detail the failure of two Mayo Clinic studies to test vitamin C in the correct manner proposed by Nobel winner Linus Pauling and his associate E. Cameron.

Richards noted the repeated refusal of the New England Journal of Medicine to publish letters and articles by Pauling and Cameron that demonstrated why the second Mayo trial was not a test of their hypothedemonstrated why the second Mayo trial was not a test of their hypothe fluorouracil for colon cancer, continued to be used despite their failure to demonstrate efficacy in placebo-controlled trials. Richards proposed a valid question: Why does the full weight of disapproval fall on vitamin C (which has low toxicity), when toxic drugs with no demonstrated efficacy are widely used?

Dr. Horrobin contends that the peer review process harbors antagonism toward innovation. While this is not the norm, it certainly is not the exception. Editors must encourage innovation as much as they ensure quality control, and that will require a conscious effort of will. He points out that the hypercritical reviews and behaviors of many distinguished scientists are unwarranted and pathological. Such professionals are gate-keepers against innovation unless the new thought or discovery is their own.

Dr. Horrobin concludes with a call for editors to muster the courage to select reviewers of the highest caliber without vested interest, or at least to note when vested interest is present. Editors must stop rejecting innovative articles for minor details which never keep establishment-approved articles out of the journals. An editor must never lose sight of the ultimate aim of biomedical science—to improve the quality of patient care. Only after scrupulous study of both the article's contents and the peer review should the editor make an objective decision.

WE MUST STOP PERSECUTING
ALTERNATIVE PRACTITIONERS

To refuse to learn from history is to repeat it. The medical profession continues to libel and slander innovative doctors. The term "quack" has no legal definition. It is often misused to libel a doctor who is bright, full of initiative and well-loved by patients, and who has made an original discovery or happened to acquire the non-toxic methods that in the U.S. are referred to as alternative. Real charlatans should certainly be stopped. But should there be these programs aimed at American doctors such as the chelation doctors or those who employ alternative methods for treating cancerous tumors or other chronic diseases such as arthritis, multiple sclerosis, etc.?

This moral injustice should be halted. The involved branches of business, government and medical profession will in the near future have to answer the well-documented evidence spanning the twentieth century, that, hidden from the trusting public, a horrible orchestration of doctorbashing has occurred to destroy the competition.

And what does Organized Medicine say for itself? Why, they believe in an overly-rigid definition Canadian agriculturalist who intended for it to be used in such a rigid manner. It was intended to eliminate the subjective bias of scientific investigators and their research assistants, not to become the gold-standard bearer for scientific proof in clinical medicine. Most genuine scientists (the term excludes the majority of the medical profession) do realize this fact. Real scientists understand that a)) science starts with careful observation and the recording of events.

This point can be best ill us trated with a story. In the time of Julius of what constitutes scientific proof. The developed the double-blind study never Caesar, there was a legendary bandit by the name of Procrustes. Now, a Procrustean bed which bears his name is an adjustable hospital bed. Legend had it that Procrustes would kidnap people, bring them to his home and force them to lie down on his bed. If they were too tall to fit his bed, he just cut off their legs and they bled to death. Too short? He put them on a rack and stretched them until they died screaming. The highly regarded Dr. Edward Whitmont, homeopathic physician of New York City, likens the rigidity of the cruel Procrustes to the rigid adherence to a methodology that blinds one to an obvious truth in medicine—that an alternative treatment works. The obsession with a rigidly narrow definition of what constitutes scientific proof is more slavishly believed by physician scientists than by modern physicists. Recognizing only this rigid, narrow definition of proof, orthodox medicine holds a sword of

Damocles* over their competition.

Do they really believe that they can keep alternatives out of medicine? Or do they know that the exclusion will end in the near future and so "make hay while the sun still shines"?

* A fourth century Greek courtier to Dionysius the Elder, who, according to legend, was forced to sit under a sword suspended by a single h a i r to demonstrate the precariousness of a king's
fortunes.

The Great Fluoridation
Hoax; Fact or
Fiction?

Dr. Ronald S. Laura and John F. Ashton

DOES IT BENEFIT YOU? OR BIG BUSINESS!

The controversy surrounding fluoridation raises a number of important socio-ethical issues which cannot be overlooked. One of the most burning questions is whether the fluoridation programme represents a milestone in the advancement of community health or the opportunistic outcome of a powerful lobby concerned largely to advance its own vested interests at the expense of the interests of the public. The historical origins of fluoridation are revealing, though we shall for obvious reasons in what follows not interpret the revelation itself, but rather tease out a few of the truly remarkable coincidences which make those origins revelatory.

In a more direct approach to a related issue, however, we shall argue that the potential and actual health risks associated with fluoridation have not been sufficiently appreciated by those in favor of fluoridation. The intentional introduction of fluorides in drinking water has certainly not received the rigorous scrutiny and testing properly brought to bear on the wide array of available medical drugs, many of which can be bought without prescription. Finally, we urge that even if it were determined that the addition of a minimal amount of fluoride to our water supply was both safe and effective in the reduction of caries in the teeth of children, the relevant dosage of fluorides could not be satisfactorily restricted to ensure that the harmful effects of fluoride did not outweigh the alleged beneficial effects.

THE GENESIS OE FLUORIDATION

Many readers will be surprised to hear that fluorides have been in use for a long time, but not in the prevention of tooth decay. The fluorides we

Dr. Ronald S. Laura is a professor
PERC Fellow in Health Education, department of education at the University of Newcastle.

of education at the University
Harvard University, and John F.

of Newcastle and is a
Ashton teaches in the

now, in the name of health, add to our drinking water were for nearly four decades used as stomach poison, insecticides and rodenticides. Fluorides are believed to exert their toxic action on pests by combining with and inhibiting many enzymes that contain elements such as iron, calcium and magnesium. For similar reasons fluorides are also highly toxic to plants, disrupting the delicate biochemical balance in respect of which photosynthesis takes place. Nor is there any reason to suspect that humans are immune from the effects of this potent poison. Even a quick perusal of the indexes of most reference manuals on industrial toxicology list a section on the hazards of handling fluoride compounds. In assessing the toxicity levels of fluorides Sax confirms that doses of 25 to 50 mg must be regarded as "highly toxic" and can cause severe vomiting, diarrhea and CNS manifestations.
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