Dr. R. L. Wysong
June 1988
Medicine – Always the Place for Scrutiny
    Medical practices must be the focus of intense scrutiny and reevaluation on a continuing basis.  For example, today there are a number of bloodletting (medical vampiring) practices.  The average adult admitted to an intensive care unit has at least two units of blood removed during their stay.  This subjects them to hazards as a direct result of blood loss as well as hepatitis and other complications from blood replacement (vampiring, cannibalism).   Excessive amounts of blood are often removed, almost indiscriminately, for testing and repeat testing.  Serial samples are taken when one sample would do for several tests.  Several milliliters are drawn when often a drop would do for many modern testing procedures.  Once admitted to an Intensive Care Unit, the potential is great that the patient will be swept along in a technological bloodletting imperative, taking a procedural life of its own with little regard for peripheral risks to the patient.   Both patient and physician must constantly assess the risk-to-benefit ratio.   We mustn’t assume that a modern medical procedure is any more valid than accepted practices in the past that we now consider quackery or witchcraft. 
        The New England Journal of Medicine
Medical Liberty
    There are three methods by which medical utopia might be achieved.  One is by setting objectives and reaching toward them using whatever resources are available.  The second would be to identify problems as they occur and try to solve them at that point.  The third method is to do as is commonplace today, namely to muddle around defending the status quo against change until change is forced.  This third method does not lead – it follows.   It is the method by which the majority of us proceed through life…or through medical care. 
    The resistance to change, the resistance to initiating change, seems to be inherent in human character.  Perhaps it is nothing more than an expression of the herd, or flocking instinct.  Members of a herd of animals or a flock of birds are more secure, more safe within the confines of the flock and much more vulnerable if they should veer from the safety of the flock.   There are other economic reasons for maintaining status quo.  If a system is prospering, those who are in control dictate this as the norm, as status quo.  Any effort to change, to veer, would threaten the economic hold of the status quo.  It can be argued that an individual has the right to choose whatever method of treatment they desire and receive health care from whatever source they wish, be it the next door neighbor, midwife, chiropractor, naturopath, voodoo healer or a magician.  But can we expect that the conventional medical establishment is going to support this regardless of whether the evidence indicates such liberty could result in better health for the community or not?  Resistance to change occurs in all aspects of society, be it political, economic, academic, religious or social.  Those who are in power and have vested interest in maintaining the status quo are not going to yield easily.
    But status quo does not result in progress and does not move the human condition forward.  Change must occur; change is a part of life at all levels.  If a species is incapable of adapting, survival is in jeopardy.  The prevailing medical establishment is too often guilty of failure to listen to patients, failure to listen to the public, insufficient preventive medicine efforts, increasing the percentage of the gross national product used for medical health care, entrepreneurialism, poor business ethics, greed, conflicts of interest, hucksterism, prolongation of dying, rationing of medical service, failure to care for the poor, and inappropriate use of resources.  The true enemies for the physician are death, disease, disability, pain and human suffering.  The impasse for vanquishing these foes are profiteering politicians, health care financing, administration, bureaucrats, insurance companies, and health care practitioners who simply wish their vested interest be protected. 
    In order to effect change, in order to address issues of death, disease, disability, pain and suffering, one needs to use whatever resources there are.  But vested interests create one-sided information assuring conformity to orthodoxy.  Medical utopia will never occur without medical liberty.
        The American Medical Association
The Modern Farming Tragedy
    We might wonder how the farm can impact upon society when only about 3% of the population still manage or live on farms.      Well, we all eat, and that links us all to farms. Also, a large portion of the wealth and power of the country flows through the agricultural system.  The farmer and the farm are looked upon as a means to offset trade deficits.  The farm is also a place to externalize costs. 
    To understand externalization of costs, look at the environmental model.  The discharge pipes and stacks of industry should all plug directly back into the intake side of society and not be externalized to a voiceless environment.  Instead, we have been able to get away with, through the years, consuming and marauding and exploiting without regard for consequence.  There is debris.  That cost has, up until now, been simply cast off into the environment.  We plug the cost of industrialization into our streams and rivers, or pump it into the atmosphere.  We do not pay the price for that cost, so it has been kind of a free meal sort of thing and it is now catching up to us.  If we were serious about the health of modern agriculture, we would treat it as inherently biological and cultural and not industrial.  Certainly the technology of modern farming practices is impressive.  However, in terms of meaningful sophistication, they are primitive because modern farming practices do not take into account justice for future generations.  We must always ask the cost – we must ask the question “And then what?”  No technology can be considered sophisticated unless it really does this, unless it asks these questions, “And then what,” “What is the impact upon the environment at large,” and “What is the impact upon future generations?” 
    When forests and prairie were leveled to make way for modern agriculture, ecosystems were replaced by rows of tilled land marauded by monster tractors.   It would be a tragic mistake, as well as a great vanity, to believe that our scientific cleverness is so wonderful that we can abandon the wisdom of nature and not pay a price.  The information explosion resulting from the technological era may be more than offset by an information implosion as a result of the agricultural wasteland destruction of the genetic material lost through extinctions.   In fact, it is estimated that just in the last 50 years, there has been more genetic information lost than all of the accumulated information that has been gained by scientific inquiry. 
    We are lulled and dazzled by the technological progress that we see.  We have come to rely upon it for our everyday sustenance, convenience and comfort.  We believe that when difficulty arises, that something will come forth out of technology as savior.  If ecosystems are destroyed and genetic material lost, will biotechnology or genetic engineering be the magic bullet to solve all of the resultant problems? 
    The problems of the modern day farm are not going to be solved by rearranging economic structures or by some new technology.  They are symptoms of a collective disease.  The beauty and richness of the land and the intimacy of living with it are readily sacrificed, for self-aggrandizing progress.  For the sake of this progress, much of the land of this country has been grossly, negligently wasted. 
    We really can’t blame the farmer.  He is not the cause. He is a pawn in a large game.  The farming system has evolved to fill a need – the need for more and more cheap food with less and less effort. 
    Are we all plunderers, slaughterers and violators?  Conquering the land is as old as human history.  It has always been a frontier, always a horizon to reach out for, to achieve progress.   Now there are no new lands to colonize or exploit.  The notion that our actions would be infinitely diluted by an infinite reservoir of land is no longer valid.   We live in a unique time in all of human history.  Ultimately, to be divided against nature, against wildness, for the sake of agribusiness, is a human disaster.   It is to be divided against ourselves.  It confines our identity as creatures entirely within the bounds of our own understanding, which is invariably a mistake because it is invariably reductive.  It reduces our largeness; our mystery to a petty and sickly comprehensibility, to create ease, commercial success, and feed population growth that will eventually implode by collapsing sustainable resources.  For what purpose?
        Jackson, Wes.,  Alters of Unhewn Stone.
        Berry, Wendell.,  Home Economics.
National Parks
    About 115 years ago, Yellowstone became the first national park.  This was several years before Custer died at Little Big Horn and almost 50 years before the National Park Service came into existence.  Since then, other national parks have been developed including Yosemite and Mount Rainier. 
    But these areas set aside to be wilderness areas, enabling the preservation of American wildlife, are too small.  In fact, over 25% of the original wildlife has been lost in Yosemite and over 33% in Mount Rainier.  All of the national parks combined comprise only about 1% of the land area in the United States – hardly enough for the sustenance of wildlife. 
    Species that knew no boundaries have become island species.  Yosemite and Yellowstone, when originally established, were surrounded by other wildernesses where animals could freely intermingle and migrate unimpeded.  Blacktop, range fences, shopping malls and industry now restrict them.   Island species are the most vulnerable of all.  The more restricted to a particular environment, the more specialized a species becomes.  The more specialized it is, the more it is vulnerable to environmental change.
    Wildlife is part of a whole.   This whole is nature, a scope beyond the artificial boundaries that humans erect.   Survival for many species requires migration to areas where climate or food supply is more beneficial. 
    Prior to the intrusion of humans, most species were at equilibrium.  They were in tune with other species and their environment.  Pre-industrial humans were also at equilibrium.  Since the discovery of agriculture, and particularly with the industrialization of agriculture, humans have changed from a species at equilibrium to opportunism, capitalizing on the environment beyond that possible with individual biological capabilities.  Humans also thrive on change. Change distorts equilibrium.  Humans have now distorted the lives of thousand of plants and animals on the face of the Earth.  It is a unique event that has never been duplicated in history. 
    If a piece of notebook paper represents the land area in the United States, a period on the paper represents all of the people in the United States standing side-by-side, shoulder-to-shoulder.  But my, what a period can do armed with machine and not ecological conscience. We continue to attempt subjugation of the environment by simplifying it.  A blacktop road is certainly simpler than the ecological system on the ground it displaces.  So, too, is a lawn simpler than the field plowed under, and so forth.  Simplification is, however, the opposite of nature.
    There are many things that can be done.  Movements are afoot to expand the boundaries of national reserves.   There are efforts to change farming and ranching practices to eliminate fencing and road barriers that interfere with the ability of wildlife to move.  There are movements to change grazing species, such as substituting bison or elk for the very destructive grazing practices of sheep and cattle. 
    Even small acts that we as individuals can perform in our own yards can make a difference.  For example, an area can be set aside as a wildlife refuge. Land can be purchased that is still wild and posted as a wildlife refuge.  Locally, actively help with city planning so that natural wild areas are not destroyed for the sake of urban sprawl.   Why not redevelop the already denuded inner city?
    It is easy to pass off such concerns as faddist or radical.  But we do stand at a unique point in human history where humans can impact the ecology of the entire planet. 
    But nature is not “out there” and we somewhere apart.  When we destroy nature we destroy part of ourselves.  From an aesthetic standpoint, it would be a shame for our children and their children not to be able to enjoy nature in its pristine untouched state.  It would be a loss never to be recovered regardless of the amount of technology that was put in its place. 
Anti-Nutritional Factors
    Various chemical factors within certain raw plants can affect digestion adversely.  The botanical function of these factors is extremely varied.  For example, they may prevent the seed from germinating prematurely.  They may also protect the seed against a variety of environmental threats. 
    Many plants are far more complex genetically than even higher mammals. This results from the fact that they are not mobile; they must simply sit there like sitting ducks.  Without the ability to flee, they can only fight through the use of chemicals.  Modern food processing not only cosmetically upgrades food, but also destroys these anti-nutritional factors. 
In high concentrations plant anti-nutritional factors can cause malabsorption of protein, carbohydrate and fat, and they also result in various gastrointestinal symptoms such as bloating and diarrhea.  There is also evidence they may induce a variety of diseases.
    There are two basic ways in which these anti-nutritional factors can be inactivated.  One is by germinating the seed; the other is by heat.  Germination, in effect, causes the release of the inhibiting factors so that enzyme systems that are responsible for sprouting and subsequent plant growth can become active.  Heat simply destroys or denatures these complex chemicals so that they cannot exert their specific biochemical effects. 
    These anti-nutritional factors include enzyme inhibitors, saponins that are steroidal glycosides that have the ability to interfere in various ways with fat digestion including fat-soluble vitamins and cholesterol.  There are also tannins; these are condensed polyphenols that have the ability to reduce the activity of the enzymes trypsin and amylase, the first digests protein, the second carbohydrates.  Lectins are a family of proteins and glycoproteins, which, at high concentration, may result in mucosal damage.       Phytates, (myoinositol hexakis dihydrogen phosphate) bind metal ions, protein, and starch, thereby reducing both macro and micro nutrient digestibility. 
    The lectins, phytates, and tannins should not be confused with the nondigestible short-chain carbohydrates present in many seeds and legumes called oligosaccharides, short-chain saccharides.  These oligosaccharides include raffinose, stachyose and verbiscose.  Along with sucrose, these are the main carbohydrates in the dormant plant.  They are pretty much indigestible in their raw form and will pass through the upper digestive tract into the lower bowel where fermentative autochthonous bacteria have the ability to break them down, producing gasses and lower bowel discomfort.   They are to a large degree inactivated by heat.  Processed food manufacturing cooks, refines, and fractionates, inactivating or removing many anti-nutritionals.  Many commonly used foods today such as confectionary products, cereals, breads, pastas, and snacks are made of refined degraded starches reduced to a more simple form.  Upon consumption, these isolated fragmented nutrients are very rapidly absorbed.  Sugars and refined starches create a dramatic glycemic (blood sugar) response postprandially (after eating).  These constant shock waves of postprandial glycemia are believed to relate eventually to a variety of pathologies including cancer, diabetes and hypercholesterolemia. 
    In the effort to make foods nice and fluffy, white, pure, and easily digestible, we have created a situation where a large number of calories can be eaten easily.  It takes little mastication to eat the refined carbohydrates say in a Twinkie or donut, as opposed to the whole grain product.   The body is constantly assaulted by this metabolic oddity of blood sugar spikes.  
    In one of our divisions studying ruminant nutrition, we have been working on the development of rations for calves that would help to eliminate the use of antibiotics.  In this research, young cattle that are fed high corn, easily digestible carbohydrate diets develop a malady called the adolescent short and fat calf problem.  These calves are late in maturing and are not able to reproduce as readily as other more healthy calves.  They also do not produce a good yield of milk and are much more susceptible to disease. 
    I couldn’t help but think back to the fact that in the human population, it is believed that there are about eleven million overweight children between the ages of six and seventeen.  This is in large part due to a carbohydrate calorie glut, a glut directly related to refined easily digested carbohydrates.  These are empty calories delivered to the body without any micronutrients to process them, and no fiber to moderate the release of carbohydrates throughout the digestive tract. 
    Each day there are 815 billion calories consumed in the United States.  Two hundred billion of these are in excess.   These two hundred billion extra calories consumed in the United States each day are enough to feed the entire eighty million population in Mexico. 
    The tendency in processed food manufacturing to simplify the diet has done nothing to enhance the health of the nation.   Recent evidence indicates that the inclusion of anti-nutritional factors can actually result in beneficial effects.  These effects are a result of canceling out the detrimental effects of the glycemic surge from modern processed food.  Whole grain products, particularly legumes including beans and chickpeas, were particularly effective in lowering blood glucose levels.  This lowered glycemic response is not an indication necessarily that foods are not being digested or absorbed, but rather that the absorption is simply being slowed. 
    So we have come pretty much full circle from suspecting natural products as being anti-nutritional to the discovery that modification of whole foods could result in a predisposition to a variety of diseases. 
This is not to say that humans should consume raw soybeans or wheat kernels.  They are difficult to masticate, difficult to digest and much of their substance will pass right through the intestinal tract unaltered.   Grains must be cooked or sprouted.  If cooked, they should be cooked in their whole state so that the inherent fiber, the entire properties of the grain (less much of the anti-nutritional content), is retained.  The result is food with a much broader spectrum of nutrients and a leveling of the glycemic response.
    To be sure, cooking is a compromise from the ideal raw genetically adapted to diet.  But by using whole ingredients and uncooked sprouts where possible, that compromise is considerably softened.
        Third Chemical Congress of North America by Dr. Rao
    We live in a time in need of revolution.  The most profound insights in health, nutrition and deep ecology require far reaching modification of long-standing social, economic and political arrangements.   For changes to occur that will result in a better life for all, deeply entrenched ideas, philosophies and institutions will need to be overturned. 
    This is part and parcel of history.  History demonstrates a dynamic.  Even within long pauses of intellectual stalemate such as in the Middle Ages, there were revolutions in the making, simply waiting for the right circumstances to emerge and exert their effects. 
    Today problems compress in time due to the greatly magnified ability of people to affect their surroundings.   Solutions require more rapid change than in the past.  Otherwise, defects that may bring widespread harm will go unharnessed. 
To make change requires overturning the establishment.  This first requires criticism.  Criticism has always been and will always be an indispensable tool of scholarship in the pursuit of truth.  Are criticism, change, and revolution only the domain of the expert?  Or is the responsibility on us?  What is the difference between a layperson and an expert?   Finding truth is not an easy task since it requires dispassionate inquiry.   But the passions or necessity of the moment fouls objectivity.  Letting immediate need, the short view, dictate action rather than long-term evaluation has repeatedly led to catastrophe for civilization. 
    On the surface, issues may appear black and white, right or wrong, but close examination of details usually muddy the water making everything much more gray. 
    We tend to think important discovery is a result of highly technical, sophisticated experts laboring away in esoteric laboratories logically and methodically arriving at grand truths and discoveries.    In actual fact, this is rarely the case.  Small seemingly insignificant discoveries accumulated over time flower into gigantic principles and the laws of science.   Chance circumstance in a laboratory or in a setting that is far removed from a laboratory can result in discovery that can impact greatly upon generations to come.   For example, look at the field of probability.  This discipline is used to identify the cause of disease, the establishment of insurance rates, and the achievement of quality control in manufacturing.  Even electrons are now viewed as probability shells.  This far-reaching stochastic tool used by statisticians, scientists, biologists and physicists originally arose when a member of the minor French nobility needed to divide the stakes in an interrupted gambling game.  Pascal, a philosopher/scientist and Pierre de Fermat, a lawyer/mathematician, resolved this.   From this beginning, the current field of probability arose. 
    Another example is in high temperature superconductor research attempting to conduct energy through nonresistant materials close to room temperature.  How do the experts proceed?  They combine and recombine a variety of elements out of the periodic table in more or less random fashion.  In all that is known in physics and chemistry, it is impossible to be able to predict what the combination of various elements will create.  Chance and serendipity, not logical, methodical or scientific skill, create discovery.  Honest experts in every field will admit to the simplicity of their work privately while publicly protecting their position of power, money, and prestige by arguing they alone are qualified.  Experts tend to know more and more about less and less.       From the time that we enter school, we are taught ABC, parts, and then more and more details about parts.  Then, into college and graduate work, we learn parts about parts of the parts until we become so focused that our range of knowledge, although expert about the miniscule, lacks the panoramic view. 
    Everyone is a layman, even if expert in a particular field.  An expert in physics is a layman in medicine or in law.  An expert in one field cannot assume privilege of thought and authority beyond their specific skills.  On almost any given issue, you can find Expert A, who believes one way and Expert B, who disagrees with A and believes something else.   Expert A disagrees with B, and B disagrees with A.  If we, as a third party layman, disagree with them both, then we have expert backing.  If we disagree with A, we have the backing of Expert B.  If we disagree with B, we also have the backing of Expert A.   Therefore reliance on an expert does not give us any corner on truth or reliability.  Ultimately decisions must be made by all of us as lay people. 
    The importance of the laymen’s perspective is typified by the following.  When discussions were being held in Alaska as to the safety and viability of the proposed 800 mile Alaskan oil pipeline, there were many experts brought forth.  There were statistical analyses, lots of graphs and charts and much assurance of the merits of the proposed system.  After listening to all of the experts speaking on the merits of the pipeline, there were few if any questions that could be asked that were already not anticipated and answered.  But then enter the spoiler layman’s question to one of the presenters.  He said, “If I get this right, you are saying that oil is going to enter the mouth of this pipeline at 190 degrees and travel for 800 miles and be 130 degrees at the other end and still remain fluid.”  He was assured that this was exactly right.  More questions:   “What if there is an interruption of the ships supplying or picking it up?   What if the storage tanks are full?  What if there is any interruption in either the supply or the removal of oil at the other end of the pipe?”  The presenter engineers replied, “That’s an interesting question?”       The layman was able to sort through all of the detail to understand that if there was an interruption of that flow and the oil in the pipeline was not allowed to move at a particular rate so that it maintained its temperature, it would eventually turn to tar and create an 800 mile, 9 million barrel tar sludge with no conceivable way of turning it back into a liquid given the Alaskan climate.        Opening spigots along the course of the pipeline and allowing these 9 million barrels of oil to flow out onto the Alaskan tundra and into its rivers would create an ecological disaster beyond imagination.  As it turns out, the pipeline was built.  Those questions have never been adequately answered and luckily to this day the problem has not occurred.  That is not to say it could not occur, that these questions should not have been adequately answered before the pipeline was built.  Once it fails, it is too late to solve the problem.
    If we look at only a narrow range of data, or only listen to experts, we can lose the panoramic view – and the ability to foresee long-range consequences.  How can one sort through the morass data, and conflicting opinion?  A rational worldview is the starting point.   This worldview creates filters.  For example, there is the literate filter.   We must sort through words, to determine their true meaning and merit.   Another is the numerate filter.  We must sort through the numbers, the quantitative data, to determine their meaning.  Then there is the ecolate filter, which simply stated means, “And then what?”  In other words, in any situation, one must be able to sort through the literate arguments, the numerical arguments to determine the effect, the impact of the proposal and the course of action in terms of consequences.  It is one thing to argue with words, even though they be persuasive.  It is another thing to argue with numbers, even though they be persuasive.  These are unimportant without the question, “And then what?”  
    There must be much that can be argued in words about the merit of the Alaskan Pipeline.  There must be much in terms of the numbers of physics, chemistry, engineering and economics relevant to the Alaskan Pipeline.  But if only these two filters are examined without the layman’s ecolate questions of “What is the long-term impact?  What are the possible consequences if things do not go in a particular way?”  Then we are remiss.   Experts usually only input on the first two – the literate and the numerate.   Ultimately it depends upon us, the layman, to make sure all three filters are used, and most particularly the ecolate filter, the one most commonly avoided or ignored.   We must always ask the question, “And then what.”  And we, the laymen, with our mere panoramic and less encumbered agenda, are often best suited for applying that filter.
Limits In Health Care Options
    Heart attacks affect approximately 1 million Americans during the course of the year.  One quarter will die immediately; another quarter will be unaware that they even had an attack.  The remainder becomes subjects of medical intervention.  Thrombolytic agents include primarily TPA (tissue plasminogen factor – the cost is approximately $2,200 per patient administered by IV shortly after a heart attack to prevent further clotting and to help remove the clot that is already there), streptokinase and ABSAK (a version of streptokinase).  Gentex’s TPA required 220 million dollars to develop.  But in the first quarter after its introduction, it generated 93 million dollars in sales.   Many forecast this to be a billion-dollar biotechnology product.  On the other hand, streptokinase is no longer under patent.  Its cost to the patient is $200.   Aspirin or dietary modification is even cheaper.  Does cost equate to effectiveness?  If it costs $220 million to develop a product, you can be sure that no company would invest that if it or a similar product were generally available.   Therefore medicines with a substantial log of data and accepted provings are going to be those protected by patent.  Commonly available foods, herbs or life-style changes, will likely not have a great body of evidence in support of them.  Who is going to pay for such accepted proof if there is no return on investment or the information can be used by any Tom, Dick or Harry to sell competing products?  Sheer data may only indicate funding and patentability and have nothing to do with true relative merit.  Treatments in the forefront of orthodox medicine are profit centers.   Although the rigorous system of proof for medicine was ostensibly put in place to protect the public, it in effect greatly limits treatment options if detailed scientific proof is to be the only criterion by which treatment choices should be made.