The Foundation for Integrated Medicine: Supporting Health Care for the Twenty-First Century

Despite great advances in the treatment of infectious epidemics, trauma and critical care, modern medicine is failing in its mission. Childhood mortality rates around the world are rising and the major medical challenge of the twenty-first century–decreasing the burden of chronic illness and disability–is not being met. The reason lies in the faulty blueprint used to guide contemporary health care.

Conventional Western medicine is organized around the treatment or prevention of specific diseases, with each disease seen as a separate and independent entity. This approach no longer serves a useful purpose. Experts of the World Health Organization, meeting in the Dominican Republic in September, 1997, expressed the view that trying to deal with each of the various diseases that kill young children is futile. The factors responsible for disease must be dealth with. Most fatal illness results from a combination of poor nutrition and poor environmental hygiene. They expressed the view that reduction of childhood mortality can only be achieved by an integrated management approach, improving nutrition and environment so that many diseases are dimished or eliminated at the same time.

Experts in the problems of aging have expressed a similar view. The longer a person lives, the more diseases she develops and the more drugs she takes. Adverse reactions to prescription drugs have become the fourth leading cause of death in the United States, killing over 100,000 people a year, more people than are killed by accidents of all types. The immense number of medi-cal prob-lems associated with un-healthy aging cannot be addressed by attempts to prevent and treat the specific diseases that appear with increas-ing frequency as people age. Prevention and treatment must strengthen the resistance of the person in ways that allow a multitude of different disease entities to diminish.

This is an old wisdom, shared by all ancient systems of healing. Traditional healing systems approach sickness as a problem of balance and relation-ship, the result of dishar-mony between the sick person and his or her environ-ment. For the traditional healer, the “dis-ease” itself has no independent reality. The healer’s job is not to identify and treat the disease entity, but to characterize the disharmonies of each particular case, so that they can be cor-rected.

Integrated Medicine couples the ancient perspective that health is balance with the powerful tools of modern biological science. It embraces the best of conventional and alternative therapies, but is more than just a mixture of therapeutic techniques. It is a process of medical practice that acts to heal the person rather than just treat the disease. A person has social relationships, beliefs and feelings, memories and expectations, a sense of identity, a daily pattern of eating and drinking, exercise and rest, hygienic habits, an occupation, an environ-ment, and innate systems for detoxi-fica-tion and repair. It is these aspects of the person–the common components of his or her life–that Integrated Medicine attempts to support, applying strategies that are scientifically validated. Learning how to recog-nize, understand and respond to the impact of the common components of life on health and illness is a challenge of such magnitude for conventional medicine that it has been called a paradigm shift. Unfortunately, medical doc-tors are large-ly unprepared for this paradigm shift, frequently failing to recog-nize the psychological or social needs of pa-tients or to meet “essential core compe-tence” in clinical nutrition. It is the goal of the Foundation for Integrated Medicine to help the public and health professionals acquire the knowledge necessary to move from a disease-centered to a person-centered model of health care.

Science has demonstrated several factors that profoundly influence health, longevity and the ability to recover from illness. In educating health professionals and the public, The Foundation for Integrated Medicine will concentrate its efforts by disseminating information concerning four of these factors. They are:

(1) Strong interpersonal relation-ships, including both the network of family, friends and community involvement that is referred to as “social support” and the relationship between the person who is sick and the caregiver. Helping people to nurture the bonds of closeness with others is the first goal of Integrated Medicine. Helping health professionals improve their skillfulness in the science of caring for patients is the second. Doctors demonstrate skill in the science of caring when they listen to their patients’ concerns, elicit and acknowledge their patients’ viewpoints, meet their patients’ needs for information and encourage their patients to become active in their own care. Study after study shows that doctors who follow these principles get better results, independently of the diagnosis or the specific treatment that is given.

(2) Sound nutrition. Poor nutrition is the leading cause of immune deficiency, worldwide and within the United States. North Americans, unfortu-nately, obtain about one-third of their total calories from nutrient poor junk food. Even well-educated, presumably well-nourished adults taking nutritional supplements frequently do not consume nutritionally adequate diets and, despite their supple-ments, fall short in their con-sumption of important minerals like magnesium, iron, zinc and calcium. The vitamin E levels of U.S. children are markedly lower than those of Japanese, German, Austrian or Canadian children, suggesting that children in the U.S. may as a group suffer from Vitamin E deficiency. Healthy chil-dren with lower vitamin E levels have impaired immunity on laboratory testing. When apparently healthy adults are followed for ten years, those people who have impairment on those same laboratory tests of immune function have twice the mortality rate of those with normal immuni-ty. Study after study has found that vitamin and miner-al supplements improve the immune function of elderly Americans. The specific nutrients with the most profound effects on immune function are essential fatty acids, selenium, zinc, vitamin A, vitamin E, vitamin B6, folic acid and iron. Helping people build optimum immunity through nutrition is a third goal of Integrated Medicine.

(3) A hygienic environment. Numerous studies conducted in U.S. cities demonstrate a close correlation between daily death rates and exposure to small particles of dust, even at levels of pollution that are considered safe by the World Health Organization. Community-wide pollution has been well established as a cause of respiratory ailments, but its effects extend beyond the respiratory tract. The rate of cancer among suburban women increases with outdoor exposure to airborne dust parti-cles. In the industrialized nations of the world, people spend ninety per cent of their time indoors and the greatest airborne health risks may be posed by indoor air pollutants. The rising incidence of childhood cancer in industrialized countries is probably related to environmental toxins encountered in the home. A child born in the U.S. today faces a risk of 1 in 600 of developing cancer before the age of 10. The Environmental Protection Agency has proposed a new direction, “moving beyond the chemical-by-chemical approaches of the past, and instead looking at a child’s total cumulative risk from all exposures to toxic chemicals.”(New York Times, September 29, 1997, page 1.) Children are routinely exposed to low levels of toxins from many different, unrelated sources. A goal of Integrated medicine is the education of the public and of health professionals in the dangers of environmental toxicity and the steps that can be taken to decrease the overall toxic burden of children and adults.

(4) Intestinal health. “Toxicity” is a concept readily grasped by all ancient healing systems, but often ignored by conventional medicine. The idea that the intestines constitute a source of endogenous toxins is as old as the practice of medicine. The human intestinal tract is thirty feet long, contains over a hundred billion bacteria and has the surface area of a doubles tennis court. Although this immense surface area is necessary for efficient absorption of nutrients from food, it must be closely guarded to prevent bacterial toxins and allergens from entering the body. Almost three-quarters of the human immune system is located in the walls of the small intestine, signifying how important the guarding of this intestinal frontier is to health. When the integrity of the intestinal lining is damaged by infection or by drugs like aspirin or alcohol, tiny breaks occur that allow allergens and bacterial toxins to enter the body, taxing the liver’s detoxification capabilities and over-stimulating the immune system, sometimes making it turn aggressively against the body itself.

Improving knowledge of the rela-tionship between intestinal toxicity and chronic disease is a major goal of the Foundation for Integrated Medicine. For this reason, we have embarked on the Parasite Project, an educational endeavor focused on the high prevalence of intestinal parasites in all countries of the world, the impact of these parasites on nutrition, immune function and the development of disease, and the most effective means of diagnosis and treatment.

A weakness of all traditional healing systems is their ignorance of microbes and the role that microbes play in causing disease. The development of the microscope and of methods for isolating and studying microbes was an essential step in the evolution of health care, aiding control of the major epidemic diseases and of the sterile techniques that make modern surgery possible. Contemporary medicine’s initial cooncept was that microbes are the primary causes of infectious diseases like pneumonia, TB or polio. More recent research demonstrates that microbes alone do not cause disease. It is the reaction of the person’s immune system to the microbe that causes disease. The most recent research indicates that harmful immune reactions to microbes may be important for the development of many diseases that were not initially thought of as infectious. Today microbes are the proven or suspected triggers for coronary heart disease, ulcers, some forms of cancer, multiple sclerosis, rheumatoid arthritis and other inflammatory diseases, asthma, psoriasis, Crohn’s disease, ulcerative colitis, some types of irritable bowel syndrome, and the fibromyalgia syndrome. Infectious diseas-es can no longer be thought of as discrete disease entities with clearly defined causes. They must be understood wholistically: microbes are the triggers that initiate a series of reactions in the body that contribute to the development of a wide range of different, apparently unrelated disorders. The way in which the person reacts to the presence of the microbe, which is influenced by nutrition, environmental toxicity and emotional health, is as important for determining the pattern of illness and recovery as are the microbes themselves. It is within this context of under-standing that the Parasite Project is taking place.

The Foundation for Integrated Medicine can be contacted through this column at HealthWorld on Line (healthy.net), by mail c/o Dr. Leo Galland, 133 East 73 Street, New York N.Y. 10021, or by fax at (212) 242-1057 or (212) 794-0170.