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Journal of the academy of rheumatoid diseases vol. 2


Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment.
this theory was incorrect, the treatments developed from it have The Journal
2. To contract with professional scientific and medical organi- Academy of
zations for research and develop mental studies related to the cureand/or remission of Rheumatoid Diseases; 3. To fund basic research with such professional organiza- 4. To provide free and/or contributory treatment to needy victims of Rheumatoid Diseases; 5. To solicit funds from the general public in support of the above programs.
Officers and Board Members:
President (Chairman):
Gus J. Prosch, Jr., M.D.
Vice-Chairman: Sheldon Nelson, D.O.
Editorial
Executive Director/Secretary: Wayne Martin, B.S.
Too many patients have accepted verbatim the propaganda Medical Journal Editor: Robert Bingham, M.D. (1986); Stephan
and money-raising line of the Arthritis Foundation — "There is no Cooter, Ph.D. (1994) known cause for arthritis and no known cure." This may be a good Chief Editor/Treasurer: Robert Bingham, M.D. (1986)
emotional approach to the public in soliciting funds, but it gives an arthritis patient no hope in seeking a recovery from the disease. It Robert Bingham, M.D.; Warren M. Levin, M.D.; W. W. Mittelstadt, may steer the person suffering from arthritis to the rheumatologist D.O., M.D.; Archimedes A. Concon, M.D.; Harley Robinson, D.O; and to content him into accepting palliative treatment. But it is Albert Jellen, M.D.
fatalistic to any hope of a permanent remission or "cure." Research Advisory Board:
Those of us who have been offering our patients a "total arthri- Harold Buttram, M.D.; Lazlo I. Belenyessy, M.D.; Dr. Paul K.
tis program of treatment" with emphasis on improving their health and resistance to disease — in addition to the usual drug treatmentswhen necessary — by improving the patient's diet, giving food andvitamin supplements, prescribing exercises and physical therapy, In Memoriam to Robert Bingham, the 1994 republication of The have seen many more recoveries from arthritis than the averages Journal of the Rheumatoid Disease Medical Association , is being reported in the medical literature.
made by The Arthritis Trust of America. Editorial and subscription And those physicians who are bold enough and experienced office: c/o Perry A. Chapdelaine, Sr., The Arthritis Trust of America®, enough to use alternative treatments and "approved drugs for un- 7376 Walker Road, Fairview, TN. 1986 by The Rheumatoid Dis- proven indications" have even higher percentages of improvement ease Medical Association, ISBN 0-930991-10-9.
and remissions in their arthritis patients.
Examples of these are the use of therapeutic doses of minerals and vitamins, herbal extracts such as Yucca, non-specific vaccine Table of Contents
immunizations to build up patient resistance to infections, highprotein and complex carbohydrate diets, and the prescribing of anti-protozoal drugs rather than the anti-malarials.
A journal such as this will bring to the practicing physician the clinical results of many physicians in many countries who are on Secretary's Report the forefront of Arthritis Treatment. They may be using "orphan
The Free-Living Amoebic Causation and Cure of Activity in drugs" whose patents have expired so that no pharmaceutical com- Rheumatoid Diseases Roger Wyburn-Mason pany has any interest in financing their clinical testing for "effi- Arteriosclerosis — A Vital Message to My Patients cacy." They may have discovered some new use of an old remedy Gus J. Prosch, Jr., M.D. and Wyatt C. Simpson, M.D. or treatment. They may have by serendipity observed a patient Anti-Amoebic Treatment of the Rheumatoid Diseases (Part 2) improve or recover with some new or different substance or method.
Gus J. Prosch, Jr., M.D. All of these can be reported in this publication. The test of a Boron in Medicine — An Up-Date Rex E. Newnham, B.Sc., D.O. new method or treatment should be: "It must be beneficial to the The Rheumatoid Disease Foundation (now The Arthritis Trust patient, and it must do no harm." In other words, it is the Risk/
Benefit Ratio that is important — not just that it has been "Ap-
The Academy of Rheumatoid Diseases proved" for advertising by the manufacturer or distributor by theFood and Drug Administration.
Why the medical profession has allowed the government and The Rheumatoid Disease Foundation
the legal professions to control our "standards of practice" is some- [The Arthritis Trust of America]
thing I will never understand. Only physicians know what is best The Rheumatoid Disease Foundation was chartered as a non- for their patients, and their judgments should not be controlled by profit, charitable organization in the State of Tennessee, October laymen — only their peers.
13, 1982, and received its retroactive tax-exempt status from IRS The Academy of Rheumatoid Diseases solicits members who March 29, 1983.
are open-minded and progressive in their arthritis treatment and in The purpose of The Rheumatoid Disease Foundation is: their own clinical experiences and investigations. We will welcome 1. To disseminate the scientific findings of Professor Roger papers and case reports which will help and encourage other doc- Wyburn-Mason, that the Limax amoeba is the source-cause of tors in the management of this large family of diseases, "about most forms of Rheumatoid Diseases; [although it appears now that which more is unknown than known." This Journal may play an Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment.
important role in reversing this void in medical knowledge.
ROBERT BINGHAM, M.D., EDITOR Notes on the meeting of the elected officers of the new organi- zation, the "Rheumatoid Disease Medical Association." Meeting at the Miramar Sheraton Hotel, Santa Monica,
CA, July 16, 1986.
Those present: Gus J. Prosch, Jr., M.D., President; Sheldon Nelson, D.O., Vice-President; Robert Bingham, M.D, Treasurerand Editor of the Journal; Warren M. Levin, M.D., Director.
Dr. Bingham reported that of 205 physicians invited to join the new association there are 43 who have paid their first twoyears' dues to become Charter Members. Many more are expectedto join on an annual membership basis. More than $8,600 has beencollected to date of which $2,600 has been paid for production andmailing of Volume 1, Number 1, of the new Journal which wasdistributed at the meeting and will be sent to all physicians on thereferral list of The Rheumatoid Disease Foundation [now known asThe Arthritis Trust of America].
Dr. Bingham reported that 3 of the doctors had either resigned or were being removed from the list for not using the treatmentprotocols of The Rheumatoid Disease Foundation.
A motion was made, seconded and passed (M.S.P.) that the new association be a separate entity from the The RheumatoidDisease Foundation to avoid any conflict of interest between sup-porting the association and the Foundation just to receive referralof arthritis patients. The association will be a non-profit charitableand educational corporation, entirely and legally independent ofThe Foundation.
A new name was suggested for the association to emphasize its scientific and medical educational purposes: the "Academy ofRheumatoid Diseases." All of the officers and directors will besolicited for their comments and approval if agreeable.
It was M.S.P. that the by-laws and Articles of Incorporation, so well-researched by Perry Chapdelaine be sent to each officer anddirector for their recommendations and changes necessary for thenew organization.
Discussion followed as to the purposes of the association, and it was generally agreed that they should be very broad, encompass-ing all of the rheumatoid and related diseases and not be limited tothe amoebic aspect or the anti-protozoal aspect of treatment forrheumatoid arthritis.
It was decided that the officers and directors should meet together again, in about six months, at a convenient location, such asNashville, TN, to plan the first annual meeting of the new associa-tion — to be held in conjunction with the Third National Seminar ofthe Rheumatoid Disease Foundation at a city yet to be selected. Itwas recommended that our new organization be very active in ad-vertising and promotion of the next annual meeting, with greatestthanks and appreciation to Perry A. Chapdelaine, Sr., for the excel-lent program and fine speakers of this Second Annual NationalSeminar. With the permission of the Foundation, as many of thepapers presented as possible will be printed in the quarterly issueof the new Journal. Wayne Martin, B.S., Secretary25 Orchard CourtFairhope, AL 36532 Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment.
The Free-Living Amoebic Causation and Cure of
lymphocytes. This is a feature repeatedly observed in experimen- Activity in Rheumatoid Diseases
tal infections with free-living amoebae in laboratory animals. (This by Roger Wyburn-Mason recalls the situation in syphilitic lesions until stains for the tre- A reactive arthritis may occur with gastrointestinal infection ponema pallidum were discovered). The organisms in rheumatoid with bacteria, such as Campylobacter jejuni, Salmonella, Shigella arthritis can, however, be demonstrated in tissue sections by and Yersinia, in patients with HLA-B27 tissue types and disappear immuno-fluorescent staining using sera containing appropriate an- with successful treatment of the infection (Kosanen et al. 1980).
tibodies to the organisms and by studying their mitosis and chro- Between 1922 and 1952, numerous publications described E.
mosome content in marrow biopsy material.
histolytica bowel infection with or without dysentery as associ- Rheumatoid Arthritis, a Generalized Disease
ated with a condition practically identical with rheumatoid disease.
Rheumatoid Arthritis is not solely one of joints but may in- Both conditions are cured by emetine without any exaggeration of volve any tissue of the body. The same histological changes in the the joint symptoms. Yet it is not unusual for sufferers from rheu- joint capsules may be found in extra-articular lesions and consist of matoid arthritis to show E. histolytica or its cysts in the feces and inflammatory lymphocytic infiltration, formation of germinal fol- never in the rheumatoid lesions.
licles and often plasmocytosis accompanied by arteritis, arteriolitis, All terrestrial animals and plants, and those inhabiting fresh or endarteritis. Many of the extra-articular lesions constitute so- water and the sea, live in a world surrounded by many species of called "auto-immune diseases," but also include Sjogren's syndrome, free-living amoebae. These may pass mammalian respiratory pas- bone marrow infiltrations, and thymic lesions with or without sages as cysts or trophozoites and may be present as trophozoites myasthenia, fever up to 40° C, sweating and raised ESR, typical of in the gastrointestinal tract of many animals, including man since an infection. Any of the extra-articular of AI lesions may occur in they are found in their feces. As the organisms are motile, it would any combination with or without arthropathy.
be reasonable to suppose that once they had entered the orifices of From a study of the world literature, it seems that some of the man or other warm-blooded animals, they would migrate under extra-articular lesions may involve: thermotropic influences into some body tissues. Since amoebae 1. Exocrine glands often producing enlargement and dilatation may be either non-pathogenic or pathogenic to animals, the same of the ducts. It may involve the lacrimal and salivary glands (Sjogren's may apply should the organisms reach human tissues.1 syndrome, R.A. in miniature), breast (cystic mastitis), pancreas In 1922, the eminent protozoologists, Kofoid and Swezy, in (lymphocytic pancreatitis, which may exhibit calcification), liver California, reported the presence in the bone marrow in cases of (active chronic hepatitis, primary biliary cirrhosis), gall bladder and rheumatoid arthritis, without dysentery of E. histolytica in the bile ducts (chronic cholecystitis and stenosing cholangitis), and kid- feces, of a free-living amoeba distinguished from human cells by its neys (chronic nephritis, pyelitis).
mitotic processes which contained only 6 chromosomes as com- 2. Endocrine glands, including the thyroid (lymphocytic or pared with the normal 46 of human cells. It showed a single blunted Hashimoto's thyroiditis), adrenals, parathyroids, thymus (with or pseudopodium and numerous vacuoles. They suggested an without myasthenia) and pituitary.
aetiological relationship between the infection and the arthritic pro- 3. Polymyositis, myasthenia, bursitis, tenosinovitis, or rheu- matoid nodules in any tissue.
In numerous recent publications, the speaker14, 18 has shown 4. Mucosal inflammation followed by atrophy, which may that, using the property of thermotropism, free-living amoebae involve the gastro-intestinal tract producing atrophic stomatitis, pathogenic or non-pathogenic, can be made to migrate in varying pharyngitis, esophagitis, gastritis, or coeliac disease and ulcerative numbers out of human tissues, including those of the newborn and colitis, or in the respiratory tract leading to atrophic rhinitis, Eusta- fetus (Figs. 1, 2). They are also found especially in the affected chian salpingitis, laryngitis, or bronchitis.
tissues of patients with rheumatoid disease, in malignant tumors, in 5. Fibrosing alveolitis, pulmonary nodules, lung fibrosis, or normal feces, in uncooked butcher's meat, and in surface soil.
They may be recovered in small numbers from some tissues of 6. Peri-, myo-, or endo-carditis.
apparently healthy humans, where they are presumably of non- 7. Bone marrow infiltrations with various disturbances of pathogenic nature. They appear identical with those found by blood formation.
Kofoid and Swezy. These findings have been confirmed in various 8. Paget's disease of bone, spondylitis.
parts of the world, including Vanderbuilt University, U.S.A., the 9. Lymphadenopathy or splenomegaly with reactive lym- Oncological Research Institute, Bratislva, Czechoslovakia, Waikato phoid hyperplasia.
Hospital, New Zealand, the Hospital for Special Surgery, and St.
10. Choroiditis, uevitis, retinitis, scleritis.
Vincent's Hospital, New York and in England.1 11. Various skin lesions, including icthyosis, dermatitis, leu- These organisms can be cultured in the laboratory in "amoeba koderma, and melanoderma.
saline" into which a culture of E. coli has been introduced. The The serum may or may not contain RF, various auto-antibod- effect of various antiamoebic substances in killing the organisms ies, ANF, increase in gammaglobulins and usually a raised ESR.
can then be studied by adding them to the cultured cells. Those The Effect of Antiamoebic Drugs on Active
which do so include one percent solutions of bile salts, 4- Rheumatoid Disease
aminoquinolines, very dilute solutions of copper sulfate, metallic The author has shown that when any substance which kills copper, gold salts, emetine, dehydroemetine, pentamidine, levamisole the free-living amoebae in vitro is administered to cases of active (which contains an imidazole group), and in particular the 5- rheumatoid disease or its extra-articular manifestations, it may cause nitroimidazole group of drugs, including metronidazole, clotrimazole, a rapid disappearance of the inflammatory symptoms around the tinidazole, ornidazole and nimorazole. All of these possess a wide joints and elsewhere in the body.1 This includes coeliac disease, spectrum of antiprotozoal, including some antiamoebic activity.
ulcerative colitis, cystic mastitis, lymphocytic thyroiditis, etc.
The organisms have been recovered with great difficulty be- Myasthenia gradually disappears and in early cases11, complete cause they are not observed in affected tissues stained by ordinary cures may be obtained. These drugs often induce an Herxheimer methods. They are not numerous and look like macrophages or reaction that is a transitory exaggeration of the inflammatory changes Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment.
around the joints and elsewhere. This may be accompanied by
cause of the second grade type of chronic arthritis. Calif. State J. influenzal symptoms, sweating, pyrexia, lymphadenopathy, rise in Med. 20:59; 1922.
ESR, and eosinophilia.
9. Kofoid, C.A., Swezy O. On the occurrence of Endamoeba This reaction has been reported by others in cases of active dysenteriae in the bone lesions of arthritis deformans. Calif. State J. rheumatoid disease treated with gold salts18 and levamisole19, (which Med. 20: 59; 1922.
kill free-living amoebae). Such a phenomenon, first described by 10. Kofoid, C.A., Swezy, O. Amebiasis of the bones. JAMA Herxheimer20 in 1902, when cases of syphilis were treated with 78: 1602-4; 1922.
mercury, also occurs in syphilis treated with penicillin and in other 11. Kofoid, C.A., Boyers, L.M., Swezy, O. Endamoeba diseases due to organisms more complex than bacteria when drugs dysenteriae in the lymph glands of man in Hodgkin's disease. Univ. which kill the causative organism in the tissues are administered.
Calif. Publ. Zool. 20: 309-12; 1922.
This reaction is due to liberation of irritant and antigenic substances 12. Kofoid, C.A., Swezy, O., Boyers, L.M. The coexistence from the dying and dead organisms. The Herxheimer reaction in of Hodgkin's disease and amoebiasis. JAMA 78: 1602-4; 1922.
cases of active rheumatoid disease treated with antiprotozoal sub- 13. Kofoid, C.A., Boyers, L.M., Swezy, O. Occurrence of stances has been confirmed in various countries, notably in U.K., Endamoeba dysenteriae in the lesions of Hodgkin's disease. JAMA U.S.A., Holland, and New Zealand.1 It is not observed in healthy 78: 1604-7; 1922.
persons so treated or in rheumatoid diseases given anti-biotics. It's 14. Wyburn-Mason, R. A new protozoon, its relation to occurrence in rheumatoid disease, including "autoimmune" lesions malignant and other diseases. Kimpton, London; 1964.
during treatment with various antiamoebic drugs proves the pres-ence in the affected tissues of a causative pathogenic organism.
By administration of antiamoebic drugs, especially 5- nitromimidazoles, to cases of rheumatoid disease for 3-6 months,the evidences of disease activity usually completely disappear injoints and extra-articular tissues. "Autoimmune" lymphocytic andhumoral reactions are thus not the primary disturbance in rheuma-toid and "autoimmune" diseases, but are the cellular-antibody re-sponse to the infection and its antigens and contribute to the tissuedamage.
Practical Details of Treatment of Rheumatoid and
A simple method of treatment of rheumatoid disease is to administer 2 grams on 2 successive nights of one of the 5-nitroimidazoles for a 70 Kg patient. In some cases, the organism ,as judged by the severity of the Herxheimer reaction, may prove tobe susceptible to one or another of the 5-nitroimidazoles.
In order to prevent any severe Herxheimer reaction, the pa- tient may be given an anti-inflammatory drug. The drug may re-main at an effective level in the blood for four or more weeks whilethe inflammatory reaction is dying down.
If it is necessary for a further dosage of the antiamoebic drug to be given, wait until three months after the original doses to give theinduced inflammatory response [time] to die down. Often only asingle treatment is necessary and improvement may continue overthe course of a year or more with return of a normal ESR anddisappearance of all signs of disease activity.
1. Wyburn-Mason, R. The causation of rheumatoid disease and many human cancers. A new concept in medicine. Tokyo, IjiPublishing Co., Japan; 1978.
2. Editorial. Pathogenic free-living amoeba. Lancet ii: 165-6; 3. Craig and Faust. Clinical parasitology. Ed. by Faust, E.C., Russell, P.T., Jung, R.C. 8th Edition, Lea and Fibiger, London;1970.
4. Dobell, C. The amoebae living in man. John Bale, Sons and Danielson, London; 1919.
5. Carter, R.F. Amoebic meningo-encephalitis. Transactions of Royal Society of Tropical Medicine Hygiene. 66: 195-7; 1972.
6. Nagington, J., Watson, P.G., Playfair, T.S., et al. Amoebic infection of the eye. Lancet ii: 1537-8; 1974.
7. Kofoid, C.A., Swezy, O. Mitosis in Endamoeba dysenteriae in the bone marrow in arthritis deformans. Univ. Calif. Publ. Zool.
20: 301-307; 1922.
8. Ely, L.W., Reed, A.C., Wyckoff, H.A. The amoeba as the Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment.
topsies performed on soldiers killed showed approximately 60% A Vital Message to My Patients
suffered from advanced arteriosclerosis. We must do something Gus J. Prosch, M.D., and Wyatt C. Simpson, M.D. about this trend, and that is the purpose of this paper.
We sincerely desire that all our patients and their families Recent research has proven that all hydrogenated oils block enjoy the best health possible. During the past 2-3 years, there has the chemical pathways that are necessary for our bodies to use the been an explosion of research and knowledge that can vitally effect cholesterol that our bodies manufacture. Also, our bodies must the health of each of us. This paper was written in an effort to teach have certain essential fatty acids (now being removed from our you, inform you, and convince you to change some of your eating foods) to assimilate and use our cholesterol as well as to manufac- habits so that you and your family will enjoy a healthier life and ture certain hormone-like chemicals called prostaglandins, our cells fewer health problems. Some authorities may question some of our cannot function properly, and they will be subject to disease. We conclusions, but when we daily observe the health of our patients believe that this is one of the main reasons that we are seeing an improve from following these suggestions, in the name of Truth we explosion of many chronic degenerative diseases such as Arterio- must speak out and share this information with you.
sclerosis, Arthritis, Diabetes, Lupus, Schizophrenia, Multiple Scle- Today's number one health hazard is arteriosclerosis or hard- rosis, Asthma, and numerous others. Other conditions that can ening of our arteries. This causes heart attacks, strokes, and pe- benefit from these dietary changes include hyperactivity and learn- ripheral vascular disease (usually in the legs) which leads to more ing disabilities, premenstrual syndrome, systemic yeast infections misery and suffering than any other disease known today. This as well as many skin disorders and allergies.
does not count the expenditure of billions of dollars and the loss of What You Can Do!
millions of days of productive work for the American work force.
1. Totally avoid all hydrogenated oils as in margarine, cooking Before 1900, this disease was hardly known and was extremely oils, deserts (doughnuts, cookies, cakes, etc.) and deep fried foods rare. In fact, the first "heart attack" was described in the medical such as French fries, corn and potato chips, etc. You can use cold literature in 1910. Dr. Paul Dudley White (President Eisenhower's pressed oils found at health food stores for cooking, but do not use heart specialist) saw a heart attack for the first time in 1929. The extremely high temperatures. If the cooking oil label doesn't state disease began with the advent of hydrogenated oils (margarine) and "cold pressed," it is probably hydrogenated. You should read all the processing (refining) of our grain foods such as wheat, corn, rye, food labels and avoid those that have hydrogenated oils as ingredi- barley, oats, etc., where all the vital fatty acids are removed from ents. Don't cook foods with high temperatures as all oils over 350 these grains. The food companies must remove these fatty acids so degrees become hydrogenated. Cook longer at lower temperatures.
that the grain foods do not turn rancid and spoil, otherwise the 2. Increase the essential fatty acids in your diet.
foods would not last long on the shelves of our super-markets. Our a. Eat cold water ocean fish 3-4 times per week such as great-great grand parents and their parents had very little arterio- salmon, cod, mackerel, sardines, (pour off hydrogenated oils), wa- sclerosis even though their diets included foods known to be high in ter packed tuna. Warm ocean fish (snapper, flounder, perch, etc.) is cholesterol such as eggs, butter, lard, and "sow-bellies," etc. How- second best. Fresh water fish (cat fish, trout, etc.) contain the ever, they did not eat any hydrogenated oils, and their grain foods smallest amount of the fatty acids.
were home ground and not processed.
b. Try to eat 3 teaspoons of 1 tablespoon of virgin (not We have known for 20 years that the dietary cholesterol can- pure) olive oil daily (as on salads) but keep refrigerated after open- not be the cause of arteriosclerosis for several reasons. First of all, the dietary cholesterol in the stomach is broken down into its tiny c. As a snack food, walnuts are very high in fatty acids.
component parts and although some is absorbed through the intes- d. Only eat breads and cereals that have "100% whole tinal wall, most of our cholesterol in our system is manufactured by wheat or whole grain" written on the package. Most brown breads our own body. The problem of arteriosclerosis develops because are not whole grain but have coloring added. Avoid processed or our bodies do not use the cholesterol properly that our bodies refined cereals or white flour products such as breads, crackers, make. Also, Iceland Eskimos, whose diet by the way is ten times macaroni, spaghetti, noodles, etc. You can get these foods as whole higher in cholesterol than our diet, have very little arteriosclerosis.
grain from health food stores.
They should be "dying like flies" if dietary cholesterol intake caused 3. With any chronic illness at all, you should follow the above arteriosclerosis. But they do not suffer from heart attacks, strokes, plus add the following supplements and follow the additional in- and poor circulation in their extremities unless they move to more civilized areas of the world and begin eating as we do. The two a. Purchase some salmon oil capsules (Maxepa) at a things these Eskimos eat differently from us are: (1) they do not eat health food store and take 4-6 capsules daily. Extreme care must be any hydrogenated oils and (2) they eat a great deal of cold water exercised in locating this product as it is made only in England and ocean fish which are very high in fatty acids.
many health food store products claiming this ingredient only con- In the early 1940s, when the Germans overran Norway, the tain soy oil. Efamol is one acceptable brand and Nature's Way is incidence of arteriosclerosis, cancer, and schizophrenia was quite high in that country. The Germans took away all the margarine c. Decrease your red meat intake since red meats contain from the Norwegians, and the incidence of these diseases dropped arachidonic acid which can provide too much of a bad prostaglandin significantly. After the Germans left and Norwegians again began to plus a very bad substance called leukotrienes which will aggravate eat their margarine, the incidence of these diseases increased to their many disease conditions.
former levels.
d. Avoid all sugars, sweets, deserts, and all white flour In America, we are developing arteriosclerosis at earlier ages than ever before even though there is a greater effort on the part of e. Get a good hypoallergenic, non-yeast multiple vitamin most of us to decrease our cholesterol intake in our diets. Autop- and mineral tablet and take 3-4 tablets per day. Be sure you get at sies performed on soldiers killed in the Korean War showed ap- least 500 mg. vitamin C, 50 mg. B-3 and B-6, 50 mg. zinc, 100 mcg.
proximately 30% of these young men suffered from advanced ath- selenium, and 400 mg. of magnesium in your supplements. The erosclerosis. About twenty years later, in the Viet Nam War, au- above mentioned vitamins are necessary in the fatty acid chemical Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment.
reactions.
Anti-Amoebic Treatment of
If you and your family will follow the above recommenda- The Rheumatoid Diseases
tions in your dietary habits, you will enjoy a longer, healthier life Gus J. Prosch, Jr., M.D. with much less chance of developing any chronic degenerative dis- I was asked to speak on the anti-amoebic treatment of the ease. You may pass the information on to friends and relatives to Rheumatoid Diseases, and I even discussed this subject at last year's help them enjoy a happier and healthier life.
seminar to a degree. I also realize that the protocol is spelled out indetail in the information sent out by The Rheumatoid Disease Foun-dation [now The Arthritis Fund] to physicians, but one of ourprimary problems is physicians not using the protocol and instruc- tions properly and therefore not getting good results.
Because of this, I feel it is appropriate at this time to go into detail about the present treatment and a tape-recording of this talkcan be provided for any physician who wants to treat their patientsproperly.
To begin with, since the anti-amoebic treatment is controver- sial, I believe it is very important that all patients be completelyinformed as to what we do, and we should instruct the patient whatto expect during the treatment. I believe that the more confidence apatient has in our treatment, the better results we will see. In mypractice, I give every new patient a brochure that explains every-thing about the treatment so the patient will know exactly what toexpect. Besides this, I have made a 45 minute videotape that all newpatients are required to watch before I actually treat them. This notonly develops confidence in the patient about the treatment, but itsaves me considerable time when talking to the patients. Most allquestions are answered on this videotape. In addition to this, I giveeach patient an audio tape recording of the videotape so they can re-listen and review everything should they forget or get confusedabout the instructions.
One big problem that we all face with out patients is that orthodox or established medicine today convinces rheumatoid ar-thritis patients that they are going to have to live with their arthritisfor the rest of their lives. When patients believe they are not goingto get well, the brain produces more harmful chemicals that sup-press the immune system, and that actually hinders the patientfrom getting well faster and better. We therefore in treating ourpatients, must give our patients hope, not a false hope but a beliefthat there's a good chance that they can get well. And I do believethat if we can rid the patients of amoebae in their bodies, they canand will get well. With newer and better drugs such as clotrimazoleand tinidazole available in the future, I do believe we are going to beeven more successful than we are now. I have patients tell me everyday, "Dr. Prosch, you are the only doctor who has given me hopethat something can be done for my arthritis." And those patientswho don't have this hope do not respond as well to the treatment.
Now concerning anti-amoebic therapy, when a patient comes for my treatment, I usually begin therapy with prescriptions forFlagyl or Metronidazole and Allopurinol. The dosage for Allopu-rinol which inhibits the enzyme systems of the amoebae is 300 mg.
tablets, three times daily for 7 days. If the patient weighs less than100 pounds, I usually give one 300 mg. tablet twice daily and, if achild, I cut the dosage proportionately. In treating nearly 1000patients, I have only seen 2 reactions to the Allopurinol, and theyboth consisted of a moderately severe hemorrhagic rash that wasgeneralized. They both cleared up on discontinuing the Allopurinoland giving high doses of vitamin C and bioflavinoids. I do advisepatients when taking any drug to call me if anything arises that Ihaven't told them to expect. I therefore do get extra calls whenpatients begin having the flu symptoms with the Herxheimer reac-tion, and I have one of my personnel talk to them first to screen outthe Herxheimer symptom patients from the drug reaction patients.
With metronidazole, for patients weighing less than 150 pounds, I give two, 250 mg. tablets or 500 mg. after each meal, two Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment.
days in a row each week for six weeks. This means 1500 mg. each
patients developed a Herxheimer reaction, and I became personally of the 2 days they are treated each week. For those above 150 convinced that a good percentage of these patients had the pounds and up to 175 pounds, I give 1 extra tablet each day of Herxheimer reaction because I had suggested to them that they treatment. For those patients weighing 175 to about 225 pounds, I might get the flu symptoms. I came to this conclusion when I gave give two tablets after meals and 2 at bedtime each day, making a the beads to a dozen patients without mentioning the Herxheimer total of 2000 mg. daily. For patients above 225 pounds, I give 3 reaction, and none of them had any Herxheimer and their arthritis tablets after each meal, making a total of 2250 mg. daily. I impress symptoms did not improve at all. However, I must say that I have on these patients that when they have the flu symptoms, this is a had 3 or 4 patients that sincerely believe the copper beads helped good sign, and they should not discontinue the treatment. These them better than anything else. So I occasionally use the copper amoebae can invade any tissue in the body, and patients may have beads in resistant cases but only as a last resort and then as a Herxheimer symptoms wherever the germs are located. For ex- desperation trial — just like I occasionally try bile salts in the form ample, with amoebae in the heart, the patients may notice their of Decholin, 2 tablets, 3-4 times daily. Rarely, a resistant patient heart racing or skipping some. In the bladder, the patients may will get some response to the Decholin, but this is the exception and have cystitis symptoms such as urgency, frequency and burning on not the rule.
urination. In the brain, the patient may develop temporary depres- My second choice of drugs is either Yodoxin or Furoxone or a sion or cloudiness or fogginess in their thinking. In the breast, areas combination of the two depending on the patient. I usually begin of pain, tenderness or soreness may develop. These are all good Yodoxin, 2 tablets 3 times daily for two weeks only. There have signs and mean the amoebae are being killed in these areas. Of been some eye problems when given longer than this, so I usually course, some joints may ache and hurt that the patient didn't know limit the Yodoxin treatment to 2 weeks. I have seen some good were arthritic and this is normal. Metronidazole has been known to responses and Herxheimer reactions to the Yodoxin.
cause paresthesias in the arms and legs or numbness and tingling When prescribing Furoxone, the dosage is 100 mg. or 1 tablet feelings. The drug should be discontinued if this happens, and the 3 times daily for patients under 125 pounds, and one tablet 4 times paresthesias usually go away. I've had this happen only a couple daily when over 125 pounds of weight. I usually write the pre- of times, and I usually do not mention this beforehand as many scription for a 30 day supply and write in 2-3 refills. I instruct the patients are quite suggestible and will develop these symptoms; I patient to call me in 30 days; and if they are having a Herxheimer usually tell them to take some Benadryl and continue the treatment reaction, I have them get a refill for another 30 days.
for 1 more week and call me again. If symptoms persist, I discon- My next choice of an anti-amoebic drug is Rimactane or tinue the Flagyl, but usually the symptoms go away.
Rifampin. The dosage is 2,300 mg. capsules daily for 30 days with On the patient's first visit, I give 1 c.c. of Depo Medrol which 2-3 refills given. If after 30 days, the patient is still having some counteracts the most severe Herxheimer symptoms the first week Herxheimer reaction, I have them refill the prescription and take it as more germs are killed then, and the Herxheimer reaction can be another 30 days. This drug is normally used for tuberculosis, but it very severe that first week. Many patients have fairly severe flu- is a very good anti-amoebic. I have seen some very severe like symptoms the second and third week and this is good. If the Herxheimer reactions with this drug, and I always impress on these Depo Medrol is not given, the flu-like symptoms can be so severe patients to call me if anything unusual other than routine Herxheimer that the patients may discontinue the medications and will not reactions develop. I have seen one patient develop fairly severe respond to the therapy.
paresthesias in the toes and feet when he continued the medication I try to have the patients return to the office for their second after the numbness and tingling began. He developed weakness and visit in 6 weeks. At this evaluation, I usually see one of three minimal loss of function in his toes, but it went away after about 8 responses. They may have had no Herxheimer reaction, and usu- months. I discontinue the medication immediately now if ally in this case their arthritis is still quite active, but fairly often paresthesias develop, and they usually clear up promptly. Also they are quite improved even without a Herxheimer reaction. With one patient developed double vision or diplopia which cleared up no improvement and no Herxheimer reaction, I then use another on stopping the Rimactane.
anti-amoebic drug. More commonly they have had a fairly severe These medications or anti-amoebic drugs are the main ones Herxheimer and especially the 2nd, 3rd, or 4th week of treatment; available in the U.S. today; and sometimes when patients are not and in many cases, many are asymptomatic with their arthritis. If responsive satisfactorily to the methods or treatment I have dis- they had no Herxheimer the 5th or 6th week but still have arthritic cussed, I may then try combinations. For example, Furoxone and pains, I try another anti-amoebic drug. If they had a Herxheimer all Allopurinol, or Metronidazole and Yodoxin, or Furoxone and six weeks of therapy, I continue them on the Metronidazole for Yodoxin, and have found in some cases good results. Occasionally another 4 to 6 weeks of treatment.
I re-prescribe one of the above medications and add Potaba in the Whenever I see that the Metronidazole isn't working or maybe dose range of 12 grams daily in divided doses. Envelopes contain- the amoebae have built up a resistance to the Metronidazole, I ing 2 grams of Potaba are available and can be mixed with water, 2 usually beigin other anti-amoebics. During the initial visit, I usually packages, 3 times daily with meals. Potaba, or potassium Para prescribe also copper aspirinate, 1 tablet after each meal. This is Amino Benzoic Acid is a vitamin but must be used in high doses to my own personal therapy as I believe the amoebae are strongly be effective as an anti-amoebic.
infested in the colon, and the copper has some effect on killing these I have found that I get very good to excellent results in 8 out of colon germs. And if any of the copper is absorbed into the system, 10 patients with treatments I have described so far. I'm not sure it should have an additional positive effect on the amoebae. I do not whether there is a different germ involved in the 2 out of 10 that believe the copper is efficiently absorbed, however, as I personally don't respond, or possibly these patients' amoebae are just resis- took 80 mg. of copper daily for 3 weeks, and my serum level of tant to the available medications we have in the U.S.
copper was not increased at all.
When I have a patient that comes in with a very acute rheuma- I have also tried the copper beads sublingually that Dr. Sheldon toid arthritis and numerous joints are very hot, that is, swollen, red, Nelson developed, on about 150 patients, and I finally discontin- and very painful, these patients can be relieved very nicely by ued this method of copper administration as only about 20-25% of giving high doses of the enzyme Bromelain. I use a Bromelain tablet Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment.
containing 500 mg. per tablet. By giving 2000 mg. or 4 tablets a.m.
thritic patients. I have patients who come to me from all over the and p.m., the acute inflammation usually subsides rapidly and these United States who mainly just want the intraneural injections be- patients are very grateful. The theory is that the enzymes destroy cause they get so much relief. The injections help tremendously in the auto-antibodies in the inflamed sites that are responsible for the rheumatoid arthritic patients but are even more effective in osteo acute inflammation. I usually keep the patients on 4 tablets twice arthritic patients. Even patients with acute back sprain and other daily for 7 days then decrease the dosage to 3 tablets twice daily for muscle sprains often get immediate relief of their pains and muscle 1 week, then 2 tablets twice daily for 1-2 weeks. I try not to give spasms. It is an excellent tool to add to any physician's armamen- Bromelain if the patient is also given Depro Medrol or other corti- tarium of treatments and skill.
sone like medications; and in these cases, I wait a week after the The sincere and genuine physicians on our referral list can steroid is stopped and begin the Bromelain.
easily be the best doctors in their part of the country. These phy- I might also mention at this point that when patients come in sicians are men of vision, they have taken off the blinders placed on and are taking prednisone, gold injections, or penicillamine, they do them by orthodox medical training, and most of all, they have cour- not respond to any treatment as well as those patients not taking age, fearless courage, to stand up for their convictions and give their these drugs. Dr. Wyburn-Mason liked to get the patients off these patients the very best treatments available today. I'm proud of drugs completely for at least 4 months before initiating the ant- these pioneers in medicine and delighted to work with them.
amoebic therapy. I have found that much better results are achieved The actual techniques of the intraneural injections were first when his recommendations are followed.
pioneered by our chief medical advisor, Dr. Paul Pybus and Dr.
I've gone over the primary anti-amoebic drugs and how they Roger Wyburn-Mason. Dr. Pybus has further refined the art.
are to be used to get the best results. I do not mean to insinuate thatany physician must use this protocol exactly because I realize thatsome cases are different, but I get calls every week from patientswho tell me that other physicians on our referral list gave them thedrugs in a different manner. For example, some physicians pre-scribe the Metronidazole, 1-250 mg. tablet, 3 times daily for 10days, which is the treatment for Trichomonas vaginitis but will notkill the amoebae. Or the Allopurinol is given only 1 tablet daily.
These physicians simply have not studied the protocol, and whenthey do not get results, they have only themselves to blame — atthe expense of the suffering patient. This can only give our treat-ment and protocol a bad result which will discredit every physicianon our list plus our foundation. Let me make an urgent plea to anyphysician listening to me now or whomever listens to the taperecording of this talk to study the protocol and treat your arthriticpatients in the proper manner. You owe it to yourselves and toyour patients. I've had patients who have read Rheumatoid Dis-ease Cured at Last go to doctors on our referral list and fully expectto receive the recommended treatment but instead receive treatmentfor allergies or just nutritional supplements, and occasionally theyare given gold injections or the orthodox, non-steroid anti-inflam-matory drugs. Heaven forbid! These physicians are charlatanswho join up with us to use the anti-amoebic therapy, then treat thepatient in the orthodox manner. We are learning who these physi-cians are who have been using us to get new patients, and we arekicking them out of our organization. In my opinion, it is thelowest character for any physician to represent himself as one of usand not treat a patient properly who came to him in the first placefor that particular treatment.
Another large area of complaint is certain physicians who represent or claim on our physician referral list to give the intraneu-ral injections and they know nothing about how to properly givethe injections. This is unfair to our organization, the physiciansthemselves, but especially to the patients, and this is blatant deceit.
These physicians also are being weeded out of our organization.
Those physicians attending this seminar will observe a videotapethat will show them exactly how the intraneural injections are to begiven, and this tape is available from The Rheumatoid Disease Foun-dation [now The Arthritis Fund] to any physician who wants tolearn. The videotape is overly repetitious to make sure the physi-cian can properly give the injections after studying the tape, soreally there is no excuse for not giving the injections properly.
Let me give a brief review about these intraneural injections because those of you not using the intraneural injections are reallymissing out on a tremendously beneficial technique to help all ar- Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment.
Boron in Medicine — Update
mother who cleansed her nipples with a boric acid solution. A Rex E. Newnham, Ph.D., D.O., N.D. proper autopsy and analysis should have been used to prove the Cracoe House Cottage cause of death. Many of the deaths were due to absorption of Cracoe, Skipton BD23 6LB borax/boric acid through damaged skin. Granulating skin will readily North Yorkshire, England absorb these substances and so will mucous membranes.5 History. Boron as the sodium salt has been used by man for
The acute toxic dose for an adult is from 20 to 60g in a single over 2500 years as a flux for welding gold and as an embalming agent dose, but infants have died with 5g, yet others lived after being by the Egyptians. As supplies became easier to get, namely from given 9g boric acid. There is a great individual variation with these Italy, boric acid and borax became increasingly used as a mild anti- substances. A 50% plasma — Ringer's solution IV is the best septic, especially for eyes and burns.
antidote and will increase the LD-50 for mice by 250%.
For the last 200 years, boric acid has often been used as a food The Position in Australia. In 1981 or soon after, the various
preservative, but this use has been recently stopped because it states scheduled boron compounds in any concentration, and this is tended to disguise food that was unfit for use as being in a reason- an extreme case of bureaucracy because an apple can contain over able condition for use. People must have ingested considerable 10mg of elemental boron. Many fruits and vegetables contain over quantities without any ill effect during this period. Much has been 50 ppm boron and when these are grown on a really good soil, they used as a simple home remedy for stings and burns, and as a powder will have up to 160 ppm boron. Should these foods be scheduled? to prevent rash.1 Yet at the same time, a mouth-wash containing 68% borate was Antipathogenic Action. Boric acid and borax in a 2-3% solu-
acceptable for OTC sales. A good mouthwash with this substance tion will prevent the growth of most bacteria and will kill many would put many mg of boron into the blood. To become dangerous, fungi. A 1.5% solution has some stimulating effect on phagocytosis the solution would have to be held in the mouth for many hours.
in vitro, but at 2% this ceases.6 Strong solutions or the powder when introduced into other body Biochemistry.10 Borates are active complexing agents for diol
cavities have proved fatal. That legislation was introduced because groups particularly in secchorides, and in some of the B-vitamins a product called Bor-ex containing 5% boron was having remarkable and ascorbate and can inhibit certain enzyme reactions. They can results with both rheumatoid and osteo arthritis. Without advertis- reverse gel formation.
ing, the sales of this product went from zero to 10,000 bottles a Pharmacology. These substances are readily absorbed by dam-
month in 5 years. No unwanted side-effects were noticed during aged skin and by mucous membranes. 50% of borate is eliminated these 5 years.
via the kidneys in the first 12 hours, and 90% of the remainder is A properly organized trial of Bor-ex is being carried out in one gone within a week, in all but extreme doses.7 of the country's bigger hospitals. This started 3 years ago, but very Borates are slightly astringent and will tend to allay the pain of regrettably is still not completed.
burns and wounds. If the dry powder is introduced to the nose, it Carnarvon has 0.2 ppm boron in the water supply and people can bring on sneezing and lacrimation.6 do go there from 1000 miles away in the Southwest to enjoy the Toxicology. These substances are not dangerously toxic, but
good climate and get relief from their arthritis. It is really the good large doses can be dangerous. The LD-50 for borax is 5.33 g/Kg for water and not the good climate that helps them. Yet some people in guinea pigs, and 2-3 g/Kg for Swiss mice. But for boric acid, it is Carnarvon never drink local water. A survey was conducted there in greater than 4.1 g/Kg for mice.9 1981 that brought these facts to light.
Rats and dogs were fed a diet containing 52.5, 117, 350, 525, The Position in the Rest of the World. West Germany
and 1750 ppm boron as borate and as boric acid for up to 38 weeks.
stopped the use of boron compounds in medicine three years ago In this period, reproductive studies were possible. Only the high- on the assumption that there were other drugs that would do every- est level was there any toxicity with congestion of the kidneys, thing that boron would do and that they would do it better.
liver, small gonads, thickened pancreas, and a swollen brain. Even In many other countries, a boron supplement is being used as a at 525 ppm, there was no adverse effect. Rats ingesting 350 ppm food supplement, and no claims are made, but satisfied users soon boron for 2 years showed no histologic changes at necropsy.9 tell other people who need it. Over 250,000 people have used this Some workers have shown that 3 g boric acid or 5 g borax have supplement, and it corrects between 80 and 90% of all arthritis. No no effect on the adult human, while others have reported symp- untoward side effects have been noted, but there are some useful toms at 1-2 g per day.2 No one is likely to take too much in their side-effects, such as would be noticed if boron were the limiting food even if they do use a supplement that has only a few mg per factor in a person's well-being. Cardiopathies have been corrected, tablet. Greater absorption is likely to come from a mouthwash or if vision has been improved, psoriasis has been much improved, bal- a borate is applied to damaged skin.
ance has been corrected. Arthritis in horses, cattle, dogs, deer, and Extensive laboratory studies on both man and animal have not goats have all been corrected.
shown the exact role of boron in their metabolism. Patients have As we use more and more superphosphate on our food crops, been given 10 g/day for extended periods and were still excreting the availability of soil boron is decreased. It is estimated that most boron after 7 weeks. The LD-50 for the dog is 1 g/Kg and these people in western societies ingest about 2 mg boron daily. This is dogs developed a violet red skin color with persistent vomiting, based on the analysis of school meals in the U.S.A,3 but analyses diarrhea, and meningismus. Acute intoxication can include hypoth- earlier in this century put the figure at 8 mg.9 ermia, depression, and ataxia.5 The prevalence of arthritis seems to follow inversely the avail- With daily doses of 100 mg/Kg, it takes 18 days for the dog to ability of boron in the soil. Jamaica has the least boron and 70% reach a plateau in boron excretion.5 with arthritis. Mauritius has very little and has arthritis. Northern The literature from 1848 to 1948 contains data of 86 cases of Thailand is very short of boron and much arthritis, but no figures borax-boric acid toxicity and 42 of these died. Some were given are available. In Fiji, the Indians have much more arthritis than do doses of over 100g, yet many had no real confirmation of the cause the Fijians, and the reason is that Indians eat mostly rice while of death. One 2 day old infant died and this was blamed on the Fijians eat mostly starch root vegetables. Monocotyledons have amuch less need for boron than do the dicotyledons.
Medical data is for informational purposes only. You should always consult your family physician, or one of our referral physicians prior to treatment.
The Theory Behind Boron Metabolism. Based on work
done at Oxford in the Agriculture Faculty4 it is believed that at thecellular level mineral metabolism is similar with both plants andman. If this can be relied on, then boron is a membrane catalystwhich allows various ions to pass through the cell membrane, par-ticularly phosphates to support synthesis of ATP. This will giveenergy for efficient repair. It is obvious that in osteo arthritis thecartilage is worn out, if it is because it lacks the necessary energy forcell division, it explains the action of boron. Then in rheumatoidarthritis, there is an autoimmune reaction for no known reason. It issuggested that the reason is that certain collagen fibers are overageand cannot repair themselves, due to lack of energy-rich compoundswithin the cells.
Other Boron Compounds. Boranes are hydrides of boron
and are very toxic. They are used as solid rocket fuels and can beused to prevent bacterial decontamination of diesel fuel.
Boron analogues of many of the amino acids have been made and tested in North Carolina. The original research was to findcarcinostatic compounds of boron, but some of these are also anti-arthritic, anti-inflammatory, anti-tumor and anti-hyperlipidemic intheir action on test animals. The amino carboxyboranes are rela-tively non-toxic, but the cyano boranes are very toxic. More will beheard about these compounds.7 Some of the analogues of amino-acids have an LD-50 of 1800mg/ Kg so they do not present any problems.
The Future of Boron. When the aforementioned trial is com-
pleted, it is likely that many people will require the boron supple-
ment so as to relieve their arthritis and the health departments over-
reaction will have to be reversed. Farmers will also have to look
more to quality instead of quantity, and will have to add trace
elements to their soil so as to give good quality crops.
Bibliography
1. Fisher, R.S. Boron — its occurrence in nature, foods, and
humans. Dept. of Medicine, Univer. of Maryland; 1959.
2. Levinskas, G.J. Metallo-Boron Compounds and Boranes. Ed.
Adams, R.M. Interscience Publishers, New York; 1964: Ch. 8.
3. Murphy, E.W., Watt, B.K., & Page, L. Regional variation in
vitamin and trace element content of type A school lunches. Trace
Substances in Environmental Health
IV, Univ. of Missouri; 1971:
194-205.
4. Parr, A.J. & Loughman, B.C. Boron and Membrane Function in
Plants. Metals and Micronutrients: Uptake and Utilization by Plants
.
Academic Press; 1983: Ch. 6.
5. Pfeiffer, C.C. & Jenny, E.H. The pharmacology of boric acid and
boron compounds. Bulletin of National Formulary Committee xviii:
57-80; 1950.
6. Solis-Cohen. Pharmacotherapeutics. 1928: 583-585.
7. Spielvogel, B.F. Synthesis and Biological Activity of Boron Ana-
logues of the Alpha Amino Acids and Related Compounds
. Duke
University. Durham Press: 119-129.
8. Underwood, E.J. Trace Elements in Human and Animal Nutri-
tion
. Academic Press; 1971: 434-436.
9. Weir, J.R. & Fisher, R.S. Toxicologic studies of borax and boric
acid. Toxicology and Applied Pharmacology 23: 351-364; 1972.
10. Zittle, C.A. Reaction of Borate with Substances of Biological
Interest. Advances in Enzymology
, vol. 12, Interscience Publishers;
1951.

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nopanic.fr

En abordant le sujet SE SOIGNER – LES PREMIERS SECOURS, nous entrons dans unepartie non négligeable de la survie. Accès rapide - - - - - HYGIÈNE ET SOIN – HYGIÈNE La base de l'hygiène c'est l'eau. Il est très risqué de boire de l'eau du robinet, elle peut êtreimpure à la consommation voire pire. Il existe une solution pour prévenir pas mal derisques, les pastilles Micropure Forte.

A traveller presenting with severe melioidosis complicated by a pericardial effusion: a case report

Schultze et al. BMC Infectious Diseases 2012, 12:242http://www.biomedcentral.com/1471-2334/12/242 A traveller presenting with severe melioidosiscomplicated by a pericardial effusion: a casereport Detlev Schultze1*, Brigitt Müller2, Thomas Bruderer1, Günter Dollenmaier1, Julia M Riehm3 and Katia Boggian4 Background: Burkholderia pseudomallei, the etiologic agent of melioidosis, is endemic to tropic regions, mainly inSoutheast Asia and northern Australia. Melioidosis occurs only sporadically in travellers returning fromdisease-endemic areas. Severe clinical disease is seen mostly in patients with alteration of immune status. Inparticular, pericardial effusion occurs in 1-3% of patients with melioidosis, confined to endemic regions. To our bestknowledge, this is the first reported case of melioidosis in a traveller complicated by a hemodynamically significantpericardial effusion without predisposing disease.