Richard Moskowitz, MD

I am honored by your invitation to participate in this Conference, and deeply moved by the fraternal spirit, youthful vitality, and sincere dedication to homeopathy everywhere in evidence here.  Homeopaths in all lands and of every stripe would do well to follow your example.  Andrew Tyler of the London Evening Standard recently told me that the National Health Service pays a substantial bonus to physicians with documented vaccination rates over 70%, and a still higher increment if the figure tops 90%.1  His drift seemed to be that you overly civilized Brits need only informal pressures and inducements to obey authority, while we more rebellious, outspoken Yanks have to be coerced with laws and penalties.  If that is true, I can understand why you wanted to fetch somebody from America, and I shall try my best not to disappoint you.

My interest in vaccinations arose out of a “gut” feeling not to do them that I have devoted a considerable part of my career trying to clarify.  In this as in so many other ways, the study of homeopathy has helped me articulate what my heart and soul already seemed to know.  To recognize the living organism as a “totality of symptoms” already implies that any more narrowly defined standard of vaccine safety or effectiveness cannot possibly be adequate.  Other equally troubling inconsistencies include imposing mandatory vaccination laws in the absence of any public health emergency, and waiving the established rules of scientific investigation in their honor.

These special privileges give some measure of the reverence accorded to vaccines and vaccination in what can only be called the “religion” of modern medicine.2  Its theology was admirably summarized by the French physiologist Claude Bernard well over a century ago:

What we call the immediate cause of a phenomenon is nothing but the physical and material conditions in which it exists or appears.  The object of the experimental method and the limit of every scientific research is therefore the same for living as for inanimate bodies.  It consists in finding the relations which connect every phenomenon with its immediate cause, or putting it differently, which define the conditions necessary for its appearance.  When the experimenter succeeds in learning the necessary causes of a phenomenon, he is in some sense its master: he can predict its course and appearance; he can promote or prevent it at will.

As a corollary to the above, neither physiologists nor physicians must imagine it their task to seek the cause of life or the essence of disease: that would be entirely wasting one’s time in pursuing a phantom.  The words “life,” “death,” “health,” and “disease” have no objective reality.  Only the vital phenomenon exists, with its material conditions.  That is the one thing that they can study and know.3

Precisely as Bernard foresaw, the search for identifiable components of human structure and function, and for powerful technologies to control them, has obscured both the need for and the possibility of any unifying concept of life or health against which to judge them.  Thus to be considered effective by present standards, vaccines need satisfy only two very minimal statistical criteria, i. e., reducing the incidence of the corresponding natural diseases substantially, and demonstrating measurable blood levels of specific antibodies to them for long periods of time.  They have become sacraments of our faith in biotechnology in the sense that

1) their safety and efficacy are widely seen as self-evident, and requiring no further proof;

2) they are given automatically to everyone, by force if necessary, and always in the name of the public good; and

3) they ritually initiate our loyal participation in the medical enterprise as a whole.

In short, they celebrate our right and our power as a civilization, to manipulate biological processes, for profit and more or less at will, without undue concern for or even an explicit concept of the total health of the populations about to be subjected to them.  For that reason, I want to re-examine and update the major concerns of my previous article4 from this quasi-theological standpoint.  Now as then, I have mostly a lot of questions to offer, questions so thorny and difficult that years and even decades of careful investigation and painstaking research will be needed to disentangle them.  But they seem so basic and important that it would be reckless indeed to require vaccination of every newborn child without adequate measures being taken to address them.  Until then, my position remains simply to make the vaccines optional and freely available to all at the discretion of their parents, as is now the rule in the UK and other European countries.

 

A Brief History of the Measles Vaccine.

I want to begin with the dramatic career of the measles vaccine, which highlights a great many issues that are pertinent to the others as well.  In its natural state, the measles virus enters the body of a susceptible person through the nose and mouth, and incubates silently for about 14 days, first in the tonsils and lymphoid tissues of the nasopharynx, then in the regional lymph nodes of the head and neck, and finally in the liver, spleen, bone marrow, and the lymphocytes and macrophages of the peripheral blood.  The illness known as “the measles” is the process by which the virus is expelled from the blood, through the same orifices that it came in, and involves a massive and concerted effort of the entire immune system.  Once specific antibodies have succeeded in targeting the virus, the ability to synthesize them on short notice remains as a coded “memory” of the whole experience, and a virtual guarantee that those who have recovered from the measles will never get it again, no matter how many times they are re-exposed.

In addition to conferring this specific immunity, the process of mounting and recovering from a major illness like the measles also “primes” the organism non-specifically, to respond promptly and efficiently to other microbial infections in the future.  A crucial step in the maturation of a healthy immune system, the ability to mount a vigorous, acute response to infection unquestionably represents a fundamental ingredient of optimal health and well-being in general.

Finally, measles is about 20% fatal in populations exposed to it for the first time.  It has required many centuries of adaptation for us to convert it into an ordinary disease of childhood, such that, when I first encountered it at the age of six, non-specific mechanisms were already in place to help me deal with it effectively.   In that larger sense, the lifelong specific and non-specific immunity each of us acquires from mounting and recovering from the natural disease represents an absolute and substantial net gain for the total health of the race as well.

However the vaccines may act inside the human body, true natural immunity in both these senses cannot be ascribed to them: their effectiveness is merely a statistic, and the resulting “immunity” a narrowly-defined technicality.  In contrast with the natural disease, the attenuated vaccine virus is designed to produce no local sensitization at the portal of entry, no massive outpouring of the immune system as a whole, and no acute disease of any kind.  It can elicit long-term antibody production solely by surviving in latent form within the lymphocytes, macrophages, and plasma cells of the peripheral blood and blood-forming organs. The considerable technical feat of providing these antibodies thus becomes a memory of the chronic infection, and the price we must pay for them is simply that we have no way of getting rid of them.  Nobody would be foolish enough to argue that vaccines render us “immune” to viruses if in fact they merely weakened our ability to expel them, and forced us to harbor them chronically instead.  On the contrary, such a long-term carrier state would also tend to compromise our ability to respond to other infections as well, and would have to be regarded as immunosuppressive to that extent.

The laws mandating vaccination against the measles were enacted in the 1960’s, when the disease was limited almost entirely to children in elementary school, and deaths and serious complications had already reached an all-time low.  The decision appears to have been made purely as a matter of policy, as soon as the vaccine became available; and with very little public debate, and very few people requesting exemptions, the compliance rate averaged well over 95%.  From an average of over 400,00 cases annually in the pre-vaccine era, the incidence of measles in the United States dropped to less than 5000 by the early 1980’s,4,5 and it looked as though the disease would soon be eliminated.

In the 1980’s, however, this comforting scenario began to unravel, as measles began to reappear even in fully-vaccinated populations, and public health authorities grappled with the mysterious phenomenon of “vaccine failure.”  In 1984, for example, 27 cases were reported at a high school in Waltham, Mass., where more than 98% of the students had been vaccinated.6   Over a 3-month period in 1985, 157 cases were reported in Corpus Christi and the surrounding Nueces County, Texas, notwithstanding a vaccination rate of over 99% and supposedly “immune” antibody titers in over 95%.7  In 1989, a High School in Illinois with documented vaccination records for 99.7% of the students nevertheless reported 69 cases over a 3-week period.8  In all three outbreaks, the authors concentrated on the documented vaccination rates, and curiously neglected to mention the number of actual cases that had not been vaccinated.  But they convincingly refuted the conventional assumption of a “reservoir” of the disease in the unvaccinated, an argument still popular with pediatricians and health departments alike for browbeating wavering parents into compliance.

As the data were collected and analyzed, tentative generalizations were made, and new strategies formulated.  A survey of over 15,000 Canadian cases in 1985-86 indicated that 60% of the patients had documented vaccination records, 285 were “unvaccinated,” and 12% were listed as “unknown,”9 which presumably refers to those who claimed to have been vaccinated but were unable to prove it.  A comparable American survey of over 9000 cases in 152 separate outbreaks in the same 2-year period yielded similar results:

 

1) a large majority (69%) were children in school, 5 to 19 years of age;

 

2) of these school-age kids, 60% had been “appropriately vaccinated,” i. e., at 15 months or older, the schedule then in vogue, and another 20% “inappropriately vaccinated,” i. e., at 12-14 months, the schedule recommended before 1979, with the exact number of unvaccinated children again oddly omitted; and

 

3) a significant minority of the total cases (26%) were children less than 5 years old, mostly unvaccinated and belonging to black, Hispanic, or other indigent minorities in urban ghettoes.10

 

These data indicated a partial resurgence of the disease, mainly in older children and adolescents of high-school and college age, groups with much higher rates of serious complications.  The favored explanation was simply that vaccine-mediated immunity was temporary, and “wore off’ with increasing age, presumably leaving the child otherwise unaffected, and susceptible as before, an assumption which also, though rarely stated as such, formed the principal rational for re-vaccinating at a later date. Unfortunately, this assumption had already been disproved by an earlier study, which demonstrated quite conclusively that previously vaccinated children with declining antibody titers responded only minimally, and for an unacceptably short time, to booster doses of the measles vaccine.11 Another refutation came from a sustained outbreak of 235 cases in Dane County, Wisconsin, over a 9-month period in 1986.  Along the same lines as in earlier studies, the authors found that the majority of cases were in children of school age (5 to 19), but that only 6% of these had not been vaccinated.12   They were even more surprised by the sizeable number who developed “mild measles,” with a typical measles rash, but little or no fever or systemic symptoms.,  a syndrome that was much commoner in vaccinated kids who lacked measles antibodies than in those who were unvaccinated, or those who had antibody titers that were read as “immune,” both of whom were far more likely to develop the typical acute disease.  Although the authors themselves failed to draw the inference, this paradoxical result suggested some kind of inapparent or latent activity of the vaccine virus that had not been suspected before, and that serological testing failed to detect. 

Despite these warnings, none of these investigators seems to have taken seriously the possibility that the immunity conferred by the vaccines might not be genuine.  Like the repeated bouts of chemotherapy for advanced cancer patients after the preceding rounds have failed, the purely quantitative redefinition of immunity cleared the way for simple escalation of force as needed, to approximate the desired goal.  In the past three years, the policy of revaccination has carried the day, despite all the logical, scientific, and ethical considerations against it, and justified to some extent by the recent spread of the disease among unvaccinated minority infants in low-income urban neighborhoods. 

In 1988, for example, over 500 cases were reported in Los Angeles County, more than 17% of the total nationwide, of whom about 65% were under 5 years old, 77% were Hispanic, and 38% were less than 16 months old,13 the date at which the vaccine is usually given!  These data have been used effectively to bully state legislatures into allocating more funds, and local officials into tighter enforcement of vaccination laws in minority districts.  In such relatively higher-incidence areas, even lowering the vaccination age to 9 months has been recommended, an idea that brings us back full-circle to the pre-1979 era, when large numbers of kids were “inappropriately vaccinated” according to similar guidelines, as we saw.

Finally, although these considerations apply solely to the measles vaccine, both the medical and public health authorities are presently advocating revaccination against mumps and rubella vaccine as well, for no better reason than that the triple MMR vaccine is the only one still commonly available, but are not yet in agreement as to the proper age, leaving state legislatures to decide for themselves which of them, if any, to pay attention to.  Thus the American Academy of Family Practice currently advocates a second MMR booster at 4 to 6 years of age,14 while a bill before the Ohio legislature mandates documented proof of revaccination before entering the seventh grade.15  The obvious implication is that the extra dose can’t possibly hurt, so that there’s no reason not to throw in the mumps and rubella vaccines as well.

 

The DPT Story.

The DPT vaccine was the first to be developed and marketed on a large scale, and still remains the major battlefront of the vaccine controversy in the United States, as well as the area in which most of my own experience with vaccine-related illness has so far been concentrated.  Thanks largely to parent organizations like Dissatisfied Parents Together (DPT), and books like A Shot in the Dark, by Harris Coulter and Barbara Loe Fisher,16 the plight of vaccine-injured children and their families is at last being recognized and taken seriously by the general public.

In 1986, despite intensive lobbying efforts by the vaccine manufacturers, the American Academy of Pediatrics, and other medical and public health authorities, Congress enacted the National Childhood Vaccine Injury Act, which directs the Public Health Service to investigate all reports of vaccine injury, and to formulate guidelines for compensation.17 Unfortunately, both the PHS and the Centers for Disease Control, its subsidiary agency, are funded mainly to advocate and enforce the same mandates that the Act charges them to investigate, and can therefore be expected and indeed relied upon to minimize the risks. 

The official compensation guidelines accordingly rule out every condition other than the few already identified, namely, “collapse,” anaphylaxis, and encephalopathy, or “brain damage,” as well as everything of a persistent or chronic nature, unless it appears in less than 7 days after the vaccination.18 Even these massive exclusions are insufficient for many leading vaccine proponents, who still adamantly refuse to accept any connection at all   between even the most egregious cases of encephalopathy and the DPT.19,20

Since these guidelines were published and put into effect, the unit cost of the DPT has skyrocketed, as have the number and size of personal injury awards against the vaccine manufacturers, with the result that many pediatricians are privately willing to give the DT alone if the parents insist.  Meanwhile, whooping cough itself has made a bit of a comeback in recent years, the CDC reporting 10,500 cases in the years 1986-88,21 and once again, as with measles, the bureaucratic language effectively conceals the true demographics.  Thus, of those cases with known vaccination status, 63% had been “inappropriately immunized,” and 34% had not been vaccinated at all.  From these figures, we are meant to infer that the vaccine is highly effective, with very few cases in the vaccinated group.  Only by reading the fine print do we learn that those whose vaccination status was “unknown,” a whopping 7700 cases, actually comprised more than 70% of the total.  With even its chief proponents conceding the DPT to be among the least effective of all the vaccines, it is a safe bet that “inappropriately vaccinated” means simply having received 1 to 4 doses, but not the full 5 required for entrance to kindergarten, while “status unknown” once again refers to those claiming to have been fully vaccinated but lacking documentary proof.  Indeed, after reporting several cases in infants less than 2 months old, a Philadelphia pediatrician recently advocated that the vaccine be given even earlier, ideally “as soon after birth as possible.”22 The sacramental status of vaccines is thus widely interpreted by public health authorities as blanket authorization for vaccinating almost anyone against anything at any time.

 

Other Vaccines.

The same generic faith continues to bless the pharmaceutical industry in its hugely profitable quest for more and more new vaccines, often for no more compelling reason than its technical capacity to make them. 

Thus in the late 1980’s, a vaccine was introduced against Hæmophilus influenzæ B, an organism associated with scattered outbreaks of bacterial meningitis in overcrowded day-care facilities.  At first purely optional for pre-schoolers from 2 to 4 years old, it was eventually made compulsory for all infants, even those who never need day care, and is presently given at or before 18 months, in some cases before the first birthday.

Always primarily a disease of adults using IV drugs, hepatitis B inevitably found its way into blood banks, and thus became a more or less institutionalized risk of hospitalized patients requiring transfusions of whole blood, plasma, and other blood products.  While the Hep B vaccine was actually developed in the 1970’s, the medical authorities have never figured out how to target the IV drug subculture in a selective fashion.  So when the disease began propagating through the blood banks, the favored solution, as always, is simply to vaccinate everybody.  In the past few months, the American Academy of Pediatrics and the CDC have accordingly decided to mandate Hep B vaccination for all newborn babies,23 and are still trying to decide whether to give it at birth, or with the DPT at 2 months of age.  It remains to be seen if the American public, already increasingly upset over the vaccination issue, will simply acquiesce in this latest baptism of the newly born, explicitly intended as their very first immunological experience.

While still theoretically optional, comparable transubstantiations are also available at the other end of life.  Originally intended and still widely promoted for reducing the risk of pneumonia and death among the elderly, especially in nursing homes and extended-care facilities, the influenza and pneumococcus vaccines have not been very popular with that demographic, and a number of studies have shown them to be ineffective as well.24,25  In 1978, when the dreaded “swine flue” epidemic never materialized, and large numbers of vaccines developed the crippling Guillain-Barré polyneuritis, the American public began to question the concept of vaccination openly for the first time.  Yet the elderly and infirm continue to be pressured heavily to accept these “rejects” on a yearly basis, as a form of extreme unction against both diseases.

Thus the search goes on, seemingly without limit, now indissolubly linked to the biotechnology industry.  Currently in the works are vaccines against Group A streptococci, the common cold, and bronchiolitis, all of which are being bred into the gene pool of mice, rats, baboons, and other experimental animals, without any discernible, caution, restraint, or regulation.  Not far off, a fitting dénouement is the AIDS vaccine, which is monstrous even in principle, inasmuch as those at risk are already seriously immunocompromised, so that a suppressive vaccine would not only increase their chances of getting it, but would also help to soften up the general population as well.

 

Some Vaccine Cases.

With that as background, I want to speak about some of my own patients, with illnesses traceable to the DPT vaccine, the one I am most familiar with.  Because the link is often far from easy to document, and indeed may not even be suspected until long after the fact, I have no doubt that other vaccines will prove to be equally important clinically, once we learn better how to recognize and look for them.

By no means least of what homeopathic medicine has to teach is the reaffirmation of the individual patient as the bearer of what the physician needs to know.  Whereas modern medicine seeks to define itself quantitatively, as a series of technologies powerful enough to manipulate and control antibody levels and other key variables, the homeopathic vision is essentially qualitative, matching the unique ensemble of signs and symptoms in each patient with the equally characteristic totality of the medicine that most closely resembles it.  I offer the following cases as evidence for the speculations and hypotheses I have so far proposed, because they are the ultimate source of them as well.

Although the DPT has already been implicated in brain damage and a variety of other neuropathic syndromes, as we saw, which are themselves amenable to homeopathic treatment to some extent, today I want to concentrate on illnesses that are far less serious, but also much commoner, easier to understand, and more representative of the problem as a whole.  Both involving high fevers of unknown origin that were cured by a single dose of the vaccine nosode, my very first DPT cases illustrate the thought process whereby various symptoms may be added to the clinical picture of any given vaccine.  Although ideally the history must also show that the child has never been well since one or more DPT injections, this connection may not be obvious or even suspected, unless specific questions are asked to elicit it.

In some cases, an abnormal white count and differential may give independent pathological confirmation, while other examples include tender or enlarged posterior auricular and suboccipital nodes for rubella, parotid swellings for mumps, and the like.  Naturally, acute symptoms like fever, that seem aberrant or unusual to the parents, are more suspicious and easier to trace.  But only a curative response to the corresponding nosode suffices to prove that the illness in question was specifically related to the vaccine.

 

Case 1.  A baby girl of 8 months had had 3 episodes of high fever, typically 105˚F. or more, but lasting 48 hours at most.  During the second episode, she was hospitalized for tests, but her pediatrician found nothing.  Each time she felt well afterwards, and appeared to be growing and developing normally.  The only other information I was able to elicit from the mother was that the episodes had occurred exactly one month apart, and that the first episode had come just one month after the last of her DPT shots, which had likewise been given at one-month intervals.  Recognizing this coincidence further helped her to recall that similar episodes had also occurred after each injection, but the pediatrician had advised her to ignore them, since fever

is perhaps the commonest reaction to the vaccine.  I therefore gave the girl a single dose of DPT 10M, and the child never had another episode.

 

Case 2.  A 9-month-old baby girl was brought in with a fever of 105˚F. and very few other symptoms.  Two previous episodes had occurred at irregular intervals, and the parents, who already felt ambivalent about vaccinations in general, had given her only one DPT shot, especially since the first episode came less than 2 weeks after it.  For the next 48 hours, I tried several acute remedies without success, and finally ordered a CBC.  With a white count of 32,000, the differential showed 43% lymphocytes, 11% monocytes. 25% neutrophils (many with toxic granulations), and 20% immature “band” forms.  A pediatrician friend who looked at the slide with no other information immediately identified it as pertussis.  After DPT 10M, the fever came down in 2 hours, and the girl has been entirely well since.

 

These cases are noteworthy for two reasons: first, because they both exhibited a characteristic symptom or “keynote” of the DPT vaccine, namely, high fever; and second, because their responses were strong and healthy, such that their illnesses, while recurrent, quickly resolved without sequelæ.  But, like the brain-damaged cases, they are also the exception, rather than the rule, and instructive mainly in contrast to the others, which are less specific and therefore more difficult to trace.

In all the remaining cases, the vaccine appeared to act non-specifically, either by exacerbating an already established chronic condition, or by casting a shadow over the background of a chronic condition that did not materialize until later.  Because excellent results were obtained with the usual constitutional or miasmatic remedies employed in such conditions, the specific nosode was often not needed, so the vaccine connection could not always be proved.  In other cases, the nosode was useful later, in removing a “block,” i.e., when seemingly well-indicated remedies didn’t work, or failed to hold or act deeply.

In general, these cases are reminiscent of the way that grief, physical injury, or some other stress simply exacerbates the pre-existing “miasmatic” or chronic disease structure, rather tan substituting the specific picture of Ignatia, Arnica, or other remedies illustrating a “never well since” pattern.  In another subgroup, those symptoms specific to the vaccine and those already latent or pre-existing in the patient come all mixed up together, and begin to disentangle only as the treatment develops.  But far from being restricted to any particular category, vaccine-related illnesses encompass the full range of chronic diseases seen in children, from asthma, allergies, and otitis media, far and away the commonest in my practice, to learning disabilities and emotional and behavior problems.

 

Case 3. A girl of 6 was brought in for being “sick all the time,” especially with ear infections, which she had had repeatedly since the age of 5 months, when she was given antibiotics continuously for 4 months.  Especially vulnerable in the fall, and with abrupt changes in the weather, she would often become “grumpy” when ill, and lost her appetite, but rarely had fever or earache.  Although showing no obvious reaction to her regular DPT shots at 2, 4, 6, and 18 months, she had had another ear infection for 4 months straight soon after her last one, just before entering first grade.  Over the next 18 months, she did beautifully on Sulphur, Pulsatilla, and Mercurius, coming down with colds and acute illnesses at times, but responding well to these remedies, never needing antibiotics, and seeming entirely well in between.  Three years later, her mother called to report that she had not missed a single day of school since, and required no further treatment.

 

Case 4.  A 5-year-old girl was brought in for treatment of seasonal asthma, which had begun the previous spring, did not respond very well to the usual drugs, and worried the parents in view of their own allergic histories.  Soon after weaning at 13 months, her health problems began in earnest, with protracted ear infections, often associated with teething, and always requiring antibiotics.  While her first series of vaccinations provoked no obvious reaction, she had recently developed pneumonia and a high fever 2 weeks after her 5-year DPT booster, followed by the return of her asthma, for the first time in the dead of winter.  After two years of treatment with Arsenicum album, Phosphorus, and Lachesis, her health steadily improved, to the point where she no longer needed either drugs or remedies, and the nosode was never given.

 

Case 5.  A 2-year-old boy was brought in for treatment of recurrent ear infections that tended to drag on for months, and responded only temporarily to antibiotics.  His first one followed a URI at 6 months of age, and was picked up at a routine office visit with no symptoms whatsoever, although he often complained of earache at other times.  But his worst illnesses had been acute episodes of high fever and pro-longed screaming soon after his first two DPT shots, after which he was given the DT only, with no obvious reaction. While his ear infections quickly subsided with a few doses of Calcarea sulphurica and Tuberculinum, he developed intense jealousy and

extreme tantrums around the birth of his baby sister a year later, and was finally given DPT 10M when the seemingly indicated remedies failed to help.  Now 4 years old, he is healthy, free of ear infections, and continues to grow and develop normally.

 

Case 6.  A baby girl of 10 months was brought in with acute otitis media, ie., high fever, earache, and screaming, her 4th such attack since the age of 2 months, each one beginning soon after stopping the antibiotics from the one before. Weaned at 2 months, when her mother returned to work, she could not tolerate her milk-based formula, but did well on soy milk.  When of cranky behavior developed soon after her first DPT shot, and the first ear infection followed close behind, she was given only the DT thereafter, and didn’t seem to react to it, but the ear infections went on as before.  These stopped readily enough after Chamomilla and Calcarea carbonica, but recurred 8 months later, when her parents separated, and she received the MMR while visiting her father.  Again she did beautifully on remedies, mainly Lycopodium and Sulphur, despite occasional relapses, like the one that followed soon after a DPT booster that her father insisted on, which ended only after the DPT nosode was given.  Over the past 4 years, I have continued to see her after further relapses that coincided with visits to her father, who plied her with dairy products, and her full quota of vaccines and antibiotics.  Yet she remains fundamentally healthy, with longer and longer intervals in between.

 

Case 7.   After 5 episodes of otitis media, all treated with antibiotics, a 16-month-old boy was referred to me for constitutional treatment.  Colicky for the first 3 months, he developed acute otitis with fever at 6 months, but all the subsequent episodes were afebrile.  He also reacted violently to his first DPT shot, with vomiting and “hard crying,” somewhat less so to the second, with general malaise and “sad crying,” and not at all to the third, or the MMR, which had just been given the week before I saw him.  I save him one dose of Sulphur 10M, and within 3 days he ran a high fever with diarrhea, from which he soon recovered.  Next he was given Calcarea carb. 10M, 1 dose, and Calcarea sulph. 12C, to be used p. r. n. for a threatened or actual cold, and he had no more ear infections and no more remedies for well over a year.  I then repeated the Sulphur, and he has been well for the past 3 years.  The nosode was never needed.

 

Case 8.  A boy of 3 had never reacted to any vaccination, and appeared to be in good

health until about 8 months before seeing me, when he contracted a flu-like illness, followed by otitis media, for which antibiotics were prescribed.  According to his mother, he seemed lethargic and “not himself” while taking them, with outbursts of stuttering and a foul diarrhea, from which Giardia lamblia was isolated.  At this point no -globulins could be found in his serum, and he had to be given transfusions on a regular basis.  Over the next 6 months he was given Influenzinum, Stramonium, Cuprum, and then Sulphur the following year.  Within a few weeks of starting the treatment, his serum proteins rose dramatically, the stuttering subsided, and he continued to improve steadily after that.  The transfusions were discontinued after a year, and he has remained well since.  No one vaccine was clearly implicated, and no nosode was needed, but total unresponsiveness to vaccines and general immune collapse are two similar paths whereby any vaccine could act non-specifically to weaken the immune system of a sensitive individual.

 

Case 9.  A girl of 15 months was brought in for repeated ear infections and courses of antibiotics since her first episode at 4 months of age.  Associated with typical URI symptoms, ear involvement was often accompanied by pain, but she had never had a fever in her life.  An hour after her first DPT shot, she awoke from a nap screaming, and soon developed her first cold.  The same thing happened after the second dose, with her first earache 2 days later, which coincided with her mother going back to work and putting her on a milk-based formula.  A similar episode followed her third dose, and this time the eardrums did not improve from antibiotic treatment, but the mother tried homeopathy only when myringotomy was proposed 8 months later.

Responding almost miraculously to Calcarea carbonica, the girl cut 3 teeth almost immediately, and her ears cleared up, but she later developed persistent diarrhea after a bottle of cow’s milk.  At this point I gave her the DPT nosode, and within an hour she developed a high fever, the first in her life, the diarrhea was gone the next day, and her health has continued to improve ever since, with no ear infetctions and no other remedies needed for the past 5 years.

 

As documented in many of these cases, the evolution and natural history of otitis media in recent years exactly parallels the theoretical concerns we discussed above.  As a medical student in the early 1960’s, I saw acute ear infections daily in the Emergency Room, with high fever and violent earache.  Almost always, they responded to penicillin at levels of 100,000 units daily, or less.  If the eardrum had already burst, as often happened, the children recovered promptly and completely without any treatment at all.

Today, although such cases are still seen occasionally, otitis media is predominantly a chronic or relapsing illness, with significantly less fever and pain than in the past.  In a surprisingly large number of cases, there are no symptoms whatsoever, and the diagnosis is made solely on morphological grounds at the time of a routine examination.  For no doubt the same reasons, it is also much less likely either to heal spontaneously or to respond favorably to antibiotics, has a much greater tendency to relapse after the drugs are stopped, and is more often associated with residual symptoms, such as behavior problems, learning disabilities, swollen tonsils, and hearing loss.  Recent studies also indicate that myringotomy tubes inserted to facilitate drainage, the most advanced technology yet available, are themselves an important cause of permanent hearing loss, the same risk that is always invoked to justify them.26

To be sure, many immunosuppressive factors other than vaccines must also be considered, such as the widespread use of antibiotics, the inevitable development of resistant organisms, urban and industrial pollution, and doubtless many more.  But my fear is that any other chronic disease of children will tell the same tale.   In addition to their specific effects, only a very few of which have so far been identified, I suspect that every vaccine probably has non-specific effects of an auto-immune or immunosuppressive type, which would look quite different for each individual patient, but would all involve favoring chronic responses at the expense of acute ones, i. e., having to do with “style,” rather than specific content.  Certainly for the DPT vaccine, and I daresay for the others as well, the net will have to be widened to include enuresis, asthma, eczema, allergies, sinusitis, nervous and mental diseases, auto-immune phenomena, cancer, and indeed the entire spectrum of pediatric and adult medicine.

 

Research.

In conclusion, I want to address the most important and difficult problem of all, namely, the research that will have to be done in the future, and the political will that will be required to carry it out.  Both of these aspects are inseparably connected, and both will need radically new models to succeed.  Since current studies ignore the chronic dimension entirely, and therefore preclude any concept of the total health picture of an individual over the lifetime, they cannot provide unambiguous information about how vaccines act.  At the same time, well-controlled scientific investigations of vaccines, based on the totality of signs and symptoms that they produce, will obviously require a large population of unvaccinated kids, precisely what the existing laws are designed to prevent.  To those parents who decide not to vaccinate we therefore owe a considerable debt of gratitude. 

Moreover, the standard accusation that unvaccinated children help to propagate the corresponding natural diseases and thus threaten the rest of the population cuts both ways.  For if that argument were true, it would also mean that the vaccines are ineffective by their own test; and conversely, if the “immunity” they conferred were genuine and long-lasting, then the unvaccinated kids would pose a threat only to themselves. 

Furthermore, it will not be possible to study each vaccine independently unless we legally authorize parents to choose some vaccines, but not others.  At present, even the most liberal states allow parents to refuse all vaccines, on religious or philosophical grounds, but not to make informed medical decisions for their children.  Once vaccines are made totally optional, as in the UK and various other countries, the experimental and control groups can become purely self-selecting for each vaccine, with those receiving it matched as closely as possible to those exempted.  Once these groups are in place, it will be necessary to follow them prospectively for at least a generation, if not a whole lifetime.  For the present, pilot studies could also be done retrospectively, using kids with known vaccination histories.

But by far the most difficult and important questions are the theoretical one of what to measure, and the technical one of how to measure it, which are of course thoroughly interconnected.  As homeopathic clinicians, we already have a reasonably good sense of how to ascertain a working totality of symptoms that is tailored to our individual patients, and how to follow them over extended periods of time.  In studying large populations, we will need to identify a few key variables that are broad and inclusive enough to reflect the most fundamental aspects of human functioning, yet also flexible enough to accommodate the infinite richness and diversity of real people.  Which ones we choose will then further determine and be determined by the techniques with sufficient detail and precision for measuring them.  Probably this means that we won’t really know what we need to measure without first following a much smaller pilot group very closely for a shorter period of time, perhaps 4 or 5 years, and just see what happens to them.  In any case, what I shall call the homeopathic agenda, ascertaining the total health picture of the individual over time, is still the best available methodology for such an investigation, and any progress that we can make toward achieving it will also inevitably contribute to a more fruitful design in biomedicine generally.

How, then, are we to investigate the total health picture of large populations over extended periods of time.  Clearly, to begin with, we need to follow the outline of a standard medical history, regarding the incidence and severity of both usual and unusual acute and chronic diseases.  Regular physical and laboratory examinations might also reveal persistent or subclinical changes of a more “constitutional” or chronic variety, analogous to the swollen nodes of rubella, inflamed parotids for mumps, abnormal WBC and differential counts for pertussis, and so forth, as well as global and nonspecific developmental criteria (height, weight, dentition, nursing behavior, gross and fine motor co-ordination, vision, hearing, etc.  Other important variables lying to some extent outside the medical history per se would include intelligence testing, language development, family and school socialization, and other demographic, socioeconomic, and psychological factors (poverty, race, learning disabilities, mood, behavior, and temperament, and school attendance and performance).

At the other extreme, pilot studies of the pneumococcal and influenza vaccines might require only a few simple variables, since they are given primarily to elderly people at high risk or in nursing homes, when their chronic disease structure is already more or less firmly established.  Under these circumstances, a reasonable first approximation of how these vaccines act might be simply to measure their effect on the life span, the sheer ability to survive, compared to that of their unvaccinated friends, neighbors, and peer group.

Finally, I want to say a few words about why, in spite of the very real and present dangers I have been discussing, and many others that could as well be mentioned, I remain strangely optimistic about the future of the healing arts, and indeed of homeopathy in particular.  The chief reason has to do with the growing awareness of ordinary people taking more responsibility for their health, including their transactions with the medical system as a whole.  In the United States, the vast and growing movement for free choice in health care now includes not only groups critical of mandatory vaccination, like DPT, but also supporters of midwifery, home birth, homeopathy, and other forms of “alternative” or complementary medicine, and the right to die with dignity self-determination.  Within the last 10 years or so, these groups have already helped bring about substantial changes in the doctor-patient relationship.  With even the vaunted American economy manifestly unable to afford the top-heavy medical system now in place, no matter how it is financed, it is virtually certain that these changes will continue to accelerate, and that organized medicine will face still more bruising reversals, until it accepts them.

In the meantime, lest you suppose that I am opposed to religious concepts of any kind in medicine, I propose the following three aphorisms of Paracelsus, the great Renaissance physician and alchemist, as a practical and ecumenical theology of healing that health professionals and lay people of every persuasion can accept and live by, without having to ram them down anybody’s throat:

 

The art of healing comes from Nature, not the physician . . .

Every illness has its own remedy within itself . . .

A man could not be born alive and healthy were there not already a Physician hidden in him.27

 

Taken together, these sayings encompass most of what the present medical system has tended to leave out, and I interpret them roughly as follows:

 

1.  Healing implies wholeness.

The verb “to heal” comes from the same Anglo-Saxon root as “whole.”  “Healing” thus means simply to make whole [again], is a basic attribute of all living systems, and is evident in wound healing, in spontaneous recovery from illness, and in effective medical and surgical treatment as well.  As a concerted response of the entire organism, it implies a living totality, a qualitative integration on a deeper level than can be defined by any assemblage of parts, or approximated by any purely quantitative measurement.

 

2.  All healing is self-healing.

As a fundamental property of all biological systems, healing proceeds continuously throughout life, and often completes itself spontaneously, with or without outside help.  This means that all healing is ultimately self-healing; that the role of physicians and other professional or designated “healers” is essentially to assist and enhance the natural process that is already under way, not to interfere with it; and that the mechanical correction of abnormalities, while still legitimate and useful under certain circumstances, earns that legitimacy by virtue of this prior standard.

 

3.  Healing pertains solely to individuals.

Always possible, but also problematic, even risky, healing applies only to individuals in unique, here-and-now situations, rather than to abstract “diseases,” principles, or categories.  In other words, it is inescapably an art, and can (and should) never be reduced to a mere technique or procedure, however scientific its formulation.

To these I propose a fourth of my own, which is not exactly theological, but feels like a political and legal right, in the spirit of Magna Carta and the American Bill of Rights:

 

Health, illness, birth, and death are inalienable life experiences belonging wholly to the people undergoing them, which nobody else has the right to manipulate or control without their explicit request, or that of somebody duly authorized by them to act on their behalf. 

 

My concluding principle was contributed by Lao-Tse, and provides an appropriate “bottom-line” criterion:

 

A leader is best when people hardly know he exists,

Not so good when they obey and acclaim him,

And worst when they despise him.

Of a good leader, when his work is done and his aim fulfilled,

The people will say, “We did this ourselves.”28

 

NOTES.

 

  1.   Tyler, A., London Evening Standard Magazine, September, 1991, p. 74.

 

   2.   Mendelsohn, R., Confessions of a Medical Heretic, Contemporary, Chicago, 1979, p. xiv.

 

   3.   Bernard, C., An Introduction to the Study of Experimental Medicine, Dover, New York, 1957, pp. 65-67, passim.

 

   4.   Cherry, J., “The New Epidemiology of Measles and Rubella,” Hospital Practice, July 1980.

 

   5.   Markowitz, L., et al., “Patterns of Transmission in Measles Outbreaks in the U. S.,” New England Journal of Medicine 320:77, 12 January 1989.

 

   6.   Nkowane, B., et al., American Journal of Public Health 77:434, 1987.

 

   7.   Gustafson, T., et al., “Measles Outbreak in a Fully-Immunized Secondary-School Population,” New England Journal of Medicine 316:771, 26 March 1987.

 

   8.   Chen, R., et al., American Journal of Epidemiology 129:173, 1989.

  

   9.   Medical Tribune, 26 August 1987, p. 2.

 

10.   Markowitz, op. cit., pp. 75-81.

 

11.   Cherry, op. cit., p. 52.

 

12.   Edmondson, M., et al., “Mild Measles and Secondary Vaccine Failure During a Sustained Outbreak in a Highly-Vaccinated Population,” Journal of the AMA 262:2467, 9 May 1990.

 

13.   “Measles: Los Angeles County, 1988,” MMWR Report, Journal of the AMA 261:1111, 24 February 1989.

 

14.   Family Practice News, 1 April 1990, p. 3.

 

15.   LSC 119 0411-1, Sub. H. B. 168, Ohio General Assembly, 1991-92.

 

16.   Coulter, H., and Fisher, B. L., A Shot in the Dark, Harcourt Brace Jovanovich, 1985.

 

17.   “Vaccine Adverse Event Reporting System (VAERS),” Public Health Service, 1986.

 

18.   “Reportable Events Following Vaccination,” VAERS, op. cit.

 

19.   Griffin, R., et al., “The Risk of Seizures and Encephalopathy after Immunization with the DPT Vaccine,” Journal of the AMA 263:1641, 23 March 1990.

 

20.   Cherry, J., “Pertussis Vaccine Encephalopathy: It’s Time to Recognize It as the Myth That It Is,” Editorial, Journal of the AMA 263: 1679, 23 March 1990.

 

21.   “Pertussis Surveillance: United States, 1986-88, MMWR Report, Journal of the AMA 263: 1058, 23 February 1990.

 

22.   Family Practice News, 15 November 1990, p. 6.

 

23.   Boston Globe, 11 June 1991, p. 1.

 

24.   Medical World News, 14 April 1986, p. 53.

 

25.   Simberkoff, M., et al., “Efficacy of Pneumococcal Vaccine in High-Risk Patients,” New England Journal of Medicine 313:1318, 20 November 1986.

 

26.   Family Practice News, 15 December 1990, p. 1.

 

27.   Selected Writings of Paracelsus, Pantheon, New York, 1958, pp. 50, 76.

 

28.   Lao Tzu, The Way of Life, trans. W. Bynner, Perigee, New York, p. 46.

VACCINATION: A SACRAMENT OF MODERN