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Thursday, December 29, 2016

Fluoridation: A Struggle With Titans - Then and Now

One of the first scientists to doubt and then oppose fluoridation had impeccable credentials and made amazing medical discoveries.  Yet, his fluoride expertise was disregarded.  George L. Waldbott, MD, wrote a book detailing how science and common sense was ignored  to promote and protect fluoridation (just as it is today.  Only the "titans" have changed.) This is Chapter 1: ("Why I Became Curious") in Waldbott's book A Struggle With Titans.

"What do you know about fluoridation?"
This was my wife's greeting late one afternoon in the spring, 1953, upon my return from a busy day in  my office.

"Fluoridation?" I question.  "Fluoridation? - I do know something about fluorine. It is a poisonous gas. Like chlorine it belongs to the halogen group, but-fluoridation? I confess that I am only vaguely familiar with the subject."

"I just read an article about it in a magazine called The Freeman," she replied. "It told the full story. The United States Public Health Service (USPHS) is adding fluoride to drinking water in a number of American cities. It is supposed to prevent tooth decay."

"Fluoride is a gas. Is it being added to drinking water?" I inquired. "Who wrote this article?"

"The author?  What was his name? Let me get it. His name is Rorty, James Rorty. No, it isn't the gas that is added to the water, it is fluorine salt, sodium fluoride."

"Fluoridation? The current US medical literature has only occasionally dealt with it. If sodium fluoride really prevents tooth decay this would certainly mean progress. It would reach every person in a community. But is it wise to add a chemical to water other than to purify it?" I asked.

"This is the very idea. The article objects to it. It says that fluoride salts are extremely poisonous. they are used to kill rodents." This remark aroused my attention, but I felt sure that in such small amounts it would not be harmful.

"Oh, I wouldn't be concerned. The USPHS certainly must have made enough studies  to make sure that there cannot possibly be any harm. They have excellent scientists. They have every medical and dental school at their disposal to carry out controlled studies. They must know what they are doing. Who are we, you and I, to question their decision?"

This settled the matter for the time being. I had my hands full. It was hay fever season, the time when I am unusually busy in the office and dead tired in the evenings. Furthermore, I was devoting all my spare time to preparing an article for the newly formed medical magazine, GP.  I was on their consulting staff and felt that I should make a contribution. I had just completed some studies on dermatitis, an allergic skin disease. In my book entitled Contact Dermatitis where my observations had been assembled, I had proposed a new approach for determining the cause of this disease. A most intriguing endeavor, it presented to the profession a glimpse into the detective workshop of an allergist. I was thoroughly preoccupied and my good wife knew it.

That night, after the lights in the bedroom had been turned off, she asked again:

"I have been thinking about that article. There was a Hearing in February, 1952, in Washington DC, before the House Select Committee to Investigate the Use of Chemicals in Foods and Cosmetics, according to the article. Experts on both sides were heard. It was brought out that the question of toxicity and possible damage from fluoride added to water is very much up in the air. There are still too many unanswered questions."

"If this is true, " I assured her "they will be answered by the proper authorities, particularly by the American Medical Association, before the USPHS introduces fluoridation on a large scale."

"But, no" she explained, "it is already being used in many cities in the United States and no one knows how much harm it can do!"

At breakfast she brought the subject up again.

"I have been thinking about that fluoride business again during the night couldn't the America Medical Association be in error? Don't medical ideas and medical practices change, especially when they are new and inadequately tested?

"Look at your own experience with the case of a penicillin death! No one would ever have predicted that this most valuable wonder drug could be harmful under certain conditions; that it could even cause death. There is evidence that milk contains penicillin in small amounts. Isn't this liable to sensitize people, especially your own allergic patients?"

The reference to penicillin aroused mixed feelings. One of my patients had died suddenly after an injection of penicillin for a chronic lung infection. It was the first case of its  kind ever reported in the medical literature. It appeared in 1949 in the Journal of the American Medial Association.  A middle aged lady with asthma had been given several injections of penicillin. Since she had greatly benefited from this drug, she asked me to instruct her sister, a registered nurse, to let her have a few doses at home. Within ten seconds after the injection of a relatively small dose of 30,000 units she collapsed and expired. No one could have known that during the two to three weeks which had elapsed from one injection to the other she had become allergic to the drug.

The wonder drug - penicillin - which was, and still is, the greatest saver of lives also has the  power to kill. My report, the first of its kind, made a definite impact on our approach to penicillin therapy.  Time magazine covered it in its March 7, 1949, issue. Up to that time hives, dermatitis and other allergic trouble were known to result from penicillin, but no one had died from it.  My report alerted physicians to the potential danger of using it indiscriminately.

"Valuable as penicillin is, do you think anyone would even so much as suggest that it be added to drinking water to prevent imminent infection on a large scale?" she asked.

I had nothing to add. Somehow I couldn't entertain the thought that the AMA would endorse anything unless they knew exactly what they were endorsing.

"You can't discount, " she continued, "the importance of the testimony of some of the country's most respected career scientists who presented unfavorable evidence at the Washington, D.C. hearings."

"If they were competent scientists," I replied, "they would have registered their views with the AMA.  Every so often quacks and charlatans are admitted at public hearings to give medical testimony. They act as so-called experts, yet they are in no way qualified. Do you remember ten or fifteen years ago when I appeared at a Detroit Federal Court as a key witness for the US Food and Drug Administration in the trial against a physician who claimed to cure cancer and 'allergies' with a single injection? What an assortment of so-called 'experts' appeared in his behalf. their testimonials regarding cancer cures made no sense to anyone with a scientific background; yet most of the men testifying for him were bona fide MD's qualified physicians."

"But - No!  The hearing in Washington was quite different," she retorted. "The witnesses representing the opposition were outstanding scientists, leaders in fluoride research! Some of them had done research for a lifetime - let me ask you this: Can't 'real experts' be mistaken, too, on some questions?"

My wife had seen an article in the Seattle times of Dec. 15, 1952, which stated that The Aluminum Company of America had offered many grants to research groups for a solution of their serious disposal problem. Fluorides, by-products especially of the aluminum, steel and fertilizer industries, contaminated the atmosphere and induced poisoining of livestock and damage to plant life.
"The PHS," she stated, "is collaborating closely with industry in the disbursement of research funds to overcome the menace. Isn't it possible that a conflict of interest might tarnish the objectivity of a researcher holding an influential position?"

This thought was revolting to me. to think of scientists in the PHS as being motivated by politic and/or buy personal gain - a fantastic accusation!

"How can you make such a statement?" I retorted irately. "the men in the PHS are scientists, highly respected altruistic scientists."

At that time I would not have believed what happened a few years later. According to Time, May 30, 1960, p. 3, a director of a branch of the PHS, Dr. Henry Welch, was  obliged to resign his post because he had received $260,766.00 derived in one way or another from the interests he was sworn to regulate." How a scientist with the best intentions can be caught in a dilemma I learned from my own experience.

Indeed, at this moment I myself, was the recipient of a sum of money "for research." Strangely enough, I was completely unaware of what later turned out to be its real purpose, namely to bury the facts should the study  produce results not in harmony with the donor's aims. Whether or not such money is "compensation for services" is a matter for individual interpretation. This is how it happened:

In 1953, I described a new disease in the Journal of the AMA which I termed "Smoker's Respiratory Syndrome."

This condition closely simulates asthma. It begins with a chronic inflammation of throat and pharynx which gradually descends into the bronchial tree. I had observed it many times in my extensive allergy practice among people who had been steady cigarette smokers. I had never attributed it to smoking. These patients cough and wheeze as though they had real allergic asthma. they have pains in chest and arms in conjunction with this cough.

Through a peculiar coincidence I was able to discover the cause of a disease which others as well as myself had encountered many times in their daily practice but had never been able to explain:

I, myself, had suffered from it.

Wheezing in the chest had gradually increased. It was especially noticeable in the morning. Day after day I coughed up heavy mucus. My throat was constantly irritated. I realized it could not be bronchial asthma, a disease to the study of which I had devoted my life's work. The next logical diagnosis to consider was cancer of the lungs.

I was faced with hospitalization for bronchoscropic examination, a rather unpleasant procedure. Reflecting upon the course of my ailment, it occurred to me that my cough and wheezing were usually worse on Monday mornings than during the balance of the week. On Sundays I was in the habit of smoking incessantly; during the week I could only smoke at mealtime, since most of my asthma patients could not tolerate tobacco smoke in my office. I decided to stop smoking.  To my surprise, after about three weeks time this peculiar disease which had been a source of much concern to me had promptly and completely subsided.

Those who have done research know only too well how practically every new discovery is subjected to critics. Most of it comes from individuals with little knowledge of the subject. Critiques, however, are desirable. They stimulate further thought and work. surprisingly, my report in the AMA Journal aroused very little adverse criticism. Numerous physicians throughout the country congratulated me on pinpointing this new disease and its source. Many who read my article recalled cases in which they had made an incorrect diagnosis as had I many times.

Eight years later, two Boston clinicians, Dr. F. C. Lowel and Dr. W. Franklin, followed my lead and reported on the more advanced state of this disease, chronic emphysema. this represents a serious complication interfering considerably with the function of the lungs and even affecting the heart.
One morning a letter arrived from a well-known physician a consultant to many news magazines and drug companies. He asked me to do some research for one of the cigarette companies for which he acted as intermediary. He suggested that I set up a research program to determine whether or not a newly devised cigarette filter might prevent the disease that I have described. He asked how much money such an investigation would entail.

For a controlled study I suggested that patients, once they had recovered their health, be asked to smoke the particular brand of filtered cigarettes. Bacteriological tests, tissue examinations and lung function studies were to be done before and after the experimental period. I determined the amount of money necessary for those who were to assists me in this project, for the equipment that had to be purchased and for my own services. The research was bound to make considerable demands on my time. Several thousand dollars were involved.

When the work was completed and ready for publication I was told that the company would publish it at some future date.  It was to be a portion of a comprehensive report together with two or three other pieces of research by other investigators who had made similar studies. I dismissed the entire subject from my mind in the firm belief that the company's representative would eventually publish it in one of the medial journals which he edited.

This was never done because my report had not shown that the cigarette filter prevented the disease. After several months, when I inquired about its fate, I was assured that the article would be published eventually. After the lapse of many more months, I requested the article's return, but no answer was ever forthcoming.

As I was later to realize, the outcome of this research is related to what is happening with respect to research on fluoride:

As physicians we may be confronted with a common disease. We would never suspect its origin or its precipitating cause until someone first clearly pinpoints its manifestations and relates cause to effect. Since I became aware of the ill effect of smoking by the simple expedient of advising a person  to discontinue it, many others, like myself, have been cured - and I use this term advisedly, many of these patients had been incorrectly diagnosed as "intrinsic" or "idiopathic" asthma, i.e., asthma, without cause. Indeed this disease has taken many a life without anyone, not even the greatest experts in medicine and pathology, so much as suspecting that cigarettes were the cause.

My experience with the cigarette company demonstrates something much more significant than the establishment of a scientific fact or the discovery of a new disease:

Research which does not prove a predetermined theory is often not published. Its results can be shelved by its sponsor. Even the investigator engaged to carry out research may not ever learn why. Nevertheless, my wife's suggestion that scientists cooperating with industry might abandon their objectivity to do their benefactors' bidding did not shake my faith in their integrity.

A few years later, in 1956, a newspaper report in the St. Louis Post Dispatch, May 18, evoked further skepticism about the US Public Health Service concerning their promotion of fluoridation:

The late famous St. Louis, Mo., surgeon, Dr. Evarts A. Graham, had delivered the Roy D. McClure lecture at Detroit's Henry Ford Hospital. Dr. Graham was critical of the USPHS because they failed to warn the public about the hazard of cigarette smoking.

"If there were as much evidence that spinach caused cancer of the stomach, the USPHS would have plastered the country with placards", Dr. Graham stated.

He expressed the hope that the scientists conducting a $1,500,000 dollar research program for the tobacco companies "won't set up a smoke screen."

Dr. Graham "charged the tobacco companies with campaigning to offset lagging sales by starting people smoking at a younger age", the Post Dispatch reported.

The PHS seemed to accept the explanation of manufacturers of cigarettes that air contamination, not smoking, is the principal cause of lung cancer.

I wrote to D.r Graham concerning his views on fluoridation. Judging from his own experience, he was convinced that not all was well on the fluoridation front. He blamed the PHS for launching a project fraught with danger.

My experience with the tobacco company had aroused my misgivings about some industry-sponsored research.

My strong rebuke to my wife when she mentioned that scientists might have ulterior motives ended our discussion of fluoridation.

She, however, was not satisfied with my answer. The next morning several letters were ready for mailing, addressed to scientists who had appeared as expert witnesses in opposition to artificial fluoridation at the Washington hearing in February, 1952.