The history and fundamentals of environmental medicine
Review of An Alternative Approach to Allergies by Theron Randolph and Ralph Moss
This classic book by the founder of environmental medicine describes the basic methods for diagnosing and treating food allergies and chemical sensitivities (MCS). It is a pleasant book to read.
Keywords: environmental medicine, chemical sensitivity, MCS, chronic illness, food allergy, diagnosis, treatment, history, Theron Randolph
Dr. Theron Randolph is an allergist who pioneered environmental medicine for treating allergies and chemical sensitivities (MCS). This book is written for patients, it has little jargon and is easy to read.
There are more than two dozen patient stories throughout the book. They show how different the symptoms can be despite that the underlying problems are so similar, such as food allergies or sensitivity to gas, pesticides or other chemicals.
The history of environmental medicine
Dr. Randolph was an allergist in Chicago who in the 1930s got interested in food allergies. His first research article was a study of patients with migraines, where two-thirds got better when the foods they were allergic to were eliminated from their diet.
In 1947 Dr. Randolph had a puzzling patient. He eventually realized that what made her sick was the air pollution in the city – a totally radical idea at the time.
A few years later he had another puzzling patient. This was a man who appeared to be wildly allergic to apples, but he did not get the searing headaches when he ate an apple from an abandoned orchard. It happened only if he ate an apple from a grocery store. By several experiments they found out he was not allergic to apples, but to the chemical residue on apples that had been sprayed with pesticides.
These observations intrigued Dr. Randolph, who did many experiments over the decades as more patients showed up with these problems. He published a book about it in 1962, and in 1965 he founded a medical society which was originally named Society for Clinical Ecology but in 1986 was renamed to American Academy of Environmental Medicine (AAEM).
Dr. Randolph found that food allergies are a common problem and can cause a wide variety of symptoms that vary from person to person. These include headaches, migraines, arthritis, ADD/ADHD, fatigue, muscle pain, depression, anxiety, and more. Conventional medicine has little help to offer beyond drugs for the symptoms, while Dr. Randolph found that if the allergic food could be identified, and the patient stopped eating it, the symptoms often disappeared.
He stresses that not all people with these symptoms have food allergies, and other possible causes must also be looked into.
He also stresses that there is no standard list of foods to avoid – it has to be tailored to the individual. The most common problem foods are milk, corn, cane sugar and eggs, simply because they are eaten daily by most Americans, but it can be anything. In Asia, rice is a common allergy, since that is a daily stable there.
When trying to identify allergenic foods, a good place to start is with whatever is eaten daily and whatever a person seems to crave. Cravings are a common sign of food allergy, which can show up as an addiction to that food.
Randolph says that food allergies can be permanent or temporary. If they are temporary they can be cured by not eating the allergenic food for several months.
Over the years Dr. Randolph has seen many people made sick from household gas appliances, vehicle exhaust, pesticides, food preservatives, pharmaceuticals, and much else.
He often found that drug intolerances were not to the drug itself, but to the fillers, preservatives and dyes in the pill.
Some patients were not able to tolerate allergy shots from traditional allergists, since they contained the preservative phenol.
He sometimes found that people could become addicted to certain chemicals, which they needed to feel "well," even though they also caused their chronic symptoms.
Brain fog is a descriptive term for a very common symptom in people with these sensitivities. It is impaired or "foggy" thinking that can be so bad that a person who loves to read becomes unable to comprehend even a simple text.
Randolph states that brain fog is "the most characteristic" symptom caused by food sensitivity or chemical sensitivity.
Listening to the patient
Traditional doctors are in a hurry and barely spends any time listening to each patient. Randolph says he typically spends a full hour listening to a new patient, as that often gives important clues on where to start testing. He writes:
I practice "poker-faced medicine," in that I do not pass judgment on a patient's symptoms upon first hearing them, no matter how bizarre they may seem. Many such symptoms later turn out to have significance in the patient's medical history.
The mainstay of Dr. Randolph's treatments was to discover the triggers, whether food or chemicals, and then avoid them. If there are many food allergies, the patient might go on a rotation diet where each basic food is eaten only once every four days. The book covers this method in extensive detail.
Some people are able to regain foods they are allergic to by completely avoiding them for several months.
This reviewer has followed the rotation diet for more than twenty years, and regained nearly all the many foods that used to cause so many symptoms. In some cases it took years to tolerate some foods, in others it took just six months. Randolph's methods clearly helped.
Another of Randolph's treatments is individually customized allergy shots (or sublingual drops). If a patient has a lot of toxic chemical in the body, it can be sweated out in a sauna.
Drugs are rarely used, as they tend to just mask the symptoms and not address the illness at all.
The Environmental Control Unit
Realizing that his patients' homes were often a cause of their symptoms, Dr. Randolph invented the Environmental Control Unit. This was a special hospital ward where the air was extremely clean and free of common household pollutants, such as gas, fragrances, carpets and toxic cleaning agents. The staff also used non-toxic personal care products.
In this controlled environment, patients would typically stay for three weeks, so they could discover what caused their symptoms. Such hospital units were created in several places during the 1970s and 1980s, but they were too costly to operate and the health insurers refused to pay, so they were eventually dismantled. Dr. Randolph treated more than a thousand patients in his unit, before he had to shut it down in the late 1980s.
His own clinic
Randolph's own clinic was located in a tall building overlooking Lake Michigan in Chicago, so the air quality was as good as possible while in a big city. Inside he had eliminated as many problems as he could. Most of his staff were patients themselves, so they voluntarily refrained from using toxic personal care products and could better understand and help the patients.
Dr. Randolph's ideas and results caused a turf war with both traditional allergists and psychiatrists. The pharmaceutical industry wasn't pleased to be exposed as a cause of illness and as merely covering up symptoms.
In the foreword to the book his co-author says:
We all believe we think for ourselves; we rarely do. It is only when we stray outside the bounds of what is considered "normal" that we discover the risks of such self-direction.
Traditional physicians are used to see each patient for just a few minutes, dole out a prescription and then go on to the next paying customer. Randolph's methods would totally upend these physicians' comfortable practices, which was not a welcome idea.
In chapter 16 Randolph comments on the shortcomings of traditional practices:
Conventional medicine recognizes the fact that millions of people are chronically ill and that it can offer little for their arthritis, or migraine, or fatigue, or depression but chemically derived pills. Patients with a welter of confusing symptoms are often treated contemptuously because the underlying cause of the many illnesses go unnoticed. (ch 16)
A patient with a long history and a thick file frequently becomes a "neurotic" in the doctor's eyes, and this judgment is passed along from one doctor to another. In such an atmosphere, doctors tend to become cynical about many patient's complaints, while patients bitterly reject established medicine. (ch 16)
In the last chapter Randolph again talks about the backlash and how traditional allergists were loosing customers so much it was discussed in their magazines. The future of environmental medicine looked very bright when the last edition of this book was published in 1990, but that was the year where major industries got really scared about MCS and within five years they'd successfully painted people with chemical sensitivities as mentally ill, and the doctors who try to help them as quacks. The stigma still holds today.
He ends the book with these salvos:
In almost any area of chronic illness, the failure of conventional medicine is conspicuous, and nowhere more so than in so-called psychiatric disorders.
Psychiatry has a special relationship to clinical ecology, since usually allergy patients have been misdiagnosed as neurotics and psychotics by well-meaning but misinformed physicians. (ch 22)
Some of these people either make the rounds from doctor to doctor, from old therapy to new, looking for an answer to their ill-defined medical problems, or become dropouts from a medical system that has done nothing but malign them ... Often such patients are thrown into that convenient medical wastebasket, the psychiatric category. (ch 22)
Still the best book
The latest edition of this book was published in 1990, but it is still in print and remains the best introduction to environmental medicine.
The fierce opposition from orthodox practitioners has meant no funding for medical research, so the field has not advanced much in the last two decades.
The world has changed some since the book was written. Back then fragrances were not as strong and ubiquitous as they are today, so he barely mentions them, and electrical hypersensitivity (EHS) was nearly unheard of.
Some of the terminology has since changed. He uses terms such as "clinical ecology," which today is called "environmental medicine." We have used the modern terms in this review.
New theories how MCS works have since been created, especially the TILT and limbic kindling theories.
When Dr. Randolph retired in 1993, the local Chicago Tribune newspaper published the article The Allergist That Roared about his life. It is available on their website and well worth reading.
Dr. Randolph passed away in 1995 at the age of 89.
For further reading, we can recommend the book Chemical Exposures: low levels and high stakes (second edition), by Nicholas Ashford and Claudia Miller. It is out of print, but obtainable through libraries and also as a free download from the University of Texas, San Antonio website.
Other books covering environmental illnesses are reviewed on www.eiwellspring.org/booksandreviews.html.