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From the publisher.

Ebola and Measles

Two virus newsmakers, Ebola in 2014 and measles in 2015, both appear to be on the wane. Ebola is notably having a drop in its fatality rate, and there is no apparent explanation. Physicians who work for the international medical group Doctors Without Borders have observed that a higher percentage of treated patients are surviving Ebola--50% instead of a 40% survival seen in 2014. Although there is greater organization administering hydration and other noncurative measures, workers do not believe that this explains the improved survival. Another explanation is that Ebola has evolved or mutated, making it a less fatal infection, but genomic sequencing has not substantiated this theory. Nevertheless, the reduced fatality rate is welcome news for Ebola workers who have been struggling to contain the infection in Guinea, Sierra Leone, and Liberia.

On the home front, the incidence of measles appears not to be explosively increasing, a major worry of US authorities. The question of measles vaccination remains a chief concern both medically and politically. Public health strategy is heavily supporting new legislation mandating greater vaccination compliance and less opportunity for opting out. However, many libertarian-minded individuals as well as natural-health advocates object vehemently to mandatory vaccination programs. The social media are replete with reports testifying to the ineffectiveness of vaccination and concern about its medical risks and complications. Legislative efforts in California, Oregon, and Washington State all failed to increase mandatory vaccination rules.

Of particular concern to the readership of the Townsend Letter is the difficulty in being "open-minded" in this discussion; most parties are either all for or all against vaccination. Naturopathic physicians and integrative doctors should not be pigeonholed into making this an all-or-none position.

National college of naturopathic medicine visit

In February, after completing a continuing medical education course in Portland, Oregon, I visited with my wife, Deborah, the campus of the National College of Naturopathic Medicine. We were surprised to receive the red-carpet treatment by the school; we had thought we would enjoy a Friday afternoon having a short meeting with the president, David Schleich, PhD, followed by a tour. Dr. Schleich convened the academic deans for naturopathic education, Chinese medicine, and academic research. NCNM has had the longest-running four-year ND program of all naturopathic colleges. However, in the past decade NCNM has added certificate programs in homeopathic medicine, naturopathic obstetric-midwifery, integrative mental health, as well as advanced studies in classical Chinese medicine, qi gong, and shiatsu. NCNM has opened a center for research that is actively pursuing grants for naturopathic research on and off campus. NCNM's medical clinic offers naturopathic treatment, Oriental medicine, and other clinical services while embracing insurance requirements with electronic medical records and coding. The campus has dramatically expanded in the past several years, occupying numerous buildings and grounds, including a convention center and alumni building in southwest Portland.

David Schleich has played a major role in the renaissance of NCNM during his past seven years as president. He was formerly president of the Canadian College of Naturopathic Medicine (CCNM) and before that executive of a health concern and an undergraduate college. Schleich is determined that a naturopathic college must be organic, growing, and passionate in its pursuit of excellence. He is very strong in assessing financial matters and has actively brought in community leaders to help capitalize NCNM. Schleich has recruited new faculty, especially research members who are emphasizing the need for evidence-based study in naturopathic medicine. Still, Schleich's academic and business work are tempered by his earlier studies as a graduate student in English--he balances the academics with a need for play, especially music.

Deborah and I enjoyed our tour of the campus, particularly the library's collection of rare books curated by David's wife, Sussanna Czeranko, ND. Some of the readers may know of Sussanna and David by their writing in the Naturopathic Doctor News & Review (NDNR), wherein they have regular columns. Sussanna is a 1994 graduate of the CCNM and practiced naturopathic medicine in Quebec and Toronto before coming to Portland in 2008. Sussanna's love of naturopathy's past has focused on preserving the writings of the old-time naturopaths from the late 19th and early 20th centuries. She particularly has enjoyed the writing of New York City naturopath Benedict Lust, who not only maintained long-standing naturopathic clinics and spas but also published his own journal of naturopathic treatment. Lust was a strong proponent of natural hygiene, especially hydrotherapy, applying hot and cold compresses alternatively. Authorities were not enthralled with Lust, and the medical establishment frequently reprimanded and jailed him. Czeranko is publishing the work of Lust and others in an 8-volume series on nature cure topics. The books are called the Hevert Collection and are the main publication of the NCNM Press. To order the first two books, Origins of Naturopathic Medicine and Philosophy of Naturopathic Medicine, see www. ncnm.edu/origins.

Deborah and I were also treated to dinner and hospitality at David and Sussanna's lovely home.

Psilocybin with your Hospice Care?

Ever since the Nixon's administration's ban on psychedelics in the early 1970s, research in the use of LSD and psilocybin has been prohibited due to their Schedule I classification by the DEA. In the 1950s and later in the 1960s, when recreational use was ubiquitous, researchers found that psychedelic agents were beneficial in treating addiction, depression, anxiety, and existential difficulties. For more than three decades, the early experiments, not hippie trips, by scientists lay buried in abandoned journal archives. However, in July 2006, Roland Griffiths, PhD, a highly regarded neuroscientist at Johns Hopkins, published a paper with his colleagues in Psychopharmacology titled "Psilocybin Can Occasion Mystical-Type Experiences Having Substantial and Sustained Personal Meaning and Spiritual Significance." Unlike the work done in the 1960s, Griffiths's double-blind study used 36 volunteers who had never experienced a psychedelic drug and "treated" them with either psilocybin or Ritalin as a control, then repeated the study reversing the drugs used in each group. The individuals receiving psilocybin, but not the Ritalin group, experienced as a whole a significant mystical experience. Further, most of the individuals felt that the experience was among the most meaningful experiences of their lives, comparable to experiencing the birth or death of a loved one. When these individuals were asked to comment about how the psilocybin experience affected them a year later, most felt that it remained among their most meaningful experiences and continued to affect their lives. It should be noted that Griffiths's group needed to convince skeptical physicians and researchers at the DEA, FDA, and numerous research review boards at Hopkins. They had no journal articles to support their research hypotheses except what had been "unearthed" 30 years earlier.

Armed with this respected study, researchers at New York University School of Medicine, Tony Bossis, PhD; Stephen Ross, MD; and Jeffrey Guss, MD, who had organized a "reading" group on psychedelic research, decided that they would design a study to determine if psilocybin would affect anxiety and "existential distress" in cancer care. While Griffiths's work did pave the way for the NYU workers, convincing the IRB groups and the DEA and FDA was no cakewalk. However, in 2010, they had successfully organized a clinical study at NYU. A journalist, Patrick Mettes, entered the study after reading a newspaper ad for volunteers; he had advanced liver cancer and was faring poorly on chemotherapy. Mettes documented his experience receiving psilocybin and the 17 months that followed until his death. Mettes experienced a profound change in his overall mental well-being, despite the fact that the cancer continued to advance. He spent nearly every day "living" to enjoy what people and life offered him rather than just "dying" from the cancer. A week before he died, he gathered friends and family and staff at the hospital and shared with everyone his "joy" and "happiness"--it was a remarkable event.

Psilocybin is not a self-help treatment, at least not at this time. In the NYU study, the patient is brought into a clinical setting, and after the psilocybin is given in the morning the patient is observed by "guides" who assist with whatever problems arise. There are individuals who become agitated after using psilocybin, what may have been termed in the 1960s a "bad trip," but despite experiencing shocking imagery, hallucinations, or dying, the individual is helped by the guides to get through it. Usually after 6 hours, the psychedelic unreality ends, and returning to reality might be accompanied by a headache. However, the overall experience, a mystical state persists, and the patient now confronts his/her cancer transformed.

An editorial in the January 2015 Lancet supports further psilocybin and LSD research. The possibility that these agents may dramatically counter cigarette, alcohol, and drug addiction looms as breakthrough medicine. Even more significant is the possibility that these agents may counter depression far more dramatically than antidepressants.

Please read Michael Pollan's article, "The Trip Treatment," in the Feb. 9, 2015, New Yorker for a compelling read about psychedelic research.

Chelation Revisited

Two of the articles in this issue are from colleagues who have shared my interest in chelation therapy since the 1980s. John Trowbridge, MD, and Terry Chappell, MD, have endured the longstanding derision of skeptical cardiologists and self-serving "quack busters" who have dismissed chelation as ineffective and dangerous. Too bad for the critics (including Wikipedia); the NIH-sponsored TACT published in 2013-2014 demonstrated no major adverse events. Additionally, the multicenter study revealed substantial cardiovascular benefits, including a reduction in myocardial infarcts, cerebrovascular events, and cardiovascular-related deaths. The TACT report revealed that chelation offered even greater benefit to patients suffering from diabetes. Chappell et al.'s report on "Complete Diabetes Care Now that We Have TACT" provides a rationale for making chelation therapy an important part of the overall treatment program in diabetic patients.

Trowbridge, author of The Yeast Syndrome and Chelation and Other Detox Methods to Save Your Life, titles his article "Ramblings of a Maniacal Frenetic--Pragmatic Reflections on Helping Patients Understand Their Illnesses and Treatments." This article has been on the "drawing board" for quite a period of time, and when he submitted it a year earlier, we deferred its publication. Trowbridge attempts in this lengthy report to put together a no-holds-barred guide to managing cardiovascular disease and other chronic illnesses. He makes the case that while medicine emphasizes diet and exercise, there are important nonsurgical and nonmedical interventions that must be made to rescue the patient from impending medical emergency. Chelation, treating chronic infection, removing toxic burden, improving oxygenation, and restoring mitochondrial functioning are critical early interventions.

Jonathan Collin, MD
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Author:Collin, Jonathan
Publication:Townsend Letter
Geographic Code:1USA
Date:May 1, 2015
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