The performance must stop. What to do? The conductor, believing the show must go on, may invite his principal drummer to replace the principal violinist. But the result will be cacophony, not symphony. The performance can resume only when the principal violinist recovers from her faint and can play again. Any single nutrient in the symphony of life is much like that principal violinist—it cannot be replaced by the wrong nutrient or by any drug.
ORTHOMOLECULAR PSYCHIATRY
Orthomolecular psychiatry has the same relationship to orthomolecular medicine as does orthodox psychiatry to orthodox medicine. Every patient with any disease has a psychological reaction or component that may be very minor and not require any psychiatric treatment, or it may be of such severity as to necessitate psychiatric treatment. For many patients, both specialties must work together.
Orthodox medicine tends to think in organic or psychological terms. If a thorough physical examination and tests do not reveal a sufficient explanation of the symptoms, then that patient’s illness is promptly dumped into the psychiatric area. Even the use of psychosomatic medicine has not altered this, for to most physicians psychosomatic medicine is looked upon as a disease with physical symptoms caused by psychological factors. In short, these physicians lump both psychiatry and psychosomatic medicine together.
Orthomolecular physicians recognize that a large fraction of the psychiatric patients are ill due to physical factors, not due to any organ dysfunction. The usual tests do not reveal pathology. These physical factors are changes in metabolism and/or nutrition. They might be looked upon as humoral factors or as a third category of illness. When treated successfully, the psychiatric symptoms clear. Very little psychotherapy is required, and that can be given by any competent physician.
In my practice, I have estimated that if each referring physician were to first place his or her patient on an orthomolecular regimen and wait up to three months, I would lose half my practice. Patients who require orthomolecular psychiatrists suffer from prolonged anxiety or depression, or from schizophrenia, or from other disorders that the general practitioner is not equipped to deal with due to lack of time, experience, or skill. A few orthomolecular physicians have been very successful in treating large numbers of schizophrenics, most of them failures of orthodox psychiatry (drug treatment alone).6
The same basic principles apply to orthomolecular psychiatry—the principle of individuality, the orchestra principle, and, very importantly, the recognition of the syndromes that comprise psychiatric diagnosis. None of the psychiatric diseases are homogeneous but rather are caused by a variety of factors. For example, psychiatrists have divided schizophrenia into a number of subgroups, such as catatonic, paranoid, etc. This differentiation is based on clinical descriptions but is of little value since they do not endure, nor do they help indicate which treatment should be used. The syndromes that orthomolecular psychiatrists use are based on causal factors and do help determine treatment.
A source of conflict between orthomolecular and other physicians is their expectation of the quality of recovery. Expectations of recovery depend on one’s experience of the quality of recovery. Psychiatrists who use tranquilizers only expect that they will reduce the intensity of symptoms in nearly every patient, provided they have selected the most efficient dose. But they expect few recoveries, and over the years they have learned the cost to patients for the relief they have gained—the inability to function normally in the community and neurological side effects. Tranquilizers work rather quickly and rapidly control symptoms, but they do not bring about recovery in many patients.
Orthomolecular psychiatrists combine the rapid effect of tranquilizers in reducing symptoms with the slower effect of a nutrient treatment in reaching recovery. They see a much larger proportion of schizophrenic patients get well to a degree not seen by tranquilizer therapists. The latter group believes that orthomolecular therapists are prone to exaggeration. Tranquilizer physicians with the usual prejudices against nutrients who have seen the results of treatment on their patients are usually astonished at the quality of recovery. When a patient has recovered, one does not need a questionnaire or scale to determine this. In sharp contrast, tranquilized patients may appear to be better, even though there has been no improvement in their psychosis.
LOCAL VERSUS SYSTEMIC DISEASE: A FALSE DISTINCTION
Medicine began thousands of years ago when the first human-associated discomfort was something visible or palpable, like a boil or swollen ankle or fracture. A local condition was connected with consequent discomfort. Much of today’s medicine still includes this simple cause-and-effect medicine, except that we have sophisticated technology and can make visible the pathology that could not have been visualized several decades ago. We use x-rays, computerized axial tomography (CAT) scans, and even more technologically advanced machines to show us where internal structures are abnormal.
Local, topical, or organ medicine treats a fraction of the illnesses, and perhaps only a minor fraction. The rest of medicine must deal with metabolic reactions that affect the entire body, even though the major problem may arise from one organ, such as the thyroid, pituitary, or adrenal glands. Metabolic abnormalities may be genetic, expressing themselves very early like Down syndrome, or they may come late, as does Huntington’s disease. They may arise from nutritional deficiencies, such as scurvy, beriberi, pellagra, zinc deficiency; or from toxic reactions due to heavy metals, such as mercury, copper, nickel and cadmium; or from reactions to halogens, such as fluoride or chlorine. They follow invasions of the body by viruses, bacteria, fungi, and large parasites. Distortions of the immune defense system also cause generalized metabolic stress reactions. Shock, both physical and psychological, also perturbs the body’s metabolism for as long as those stressors operate. These general or systemic diseases differ from local ones because they cannot be seen as bumps or anatomical changes. They must be inferred from the nature of the illness and symptoms, or by the use of laboratory tests on various body fluids or tissues.
There is another major difference between local and systemic diseases. Local diseases much more frequently produce a unique constellation of signs and symptoms (a syndrome). When such a syndrome is present, it points back to that local disease. Thus, angina pectoris (pain in the chest on effort) points to the heart as a source of the discomfort. Systemic diseases seldom have a specific syndrome—a listing of all the possible signs and symptoms of any systemic disease would require many pages. For example, mercury poisoning causes a variety of neurological, medical, and psychiatric signs and symptoms. Fluoride intoxication may cause as wide a range of symptoms, but pellagra may provide a similar set of problems. For each type of metabolic dysfunction, there may be a unique marker among the wide variety of afflictions. Thus, mercury intoxication may appear as a discoloration of the gums or teeth and scurvy will cause obvious degeneration of connective tissues. But often these markers are not obvious and always they are too late, for every metabolic disease becomes more difficult to treat successfully the longer it has been present.
With local conditions one will ask, “Where is the lesion?” while with systemic conditions one must ask, “What has caused the whole body to be sick?” Local conditions usually cause a narrowly defined syndrome that can be severe in nature and cause severe pain and discomfort. Systemic conditions are more apt to cause a widely diffuse set of complaints, ranging from fatigue and vague aches and pains to vague gastrointestinal disorders, skin irritations, and so on. When such a patient must be diagnosed, one can then rule out fairly quickly local causes and begin to search for the systemic causes. It would be costly and inefficient to examine each patient for every possible systemic cause. The first examination should be based on the most probable cause, which is obtained from the history. The common factors, such as nutrition and the environment, are examined first.
In my experience, up to 75 percent of systemic conditions are caused by problems in adjusting the body’s need for
