Date:   2/9/2008 4:00:02 PM ( 16 y ago)
Hits:   678
URL:   https://www.curezone.org/forums/fm.asp?i=1107163

http://www.bmj.com/cgi/eletters/335/7626/910#179199

William T. Harvey, MD,
Clinician/Research Coordinator
Rocky Mountain Chronic Diseases Specialists

8 December 2007

One notes with interest...and dismay... the number of responses to the “Lyme Wars” topic thirty years after Steere published the Lyme hypothesis[1, 2]. There should be little residual conflict given that the birth of critical thinking began centuries ago with the Renaissance via many European and UK thinkers, including physician William Harvey (reference intended). The arguments now appearing as BMJ “Lyme Wars” letters surprisingly ignore the insight shift of Harvey’s Padua University schoolmate, Nicolaus Copernicus. Although the essence of De motu cordis was that truth lay in the reality at hand, a century earlier Copernicus first made an even more fundamental point, that co-variants do not prove cause-and-effect. Unexpectedly, both concepts are ignored so frequently in the Lyme Wars thread that collectively they illustrate what has happened to recent scientific thinking and immediately clarify how such arguments can occur. Truth seems to lie in the simplest concepts, as Einstein had hoped. Here, brought to a grade school level is the concept that has invalidated most Borreliosis research over the past three decades: The finding of Borrelia in a chronically ill human does not prove Borrelia generated the illness. No one has ever elucidated the mechanism by which Borrelia exerts its claimed pathophysiology.

When Willie Burgdorfer first encountered Borrelia (burgdorferi sensu lato) in acutely ill New England patients, the correlation was initially made. Subsequently, it was verified numerous times in endemic areas of the planet. Ultimately, the numbers reached mathematically validity and in time revealed a zoonosis cycle bridged by at least one arthropod vector. This correlation came from Epidemiology devoid of a pathologic mechanism, but was strong enough to make the case for an acute illness. This method, as weak as it was, gave rise to the present US CDC case criteria for Lyme disease as an acute, readily treatable illness with predictable (but not well understood) signs and symptoms. What then is the dilemma where acute Lyme disease and chronic Lyme disease are juxtaposed in a mortal face-off? Enter semantics.

This dilemma did not occur in a vacuum. Outside the boundary of a relatively limited acute zoonosis, there must exist yet another illness; an illness so serious and pervasive that many astute clinicians and a few scientists would go to any means to give credibility to that illness. An NLM search taking only seconds will indeed uncover a veritable ocean of persistently ill humans with these similar characteristics: Their illness is chronic, multi-systemic, unpredictably varied, possibly life shortening, unsolved and appropriately kept outside the taxonomy of proven illnesses. The number of assigned labels is extraordinarily large, however, and vastly more inclusive than chronic Lyme disease is thought to be. If such an illness exists it necessarily would engender extreme clinical passion. And given no support by traditional science, labels would be found in large numbers, with similar descriptors, and would emerge as historical counterparts. This phenomenon has indeed occurred. Awareness began to appear between 1970-1980. New semantic identifiers such as Chronic Fatigue Syndrome, Fibromyalgia syndrome...and since the mid- 1980s, chronic Lyme disease…are only three.[3-13] If we follow the theme of similar intermittent laboratory abnormalities, basic abnormal physical findings and fundamental chronic symptoms, at least two-dozen other groups such as Bannwarth’s syndrome, Ekbom syndrome, Asperger’s syndrome and others emerge.[14-23]

A short foray into the universe of illness labels above reveals similar “wars” underway since 1980: Chronic Fatigue Syndrome (CFS) VS chronic Fibromyalgia syndrome (Fibromyalgia); CFS VS chronic Lyme disease (Lyme); Lyme and CFS VS Gulf War Syndrome (GWS) are among the obvious. Clinicians fortunate enough to encounter this larger chronically ill group outside of New England (where vector prevalence of Borrelia is high) were not tempted by Borrelia as a generator of chronic illness.[24-29] Rather, their semantic choices emerged from such random events as participation in recent wars, or travel to high-humidity regions where fungi are rampant.

In summary, Lyme Wars if followed to its root, is a failure of our medical education system to insist on teaching scientific method, and beginning that with the foundation of all truth: language (semantics). Something did likely occur in the world of human disease some 30 years ago as these “wars” attest to. “It” could be attributed to the population explosion, global warming, excess computer use, or even larger numbers of vaccines. But, I choose to wait until science shows us the mechanism rather than join the twenty first century’s trust in celebrity (trust papers from the most notable journals…or be pulled into the current “matrix” of popular mindset) rather than face the factual illness only where it exists: the patient. Even medical wars are cognitive constructs, generated by the human mind. If we are ever to get the term “evidence based medicine” correct, this is our wake up call. The “evidence” as Harvey showed us in the sixteenth century is in the ill (or deceased) human, not textual material often outdated before it reaches print. (812 words)

References

1. Steere, A.C., J.A. Hardin, and S.E. Malawista, Erythema chronicum migrans and Lyme arthritis: cryoimmunoglobulins and clinical activity of skin and joints. Science, 1977. 196(4294): p. 1121-2.

2. Steere, A.C., et al., Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three connecticut communities. Arthritis Rheum, 1977. 20(1): p. 7-17.

3. Eidelman, D., Fatigue: towards an analysis and a unified definition. Med Hypotheses, 1980. 6(5): p. 517-26.

4. Ballow, M., et al., Familial chronic mononucleosis. Ann Intern Med, 1982. 97(6): p. 821-5.

5. Uretsky, B.F., Does mitral valve prolapse cause nonspecific symptoms? Int J Cardiol, 1982. 1(5-6): p. 435-42.

6. DuBois, R.E., et al., Chronic mononucleosis syndrome. South Med J, 1984. 77(11): p. 1376-82.

7. Yunus, M.B., Primary fibromyalgia syndrome: current concepts. Compr Ther, 1984. 10(8): p. 21-8.

8. Caligiuri, M., et al., Phenotypic and functional deficiency of natural killer cells in patients with chronic fatigue syndrome. J Immunol, 1987. 139(10): p. 3306-13.

9. Byrne, E. and I. Trounce, Chronic fatigue and myalgia syndrome: mitochondrial and glycolytic studies in skeletal muscle. J Neurol Neurosurg Psychiatry, 1987. 50(6): p. 743-6.

10. McLaughlin, T.P., et al., Chronic arthritis of the knee in Lyme disease. Review of the literature and report of two cases treated by synovectomy. J Bone Joint Surg Am, 1986. 68(7): p. 1057-61.

11. Kriuchechnikov, V.N., [Chronic migrant erythema or Lyme disease--a new tick-borne Spirochaetales infection]. Zh Mikrobiol Epidemiol Immunobiol, 1985(9): p. 101-9.

12. Eschard, J.P., et al., [Lyme disease without arthritis: presence of antiBorrelia burgdorferi antibodies in meningoradiculitis following chronic erythema migrans]. Presse Med, 1985. 14(28): p. 1517-8.

13. Ryberg, B. and I. Thelin, [Lyme disease in Sweden. A patient with arthralgia associated with chronic erythema migrans]. Lakartidningen, 1984. 81(30-31): p. 2758-60.

14. Calabresi, P.A., et al., Ekbom's syndrome: lipomas, ataxia, and neuropathy with MERRF. Muscle Nerve, 1994. 17(8): p. 943-5.

15. Sojka, E. and Z. Afeltowicz, [Ekbom's syndrome in a patient with mitral valve disease and subacute endocarditis]. Pol Tyg Lek, 1978. 33(17): p. 691-2.

16. Harriman, D.G., D. Taverner, and A.L. Woolf, Ekbom's syndrome and burning paraesthesiae. A biopsy study by vital staining and electron microscopy of the intramuscular innervation with a note on age changes in motor nerve endings in distal muscles. Brain, 1970. 93(2): p. 393-406.

17. Fox, W.B., Ekbom's syndrome. J Am Inst Homeopath, 1967. 60(1): p. 26.

18. Roelcke, U., et al., Untreated neuroborreliosis: Bannwarth's syndrome evolving into acute schizophrenia-like psychosis. A case report. J Neurol, 1992. 239(3): p. 129-31.

19. Henriksson, A., et al., Immunoglobulin abnormalities in cerebrospinal fluid and blood over the course of lymphocytic meningoradiculitis (Bannwarth's syndrome). Ann Neurol, 1986. 20(3): p. 337-45.

20. Tantam, D., Asperger's syndrome. J Child Psychol Psychiatry, 1988. 29(3): p. 245-55.

21. Bowman, E.P., Asperger's syndrome and autism: the case for a connection. Br J Psychiatry, 1988. 152: p. 377-82.

22. Wing, L., Clarification on Asperger's syndrome. J Autism Dev Disord, 1986. 16(4): p. 513-5.

23. Kerbeshian, J. and L. Burd, Asperger's syndrome and Tourette syndrome: the case of the pinball wizard. Br J Psychiatry, 1986. 148: p. 731-6.

24. Harvey, W.T. and P. Salvato, "Lyme disease": ancient engine of an unrecognized Borreliosis pandemic? Medical Hypotheses, 2003. 60(5): p. 742 -759.

25. Burgdorfer, W., Discovery of the Lyme disease spirochete and its relation to tick vectors. Yale J Biol Med, 1984. 57(4): p. 515-20.

26. Pokorny, P., [Incidence of the spirochete Borrelia burgdorferi in arthropods (Arthropoda) and antibodies in vertebrates (Vertebrata)]. Cesk Epidemiol Mikrobiol Imunol, 1989. 38(1): p. 52-60.

27. Burgdorfer, W., Vector/host relationships of the Lyme disease spirochete, Borrelia burgdorferi. Rheum Dis Clin North Am, 1989. 15(4): p. 775-87.

28. Burgdorfer, W., et al., Relationship of Borrelia burgdorferi to its arthropod vectors. Scand J Infect Dis Suppl, 1991. 77: p. 35-40.

29. Baranton, G., N. Marti Ras, and D. Postic, [Borrelia burgdorferi, taxonomy, pathogenicity and spread]. Ann Med Interne (Paris), 1998. 149(7): p. 455-8.

30. Williamson, P.K. and J.J. Calabro, Lyme disease--a review of the literature. Semin Arthritis Rheum, 1984. 13(3): p. 229-34.

31. Berger, B.W., O.J. Clemmensen, and A.B. Ackerman, Lyme disease is a spirochetosis. A review of the disease and evidence for its cause. Am J Dermatopathol, 1983. 5(2): p. 111-24.

<< Return to the standard message view

fetched in 0.01 sec, referred by http://www.curezone.org/forums/fmp.asp?i=1107163