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The Treatment of Infection Without Antibiotics

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  1. The Treatment of Infection Without Antibiotics AANP Annual Conference August 2003 Jared L. Zeff, ND

  2. Goal: to present a system of effective treatment for antibiotic-resistant infections Overview: 1. The scope of the problem 2. Contrasting approaches to treatment 3. Principles of a naturopathic approach 4. Case illustrations

  3. Primary cause of death: 1900 Infectious pneumonia

  4. 1929: Sir Alexander Fleming discovers penicillin. Penicillin is effective against Streptococcus pneumoniae. 1930’s: Howard Florey and Ernst Chain extract and purify penicillin. 1941: British policeman is first person treated with penicillin, dies: insufficient quantity. 1943: Selman Waksman discovers streptomycin. Streptomycin is effective against Mycobacterium tuberculosis.

  5. 1940’s: penicillin available to armed forces. 1950’s: penicillin available to general public. More antibiotics are developed. The age of miracle medicine has arrived!

  6. By the end of the 20th century we will see the “virtual elimination of infectious disease as a significant factor in societal life.” Sir F. MacFarlane Burnett, MD, 1962 Australian Nobel laureate

  7. “…it [is] time to close the book on infectious diseases.” U.S. Surgeon General William Stewart 1969

  8. Causes of Death (2000) • Heart Disease 710,760 • Cancer 553,091 • Stroke 167,661 • Chronic Lung Disease 122,009 • Accidents 97,900

  9. Causes of Death (2000) • Diabetes 69,301 • Influenza and Pneumonia 65,313 • Alzheimer’s disease 49,558 • Kidney disease 37,251 • Septicemia 31,224 National Center for Health Statistics, CDC, 2002

  10. Causes of Death 2,000,000 nosocomial infections annually which kill 90,000 each year. William Jarvis, MD Director: CDC March 11, 1998

  11. Causes of Death 5. Accidents 97,900 *6. Nosocomial infections 90,000 7. Diabetes 67,301

  12. Causes of Death • Heart Disease 710,760 • Cancer 553,091 • *Infection 150,000 – 200,000 (?) • Stroke 167,661 • Chronic Lung Disease 122,009

  13. Antibiotic Resistance 1945 14% of Staph. a. penicillin resistant 1950 59% of Staph. a. penicillin resistant 1995 95% of Staph. a. penicillin resistant

  14. Antibiotic Resistance Why 1. bacteria reproduce every 20 minutes: rapid mutation potential 2. significant antibiotic exposure: common and inappropriate use environmental presence: animal husbandry 3. hospitals concentrate the worst pathogens 4. reduction in hospital hygiene (fewer staff)

  15. Antibiotic Resistance Streptococcus pneumoniae (pneumococcus) 7,000,000 cases of otitis media 100,000 – 135,000 hospitalizations/pneumonia 50,000 cases of septicemia 3,000 cases of meningitis “Between 10% and 40% of pneumococcus infections are drug resistant” CDC, July 2002

  16. Antibiotic Resistance 200,000 nocosomial Staph. Aureus infections annually; 80,000 are antibiotic resistant. CDC Fact Book, 2002

  17. Antibiotic Resistance The newest problem: “CAMRSA” Community Acquired Multiple Resistant Staphlococcus aureus

  18. Antibiotic Resistance The Problem 1. Antibiotic resistant infection is a significant and growing cause of morbidity and mortality; 2. The medical profession is increasingly concerned; 3. Vancomycin resistance has occurred: no new antibiotics are available.

  19. Standard Medical Assumptions“Diagnosis and Treatment of Disease” 1. Diseases exist as discrete entities 2. Disease entities can be identified (diagnosis) 3. Disease entities can be eliminated through treatment 4. Evidence-based application of drugs or surgery constitutes appropriate and effective treatment

  20. Standard Medical Assumptionsabout infection 1. Infection is caused by pathogens (bacteria, virus, parasite) 2. Pathogens overwhelm the immune system a. excessive virulence b. weakened immunity/host resistance 3. Antibiotics will reduce the pathogenic presence: eliminating the infection, or until the immune system can take over. 4. Antibiotics are the only effective treatment for infection

  21. A Naturopathic Perspective“The Restoration of Health” 1. The universe is ordered, intelligent, wise, and benign 2. Health is the constant and natural state of being 3. Ill health is an adaptive response to disturbance in the organism 4. Removal of disturbing factors will result in the potential return of normal health 5. Intervention should involve the least force necessary to stimulate the self-healing mechanisms

  22. Disease as Process Normal Health Disturbing Discharge Factors Process Disturbance of Function Reaction (fever, inflammation, etc.) Chronic Reaction Degeneration

  23. Standard Medical Approach:directed against the reaction Normal Health Pathogens Discharge Process Disturbance of Function Reaction *(fever, inflammation, etc.) Chronic Reaction Degeneration

  24. Classical Naturopathic Approach:reduce the disturbing factors, stimulate the vis Normal Health Disturbing Discharge Factors Process Disturbance of Function Reaction (fever, inflammation, etc.) Chronic Reaction Degeneration

  25. General Medical ConceptInfection is an interplay of several forces Virulence of pathogen Susceptibility factors Host resistance factors Immune competence

  26. Standard Medical Approach (reduce) Virulence of pathogen Susceptibility factors Host resistance factors Immune competence

  27. Naturopathic Model Virulence of pathogen (reduce) Susceptibility factors (strengthen) Host resistance factors (strengthen) Immune competence

  28. Reducing susceptibility factorsDeterminants of health What disturbs health? 1. Spiritual life self-assessment/relationship to the larger universe basic sense of safety, etc 2. Diet and digestion - toxemia 3. Emotional stresses and traumas 4. Rest and exercise patterns

  29. Reducing susceptibility factors 6. Physical Stresses, Traumas, and Exposures 7. Physical Strengths and Weaknesses 8 Illnesses, Illness Sequelae, and Addictions 9. Medical Interventions: surgeries suppressions drug effects

  30. Naturopathic Model Virulence of pathogen (reduce) Susceptibility factors (strengthen) Host resistance factors (strengthen) Immune competence

  31. Clinical Models Standard Medical Model 1. Diagnose infection 2. Identify pathogen (culture) 3. Apply appropriate antibiotic (4. Support vital functions) i.e.: Attack pathogen (antibiotics) With antibiotic failure: no viable treatment!

  32. Clinical Models Naturopathic Model 1. Reduce causes (disturbing factors) 2. Create a healthy regimen 3. Stimulate self-healing mechanisms 4. Support affected systems 5. Correct structure i.e.: reduce susceptibility factors, strengthen host resistance, and strengthen immune competence

  33. A case of Osteomyelitis Female, Age 40 May 11, 1999: Mandibular advancement surgery jaw surgically cut and held by plate. September 1: plate removed; appeared healed 2 weeks later: xray shows infection/non-union mouth wired shut, antibiotics October: systemic infection: IV antibiotics in hospital November: oral antibiotics, pain medications

  34. A case of Osteomyelitis January 4, 2000: chief complaints 1. Antibiotic-resistant osteomyelitis 2. Constant pain 3. Anxiety regarding healing 4. Anxiety regarding weight loss 5. Non-union of bone

  35. A case of Osteomyelitis Some significant aspects of history Many teeth problems Difficulty with stomach and digestion Neck and back tension hands go numb Excessive fatigue Gonorrhea age 22, tx with antibiotics (suppression)

  36. A case of Osteomyelitis Current Diet: liquid only: wired jaw: 8 months blended soup, “boost” (caloric drink), fruit juice, fruit smoothies weight: 116, began at 141.

  37. A case of Osteomyelitis Psycho/spiritual factors Sister died of measles encephalitis when patient was 8 Father died of MI when patient was 13

  38. A case of Osteomyelitis Pulse: digestive stress, acute disturbance, deficiency BP: 110/70 Sugar: 67 Stomach reflex: 3+ Arroyo: 2+ (adrenal fatigue)

  39. A case of Osteomyelitis Assessment: 1. Severe digestive dysfunction 2. Adrenal fatigue 3. Osteomyelitis with non-union 4. Significant childhood traumas 5. Suppressed gonorrhea 6. Acute pain and anxiety

  40. A case of Osteomyelitis Acute Treatment Address pain and anxiety: 1. Arnica 10M: single dose 2. Acupuncture: St 4,6, LI4, CV12, Liv 3, Gb 41 (note: patient reports immediate reduction in pain, more calm and relaxed)

  41. A Case of Osteomyelitis Treatment Regimen 1. Dietary change to reduce maldigestive toxemia: “FIT” (Carroll method): Fruit Intolerance 2. Daily Constitutional Hydrotherapy 3. Medorrhinum 200c: one dose 4. Gentiana/Scutellaria: gtt 15 tincture cc 5. “Reishi Bupleurum”: (Gaia) gtt 40, tid 6. Avena/Glycerrhiza: tincture gtt 40 tid 7. Calc. Phos. 3x: #5, tid 8. Daily exercise (note: patient leaves office feeling better: reduced pain, more relaxed, sense of hope.)

  42. A Case of Osteomyelitis January 9: (Day 5) “doing much better, reduced swelling and pain.” reduced pain meds continue regimen add acupuncture treatment: Liv 3, GB 41, St 36, 30, 25, 6, 4, Lu 2, LI 4, CV 12 January 11: (day 7) “doing better: no more pain meds needed” continue regimen acupuncture as above

  43. A Case of Osteomyelitis January 16: (Day 12) significant pain reduction significant reduction in swelling significant increase in jaw opening d/c immune tonic d/c avena/glycerrhiza acupuncture: Lv 3, CV 12, LI 4 St 36, 30, 25, 6

  44. A Case of Osteomyelitis January 23: (Day 19) much better acupuncture as above January 30: (Day 26) antibiotics cut in half by MD jaw opens more, feels better energy level significantly better: 75% February: vacation to Venice

  45. A Case of Osteomyelitis March 3: (2 months) doing well physically; jaw has knit (!) March 23: doing quite well *reports a bit of jaw pain and swelling after dietary violation (ate some fruit) May 3: doing well; reports jaw mal-alignment mouth opens to 27 mm (needs 28 to remove wires) needs neck manipulation: performed

  46. A Case of Osteomyelitis May 10: continuing improvement: date set to remove wiring repeat manipulation May 24: feeling good June 19: MD reports well healed; feeling generally better than before surgery

  47. Principles of Treatment(A Therapeutic Hierarchy) 1. Address acute symptoms 2. Reduce disturbing factors 3. Create a healthy regimen 4. Stimulate self-healing mechanisms 5. Support affected systems 6. Correct structure 7. Treat pathology 8. Suppress pathology

  48. A Case of Osteomyelitis Mechanisms of Treatment 1. Address acute symptoms: do not suppress! a. Relieve pain hydrotherapy, homeopathy, acupuncture, manipulation b. Relieve anxiety homeopathy, botanicals, confidence of doctor

  49. A Case of Osteomyelitis Mechanisms of Treatment 2. Reduce causes a. toxemia: dietary changes: no fruit digestion hydrotherapy botanical stomach tonic b. “suppression”: medorrhinum 200c single dose

  50. A Case of Osteomyelitis Mechanisms of Treatment 3. Create a healthy regimen a. appropriate dietary changes b. appropriate rest and exercise c. stress reduction d. spiritual exercise e. “air, water, sunshine”