ALLERGIES AND “MENTAL” PROBLEMS
Allergies can not only cause familiar physical symptoms but can also be responsible for a host of so-called mental problems, including some cases of what looks like outright psychoses. Remarkably, the complete avoidance of a particular food or foods sometimes brings relief of such symptoms, while the reintroduction of the incriminating food can bring back the “mental” problem.
I first observed a possible link between food allergy and mental-behavioral problems in the late 1940s. As previously mentioned, I started performing food ingestion tests in my office upon beginning my practice in Chicago in mid-1944. A commonly eaten food to be tested would be avoided completely between four and six days before such an ingestion test. Although minor abnormalities of mood and behavior had been observed earlier in patients undergoing these tests, the following cases confirmed the credibility of the relationship between given foods and mental reactions.
CASE STUDY: HEADACHE WITH FATIGUE
Janet Cott, a young woman, complained of headache, fatigue, depression, and intermittent lapses of memory. She had been in the habit of eating eggs for breakfast for many years. After avoiding eggs for a week, she came to my office for an egg ingestion test. Five minutes after eating two eggs, she reported the onset of dizziness, heavyheadedness, and nasal stuffiness. At 10 minutes she started pacing in the food test room. At 15 minutes she began to cry in front of the other patients.
I urged her to come to another room. She either failed to understand or could not make a decision; she remained semiconscious for the following half-hour and cried intermittently for two hours. Upon recovering, she could not recall the events which had happened since the onset of the acute phase of her reaction. Her pulse rate, which had been 70 before this ingestion test, reached 104 at 30 minutes, and 110 at 60 minutes after the first feeding.
CASE STUDY: FATIGUE WITH COUGHING
A nurse, Edith Demarest, age 40, with a history of running nose, coughing, wheezing, and dizziness, later developed extreme fatigue and occasional headaches, as well as bouts of muscle-aching and depression. All symptoms were accentuated on arising in the morning but improved after drinking milk for breakfast. She also drank milk with each subsequent meal and at bedtime, never suspecting it. She improved while avoiding milk prior to a milk ingestion test. After drinking milk for the test, she developed, at 10 minutes, waves of yawning and sleepiness and then severe episodes of coughing and wheezing. A headache developed at 45 minutes and persisted for 15. At 60 minutes there was increased puffiness of her hands and eyes. The pulse rate of 68 at the start changed to 69, 72, and 76, at 20, 40, and 60 minutes. The white blood-cell count of 7,300 at the start decreased to 3,500, 2,400, and 2,200 cells at 20, 40, and 60 minutes.
Whereas this patient, a recent arrival in Chicago, had usually been timid when driving in traffic, she later admitted that she felt punch-drunk and very happy upon leaving the office two hours after drinking milk. She drove to her home with self-confidence and utter abandon, relatively oblivious to traffic hazards. An hour after arriving home, she felt increasingly hazy and less happy. After taking a short nap, she awakened crying and complained of intense headache, associated with pains across her shoulders, and continued depression. Residual effects persisted for two days. It is interesting that coughing and wheezing were absent during the time she had more cerebral symptoms, such as headache and depression.
Two weeks later, an ingestion test with milk was performed, all milk products having been avoided in the meantime. An increased sense of lightheadedness occurred at 3 minutes. This was followed by extreme sleepiness and grogginess at 5 minutes, which was associated with an inability to read comprehendingly. The patient then developed spasms of severe coughing after 8 minutes, and again at 40 minutes. Some crying occurred 5 minutes later, and sleepiness, grogginess, and persistent headache continued.
Although Mrs. Demarest reported feeling fine at the end of two hours, she again became pale, dopey, and sleepy upon reaching home three hours after the start of the test. The next morning she still had a slight residual headache.
CASE STUDY: HEADACHE WITH FATIGUE AND DEPRESSION
Another woman patient, Ida Koller, age 24, had complained of headaches associated with fatigue and intermittent periods of depression. I noticed that she was slightly dizzy and more talkative than formerly following a milk test in the office, but she assured me that she felt fine and was able to drive home.
Approximately one hour later, I received a telephone call from a suburban police department that Miss Koller had been arrested for “drunken driving.” She gave the unlikely story that all she had had to drink was a glass of milk in her doctor’s office. Since she did not have any odor of alcohol on her breath, the police were puzzled and called me; I confirmed her story. When asked to state this in writing, I complied, and explained how acute allergic reactions to foods may simulate alcoholic inebriation.
Clinical observations of this type which I made in the late 1940s opened several promising avenues for medical investigation, with the following tentative deductions:
Chronic reactions to the cumulative intake of given foods (best referred to as food addictions) occur initially as stimulatory levels of reaction, but later show up as progressive withdrawal responses (see Chap. 2).
Alcoholic beverages and sugars prepared from given foods, because of their greatly increased rate of absorption, induce both chronic and acute reactions more readily than do more slowly absorbed forms of the same food.
These tentative deductions were confirmed and extended by additional clinical observations. My cumulative clinical experience led to the correct interpretation of events in the most advanced case of allergy with “mental” symptoms which 1 had seen up to that time, the case of Mary Hollister.
CASE STUDY: PSYCHOSIS AND WANDERING MANIA
In 1949, Mary Hollister, age 30, was referred to me from an adjacent state with the complaint of incapacitatingly severe headaches. In some of the more serious episodes of her illness, she drifted into periods of extreme hyperactivity which resembled the effects of alcoholism, even though she had not drunk any alcoholic beverage. These episodes were followed by severe depression. Upon recovering from these acute bouts, Mrs. Hollister had no memory of the events which had transpired during them.
When first seen in my office, Mrs. Hollister was too confused to provide an adequate history. Thinking that she was too ill to be handled on an outpatient basis, I decided to have her hospitalized and placed on an elimination diet which avoided several major foods. When visited in the hospital later the same day, she was drinking coffee, which was not on her diet. With the complete avoidance of coffee and other prohibited foods, she became increasingly reclusive and depressed for the next two days.
Following this withdrawal, Mrs. Hollister improved progressively and was soon leading a normal, socially well-adjusted life, going about the floor campaigning for her favorite political candidate. Able to receive a detailed history for the first time, I learned that she had been drinking approximately 40 cups of coffee daily, each cup containing two teaspoonfuls of beet sugar. The diet upon which she improved contained only cane sugar. By pure chance, it had also eliminated four other foods which were later to be incriminated as the sources of food allergies.
When I saw her during the evening meal of her sixth hospital day, I noticed that she was eating beets as a vegetable. Upon leaving the hospital, I went to a far suburb of Chicago to lecture. I had only been there for a few minutes when I received an urgent phone call from the hospital. Mary Hollister was psychotic, racing for the exits, screaming, kicking, yelling, and trying by every means to get out of the place. She was even leaning out of the eighth floor window, her nurse told me, desperately seeking to get more air and apparently unaware of the danger of falling out.
I prescribed the injection of a sedative and left instructions that if this were ineffective they were to apply physical restraints. Mrs. Hollister was sleeping when I checked with the hospital later. But when I visited her the next morning, she failed to recognize me, to remember my name, or to recall other events of the past thirteen years. As her hyperactivity gradually decreased, she became progressively depressed. Although it was possible to remove the restraints after 36 hours, she remained apathetic, extremely depressed, disoriented, and amnesic for the following 24 hours. Then suddenly, and with little advance warning, she became correctly oriented as to time, place, and person.
Seeking a possible explanation for this strange episode, I recalled that she had eaten beets in the evening meal two hours before the onset of this attack. I now suspected that beets, which she had formerly eaten—frequently in the form of beet sugar—and was then eating for the first time in six days— may have induced the reaction, although no one at the time had ever described psychosis resulting from food intake.
After this acute reaction had subsided, 1 obtained permission to insert a tube through her nose into her stomach for the purpose of feeding her without her knowing what food she was being given. We waited expectantly for a reaction after infusing milk, but nothing happened. However, after another “blind” infusion of beets and beet juice the next day, an identical acute reaction was induced and photographed. Again she was, to all appearances, psychotic. Yet this was the result of nothing more complicated than a test reexposure to a common food which she had previously eaten on a day-in and day-out basis. As far as can be determined from having shown a film of this incident at medical meetings in many countries, this is the first recorded instance of an advanced psychotic episode resulting from a test feeding of an allergenic food. It should be pointed out that this case and the more briefly described instances leading up to it were extreme examples gleaned from a large clinical experience. These extreme cases stimulated interest in studying the possible role of food allergy-addiction in mental and behavioral disturbances, including less severe cases.
Mary Hollister’s case is considered by many to be a landmark in the understanding of this form of psychosis and of “mental” problems in general. There are, of course, many theories of mental illness. Usually, however, these theories cannot be proved or disproved, and a true cause of the illness cannot be demonstrated with any degree of scientific accuracy. Mary Hollister’s illness could be relieved or induced simply by manipulating her intake of particular foods— in her case, beets or beet sugar (although a few less important foods were also incriminated).
The cause of her problem remained hidden from her and her previous physicians because of the masked nature of allergies to common foods. Her constant, almost hourly, consumption of beet sugar kept her in a state of relatively normal behavior, but like any “junkie” she was always in danger of failing to get her “fix” or of getting an overdose of her addicting substance.
Mary Hollister’s case raised for the first time the possibility that other forms of so-called mental problems, including the various neuroses usually handled by psychotherapy, could also have an allergic basis. In pursuing this idea over the past thirty years, I have found that food allergies and chemical susceptibility do indeed cause a wide range of “mental” and behavioral problems. In fact, in this period I have seen many problems normally treated by psychiatry successfully diagnosed and treated through the methods of clinical ecology.
These “mental” and physical problems, I discovered, do not occur at random in the life of an individual, but are part of an overall continuum of symptoms in which a patient progresses from various levels of stimulation to corresponding levels of withdrawal in a predictable way, as will be described in the following chapters.
*3\110\2*
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