The Enzyme Advantage, for Health Care Providers and People Who Care About Their Health, by Howard F. Loomis, Jr., D.C., F.I.A.C.A, with Arnold Mann (21st Century Nutrition Publishing, 2015)
Medicine will always be in search of the magic bullet—that pill or potion that will do exactly what it was intended to do, and only what it was intended to do, every time, in every patient.
This is the Holy Grail of modern medicine.
The problem is, it doesn't exist.
It doesn't exist because no two individuals are identical, because biochemical circumstances will vary from time to time and over time, and because organs and organ systems other than those targeted will inevitably be affected. The proton pump inhibitor that was designed to shut down the production of stomach acid (HCl) to give an irritated esophageal lining time to heal will also impair protein digestion, by shutting down the conversion of pepsinogen into to pepsin, and fat digestion, by stemming the flow of bile, which is stimulated by the production of stomach acid.
This is where the pharmaceutical approach falls short in its targeting of symptoms with drugs. These and more serious side effects have led to a resurgence of interest in alternative/natural approaches. And it isn't just about drugs. It's about what has been described as a change in thinking on the part of practitioners—a shift from the original inductive mindset, of conducting a complete and thorough examination and looking at all the evidence, to a more deductive, formulaic approach to diagnosis and treatment.
One of the earliest voices lamenting this shift in thinking was the 19th Century English physician Thomas Addison. Addison was one of medicine's greatest diagnosticians. To his credit: Addison's disease, a skin condition resulting from the progressive destruction of the adrenal glands, and a host of other disorders, including Addisonian anemia, which is now known as pernicious anemia, resulting from Vitamin B12 deficiency, and Addison-Schilder syndrome, a metabolic disorder also known as Adrenoleukodystrophy. He is also credited with discovering the pathology of pneumonia.
But the greatest contribution to medicine during his time, Addison declared, was René Laennec's stethoscope, which "contributed more towards the advancement of the medical art than any other single individual, either of ancient or modern times." (Monk's Roll: Lives of the Fellows of the Royal College of Physicians of London, Vol III (18-1-1825). London: RCP, 1878; 205).
Addison loved Laennec's stethoscope. And yet, he had harsh words for the way medicine had come to depend on it, at the expense of physical diagnosis. Addison, who would sit at a patient's bedside and use all of his senses, all of his intellect, all of his powers of of physical sensation and observation to inductively tease out a diagnosis, came to deplore the arrival of what he called the "stethoscopist."
"The enthusiasm, the rashness, the bigotry and conceit of the exclusive stethoscopist," he wrote, "have indeed, most seriously retarded the adoption, and vitiated the claims of physical diagnosis…They seem to look upon the instrument as all-sufficient; they rush at once to auscultation and percussion; they neglect or disdain to make those careful and minute inquiries which no sound and sensible physician ever fails to do, and thereby convert an invaluable auxiliary into what, in their hands at least, proves but an imperfect and treacherous substitute."
And so the world of deductive medical thinking entered, listening through the stethoscope to the heart, the lungs and the bowels for the sound that would dictate the treatment, rather than taking a complete history and performing a hands-on physical exam, using all of one's senses and investigative powers to inductively build a diagnosis based on what the body as a whole is saying.
As a young student at Logan College of Chiropractic, in the late 1960's, I was unable to use the stethoscope because of a hearing impairment from childhood. In order to for me pass the clinical examination and start seeing patients, the Logan clinicians taught me how to evaluate a patient's pulse pressure and pulse rate with my hands. I was also taught how to distinguish between a stroke patient and a heart attack patient with my hands, when the patient was unconscious, and to detect lung problems by placing my fingers between a patient's ribs and having them take deep breaths while I felt for any telltale vibration.
I was learning to diagnose with my hands, and to think inductively.
Of particular interest to me was a book called Clinical Judgement, by Alvin Feinstein (The Williams & Wilkins Co., 1967), which showed how to sort through all the evidence and, by way of inductive thinking, evaluate which piece or pieces of evidence are most revealing and make the diagnosis.
Arthur Canon Doyle, a physician himself, modeled the great Sherlock Holmes after his renowned mentor and anatomy professor, Dr. Joseph Bell, known for his fastidious attention to detail, and for teaching his students to use all of their senses, especially their powers of observation, in making a diagnosis.
And so Doyle created Holmes, the great detective who weighed every piece of evidence leading to each "elementary" observation, and finally his ultimate diagnosis as to who done it.
So is medicine becoming a lost art in pursuit of formulaic thinking and the quick fix?
In their 1963 book, Physical Diagnosis: The History and Examination of the Patient, authors John Prior and Jack Silberstein lamented the fact that little space was being given to the case history in the textbooks on physical diagnosis and the development of the medical examination. In their opinion, a diagnostician wasn't worth anything if he or she could not take a correct and thorough case history and do a good examination.
And they were right. A thorough case history and physical exam is absolutely necessary if one is to detect deviations from normal, which should be at the heart of any diagnostic process.
It was right around this time, while I was at Logan College, that I read Hans Selye's landmark book, The Stress of Life, which demonstrated the role of stress in the development of disease, and that the early symptoms of any condition are vague and nondescript, so that one cannot really know what is going on until an actual disease can be diagnosed.
For Selye, this progression to disease involved a lack of adequate nutrition, suggesting that providing the right nutrition would be a good strategy for halting the progression to the full-blown disease state.
This made perfect sense to me, because I knew that my chiropractic career would not be spent diagnosing diseases. But if one can detect early deviations from normal by conducting a thorough patient history, including diet, and a thorough hands-on examination, and blood and urine testing, these early deviations should be correctible by providing the right nutrition to restore normal function, and possibly halting the progression to the disease state.
It all seemed quite elementary, in principle.
Instead of taking the pharmaceutical route of masking symptoms with the medication of the month, why not provide the body with the nutrition it needs to heal the underlying problem itself.
Such a strategy would in fact be urged in a 2001 editorial in the journal Postgraduate Medicine, entitled "The Case for an Ancient Cause."
In it, the authors note that the ancient Greeks believed that Asciepios, the god of medicine, had two daughters—one responsible for prevention, the other for cure. Hippocrates, the father of Western medicine, was an inductive thinker, and forceful advocate for prevention, the authors note, urging physicians "to pay attention to the environmental, behavioral, and social context in which illness occurs." His exact words: to consider the "mode of life of the inhabitants, whether they are heavy drinkers, taking lunch, and inactive, or industrious, eating lunch, and drinking little."
"Have we heeded this Hippocratic challenge?" the authors ask. "Do we favor one daughter of Asclepios at the expense of the other." (Ambrose P, Wykoff RF, Lurie N, "The Case for an Ancient Cause," Postgraduate Medicine, 2001 Mar; 109(3): pp. 9-11)
It's all a matter of maintaining health and preventing disease, as opposed to simply treating the symptoms with drugs and dealing with the full-blown disease when it appears.
It's the difference between a health care system and a sick care system.
Hence the growing interest on the part of patients in so-called alternative healthcare practitioners for things like: back pain, digestive disorders, arthritis,, sprains and strains, allergies, high blood pressure, headaches, insomnia, chronic immune problems and anxiety and depression.
What do all of these conditions have in common? They are all primarily symptomatic, with an absence of concrete pathology to say where they are coming from.
For twelve years after graduating from Logan College, I did my inductive best to come up with a method, a system, to restore normal function and maintain health. Along with my physical exam, my blood work and urinalysis, I experimented with every nutritional supplement available—protein supplements, carbohydrates, lipids, vitamins, minerals, you name it—in an effort to discover dependable strategies for relieving my patients' symptoms and slowing their progression to disease. One of the things working against me was the fact that nutritional deficiencies usually don't become apparent for 60 to 90 days, and when they do, the symptoms are vague and overlapping.
In the end, nothing worked, not with any real consistency.
Then along came Dr. Edward Howell and his enzymes.
If indeed there were a magic bullet that could be tapped for medical purposes, it would be the enzyme—Nature's Workers, Howell himself called them—each created by body cells to do one job and one job only, with a consistency dating back to the beginning of time.
Three such enzymes that are central to Howell's work, and this book, are the digestive enzymes amylase, protease and lipase, which digest carbohydrates, proteins and fats, respectively, so that they may be absorbed and used as building blocks and fuel by the body. Then there are the food enzymes, as Howell called them, which exist in all living things, plant and animal, and which facilitate their own life functions and assist in their digestion when they are consumed as food by another organism.
And so the lipase contained in whale blubber assists in its digestion when it is consumed by the Eskimo, or protease enzymes contained in various meats, cellulase in fruits and vegetables, and so on.
It's all part of Nature's cycle of life.
Unfortunately, as Dr. Howell discovered back in the 1920's, with the advent of cooking, pasteurizing and the processing the foods, the enzymes contained in the foods we eat have been destroyed, compromising our ability to completely digest them. The result is incomplete digestion leading to nutritional and energy deficits as body organs struggle to do their part in maintaining health, and, ultimately, progression to the degenerative diseases, from arthritis and diabetes to heart disease and cancer.
It is this progression from health to disease that concerns this book, with supplemental enzymes as a means of achieving more complete digestion and providing the nutritional elements needed for body cells maintain normal function and reducing one's risk of progression to the degenerative diseases.
During the next 5 years, from the time I met Howell, I would develop just such a system for diagnosing nutritional deficiencies in various organ systems and using food enzyme supplements to deliver the specific nutrition needed to the struggling organ system to restore normal function, and health.
Starting with my own ears.