The Hygiene Hypothesis: With Fewer Germs to Fight Does the Body Attack Itself?

I devour good books, and have no problem putting down a bad one after 30 pages and never picking it up again. If it’s not good, why waste my time? If it’s good, I don’t want to stop. This one is a hell of a read! So was the The Andromeda Strain.

I read Moises Velasquez-Manoff’s  An Epidemic of Absence in one sitting. This was Michael Crichton with Hookworms. The premise is fascinating, although heavy with anecdote and less on peer reviewed clinical data, even with his 307 footnotes. Definitive science should never get in the way of a good read.

I was hooked, pun intended. Remember, I am Western-trained but still consider myself very open minded.

What Velasquez-Mannoff suggests is that maybe we are a little carried away with the pure benefits of hygiene. Does using Purell at every turn really benefit us in the long run, or will we end up dying from a dirty finger nail because of it? This puts credence in what I always believed…”The 10 second rule”. You know, if it’s on the floor less than 10 seconds you can still eat it.

His adventure begins with searching to cure his premature baldness. Okay, I’m a little hard on him here. He’s really looking into an area of medicine that has not been brought to light until now, and he was really looking for a treatment for Irritable Bowel disease and MS. Every action in medicine and in life has an unintended side reaction. We are all intertwined. We, meaning every organism that is in touch within our body. We don’t need to treat everything! Not all bacteria are bad. Our intestines, mouth, and nose are lined with millions of organisms that actually are our allies in keeping us healthy. I think we all know that.

The problem as I see it, which he does not address is deeper. I’ll explain in a moment.

First, physicians have 2 main edicts that we should follow

1) Above all, physician do no harm
2) Alleviate pain and suffering

Our job is not to make people live longer. That’s just a by product of the 2 edicts.

Mr Velasquez-Manoff talks about the Tsimane tribe in South America. How they seem to be free from so many of the autoimmune disorders that we face here in America. That’s fascinating, but he also acknowledges that 25% of the children in this tribe die by 15 years of age. That’s like the old joke about the alcoholic never dying of heart disease. That’s because they die of Cirrhosis by 40!

Here’s the problem as I see it. Modern medicine has many limitations, but one of them is not the prolonging of our life expectancies. Those 25% of the Tsimane tribe who die by age 15 would probably be alive today had they been born in the USA. If those 25% had autoimmune disorders such as he speaks about, would he then blame hygiene or modern medicine for them ?

Hygiene throughout history has saved millions of more lives than it’s harmed. The number one cause of death during the Civil War was infection. In fact the Southern surgeons ran out of cotton for suturing during amputations, so they had to use horse tail strands. The horse tails were too coarse, so they boiled them to soften it up. There was a 50% reduction in death from infection because of this. Those smart doctors were sure it was from some hidden property of the horse tail and not that they boiled them. This illustrates 2 things: that it’s better to be lucky than smart and that us doctors are not that smart.

Another example would be seat belts. Some people are severely injured and even killed by the seat belts, but many more lives are saved by them. Velasquez-Manoff also does a very good job of putting to rest the risk of autism from vaccines. He is very open about what he found personally and explains his findings very clearly and honestly. He is honest about what he doesn’t know.

This book is extremely well written. I thoroughly enjoyed it. It’s an eye opener and I would have no problem for any patient who was at wits end with Irritable Bowel disease, MS, Autism or other autoimmune disease to try a hookworm or two to help alleviate pain and suffering. At least I would be following both of the physician’s edicts… I think.


Image courtesy shutterstock / kaktuzoid

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