Respectful Insolence

Sepsis is not caused by bacterial infection?

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Sometimes I come across something so bizarre, so utterly wrong, that my mind reels in confusion and amazement, not to mention horror, that anyone can actually think or write something something like it. In fact, for a moment I considered offering up this one bit of horrifically inspired craziness up as an installment of Your Friday Dose of Woo, but I decided against it. The reason, I’m afraid, is the same reason that I’ve considered some bits of woo previously for this “honor” but then ultimately declined and covered them as normal posts, dripping with my usual brand of Respectful and not-so-Respectful Insolence.

Do you remember Robert O. Young–excuse me Dr. Robert O. Young or Robert O. Young, Ph.D., D.Sc., both titles that he seems to be especially enamored with? You don’t? Perhaps you remember that he is the guy who thinks that all disease is due to excess acid (due to diet, of course!), that cancer is a “liquid acid,” and that viruses are “molecular acids,” among other complete and total woo. His one-size-fits-all treatment for all disease follows logically from his central thesis, namely that the treatment for all disease is to “alkalinize” the blood through diet and various other means. I say “logical” not because Young is right but because his conclusion does logically flow from his premise. Of course, his premise is utterly wrong, which makes his conclusions wrong. In fact, the pH of the blood is very important for cellular function and health; so not suprisingly, the body has evolved numerous homeostatic mechanisms to keep the pH pretty rigidly controlled between around 7.35 and 7.45.

Indeed, it’s very hard to change the blood pH very much. The body is very good at compensating. Moreover, there are relatively few indications for alkalinizing the blood, which, when it’s indicated, doctors usually do with sodium bicarbonate. A couple of the indications for alkalization include certain types of kidney stones and occasionally very severe acidosis, but in general there isn’t much reason to try to mess with the blood’s pH.

Don’t tell that to Robert O. Young, though. And especially don’t tell him that the acidosis from sepsis is caused by the body’s reaction to massive infection. He apparently won’t believe you, and he’s willing to abuse the memory of Mariana Bridi da Costa, the Brazilian model who recently died of massive sepsis, whose story made the news mainly because doctors amputated her hands and feet in a last ditch effort to control the sepsis. To Young, Bridi da Costa died not of massive bacterial infection, rather of the consequences of too much acid brought on by bad lifestyle choices and, yes, intravenous antibiotics. First, let’s review what actually happened:

In brief, as far as can be reconstructed, Bridi da Costa developed a urinary tract infection, which isn’t so uncommon for a young woman. Apparently in late December she felt ill and was hospitalized but was misdiagnosed with kidney stones. She ultimately became septic from her infection, and went into septic shock so profound that the blood flow to her far extremities led to gangrene of her hands and feet, which ultimately led physicians to amputate them. The causative organism was reported to be Pseudomonas aeruginosa, a nasty bug indeed. Indeed, resistant Pseudomonas is very common, and even sensitive strains of this bug are hard enough to eradicate. Moreover, Pseudomonas can infect virtually every tissue.

Of course, all of this is just my blather to Robert O. Young. To him it couldn’t have been Pseudomonas sepsis that killed Bridi da Costa. To him this is what killed her:

Just last week a young beautiful Brazilian woman died from sepsis or systemic acidosis. This is not a unique nor isolated story. It is happening every day to hundreds of thousands of people around the world! In fact, Shelley and I came very close to losing one of our own children from septic or acidic shock due to antibiotic IV’s.

[...]

Sepsis is the number one cause of death in the world and happens every day at Intensive Care Units, Hospitals and Medical Clinics!

What is sepsis or septic shock and what is the cause?

Sepsis or septic shock is a systemic acidic condition caused by acidic lifestyle choices, including acidic food, drink, and drugs – especially dextrose and/or antibiotic IV’s given at hospitals around the world.

Yes indeed, to Young it has to be those evil doctors who killed this beautiful young model with their reductionistic science, pumping her full of IV fluids containing 5% dextrose (which many IV fluids do) and antibiotics! Damn them and their inability to see the truth! Of course, the doctors must have been aided and abetted by Bridi da Costa’s apparently bad lifestyle in which she must have eaten what Young considers to be pure evil, namely “acid” foods:

When someone is over-acid and becomes tired, sick and/or injured and nothing is done to buffer or neutralize the excess environmental, dietary, metabolic, and/or cellular degenerative acids, then death from acidosis or sepsis becomes inevitable.

Most people believe that sepsis or acidosis is an infection. It is not!

It is an out-fection from personal acidic lifestyle and dietary choice. An out-fection, in the body, is the cell breaking down from the inside out from an emotional or physical stress or disturbance giving rise to increased acidity. Dietary and/or metabolic acids are generally the cause of all out-fections or cellular transformations – not the infection from some harmless bacterium and/or yeast. And, a bacterium and/or yeast present in the blood or tissues is the evidence of sepsis or an acidic state that gives rise to biological transformation or the birth of bacteria, yeast or mold.

This it typical alt-med idiocy. Basically, they take a valid idea based on science (in this case, that lifestyle and diet can predispose to disease) and extrapolate it to the point where they run right off into the deep end of the stupid pool with it. Indeed, after they’re through with the idea, it’s pretty much unrecognizable as being science any more. Robert O. Young is no different; in fact, he is a master at doing this. Here, he is once again denying germ theory, sounding in fact a bit like Bill Maher, channeling arguments that date back to the late 1800s to Antoine Béchamp, Louis Pasteur’s rival.

For those not familiar with him, Béchamp is the hero of germ theory denialists. Rejecting an external cause of infectious disease, he argued that “the soil is everything.” There’s no doubt that the “soil” is important; if the body is weakened or its defenses breached through, for instance, trauma, then it is more susceptible to infection. But that’s not how Béchamp saw things. Specifically, he postulated “pleomorphic theory,” which argued that bacterial growth in the body is a consequence, not a cause, of disease arising from the tissues and that bacteria in essence arise from the diseased tissue and change their form (the “pleomorphism”) to scavenge the dying tissue. This theory, although somewhat plausible sounding back in the 1870s, given the relatively primitive microscopes of the time (compared to 20th century instruments), the much less sophisticated knowledge about how to grow and stain bacteria, and the newness of germ theory, was abandoned in the face of the massive amounts of evidence that Pasteur and others ultimately marshaled in favor of the germ theory of infectious disease. That doesn’t deter woo-meisters, though, who seem, to prefer science that is at least 100 years old, and preferably abandoned long ago in favor of hypotheses and theories supported by actual experimental and observational evidence, so that it seems to be “challenging the existing paradigm.” Béchamp’s theory sure does that, and woo-meisters love him so much that they’ve even promulgated a myth that Pasteur “recanted” on his deathbed and that his last words were that that Béchamp was right after all. Too bad Béchamp was demonstrably wrong, and too bad for germ theory denialists that Pasteur never “recanted” germ theory on his deathbed.

Not that any of this stops our intrepid quack from sounding like Béchamp on acid and mushrooms, with a dash of whiskey and pot thrown in for good measure:

Most people believe that sepsis or acidosis is an infection. It is not!

It is an out-fection from personal acidic lifestyle and dietary choice. An out-fection, in the body, is the cell breaking down from the inside out from an emotional or physical stress or disturbance giving rise to increased acidity. Dietary and/or metabolic acids are generally the cause of all out-fections or cellular transformations – not the infection from some harmless bacterium and/or yeast. And, a bacterium and/or yeast present in the blood or tissues is the evidence of sepsis or an acidic state that gives rise to biological transformation or the birth of bacteria, yeast or mold.

Isn’t that what happens to food when it spoils? Bacteria, yeast and mold appear as the food is spoiling and are not the cause of the spoiling. Food spoils from the inside out not the outside in. Human or animal cells spoil from the inside out not the outside in. This is why I call cellular transformation from a healthy state to an unhealthy state an out-fection not an infection…..because germs are born in us and from us from spoiling or decaying cells. And, germs do not cause dis-ease or disease!

Oddly enough, Young is sort of correct about one thing. Sort of. What he’s arguably not unreasonable about is saying that sepsis itself is not an infection. That’s sort of true, although in reality it’s probably more semantics than anything else. Sepsis can actually be viewed as the body’s response to massive infection, not the infection itself. However, the infection itself causes the septic response. In the face of toxins released by bacteria in the bloodstream, the blood vessels dilate, causing blood pressure to drop; the heart starts pumping much harder, increasing cardiac output; and a number of other physiologic derangements occur that can lead to dysfunction of the clotting system, the liver, the lungs, the kidneys, and the GI tract. If several of these organs start to shut down at the same time, it used to be called multisystem organ failure, although now it’s called multiple organ dysfunction syndrome, and if three or more organs shut down this way the mortality is at least 80%. That sepsis is the response to a massive bacterial infection can be inferred from the existence of a sepsis-like syndrome from which no infectious agent is ever isolated. This syndrome, called the systemic inflammatory response syndrome (SIRS), looks all the world like sepsis but may not be caused by an infection. On the other hand, the definition of sepsis these days is generally stated: “Sepsis = SIRS + Infection.” In other words, massive infection is part of the definition of sepsis.

The reason that sepsis activates a systemic inflammatory response is that overwhelming bacterial infection activates the same sort mechanisms that generalized inflammation does–with the same sorts of physiological changes in terms of vascular dilation, increased cardiac output, and metabolic derangements that lead to inadequate organ and tissue perfusion and oxygen utilization, which in turn lead to acidosis, the common end result of metabolic needs outstripping perfusion. Actually, it’s a bit more complicated than that in that oxygen delivery usually increases in SIRS/sepsis, but the cells can’t utilize it properly. The details are too complicated (and some of them controversial) to be discussed properly here. Be that as it may, in the case of Brida da Costa, we know she had sepsis because (1) she had a diagnosed urinary tract infection; (2) she clearly had a life-threatening SIRS-type response; and (3) an infectious agent was isolated in the context of that SIRS-type response. Infection plus SIRS equals sepsis, and Brida La Costa had severe sepsis.

Not that Young believes it. He confidently brings home the stupid with more flair than any other crank besides perhaps Mike Adams:

Ms. Bridi da Costa, at the young age of 20 died from systemic acidosis from the lack of proper alkaline treatment. Acidic drugs, such as antibiotics and metabolic acids ravaged her body which forced doctors to perform amputations of her extremities and extract part of her stomach as well as both kidneys. I strongly believe that Ms. Bridi da Costa would be alive, healthy and strong today, if, the prevailing 19th Century germ theory medical dogma and subsequent acidic treatment protocols of antibiotics would have been simply replaced with alkaline fluids of sodium, magnesium and potassium bicarbonate and alkaline water and foods.

Actually, the pleomorphism theory that Young clings to is the 19th century theory–a 19th century theory that was correctly discarded based on science. Germ theory, although it originated in the 19th century, has advanced considerably since then. Alt-med quacks like Young remind me of creationists in a way in their obtuse refusal to recognize that the 19th century theory that they hate has moved on since it was first proposed. Charles Darwin and Louis Pasteur suffer the same sort of abuse at the hands of pseudoscientists spewing burning flames of stupid in geysers that obliterate any sign of intelligence, reason, or science. In this case, Robert Young is throwing the gasoline on that fire.

I was going to quit here, but Young said something that reveals the full, dangerous depths of his ignorance, and here it is:

Currently, medical science perceives there is no early diagnostic test nor effective treatment for sepsis and severe sepsis or over-acidity. But this is not true! There is a diagnostic test!

The early diagnostic test is simple, inexpensive and accurate. All you need to do is test the pH of the urine and saliva with litmus paper. If the urine and saliva is dropping from a normal 7.2 pH or higher to under 7 and then into the low 6′s, 5′s and then 4′s, you are headed toward sepsis or systemic acidosis!

As I said, this is nothing more than the purest quackery. Does this moron think that if there was such a simple test to predict sepsis that physicians wouldn’t be interested–nay, eager!–to study and validate it? What bothers me the most about Young is that he is actually convincing enough that he fools people into believing his quackery, and the result can clearly kill. For example, if a patient develops fever and symptoms suggestive of a significant bacterial infection, but foregoes antibiotics in favor of lots of alkaline treatments to raise his saliva and urine pH to the levels Young advocates, that patient runs the risk of being a corpse with alkaline urine and saliva.

Brida da Costa is an incredibly tragic case. Any time someone so young dies unexpectedly of what is now an uncommon cause of death in the young and healthy (sepsis from a urinary tract infection), we naturally want to know how this could possibly have happened. After all, Pseudomonas usually doesn’t cause infection in a healthy young person. There usually has to be some sort of preexisting wound, inflammation, or immune suppression decreasing the body’s ability to keep the Pseudomonas that naturally lives on it and in it in check. Indeed, that’s one reason why Pseudomonas is such a problem in burn patients; the protective barrier of the skin is broken down over a large surface, and Pseudomonas love to grow in the burn eschar. I remember my days in the burn unit, where I could smell the Pseudomonas on many patients. The bacteria produce a very distinctive and not entirely unpleasant fruity smell and also can make a greenish fluid.

None of this means that Brida da Costa must have been immunosuppressed before she got sick. Probably what happened is that she got a urinary tract infection, possibly due to a different bug or possibly due to Pseudomonas. Although it’s not clear whether she did or did not have kidney stones when she was initially treated, a kidney stone can certainly reduce the urinary tract’s natural defenses by causing injury to the lining of the ureter, as well as stasis of urine in the ureter and a nidus for bacteria to stick to. To me, it would make sense if Brida La Costa had a kidney stone, and that predisposed her to a UTI. In any case, the infection progressed; and when it got serious it probably resulted in sufficient immune suppression to pave the way for Pseudomonas to go from being just a localized bladder or kidney infection to becoming a systemic infection in the bloodstream. Assuming doctors isolated Pseudomonas from her blood, she was clearly septic–very septic. Another huge blow to germ theory denialists in this story is that it shows that a bacterial infection can cause an infection that can kill a young, healthy adult. Germ theory denialists will often argue otherwise, particularly with influenza.

When it comes to figuring out what alt-med quack brings home the stupid, Robert O. Young is always near the top of my list. Even Mike Adams may not be “up” to his standard, given that Adams appears mostly to parrot other people’s woo and add his special brand of conspiracy nuttery to it to produce a toxic brew of antiscience. Every time I see something from Robert O. Young, it’s more disturbing and further off the reservation than before. His “logic,” such as it is, is unrelentingly circular. If you tell him, for instance, that massive quantities of bacteria or fungus were isolated and cultured from a septic patient’s blood, he would say that it was evidence that the body’s function was deranged to let the organisms grow because bacteria can’t cause disease in and of themselves, which means that when they are found in a site of infection they must be an epiphenomenon, not the cause. Of course, when it’s pointed out that alkalization is of no benefit in sepsis except possibly in the case of very severe acidosis (and even that’s controversial), he would probably say that the body’s acid-base balance was just too deranged or that doctors simply don’t alkalize vigorously or early enough. That way, he can look at an unfortunate death such as that of Brida da Costa’s and sadly, with great confidence and self-righteousness, say that this poor young woman would be alive today if doctors only accepted his “wisdom” as scientific and medical truth.

Truly, I fear Young’s next effort that reaches my attention will turn my brain into one of his acid liquid viral tumors.

Comments

  1. #1 Blake Stacey
    January 30, 2009

    Perhaps you remember that he is the guy who thinks that all disease is due to excess acid (due to diet, of course!), that cancer is a “liquid acid,” and that viruses are “molecular acids,” among other complete and total woo.

    Wow — viruses are made from the blood of the alien in the movie Alien!

    Indeed, it’s very hard to change the blood pH very much. The body is very good at compensating. Moreover, there are relatively few indications for alkalinizing the blood, which, when it’s indicated, doctors usually do with sodium bicarbonate. A couple of the indications for alkalization include certain types of kidney stones and occasionally very severe acidosis, but in general there isn’t much reason to try to mess with the blood’s pH.

    Such as protecting oneself against the Andromeda Strain.

    Two SF-movie references in one go. I win!

    (This may also explain why I have no friends.)

  2. #2 John
    January 30, 2009

    “Isn’t that what happens to food when it spoils? Bacteria, yeast and mold appear as the food is spoiling and are not the cause of the spoiling”

    Is he arguing for spontaneous generation? Like, didn’t Pasteur specifically disprove this 150 years ago or so? :P

    Isn’t the production of that gross Natto stuff a contradiction to his theory that food rots and then bacteria show up?

  3. #3 Dunc
    January 30, 2009

    Bacteria, yeast and mold appear as the food is spoiling and are not the cause of the spoiling.

    So how does he explain the incontrovertible fact that sterile growth media don’t grow anything, whereas inoculated growth media do? I can prove this argument wrong with two culture bottles, and indeed I do every time I add a new strain to my yeast bank. I’ve still got my last control tube sitting on top of my PC at home, where it’s been happily not growing anything for a couple of months, while the inoculated tubes are sitting in the fridge with healthy colonies all over them.

  4. #4 AM
    January 30, 2009

    Too bad Béchamp was demonstrably wrong, and Pasteur never “recanted” germ theory.

    And even if he had, it would make no difference whatsoever, obviously. Theories are proven right or wrong on the basis of fact, and not on the basis of personal prestige of the proponent.
    Yet, to a crank, the prestige of the theorist is all that matters. To me this is just another way for them to excuse themselves from thinking with their own head.

    “The Fuehrer said so, therefore it must be true and we must follow like a bunch of brainless zombies! Must…kill…braaains!”

  5. #5 Dangerous Bacon
    January 30, 2009

    Out-fection is my new favorite dis-ease.

    It’s whol-istic.

  6. #6 Dianne
    January 30, 2009

    viruses are “molecular acids,”

    To be fair, viruses generally are deoxyribonucleic acid or just ribonucleic acid. But the acid part isn’t what’s (sometimes) dangerous about them.

    But I wonder if the woomeisters and their followers know that one of their favorite treatments, vitamin C, is actually ascorbic ACID! It’d be amusing to see someone who believes both in vit C treatment for cancer and Young’s theory of acids try to explain how they can both be true.

  7. #7 Dawn
    January 30, 2009

    Um…correct me if I am wrong. But from my hospital days I seem to remember that it isn’t that difficult to determine if someone is actually acidic (blood pH tests), and, if they really are, treat the condition. But saliva testing? and a pH dropping that significantly? I don’t think so…
    Oh, and by the way…if you have a pH of much less than 7.2(6?? much less 5 or 4) you are DEAD! Not just acidic. Or can urine and salivary pH levels be that significantly different from the blood pH?

  8. #8 GregV
    January 30, 2009

    The scary thing is that Young’s theories are everywhere – he’s not the only one, and probably not the leader. The whole concept of “alkalizing” is huge in the alt-med sphere. I think it’s more popular than some other alt-meds that get bigger attention.

  9. #9 Comrade PhysioProf
    January 30, 2009

    Not that any of this stops our intrepid quack from sounding like Béchamp on acid and mushrooms, with a dash of whiskey and pot thrown in for good measure:

    Whiskey and pot do not make you evil and stupid like Young.

  10. #10 Dianne
    January 30, 2009

    Or can urine and salivary pH levels be that significantly different from the blood pH?

    Urine pH can be significantly different from blood pH. Urine is one of the ways that the body gets rid of excess OH- or H+. Saliva, to tell the truth, I have no idea. It just doesn’t come up in standard medicine.

  11. #11 Marilyn Mann
    January 30, 2009

    I’ve never heard of Young but I have run across the theory that dietary acid load from Western diets may be a risk factor for osteoporosis. I haven’t really investigated to see if there is any support for this idea.

    http://jn.nutrition.org/cgi/content/abstract/138/7/1349

    http://www.ajcn.org/cgi/content/abstract/88/4/1159

  12. #12 The Perky Skeptic
    January 30, 2009

    Oh, Blake, I think you’ve got plenty of friends here! *lol*

    This is so sad– that poor girl! It’s just so utterly vile when quacks use tragedy to advance their deadly WRONG AND DISPROVEN hypotheses.

  13. #13 Tsu Dho Nimh
    January 30, 2009

    Or can urine and salivary pH levels be that significantly different from the blood pH? Urine, yes, because it’s part of the acid-base balancing mechanism. 4.5 to 8 is the usual range.

    Saliva??? We never tested it.

    And the words “Gram Negative septicemia” make any lab tech cringe. Pseudomonas aeruginosa was common in UTIs, but if it gets out of the bladder, or accidentally into a wound it can run amok.

  14. #14 Dianne
    January 30, 2009

    A couple of the indications for alkalization include certain types of kidney stones and occasionally very severe acidosis, but in general there isn’t much reason to try to mess with the blood’s pH.

    Psst. Tumor lysis syndrome. (Ok, that’s really trying to alkalinize the urine, but how could you not mention it and you an oncology surgeon.)

  15. #15 Strider
    January 30, 2009

    Dudes, O’Brien’s “theory” TOTALLY explains why Padme died giving birth to Luke and Leia!

  16. #16 Strider
    January 30, 2009

    Dudes, O’Brien’s “theory” TOTALLY explains why Padme died giving birth to Luke and Leia!

  17. #17 Orac
    January 30, 2009

    Psst. Tumor lysis syndrome. (Ok, that’s really trying to alkalinize the urine, but how could you not mention it and you an oncology surgeon.)

    Because I deal with breast cancer, and tumor lysis syndrome is pretty rare in breast cancer. It’s mainly seen in the hematologic malignancies like leukemias and lymphomas.

    Actually, it slipped my mind.

    Also, most alkalization is done to alkalize the urine, not the blood. After all, it’s the same with kidney stones. The goal is to keep the urine alkaline and prevent the precipitation of certain types of crystals that form stones, not to alkalize the blood.

  18. #18 Joseph C.
    January 30, 2009

    Dudes, O’Brien’s “theory” TOTALLY explains why Padme died giving birth to Luke and Leia!

    Dr. Ball, M.D. has dealt with that conundrum quite effectively. (For you ADD types, the answer is about 70% of the way into the clip.)

  19. #19 MissyMiss
    January 30, 2009

    If only Padme had some prenatal care, things might have gone very differently.

  20. #20 Cathy
    January 30, 2009

    Allow me to inoculate myself against woo by saying that “alternative” medicine hasn’t got much going for it other than an obsession with wholesome nutrition and exercise. Nutrition and exercise are reasonable things to advocate to help prevent disease.

    They way they go off the deep end, as Orac says, extrapolating from “good lifestyle helps prevent disease” to “all disease is caused by lifestyle” is insanity. It’s taking the whole thing too far. Lifestyle is one factor in disease. Genetics, germs, chance, and many other things are also factors. You can’t reduce disease to one single, controllable factor. Sadly, “alternative” medicine likes to reduce to absurdity. This is probably because they want to take back control from genes, germs, chance, and “Western” doctors. They want the power to perform miracles and cure disease themselves. It seems like an all-out power struggle, to me.

    However, I see a bright side to woo. Please don’t shoot me!

    Evidence-based medicine has given us many useful treatments for common conditions. These treatments are seemingly magical — we are cured quickly with few side effects. We’re used to seeing a doctor and being given magic pills for whatever ails us. We smoke, we get bronchitis, we go to the doctor, we get magic pills, we’re cured in a week and we don’t have to quit smoking or change anything. We lean heavily on our medical system in this way. We get fat, then we want statins and diuretics to take away the symptoms of being fat while still remaining fat. The medical establishment is doing nothing wrong — they’re trying to prolong our lives in spite of all the awful things we do to our bodies. But we’ve gotten addicted to the magic pills and stopped looking at (or been frustrated by a lack of help with) things we can personally do to improve our health. We may become a weaker, sicker, less-healthy people because of it.

    The bright side is this: Woo-meisters and their obsession with negating germ theory have actually generated a cult following that involves changing one’s lifestyle to cut the risk of disease. Sure, they peddle the utter nonsense that changing your lifestyle in crazy ways will make you completely immune to disease. However, they are making people more receptive to treatments that involve more significant personal investment than swallowing magic pills every day. If only they didn’t have to be so sensationalist about it, claiming to cure cancer and every other disease under the sun! Sadly, sensationalism is probably the only way humble diet and exercise can get any attention.

    For their advocacy of lifestyles that depend less on magic pills, I could (almost) hug woo. Where I draw the line is when they go insane and their insanity infects or kills other people.

  21. #21 John H
    January 30, 2009

    This nonsense was taken up by the British anti-vax jabbophobes last month. Proof positive (if it were ever needed) that if you believe in one form of specious drivel you will believe in anything.

    A moron had the gall to post the following:

    “””The first line of defense against sickness and disease is an alkaline internal environment. As soon as you put something acidic into your mind, into your mouth, into your lungs, your alkaline buffering system is engaged to neutralizing or buffer any acidic food, drink, or thought that might be present. That’s true immunity. It is found in the alkaline reserves for your body. When you have an alkaline lifestyle and diet you are able to defend off environmental, dietary or metabolic acids that would make you sick, tired and/or fat. Germs DO NOT cause disease. Acids cause pain, sickness and disease.”””

    I can see a Nobel in the offing. I would prefer him to be a candidate for a Darwin Award (his children probably will be – by proxy).

    It is impossible for a sane person to consume enough alcohol and controlled substances to make this rubbish up.

    Why do these morons seem to have the same aversion to paragraphs and punctuation that they have to vaccinations ?

  22. #22 Neuroskeptic
    January 30, 2009

    Hey, don’t believe the alka-LIES of Big Acid (aka Big Pharma and Big Food), acid causes all bad things. Up with pH! Down with protons!…

    sorry, got a bit carried away there…

  23. #23 Ramel
    January 30, 2009

    “The early diagnostic test is simple, inexpensive and accurate. All you need to do is test the pH of the urine and saliva with litmus paper. If the urine and saliva is dropping from a normal 7.2 pH or higher to under 7 and then into the low 6′s, 5′s and then 4′s, you are headed toward sepsis or systemic acidosis!”

    It has been a very long time since I took chemistry, but isn’t litmus paper of limited use in measuring ph? Should he be talking about Universal Indicator or something similar?

  24. #24 vespera
    January 30, 2009

    @ John H
    What I want to know is how would you determine the acidity of your thoughts!

  25. #25 Dr Aust
    January 30, 2009

    Good grief.. never thought I’d see salivary pH as a subject of blog discussion.

    I am a sometime exocrine physiologist and once upon a time used to give a research talk with the arresting title (not) of:

    “Why is saliva alkaline..? And who cares?”

    ….so anyway, spit pH is one of the things I actually know something about. The pH of “unstimulated” saliva (saliva collected when you haven’t deliberately stimulated production in some way) wouldn’t even tell you anything useful about the pH of saliva. To get any kind of sensible value you would have to stimulate flow, and then you would expect to record a moderately alkaline value because saliva contains significant amounts of bicarbonate (HCO3-). The general view over the last couple of decades has been that this bicarbonate is there to neutralise the acid produced by metabolising bacteria in the dental plaque layer. The HCO3- helps maintain a pH in the plaque layer that keeps the bugs from growing too fast, helps keep the pH from getting too acid which would tend to demineralize teeth, keeps the plaque pH in the right range for natural microbicidal peptides to work etc etc.

    All good useful stuff, but (as already noted by a bunch of people) jacksh*t to do with the pH of your body as a whole.

    Robert O Young is a truly tremendously crazy fruitcake, but – as observed by various people in the comments – there is a general obsession with “keeping alkaline” among the Alt.Reality fraternity, sometimes seem in connection with the “drink special alkaline water” scam. I wrote a post a while back about “Alkaline nonsense”, which was inspired by Alt.Health companies selling pH papers to the gullible. But this current story really is “The alkaline pH garbage to end all alkaline pH garbage”.

  26. #26 daedalus2u
    January 30, 2009

    This is such a sad story; that ghoulish frauds such as Robert O. Young seek to capitalize on it makes me angry and nauseated.

    If I might clarify Orac’s cryptic remark about O2 levels being higher but the body being unable to utilize it. This is complex and not fully understood. The mitochondria can’t utilize the O2 because cytochrome c oxidase is blocked by the very high NO levels from iNOS. These very high NO levels are what cause the profound vasodilation of septic shock. This is actually a “feature”. It is mostly heme enzymes that are blocked from utilizing O2 by NO. There might be some others that still can utilize O2, perhaps to make superoxide in the immune response.

    It turns out that NO is a signaling molecule that many bacteria (Gram negative and positive) use to initiate biofilm formation (including Pseudomonas). Low NO and they form a biofilm. If you have any kind of bacteria floating around in your blood stream, the last thing you want for them to do is to form a biofilm because then they become much more difficult to eradicate. If the bacteria do attach somewhere and form a biofilm, then you are SOL and they will very likely kill you. In “the wild”, your only ghost of a chance is if your body prevents them from forming a biofilm while it mounts an emergency overload immune system response. That is what sepsis is; when your body turns your immune system to 11. Preventing the formation of a biofilm is so important that it is worth a significant chance of death just from that because if a biofilm does form death is virtually certain. Evolution has configured the immune system to minimize the sum of deaths from preventing biofilm formation and from being insufficient to prevent biofilm formation. Bacteria are doubling every 20 minutes or so, so turning on the immune system as hard and as fast as possible is the only potential survival pathway.

    Many bacteria raise pH by hydrolyzing urea into ammonia. That is one of the things that Heliocobacter pylori does, raise the pH of the stomach from its normal pH ~2 to something more hospitable to it.

    The skin normally has a pH ~ 4 to 5. Most bacterial infections increase the pH to around 7 via hydrolysis of urea or by release of NH3 through deamination of amino acids as they oxidize them as food. One of the exciting things about the bacteria I am working with is that they take that NH3 and oxidize it to nitrite, restoring the normal acidic skin pH, and simultaneously making NO/NOx which inhibits most heterotrophic bacteria and by inhibiting biofilm formation and quorum sensing also prevents them from expressing virulence factors. I have some related stuff on this blog post.

    http://daedalus2u.blogspot.com/2008/06/suggestion-to-reduce-antibiotic.html

    If the doctors treating Ms Bridi had treated her sepsis by adjusting her pH, she would have died in less than a day. Pseudomonas can live and flourish in media with pH incompatible with that of blood in a living human.

  27. #27 DebinOz
    January 30, 2009

    I’m going to start preventing those out-fections by watering my scotch down with a nice splash of lye!

    My head hurts :(

  28. #28 Medical Student
    January 30, 2009

    Sometimes, it feels like you’re arguing with people who think the Earth is a tetrahedron. The word may be fancy, darlin, but that doesn’t make it true.

  29. #29 Art
    January 30, 2009

    Good post and take down of idiotic, and potentially tragic, woo.

    The picture of the cutie at the head of the post had me wondering if you were drifting into a Swedish Meatballs lite (NSFW – http://swedemeat.blogspot.com ) sort of posting style. Not that I mind something nice to look at with with my mental stimulation.

  30. #30 SquidBrandon
    January 30, 2009

    Acidic drugs, like antibiotics?

    Meropenem, for example, has a pH of 7.3-8.3 when it’s ready to be administered. This is certainly a likely treatment option for septic shock due to P. aeruginosa (of course depending on hospital formulary carbapenem and susceptibilities on isolated strains). Hmmm. Patients such as these often get straight sodium bicarbonate IV infusions (although the benefits are certainly debatable).

    Oh yes, let’s blame the drugs for being acidic. *Facepalm*

  31. #31 Chris
    January 30, 2009

    Art said “The picture of the cutie …Not that I mind something nice to look at with with my mental stimulation.”

    The picture is of the young lady who is the subject of the blog posting. She died of sepsis last week at the age of 20.

  32. #32 charles
    January 30, 2009

    On a tangent, what’s the deal with pseudo-scientists always claiming that some influential scientist has “recanted” his discoveries, as if that in itself supported woo? Could it be that this particular fixation reveals something about how whackjobs gain their “knowledge” of the world?

    It’s as if they understand knowledge as something that rests not on empirical observation (accessible to anyone) but is handed down as holy writ from godlike authority figures.

    And thus they project this authoritarian mindset onto others by trying to discredit what they mistakenly see as an absolute authority for “the other side”, hoping to claim that mantle of authority for their own particular set of “facts”, but seemingly unaware that knowledge rests on underlying reality rather than those people studying it.

  33. #33 DLC
    January 31, 2009

    Right. Acid-Woo to the max!
    I had one guy tell me he wouldn’t drink brand name soft drink, because it contained phosphoric acid. his claim being that the drink was too acidic. Then he went and fixed himself a glass of seltzer water with lemon.

    PS. about the pic. yes, she was young and beautiful.
    And she died. perhaps her death could have been prevented, perhaps not. But I do know that Young’s acid-woo wouldn’t have helped her.

  34. #34 DrunkenScot
    January 31, 2009

    Granting for now his idea of acid as badwrong and anti-life, he seems to have neglected the real, beneficial anti-life properties of acid that keeps botulism from growing in preserved food. He also neglects that conifers have acidic sap, which helps keep them from freezing.

  35. #35 Scrabcake
    January 31, 2009

    Oh man. I think the woo-meister has just solved the problem of evil as well. Think about it:
    A god who is all powerful, good, or knowing would have to give up one of those because there is evil in the world that can’t be attributed to the “fall of man”, ie. bacteria.
    Sepsis is caused by Acid, therefore microbes are harmless.
    Bacteria are microbes and therefore harmless.
    There is no non-fall related evil in the world,
    Therefore, god can be all knowing and all powerful and all good!
    QED!
    Oh, crap. Apparently if A implies B, it’s a logical fallacy to assume that B implies A. That and the above doesn’t count for tsunamis and poisonous snakes. Maybe bad weather is caused by bad vibes in the air caused by “fallen people!” And don’t a lot of toxins screw up potassium ion pumps? That’s kind of pH-y? Right?
    Oh yeah! I have this theological argument thing down! Crown me pope!

  36. #36 dt
    January 31, 2009

    It’s quite possible her Pseudomonas strain was multi-resistant. Many types of gram negative baccilli produce extended spectrum betalactamases (ESBL) and are very difficult to treat.
    Resistance is likely to arise in areas where antibiotics such as cephalosporins and carbapenems are used widely.

  37. #37 storm
    January 31, 2009

    re: vitamin C… ever hear of non-acidic C?
    hydrogen is the key, no? LOTS of single electrons to hook up with using hydrogen.

  38. #38 Marc Abian
    January 31, 2009

    My understanding is that P. aeruginosa only causes UTIs if there’s a catheter to form a biofilm on, and it’s only an opportunistic pathogen anyway.

    Did they give her a catheter to fight a kidney stone infection? Is that a treatment?

  39. #39 Laser Potato
    January 31, 2009

    Ugh…they sell 6 varieties of natto at the Asian market down the street.

  40. #40 maryQ
    January 31, 2009

    When ever I read about crackpots like that, I shudder to think of all the shitty Ph.D.’s we’re turning out because they have decent hands, even though they are dumb as a box of hammers and can’t think their way through undergrad cell bio, ‘cuz we need the labor force. Oh yeah, and we need some domestic students.
    How many more like Dr. Robert O. Young are out there?

  41. #41 Orac
    January 31, 2009

    What I wonder is what Dr. Young’s Ph.D. is in. I’m betting mail order.

  42. #42 DLC
    January 31, 2009

    Or perhaps he actually had something going on once, but diverted off into crankery and woo.
    ::shrug::: either way, he’s not doing anyone any good by pushing his acid-woo.

  43. #43 Lurkbot
    January 31, 2009

    So if this new “out-fection is the cause of dis-ease and germs are just a secondary result” meme becomes popular, would that counteract the insane germophobia that characterizes modern American society? Can both flourish in the same mind? I’m willing to bet that they can!

  44. #44 Joseph C.
    January 31, 2009

    What I wonder is what Dr. Young’s Ph.D. is in. I’m betting mail order.

    According to Wiki:

    Young obtained an undegraduate degree from the University of Utah, where he studied biology and business, in the early 1970s,[2] following which he did missionary work for The Church of Jesus Christ of Latter-day Saints for two years in London, England.[2] He received several degrees from Clayton College of Natural Health, an unaccredited distance learning school, including an M.S. in nutrition (1993), a D.Sc. with emphasis in chemistry and biology (1995), a Ph.D. (1997) and an N.D. (Doctor of Naturopathy, 1999).

    So, yeah, you’re basically right. Until someone can produce a real dissertation written by “Dr.” Young, it’s probably safe to assume that his PhD is worth about as much as the Charmin Ultra Soft in my bathroom.

  45. #45 mandrake
    February 1, 2009

    I’d say the Charmin is worth more, since it’s actually good for *something*.

  46. #46 Tracy W
    February 1, 2009

    Cathy – I doubt your premise. Rich people got fat well before modern medicine (eg Henry VIII’s armour at the Tower of London indicates an extremely big man, and many portraits show a person of size). They couldn’t have been expecting magic pills to cure their illnesses, as doctors had no magic pills, yet they didn’t make lifestyle changes. It therefore strikes me as entirely plausible that the reason that people don’t make lifestyle changes is that making lifestyle changes is hard, not because current medicine is so effective.

    At high school and university I studied less than I should have. I was well aware that there were no magic pills that would shift all that information into my brain. The reason I didn’t study was my tendency to procrastinate, and a certain resistance to actually doing hard mental work. And I note that many of my fellow students talked about similar problems. Furthermore, many people who sign up for diet programmes like Weight-Watchers, and even ones who pay significant sums of money upfront, fail to follow through on the programme. Clearly if you sign up for Weight Watchers or a similar diet programme, you clearly believe that lifestyle changes are necessary, a pill won’t do the trick. How do you attribute those failures to a belief in a magic pill?

  47. #47 Jeremy
    February 1, 2009

    Just to add another indication for alkalinisation of the blood; severe tricyclic antidepressant overdose; the usual advice is to aim for blood of pH7.5 http://www.aaic.net.au/PDF/1996404.pdf

  48. #48 Dr Aust
    February 1, 2009

    Here in the UK we know Clayton College for Natural Health as the (long distance) Alma mater of “Dr” (Clayton College) Gillian McKeith, a TV “nutritionista” more familiar to British readers as “The Awful Poo Lady”(warning: scatological musical link) .

    I’m not that surprised to find that “Dr” Young shares the same awarding Diploma Mill.

    On the slightly brighter side, in the UK complaints to advertising regulators produced a decision that “Dr” McKeith had to stop referring to herself as “Dr McKeith” in her promotional material in a way that would tend to suggest to readers that she had a medical degree.

  49. #49 Mu
    February 2, 2009

    The picture clearly proves the woman could have been saved by a modicum of common sense like a controlled calorie diet, some exercise to achieve something of a muscle tone, and maybe some fresh air for Vitamin D production!

  50. #50 Calli Arcale
    February 2, 2009

    Saliva — I seem to recall reading that the body tries to keep that mildly alkaline, to help protect the esophagus from any stomach acids that slip a bit north. I don’t recall where I read it, or even when, and my memory is not perfect, so take it with a really big scoop of salt.

    MissyMiss:

    If only Padme had some prenatal care, things might have gone very differently.

    Yeah, but then somebody would’ve figured out a) why she was wearing baggy clothes all the time, and b) that a certain Jedi had been naughty. I mean jeez, it’s not like they went to any real effort to hide the relationship. The Jedi Council was so oblivious it’s amazing they were able to achieve anything. “Hmm, I know he had the hots for her as a kid, and he spends an awful lot of nights at her place . . . naaaah.”

  51. #51 Calli Arcale
    February 2, 2009

    Marc Abian:

    My understanding is that P. aeruginosa only causes UTIs if there’s a catheter to form a biofilm on, and it’s only an opportunistic pathogen anyway.

    Did they give her a catheter to fight a kidney stone infection? Is that a treatment?

    I don’t know much about kidney stones, but I have had several imaging studies done of my own urinary tract due to a congenital defect that makes me prone to UTIs. (I have a diverticulum. Too small to make it worth operating on, but I do still get a couple of infections every year.) These can involve catheters. OTOH, it kinda sounds like she had the infection *before* they suspected kidney stones. And a pretty advanced infection at that, if she was getting kidney pain. It’s possible she’d recently had a catheter inserted for some reason we’re not aware of, like an unrelated recent surgery.

  52. #52 IR
    February 3, 2009

    Great post. As a cf’er and lung transplant recipient with a complicated health history, I’m very familiar with P. aeruginosa. Nasty bug.

  53. #53 Lucario
    February 10, 2009

    Reading about that chick dying of sepsis frightens me. Could any of you folks tell me how not to end up with it and how to tell if I do have it? Any and all (non-woo) advice would be greatly appreciated.

    And shame on woos like Dr. Young who use tragic deaths like these to sell their philosophy.

  54. #54 win
    October 30, 2009

    If Doctor Young is a fraud, then I challenge you to allow him to publicly treat some willing cancer patients and genuinely report the results. Millions are spent on ‘cancer research’ and yet despite no cure being found (surprise surprise), no one will fund a Dr Young trial; surely it’s worth a few million even if it is just to dispell the ‘myth’ as you call it either way. That should prove it once and all – perhaps Glaxo or someone would be willing to sponsor him, or perhaps not? I have worked with pharma companies and their primary goal is money not health – go on, try and tell me I am wrong!

  55. #55 Tom
    December 5, 2009

    After sixty years on this planet there is one thing that rings true for me: “the truth is almost always somewhere in the middle”. My wife has suffered over twenty years from a mystery disease. Most of the evidence points towards some type of connective tissue/autoimmune problem. Despite countless visits to the doctor’s office and huge amount of money spent, she gets sicker as each year goes buy and still no diagnosis. I assure you there are countless so called “mainstream doctors” out there that are as bad as or worse than Dr. Young and should not be practicing medicine. As time passes on and after everything else has been ruled out, we are starting to lean towards systemic yeast/fungal infection. Our problem is, ALL the “standard medical practitioners we see” refuse to address the possibility of a systemic fungal/yeast infection.
    The truth is, systemic fungal/yeast infections (one of the main issues addressed by many practitioners of alternative medicine) is real and for a fact can make you very ill and kill you. It can be insidious and can be very difficult to diagnose. The problem is that the so called “standard medical practitioners” and the “alternative medical practitioners” have aligned themselves at “opposite ends of the stick”. There are “snake oil salesmen” out there and there always will be, but after taking care of a sick person for over twenty years, there a lot of despicable and incompetent licensed medical doctors out there.
    It’s unfortunate for the people who are probably suffering from this “mystery disease” that the two parties can’t get together and get to the bottom of this issue. I blame the standard medical practitioners (what I call the “AMA Group”) more than the alternative practitioners. The AMA has the power, money and influence to get to the bottom of this.

  56. #56 You Know Who
    December 14, 2009

    I would argue that accepting something on faith just because it is written in a textbook is a form of dogmatism too. How many of you have actually had a urinary tract infection before? The ignorance of the importance of the requirements of the body’s interstitial fluid and its affects on entire organ systems is grossly understudied in medical school. You must remember that doctors are taught to treat isolated bacteria in isolated petri dishes. We are dealing with a complex organism with multiple organ systems that participate in a large feedback loop, not killing bacteria in a petri dish. In the end, it is the body’s immune system that has to do the work in any event.

    I personally have had a urinary tract infection that affected the prostate, kidneys, and urinary bladder. The failed attempts of several rounds of antibiotics left three prominent urologists I saw not knowing what to do. I decided to mix a tablespoon of sodium bicarbonate into a glass of water, in two glasses of water per day. The infection is now gone. I know for a fact, from my own experience, that dysbiosis of the intestinal tract is also involved. Do not be so quick to rule out common sense – your life may depend upon it someday.

  57. #57 Not-so-innocent bystander
    December 14, 2009

    You must remember that doctors are taught to treat isolated bacteria in isolated petri dishes.

    (Citation needed.)

  58. #58 James Sweet
    December 14, 2009

    I would argue that accepting something on faith just because it is written in a textbook is a form of dogmatism too.

    Trust and faith are not the same thing. Trust is earned and can be revoked; faith is unconditional and unearned.

    I decided to mix a tablespoon of sodium bicarbonate into a glass of water, in two glasses of water per day. The infection is now gone. I know for a fact, from my own experience, that dysbiosis of the intestinal tract is also involved.

    Eh, what? A sample size of one on the effectiveness of a particular treatment method proves the mechanism? Woah…

    Well, I know for a fact that reading a couple of articles on Snopes causes highly fallacious comments to appear on 11 month old blog posts on Respectful Insolence. I mean, this comment wasn’t there, and then I read some stuff on Snopes, and now this comment is there. Miraculous!

  59. #59 Prometheus
    December 14, 2009

    “YouKnowWho” ["YKW"] (actually, I don’t) had a…thought provoking comment (#56):

    ” The ignorance of the importance of the requirements of the body’s interstitial fluid and its affects on entire organ systems is grossly understudied in medical school.”

    At first blush, it appears that “YKW” is saying that “the ignorance of the body’s interstitial fluid is understudied in medical school” – at least, that is what the sentence says. This is no doubt true, as there are many aspects of ignorance that are left unstudied in medical school because of time limitations (ignorance being an infinitely large topic).

    However, I somehow doubt this is what “YKW” meant. More likely, “YKW” meant that the “interstitial fluids” of the body are poorly understood by doctors. This makes more sense, but is correct only to the extent that the interstitial fluids are hard to analyze, being confined to the space outside of cells and blood vessels. However, being driven by diffusion between the cells and between the cells and the blood, it is not hard to calculate their composition. In addition, a good deal of work has been done to allow these fluids to be directly measured – such work has largely confirmed the previous calculations.

    “YKW” continues in a similar vein:

    “You must remember that doctors are taught to treat isolated bacteria in isolated petri dishes.”

    No. Medical schools do not limit their infectious diseases curriculum to the treatment of “isolated bacteria in isolated petri dishes”, no matter how much “YKW” might wish they did. While one or two laboratory sessions might be spent using antibiotics on bacteria in culture, the actual curriculum in medical school emphasizes treating infections in intact humans. Or, as “YKW” characterises them:

    “…a complex organism with multiple organ systems that participate in a large feedback loop, not killing bacteria in a petri dish.”

    “YKW” continues to extoll his (I assume “his” because of the following anecdote) experience with the limitations of the germ theory of infection:

    “I personally have had a urinary tract infection that affected the prostate, kidneys, and urinary bladder. The failed attempts of several rounds of antibiotics left three prominent urologists I saw not knowing what to do. I decided to mix a tablespoon of sodium bicarbonate into a glass of water, in two glasses of water per day. The infection is now gone.”

    Prostate infections can be difficult to eradicate, often requiring long and repeated treatment with antibiotics. So, it would be nothing less than a medical breakthrough if a couple of tablespoons of bicarbonate a day would work. One wonders what else “YKW” did (or stopped doing) at the same time. Still, it’s his story, so I will leave it up to him to support it with data (or not).

    Still, you’d think that if it was this simple to cure chronic bacterial infections (and even cancer!), Dr. Young would have managed to pull together a few case studies to prove his point. Show us the data, Dr. Young, and we will believe!

    Conversely, don’t show us the data and we’ll have no choice but to assume that you’re full of…..wishful thinking.

    Prometheus

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