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Editorial

Clinical Medicine for the Year 2000: Treating Nuclear Bomb Exposure

 

I sit here scribing this editorial on the first Saturday after Pakistan unleashed its nuclear weaponry and wonder in some amazement at the "business-as-usual" mentality afoot in Seattle. In 1962 before the Bay of Pigs invasion of Cuba, the threat of annihilation by nuclear attack was poignant in the US and Russia. Nuclear bomb shelters were a faddish cottage industry in the US and some neighbors actually had plans for installing them. The last several decades brought more countries into the club of nuclear weapon holders, but the dismantling of the Berlin Wall seemed to bring an olive leaf among the parties threatening the world with "the bomb." So for nearly 6 years the world has experienced relative peace (with the exception of Rwanda, Kuwait and others). What a rude awakening May has brought us with New Delhi and now Islamabab each detonating 5 nuclear bombs and now with Pakistan threatening to arm their missiles with similar weapons. Are we at the precipice of nuclear war? Diplomacy failed to stop Pakistan from seeking revenge for India's surprise nuclear testing. Two decades of US sanctioning in the Asian subcontinent has done little to change decision-making by the Muslim Pakistanis and the Hindu Indians. Other nations have fared little better. Russia was utterly incompetent in controlling activity by Afghanistan. Neighboring Iran threatens to develop a nuclear arsenal; Iraq will merely settle to develop biological weaponry for the world, perhaps in exchange for their own nuclear devices. China has long had its own nuclear stockpile. Meanwhile the US continues to nursemaid its collection of 2,000+ weapons and the Soviets have a similar arsenal. Do we seriously believe that there will not be some incident in the near future? The question is not if there will be another Hiroshima, the question is when and what should be done? Clinton and the State Department should be asked how will we respond to a nuclear war by these third world nations with nuclear devices. As Pogo the cartoon character has quipped, "We have met the enemy and it is us!"

From the physician point of view, treating the victims of a nuclear attack is the pressing issue. What strategies must be employed not just for the emergency but for the long-term care? Given the inevitability of such an exposure, are there any preventive courses of action? Finally but not necessarily lastly, what are the alternative medicine strategies not being considered by the civic authorities? This editorial will not attempt to define the conventional emergency procedures except to say that medical care will be delivered on a triaged basis with standard emergency procedures employed for highest priority emergencies first. Unfortunately radiation exposure is well concentrated by solid organ tissue and is not easily removed by ordinary detoxification or poison control methods. Extremely high dose radiation will probably be triaged to "untreatable" wards and "left to die." Moderate radiation exposure will probably be given first priority and it would be curious to see how civic authorities determine the criteria separating these two categories. Nevertheless, moderate radiation exposure will be very limited in survivability: such victims will probably sustain one or more major system breakdowns with radiation poisoning within 10 days to one month. The highest potential of survival will lie in the low radiation exposure category. These individuals will only have the chance for long-term survival if they undergo conventional and unconventional approaches to radiation detoxification. Of course, the unconventional alternative approaches will remain, as always, outside the mainstream treatment facilities and limited to those individuals who seek such care on their own initiative.

Within the alternative medicine arsenal (perhaps a poor choice of words) and within easy access to everyone are Vitamin C, E, A, calcium-magnesium, digestive pancreatic enzymes, silymarum (milk thistle), B vitamins, selenium, Vitamin B12 and folic acid, bioflavonoids, mushrooms, garlic, Pacific sea kelp and pure water. All of these nutrients, nutritional supplements, foods and water represent first step detoxification measures helpful in reduction of radiation burden. Silymarum should be greatly emphasized for its protective role for the liver. Vitamin C, selenium, garlic and water represent minimal supports for the kidneys which will face double-trouble first from direct radiation exposure and secondarily from diuresis of radiation-concentrated fluids. Kelp will be obligatory to support the thyroid which will concentrate radioactive iodide contamination. What sort of doses should be prescribed? Time will be of the essence and erring on the side of too much will probably be safer than giving too little. For once we should listen to Linus Pauling and treat with high doses of Vitamin C, 10,000 mg plus daily. The vitamin C should be buffered if possible with minerals and should also be complemented with high doses of Calcium-Magnesium to prevent undue chelation of these minerals from the body: 2,000 mg of Calcium to 1,000 mg of magnesium. In addition very high doses of Vitamin C tend to make people subject to more herpes outbreak and a high dose of lysine 2,000 mg daily should be employed. High doses of the other nutrients are probably indicated: Vitamin E, 1200 Units; Vitamin A 25,000 IU+; digestive enzymes, 2-4 per meal; silymarum 3-6 capsules daily; B-Vitamins, 50-100 mg; selenium 200-600 mcg; Vitamin B12 2,000 mcg; folic acid, 5 mg; bioflavonoids, 3,000 mg; garlic, mushrooms and kelp at each meal. Water intake should definitely be higher than usual, 8 glasses daily. Many other nutritional supplements should be considered in these programs and employed. This will be a race against time and we will be dealing with radioactive particles having timeless half-lives.

Chelation is definitely appropriate in these situations. EDTA chelation has been utilized in various medical emergencies in the past with nuclear workers exposed to radiation materials. Intravenous EDTA chelation, intravenous ascorbic acid and i.v. minerals should be administered if possible as early as possible after radiation exposure. Intravenous ascorbic acid assumes heroic proportions using 25-50 grams of Vitamin C per treatment. It is obligatory to buffer the Vitamin C with calcium gluconate or the individual will experience tetany from excess calcium loss. EDTA also should be employed with magnesium and other trace minerals. The safety record and relative low cost of EDTA make it a preferred treatment method, Other agents will probably deserve consideration. Many homeopathic preparations are now available for intravenous use and will also offer alternative means for detoxification.

Prevention will not neutralize radiation exposure. But individuals who have already employed vitamins and minerals and other nutritionals specified earlier will have a better chance of lessening the impact of radiation on their system. This may be the best argument yet why nutritional supplements deserve routine use regardless of the individual's state of health. The major concern for individuals having limited radiation exposure will be the long-term risk for malignancy. Those individuals having higher anti-oxidant status will probably face lesser risk than those individuals with minimal vitamin usage.

The recent turn of events has created an uncomfortable environment with various parties holding weapons of mass destruction. The provincial self-serving character of these parties threatens the ultimate deployment of nuclear weapons with massive public exposure to radiation and radioactive elements. Protocols are needed now to offset the degree of damage from exposure and to offer complementary and alternative approaches for those individuals sustaining radiation exposure. The Townsend Letter welcomes additional discussion on this topic from the readership.

Jonathan Collin, MD

 


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