Tuesday, August 30, 2016

Allergy and the Environment: A Reflection on the Writings of the First Filipino Allergist*

No period in history has man influenced the environment as much as what he is doing  today in his pursuit for a higher standard of living, and affluence. But observations show that instead of “tailoring man’s lifestyle to the environment” which his ancestor did for centuries, man today is modifying the environment to meet his growing affluence – which is exactly the opposite.(9,10) 

Before going to the main topic, kindly answer these question, True or False. 

Abercio V. Rotor. Ph.D.**

Fact or Myth?
                                   
1.      Children who grow up on the farm are at much lower risk to allergy than children in the city.

2.      Infants on the farm have fewer allergies than those who grow up in sterile environments. 

Dr Arturo B Rotor, photo

3.      Children who grow up with a cat in the house are less likely to develop allergies or asthma.

4.      Very few pet owners are allergic to the animals they love.

5.      Children who have been breastfed are less likely to have allergies.

  1. Milk, soy, wheat, egg, peanut, fish and meat comprise the most common food allergies.

7.      Most reactions to food are not allergic in nature, but rather intolerance, that is, there is no allergic antibody involved.

8.      Babies exposed late to cereal grains have higher risk to cereal allergy, especially wheat.

9.      Regular use of “foreign” materials (e.g. nail polish remover, contact lens, metals) can eventually cause sensitivity and reaction to the products.

10.  Allergy can induce strong and unwelcome mental and emotional reactions, such as altered perception or inappropriate changes of mood.

NOTE:  These above statements are all based on facts.    
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*Dr. Arturo B. Rotor Memorial Lecture, 11th Biennial Convention of the Philippine Society of Allergy, Asthma and Immunology, Sofitel Philippine Plaza Hotel, Roxas Blvd, Pasay City.
** Presently professor in environmental science, biology and the humanities at the University of Santo Tomas, St. Paul University QC, and University of Perpetual Help Rizal; author of award-winning books, The Living with Nature Handbook and Living with Nature in Our Times.   


LECTURE SUMMARY

This lecture presents and describes our environment in twenty (20) areas where significant changes are talking place on local and global scale. The author’s view on the subject as an environmentalist and media practitioner may be seen from the simple and practical design of this lecture.

Germany, then a divided country for 45 years, served as model in this lecture, classifying environment into two extreme conditions: West Germany, a progressive capitalist state, and East Germany, a poor socialist state.

When scientists from Robert Koch Institute compared allergy cases under the two environments, they found out that allergies were far more common among Germans from the affluent West.  (1)

This finding endorses a general hypothesis to guide researchers on allergy as affected by varying living standards on one hand, and the nature and degree of environmental changes affecting the area, on the other.  The hypothesis is similarly useful in comparative analysis of countries undergoing different stages of growth and development vis-à-vis incidences of allergy, other diseases notwithstanding. West Germany represents a microcosm of a global Silent Epidemic, as well as countries that have adopted the Western model of development, whereas East Germany, which has less allergy cases, represents the Third World countries that outnumber the progressive ones, among them the Philippines. (1, 9).

What are the contributing factors to the high incidence of allergy in an affluent society? And what factors are responsible for the low incidence of allergy in an underdeveloped society? Apparently the key is environment.  Environment includes all facets, natural and man-made, and factors that disturb its balance whether force majeure or man-induced calamity.  It also includes society itself, the major institutions, science and technology, trade and industry that operate through interdependence with the natural environment. As this requires far-reaching consequences, the hypothesis had to be divided into specific ones. But the intention of this paper is generally to present issues from which questions may be raised, and answers sought ideally through research, in order to provide working premises that contribute to the occurrence, real or potential, to allergy.

Reference from the themes of selected short stories written by Dr. Arturo B Rotor is included herein to reflect the honoree’s thoughts and ideas in his own time regarding the topic.  It speaks well of Dr. Rotor’s philosophy of life as a medical doctor, nationalist, artist, and nature lover – which in a larger picture, the author believes that after reading his literary works, indeed the honoree is a naturalist and environmentalist. Quotations and excerpts from his works are part of this paper and its PowerPoint version. Likewise, the author’s works are included in the reference. (6,7)


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Divided by a wall for nearly half a century, West Germany and East Germany followed a dichotomous political, socio-economic pathway - the former a capitalist Utopia, while the latter a socialist Third World.  It was a case of one people living on separate and unequal planets – each accordingly representing the developed and the undeveloped countries of the world. Then in 1990 the Cold War ended, and the two Germanys were reunited. A startling medical discovery was revealed: Allergies were far more common among Germans from the affluent West. ( 1)
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No period in history has man influenced the environment as much as what he is doing  today in his pursuit for a higher standard of living, and affluence. But observations show that instead of “tailoring man’s lifestyle to the environment” which his ancestor did for centuries, man today is modifying the environment to meet his growing affluence – which is exactly the opposite.(9,10)
  
Twenty (20) environmental issues
vital to the understanding of allergy
1. The environment has changed a lot in the last two hundred years since the start of industrialization, which is also the start of modern age. The biggest effect to human health contributed by this era is widespread pollution. Pollution is the by-product of industrialization, and the scourge of modern living. How we have spoiled the environment can be gleamed from “The Men Who Play God.” This excerpt tells us of the once pristine environs of the Philippine General Hospital.

“… sitting in the trellised balconies and, above all, the heavenly peace and quiet, to detect the unmistakable tang of the evening breeze, long before you saw the surf breaking against the moored fishing boats off Pasay beach. xxx In such an environment, convalescence was pleasant and speedy. There was unpolluted, invigorating air to fill the lungs, cool tranquil nights to encourage sound sleep, restful, uneventful days for strolling in the hospital grounds or sitting down and dozing under great spreading acacia trees.
AB Rotor The Men Who Play God

2. Pollution is no longer confined within a geographic area of land, in water and air, or   a particular country or region; it is now global. The effect is worldwide in the form of global warming, causing more erratic weather disturbances, thinning of the ozone layer, the worsening effect of acid rain, among others. Pollution allergy cases arise directly from garbage, smoke from factories and vehicles, acid rain contact, sudden changes In temperature and humidity, ultraviolet rays near the ozone hole - and most specially from the gas-fed engine.

“There is only one contrivance that can move this mass of humanity, the internal combustion engine. If you stand long enough in front of the Philippine General Hospital, you will see every model, make and variant of this wondrous invention, from scooters to ten-ton trucks, from World War II jeeps to seventy-passenger buses. At peak travel hours, which is before nine in the morning, to sunset, the combined cacophony of thousands of motors accelerating, horns blasting, tires screeching, reaches the one-hundred-twenty-decibel level. Above this basic din, boy-peddlers add a few more decibels touting cigarettes or sweepstakes tickets, and by bus conductors announcing their routes: ‘Siga-ril-yo! San Andres Bukid! Crossing! Vito Cruz!’ The din and confusion are indescribable. This must be what a mortally ill patient in delirium must go through; this must be the amorphous, unremitting jumble of hubbub, boom and barrage, without pattern or purpose or direction, that finally pushes the mind over the brink of sanity.

  AB Rotor The Men Who Play God

3. Modernization and the “good life” brought about affluence, first to the industrialized countries, and later to countries which followed the path of development of the western world. People want goods and services beyond what they actually need. Affluence - more than necessity - has greater impact on the environment in the form of depletion of natural resources and pollution. Affluence to an extreme is indeed wasteful living. 

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Go to Nature, live by her ways.  Under a natural environment, children acquire the defense the body systems need against a host of health problems from allergy to physiologic and pathological diseases, including the adaptation to weather emotional and psychological stress.  Ever wonder what it means to enjoy childhood outdoors?  Away from computers and malls?  Summer away from school? Many children look forward to the first rain in May, the kite-flying season, the next Scout Jamboree.  AVR
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4. The increase in population continues in geometric pattern.  It has reached 6.6 billion.  At its present trend, another billion people will be added in the next 25 years.  New settlements, bigger cities, increasing population density predispose people to various pathogens and allergens.

5. The general trend all over the world is exodus to urban centers.  Metropolises and megapolises with 10 to 20 million people ensconced under crowded condition are not uncommon. Meantime villages grow into towns and towns into cities. The ratio of rural dwellers to city dwellers will soon reach equal proportion, but soon it will favor the latter. People crowd subdivisions, condominiums, malls, schools, churches, parks, in great numbers sharing common lifestyles and socio-economic conditions.  Thus predisposing them to common health problems and vulnerability to disruptions (brownout, water interruptions, force majeure).

6. Destruction of the environment is a consequence mainly of increasing population and affluence, leading to the loss, not only the productivity of farms, but also loss of farmlands to industry and settlements.  It leads to the irreversible destruction of ecosystems like lakes, rivers, forest, and coral reefs. Loss of health of environment is loss of health of living things; and therefore, loss of environment is loss of life.


7. The ecosystems bear the brunt of development and progress. Wildlife is being reduced in size and biodiversity with species threatened to extinction as they are driven out of their natural habitats.  Or, that their habitats are forever lost. Our existence and quality of our life depends on a complex interrelationship of the living world, that by disturbing the balance of this interrelationship will affect us humans, so with all the members.  Ironically we also upset the balance of biotic and abiotic components of the biosphere. 

8. Meantime wildlife areas are being invaded by humans. As wildlife shrinks, its species are threatened or endangered.


Wildlife is also becoming a part of us, sharing with our homes, backyards and farms, transmitting deadly diseases like SARS, HIV-AIDS, Mad-Cow, FMDE, Ebola, and Bird Flu which can now infect humans, allergies notwithstanding.

Many diseases today are linked to the degradation of the environment, among them the effects of pesticides, diseases of animals that have crossed the barrier of defense in humans, physiologic and psychological ailments, notwithstanding.  These may not be readily expressed as to be diagnosed properly and early; they appear in many ways signs and symptoms of allergy.  Allergies make a floodgate of more severe and even life-threatening diseases. The inability of doctors to specify a strange disease may be tagged as a syndrome, as it was the case of Santiago’s Syndrome. Here’s an excerpt of a conversation of simple people confined for treatment in a hospital.

“Naku, you never saw so many doctors in your life,” Santiago reported, “a hundred, maybe two hundred. Many were visitors from the V. Luna Hospital, the Veteran’s Memorial, Far Eastern, Santo Tomas, even from Pasig and Bulacan. All of them talking about me for two hours, my blood pressure, my favorite food, my bathroom habits. See this tiny lump under my arm? They stood in line just to feel that, men and women, professors and interns. Two hundred physicians, attending just one patient.”

But Berto, who occupied a bed just across him, muttered: “That’s all very well, Tiago. But did they find out what medicine to give you to make you well again?”

“You don’t understand, Berto. First you have to identify a disease before you can treat it. My disease is so rare they have to study it some more. In that room this morning the doctors acted and spoke as if they had never seen anything like me. They don’t even have a name for it, so some professors got up there this morning and suggested that it be called Santiago’s Syndrome for the time being.”

                                                                                               AB Rotor. Santiago’s Syndrome

9. The “Good Life” has spawned obesity and other overweight conditions with millions of sufferers around the world.  In the US one out of five is an obese. The spawning ground of obesity is the city.

Victims suffer of complications in their health and difficulty in adjusting to a different life style. Because of their conditions they are merely spectators, rather than being participants, in games and other physical activities, thus exacerbating their plight.

10. Global warming is changing the face of the earth, shorelines are pushed inland, islands sink, lowlands turn to swamps, icecaps disappear, polar ice melts.  There ’s even a need to re-draw the map as sea level rises, and to review land use policy,  city planning and relocation. Adaptation is key to allergy resistance and immunity, but this cannot be done overnight; it takes a lifetime if not generations. Indeed displacement of settlements and change in living conditions predispose people to ailments and allergies. Here is a report of Time (  )

 “Physicians probably won’t be listing ‘global warming’ as a cause of death, but the burgeoning signs of climate change – swelling populations of pollen-producing plants and disease-bearing insects, warmer oceans, desertification, water-supply pollution – all add up to a deadly cocktail that will challenge health experts in the future. On allergies, plants that produce substances mostly grasses and other annual plants, to which many of people are allergic, will flourish under the warmer conditions that are a result of global warming.

“Scientists have tied local spikes in asthma and allergy attacks to increases in molds and emissions from diesel engines. Apparently, the molds attach themselves to diesel particles, which deliver them more efficiently deep into the lungs. Add a plentiful helping of dust storms and a rise in drought-driven bushfires, and you have a made-to-order recipe for increasing respiratory distress worldwide.

11. Globalization is the name of the game in practically all aspects of human activity – trade, commerce and industry, agriculture, the arts, education, politics, religion and the like. The world travels on two feet- communications and transportation. The world has shrunk, so to speak. Traveling from one place to another across latitudes and longitudes predispose one to unimaginable kinds of ailments, allergies, and discomforts, among them malaria.

“Malaria, borne by tiny mosquitoes, kills more than 1 million people each year. Scientists fear that hot weather and heavy rainfall could make global mosquito populations explode. xxx The tricky thing about predictions is that you can’t point to any outbreak or any individual’s death and say, ‘This occurred because of climate change.’ But we do know that good public health relies on a long list of factors – the availability of doctors and nurses, effective medicines, clean water, proper sanitation – and that even today, millions of people die every year of what should be preventable diseases. With global warming, we can expect the death toll to be even

12. Homogenization involves pooling of genes through inter-racial and inter-cultural marriages resulting in various “mestizos” like Eurasian, Afro-Asian, Afro-American, Amerasian, and the like.  Mélange of races is fast increasing in complexity as East and West continue to weld genetically. Native genes provide resistance to pest diseases, adverse conditions of the environment. Native genes through intermarriage may bring beneficial results, but are thinned out thus losing their resistance or immunity from gene pool. Mestizos of subsequent generations are likely to be affected. 

13. Science and Technology as the prime mover of progress and development has also brought doubt and fear to human’s future. The first breakthrough created the nuclear bomb, the second brought the globe to the size of a village with the microchip,  and the third, Genetic Engineering now enables man to tinker  with life itself.

In an article I wrote a few years ago,  A Search for Meaning in a Highly Scientific and Technological World,  I asked – ‘In our age of modern science and technology, of automation and computerization, of globalization and space travel, will we finally find the answer to this perplexing question? At its present rate, we are virtually grappling with the pole vault to cope with the leaps and bounds of discoveries and inventions, which are pushing us to change our ways, and our very lives.  It is no longer us who dictate science and technology; it is science and technology that dictates us.

Virtually there is no place to escape from our high tech world.  Imagine life if there were no cell phone, cable TV, video games, malls, hospitals, e-mail, and many more.  And if we think about today’s process in making the many products we use everyday – imagine computers and robots at work in place of man.”  

                                                                                                AV Rotor, Light from the Old Arch

14. These three breakthroughs in science and technology vastly changed our lives in practically all aspects, and our regard to institutions which include politics and religion.   

·         Splitting of the atom - nuclear energy and nuclear bomb
·         Microchip - modern communication and transportation
·         Genetic Engineering – Genetically Modified Organisms, Cloning, Gene Therapy, biological warfare.

Each invention or discovery bears heavily on the way we live.
Human conditions too, have vastly changed. Radiation related death still occurs in Nagasaki and Hiroshima, more time is spent by our children with the computer than with nature, Gene Therapy – curing gene-link diseases before they are expressed – will revolutionized medicine. Naturally all these have repercussions on human health and welfare.

15. Revolutionary industries have been born out of these breakthroughs and related discoveries linking them with the business world and society, giving rise to in vitro fertilization or test tube babies, surrogate motherhood, Human Genome Project (HGP or gene mapping), multiple childbirth, DNA mapping, etc. The prototype human robot is born, and he is not defect-free.  In fact he is more dependent on medicine and could not possibly withstand the conditions of the natural environment as we do to the extent of pampering him. Indeed he  will lead a very dependent life.

16. Globalization is changing the concept of cooperation dissolving rigid walls of nationalism to give way to regional and international cooperation such as European Union, ASEAN, APEC, CGIAR with seven members such as ICRISAT, CYMMIT, IRRI and the expansion of the United Nations to include WTO, ILO, and others.
Fighting global diseases – so with asthma and allergy -  needs cooperation on all levels. In the same way a community fights Dengue, so with whole continents arresting the spread of HIV-AIDS, SARS, Bird’s Flu.
  
“Rising temperatures could – if rainfall and other conditions are right – result in larger mosquito populations at higher elevations in the tropics, which could in turn contribute to the spread of malaria, dengue and other insect-borne infections. The World Health Organization (WHO) believes that even the modest increases in average temperature that have occurred since the 1970s have begun to take a toll. Climate change is responsible for at least 150,000 extra deaths a year – a figure that will double by 2030,  according to WHO’s conservative estimate. As with so many public-health issues, a disproportionate part of the burden appears to be falling on the poorest of the poor. That doesn’t mean, however, that the comparatively wealthy – who account for more than their share of greenhouse-gas emissions – will escape harm. A look at three key factors affected by warming offers a hint of things to come.” (Time, Global Warming)

15. Revolutionary industries have been born out of these breakthroughs and related discoveries linking them with the business world and society, giving rise to in vitro fertilization or test tube babies, surrogate motherhood, Human Genome Project (HGP or gene mapping), multiple childbirth, DNA mapping, etc. The prototype human robot is born, and he is not defect-free.  In fact he is more dependent on medicine and could not possibly withstand the conditions of the natural environment as we do to the extent of pampering him. Indeed he  will lead a very dependent life.

16. Globalization is changing the concept of cooperation dissolving rigid walls of nationalism to give way to regional and international cooperation such as European Union, ASEAN, APEC, CGIAR with seven members such as ICRISAT, CYMMIT, IRRI and the expansion of the United Nations to include WTO, ILO, and others.
Fighting global diseases – so with asthma and allergy -  needs cooperation on all levels. In the same way a community fights Dengue, so with whole continents arresting the spread of HIV-AIDS, SARS, Bird’s Flu.

17. Green Revolution opened up non-conventional frontiers intruding the seas, deserts, watersheds, highlands, swamps. GR pioneered in Genetic Engineering, the splicing of genetic materials between and among organisms that may not be at all related, pooling desired traits. Thus the growth of GMOs and Frankenfood, and cloning experiments.
Aerophonics (farming rooftops), hydroponics or soil less farming, urban greening, reforestation, organic farming, are among the measures to bring nature nearer to settlements, and insuring people the bounty of nature.

18. Agriculture today depends heavily on Post Harvest Technology. To bridge the production source with the consumption end, the farm and the market, is no easy task, specially with perishable goods. Thus the proliferation of processed goods, supermarket, fast food chains, ready-to-eat packs, sophisticated culinary art.

Many food additives and adjuncts are allergenic, from salitre in longganiza to pesticide residue in vegetables, MSG in noodles to Aspartame in fruit juice, formalin in  fish to dioxin in plastics. 

19. Modern medical science is responsible in reducing mortality and in increasing longevity.  But it is also responsible for many ills today, from genetically linked abnormalities to senility related ailments. It made possible the exchange of organs and tissues through transplantation, and soon tissue cloning. 
Evolution culls out the unfit in all stages of life.  This is true to all organisms.  Only man, or his influence on other living things, can modify Darwinism. 

20. Exploration has brought man into the fringes of our world – the depth of the sea and expanse of our Solar System, ushering the birth of inner and outer space science, and preparation of man for interplanetary travel.
We are learning to live outside of the confines of our planet earth.  We have succeeded in probing the bottom of the ocean. We have put up a city in space - the Skylab.  Now we are aiming at conquering another planet – a long distant goal of assuring the continuity of mankind after the demise of the earth.

Dr. Arturo B Rotor’ s Short Stories
- Implications and Significance

What are the implications of these environmental issues in the occurrence of allergy cases, in diagnosing and treating them as viewed from Dr. Rotor short stories? As I went though his works, I arrived at these scenarios, which provide us a glimpse of his thoughts and philosophy.  I have taken liberty to use other references including mine to further  my research on this matter.

1. As we unveil the mystery of allergy, shrouded by a changing environment, there will be need of young, talented and dedicated people in the field of medicine and healthcare.  The number of patients that our doctor can attend increases everyday, with funds and facilities to use. In The Men Who Play God, the number of patients was reduced after screening the applicants.  The conversation goes like this.
             
“We are not going through the qualifications of 163 patients this morning are we?
“No, sir, we have done some preliminary screening and we have narrowed the choice to three.”

“Fine. xxx Well, let’s hear some opinions.  I understand some of you have investigated these cases carefully and have arrived at positive decisions.”

In the story one patient is a young girl, intelligent, just finished college and her whole life is before her.  The second patient is the sole bread earner of a family of five. The third patient is a hospital attendant who has spent 17 years of his life caring for patients.

The chairman was silent for a long time.  Idly he flicked the pages of the clinical charts in front of him, as if searching for words.  At last he faced his staff squarely.

     “Which one of you would like to play God today?”

 2. There will be new cases doctors will study before these cases can be properly diagnosed and treated, more serious ailments, some life threatening - apparently related to allergic conditions.  In Orchid of Five Wounds, this is how the attending doctor to a 16-year old patient felt.

Dr. Morales felt sympathy, compassion and respect for the blind patient. He even described the flower given to her by other patients, orchid of five wounds, that according to legend, it got its name from Christ nailed on the cross.  Some drops of blood from his wound fell on this plant, hence the name. What physician could remain absolutely objective towards a 16-year old girl, an orphan, struck down by an incurable disease in the spring of her life?

The doctor was quite up-to-date in the literature of his specialty.  xxx  so far he had not obtained any information or development that he had not known before. He had gone far afield, from chemotherapeutic agents, to radioactive substances, to the newly discovered interferon, but none mentioned of a cure; the most that the investigators promised was remission which was another way of saying a postponement of the inevitable.

In desperation the doctor had turned to non-medical or pseudo-medical literature… but he could not track down the original reports.  What was left – faith healer? Prayer meetings? Water from Lourdes?

Inday, the blind patient, followed the singing of visitors and friends who literally brought  Santa Cruz de Mayo into the hospital.  She joined prayers and had light moments with other patients, while being treated and observed. 

He told Inday about the promising result of her treatment. Inday turned her face quickly to him, “I shall see again? … I shall see my flowers, my aunt, my house and friends.  I know I shall see again.”
The following week the heads of Ophthalmology, of Medicine and Neurology visited Dr. Morales and his patient and found her condition fast improving. The occurrence of spontaneous remission of malignant tumors is very rare.  A case of arrested cancer is labeled a miracle.  Inday’s case could be a simple matter of an immunological response, or a hormonal reaction.  

Dr. Morales broke the good new to Inday, with caution , and not set her hopes too high. Xxx he stopped when he saw that she had closed her eyes tightly and that a few teardrops had escaped.  He got up to leave and she released her hand. “I shall see you tonight.”

Her voice, when she finally found it, was hardly above a whisper. “No – I shall see you – I shall see you.”

3.  Alternative medicine - or traditional medicine for its age-long history and custom-tested remedies, its quaintness to village communities, will continue to be the people’s way of obtaining medical treatment and attention, as the terms alternative and traditional imply. Mystery surrounding a disease may lead to faith healing, while formality of modern medicine often lacks of personal touch and attention that patients seek. 

Thus we saw in the excerpts of Orchid of Five Wounds, the way a doctor treated a patient who at first was a hopeless case.  Then, by miracle she made it through.
  
Inday would leave the hospital within the week – when would he she her again?  xxx  He saw her among her plants, talking to them, picking her flowers… Roses and maiden-hair fern  and orchid like butterflies … and she would be in the middle of colors and fragrance.  At first she would probably need thick corrective glasses, but these would gradually be reduced as her vision improved. He would bring her books and catalogues about plants and flowers … yes, the Orchid of Five Wounds – he had promised to tell her the complete legend of the miracle.

 The theme of Dr. Rotor’s story about caring, may be seen at the border of loving, which is strongly evident in Zita, the story of a city-bred young man assigned teacher in an island, and there he provoked a young heart from among his students. Parting, as in the same case of our story, is a painful one, and leaves the reader un uncertain epilogue. longing and p in this case  

4. As people build their lives around the amenities of modern living, their lifestyle in the countryside lured into transformation akin to city life, the more they are exposed to all possibilities of allergy and related ailments.   Here is a scenario of this so-called  Good Life, which I discussed as a chapter in “Light from the Old Arch.”

“A quartz clock awakens you. You switch on the light, tune in the TV or radio, open the e-mail, cook breakfast, read the morning paper, dress up, take the elevator, drive the car, etc. All this is not surprising to most of us who live in urban centers.

But hear this. The milk you drink is genetically modified (human embryo hormone was injected into the cow to produce more milk), the corn flakes you eat comes from BT corn (corn with a gene of a bacterium – Bacillus thuringiensis), your potato fries is likewise a GMO and like your onion rings they were irradiated to extend their shelf life, your lettuce carries a trace of dioxin, the deadliest toxin ever synthesized, your tuna carries a residue of mercury, the microwave emits rays that are not good to health, the paint in your condominium contains lead, plastic deteriorates and you may not know it’s the cause of your allergy, so with synthetic fabric you are wearing.  There  is nitrate (salitre) in corned beef and in tocino, MSG (monosodium glutamate) in noodles, aspartame in softdrinks, sulfite in sugar, potassium bromide in bread, antibiotic residue in poultry and eggs. And the list goes on, ad infinitum. Again we ask, ‘Where will all this lead us to?’”
                                                                                         
                                                                                           AV Rotor, Light from the Old Arch

5. Perhaps the least understood realm of allergy is in the area of genetic engineering, the progenitor of Genetically Modified Organisms – plants, animals, protists – a number of them dubbed as Frankenfood, which we eat everyday.  Already we have Genetically Modified soybean, potato, corn,, and GO milk, poultry and eggs.  And we have barely scratched the surface.  

“Genetic engineering is creating genes and genetic materials that threaten to pollute natural genetic pools worldwide.  Once an organism acquires a foreign gene – now a GMO  – it becomes a permanent source of genetic contamination and pollution. xxx Transgenic plants and animals will definitely contaminate natural gene pools, in effect creating blindly hybrids and crossbreeds from varying combinations of genes of both GMOs and non-GMOs.

“New bacteria, viruses, prions, other pathogens are more virulent, not only by their infective nature, but by mutation or reactivation of dormant and harmless ones.  Antibiotic resistant markers (ARMs) in GM plants and animals can be transferred to other bacteria, including the harmful ones. These resistant bacteria could become gene sources of virulent forms. xxx Genetic manipulation introduces proteins from organisms never used as food, many of which could be the source of new allergens.” 
                                                                                               AV Rotor, Living with Nature in Our Times


6. Advances in our understanding about diseases, including allergy, may be thwarted by superstitious beliefs and ignorance, and by inaction on the part of government, particularly in remote communities. The case of The Boy Who Always Sneezed Three Times, illustrates Dr. Rotor’s view on this aspect.

It happened when the baby was but a few weeks old.  Mang Teban and Aling Doray and several relatives were in the room admiring the new baby. .xxx Suddenly the boy sneezed – three times.  It evoked excitement. It was sign of good luck and fortune. They predicted Baby Garcia would someday become rich and famous.

A measles epidemic struck the village. And many children came down with the familiar fever and skin eruptions.  Tigdas was nothing new to the people; it was part of growing up, unavoidable, and in fact of some advantage to the child. He gets it once and doesn’t get it again. The government sent the provincial health officer to investigate the epidemic was almost over; it was too late to vaccinate the children.

Baby Garcia was one of those who contracted the disease early, but Aling Doray recognized it only when hundreds of eruptions, as if a horde of mosquitoes had bitten him. She closed up one corner of their small bedroom, covering the door and window with thick blankets so that no light could enter.
Here she kept her baby, trying to make him eat, stroking his forehead and crooning him to sleep.  The fever and rash soon abated, but a dry cough.  When he was finally brought out of the darkened room, he looked like skin and bones His eyes were deeply sunk, his face shrunk like squeezed  orange.  He ate very little and did not pay attention to his surroundings. He was too weak xxx It seemed to take a long time to recover – and sometimes she doubted whether he would ever get well.

The one night as she dozed near the child she was awakened by his cry, which did not seem like the cry of a sick child.  The mother held her son nearer the light.  Suddenly he screwed up his face and sneezed – three times.
                                                                            AB Rotor, The Boy Who Sneezed three Times    


7. Man’s pursuit of knowledge, of affluence, of pleasure, are not necessarily of the ideals of sapiens (thinking), ludens (playing), faber (making) and spiritius (praying) that make him singularly rational.  His failure and indifference constitute the antithesis of his decisions and actions, of his gains and achievements, his inability to keep his role as guardian of nature.

Here is an excerpt from Dr. Rotor’s short story, The Clinical Trials.  It was the annual convention of the Society of Experimental Animals, the most important scientific event of the year, and every sector of society was represented: the guinea pigs, rabbits, cats, dogs, hamsters – even the pigs had their own delegation. And the subject is about human beings, not the other way around. Call it a fantasy, an allegory, science fiction, modern fable sort of.

   “The convention arrived at the conclusion that the best subject is Homo sapiens. Of all of God’s creatures, there is no species more guilt-ridden, confused and self-destructive than man. Fear, remorse and frustration underlie his basic behavior, probably as a result of his forbears having been driven out of the Garden of Eden. He kills not for food, he eats when he is not hungry, he mates in or out of season. His suicidal tendencies are unique. While the lemmings drown themselves as a result of reduced food supplies, man will willingly cultivate cancer of his lungs by smoking poisonous plants, convert his liver into a hobnailed, atrophic mass of dead tissue with alcohol, or remove himself from the control of his mind with narcotics.

“The genes bearing these characteristics have not been identified, but seem to be transmitted paternally and maternally. An important feature of his personality is that the more developed the creature and the more successful, the more likely is he to suffer from neurosis. While among all other species, infection heads mortality and morbidity lists, among Homo sapiens, neurosis is the underlying cause of ninety percent of all illnesses. As a matter of fact, in the big cities and centers of population, the archetype of the successful executive is the hypertensive, the ulcer patient, the tranquilizer-dependent. We believe that for an in-depth study of tension or anxiety, in all its typical and atypical manifestations, man is a better subject than the frog, mouse or rabbit.”

x x x The results are clear-cut and not unexpected, as far as Capsule A is concerned. However, Capsule B presents some problems. Capsule B contains nothing but milk sugar, and yet it produced the same result as Capsule A.

More theories were offered, each more complex than the preceding: telepathic communication, secondary visual and auditory organs located in the arms or shoulders, and extra-sensory perception. But none could fully explain why milk sugar acts like a food when taken as food, and sometimes like a tranquilizer when taken as an anti-depressant. The author of the report requested to clarify the technique used in the determination of the low-density lipo-proteins? xxx    

“The scientific forum was over. It had been stimulating, it had approved a new drug, and it had advanced medical knowledge. Except for one minor detail, it could have been one of the countless scientific meetings being held all the time everywhere in the world. By human beings.

AB Rotor, The Clinical Trials
                                                               x  x  x 

 









VR

References


1.      Ansorge R and E Metcalf et al (2001) Allergy Free Naturally Rodale Inc NY, Hampton JK (1991) The Biology of Human Aging, Wm C Brown Publishers

2.      Jacobson E (1964) You Must Relax, McGraw-Hill 270 pp

3.      Miller GT Jr (2004) Living in the Environment 7th Edition, Wadsworth Publishing, California

4.      Radyo ng Bayan Lecture Series (May 2003 to July 2008) Towards Functional Literacy, DZRB 738 KHz. Philippine Broadcasting System, Bureau of Broadcast, QC

5.      Raven PH, Berg LR and GB Johnson (2003) Environment 2nd edition  Saunders College Publishing NY

6.      Rotor AB (1983) The Men Who Play God: A Collection of Short Stories Ateneo de Manila University Press

  1. Rotor AB (1983) The Wound and the Scar Cacho Hermanos, National Book Store

8.      Rotor AV (2000) Light from the Old Arch UST Publishing House

9.      Rotor AV (2003) The Living with Nature Handbook. UST Publishing House

  1. Rotor A V (2007) Living With Nature in Our Times, UST Publishing House
  2. Roseburg  AT (1958) Pathways to Philippine Literature Phoenix

12.  Time (2007) Global Warming (The Causes. The Perils. The Solutions. Then Actions: 51 Things You Can Do) Time Inc.

  1. Time Magazine cvrrent and past issues (2000-2008)
  2. wikipedia.org/wiki/Allergy
  3. www.nlm.nih.gov/medlineplus/allergy     
  4. www.medicinenet.com/allergy           
  5. www.allergyuk.org/










Ad Veritatem

Research  Journal of UST Graduate School

Allergy and the Environment:

A Reflection on the Writings of the First Filipino Allergist*

Abercio V. Rotor. Ph.D.**

Fact or Myth?

1.      Children who grow up on the farm are at much lower risk to allergy than children in the city.

2.      Infants on the farm have fewer allergies than those who grow up in sterile environments. 

3.      Children who grow up with a cat in the house are less likely to develop allergies or asthma.

4.      Very few pet owners are allergic to the animals they love.

5.      Children who have been breastfed are less likely to have allergies.

  1. Milk, soy, wheat, egg, peanut, fish and meat comprise the most common food allergies.

7.      Most reactions to food are not allergic in nature, but rather intolerance, that is, there is no allergic antibody involved.

8.      Babies exposed late to cereal grains have higher risk to cereal allergy, especially wheat.

9.      Regular use of “foreign” materials (e.g. nail polish remover, contact lens, metals) can eventually cause sensitivity and reaction to the products.

10.  Allergy can induce strong and unwelcome mental and emotional reactions, such as altered perception or inappropriate changes of mood.

NOTE:  These above statements are all based on facts.    
]
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*Dr. Arturo B. Rotor Memorial Lecture, 11th Biennial Convention of the Philippine Society of Allergy, Asthma and Immunology, Sofitel Philippine Plaza Hotel, Roxas Blvd, Pasay City.
** Presently professor in environmental science, biology and the humanities at the University of Santo Tomas, St. Paul University QC, and University of Perpetual Help Rizal; author of award-winning books, The Living with Nature Handbook and Living with Nature in Our Times.   


SUMMARY

This lecture presents and describes our environment in twenty (20) areas where significant changes are talking place on local and global scale. The author’s view on the subject as an environmentalist and media practitioner may be seen from the simple and practical design of this lecture.

Germany, then a divided country for 45 years, served as model in this lecture, classifying environment into two extreme conditions: West Germany, a progressive capitalist state, and East Germany, a poor socialist state.

When scientists from Robert Koch Institute compared allergy cases under the two environments, they found out that allergies were far more common among Germans from the affluent West.  (1)

This finding indorses a general hypothesis to guide researchers on allergy as affected by varying living standards on one hand, and the nature and degree of environmental changes affecting the area, on the other.  The hypothesis is similarly useful in comparative analysis of countries undergoing different stages of growth and development vis-à-vis incidences of allergy, other diseases notwithstanding. West Germany represents a microcosm of a global Silent Epidemic, as well as countries that have adopted the Western model of development, whereas East Germany, which has less allergy cases, represents the Third World countries that outnumber the progressive ones, among them the Philippines. (1, 9).

What are the contributing factors to the high incidence of allergy in an affluent society? And what factors are responsible for the low incidence of allergy in an underdeveloped society? Apparently the key is environment.  Environment includes all facets, natural and man-made, and factors that disturb its balance whether force majeure or man-induced calamity.  It also includes society itself, the major institutions, science and technology, trade and industry that operate through interdependence with the natural environment. As this requires far-reaching consequences, the hypothesis had to be divided into specific ones. But the intention of this paper is generally to present issues from which questions may be raised, and answers sought ideally through research, in order to provide working premises that contribute to the occurrence, real or potential, to allergy.

Reference from the themes of selected short stories written by Dr. Arturo B Rotor is included herein to reflect the honoree’s thoughts and ideas in his own time regarding the topic.  It speaks well of Dr. Rotor’s philosophy of life as a medical doctor, nationalist, artist, and nature lover – which in a larger picture, the author believes that after reading his literary works, indeed the honoree is a naturalist and environmentalist. Quotations and excerpts from his works are part of this paper and its PowerPoint version. Likewise, the author’s works are included in the reference. (6,7)

   ---------------------------------------------------------------------------------------------------------- -
Divided by a wall for nearly half a century, West Germany and East Germany followed a dichotomous political, socio-economic pathway - the former a capitalist Utopia, while the latter a socialist Third World.  It was a case of one people living on separate and unequal planets – each accordingly representing the developed and the undeveloped countries of the world. Then in 1990 the Cold War ended, and the two Germanys were reunited. A startling medical discovery was revealed: Allergies were far more common among Germans from the affluent West. ( 1)
   ------------------------------------------------------------------------------------------------------------

No period in history has man influenced the environment as much as what he is doing  today in his pursuit for a higher standard of living, and affluence. But observations show that instead of “tailoring man’s lifestyle to the environment” which his ancestor did for centuries, man today is modifying the environment to meet his growing affluence – which is exactly the opposite.(9,10)


Twenty (20) environmental issues
vital to the understanding of allergy



1. The environment has changed a lot in the last two hundred years since the start of industrialization, which is also the start of modern age. The biggest effect to human health contributed by this era is widespread pollution. Pollution is the by-product of industrialization, and the scourge of modern living. How we have spoiled the environment can be gleamed from “The Men Who Play God.” This excerpt tells us of the once pristine environs of the Philippine General Hospital.
“… sitting in the trellised balconies and, above all, the heavenly peace and quiet, to detect the unmistakable tang of the evening breeze, long before you saw the surf breaking against the moored fishing boats off Pasay beach. xxx In such an environment, convalescence was pleasant and speedy. There was unpolluted, invigorating air to fill the lungs, cool tranquil nights to encourage sound sleep, restful, uneventful days for strolling in the hospital grounds or sitting down and dozing under great spreading acacia trees.
AB Rotor The Men Who Play God

2. Pollution is no longer confined within a geographic area of land, in water and air, or   a particular country or region; it is now global. The effect is worldwide in the form of global warming, causing more erratic weather disturbances, thinning of the ozone layer, the worsening effect of acid rain, among others. Pollution allergy cases arise directly from garbage, smoke from factories and vehicles, acid rain contact, sudden changes In temperature and humidity, ultraviolet rays near the ozone hole - and most specially from the gas-fed engine.

“There is only one contrivance that can move this mass of humanity, the internal combustion engine. If you stand long enough in front of the Philippine General Hospital, you will see every model, make and variant of this wondrous invention, from scooters to ten-ton trucks, from World War II jeeps to seventy-passenger buses. At peak travel hours, which is before nine in the morning, to sunset, the combined cacophony of thousands of motors accelerating, horns blasting, tires screeching, reaches the one-hundred-twenty-decibel level. Above this basic din, boy-peddlers add a few more decibels touting cigarettes or sweepstakes tickets, and by bus conductors announcing their routes: ‘Siga-ril-yo! San Andres Bukid! Crossing! Vito Cruz!’ The din and confusion are indescribable. This must be what a mortally ill patient in delirium must go through; this must be the amorphous, unremitting jumble of hubbub, boom and barrage, without pattern or purpose or direction, that finally pushes the mind over the brink of sanity.

  AB Rotor The Men Who Play God

3. Modernization and the “good life” brought about affluence, first to the industrialized countries, and later to countries which followed the path of development of the western world. People want goods and services beyond what they actually need. Affluence - more than necessity - has greater impact on the environment in the form of depletion of natural resources and pollution. Affluence to an extreme is indeed wasteful living. 

         -----------------------------------------------------------------------------------------------
Go to Nature, live by her ways.  Under a natural environment, children acquire the defense the body systems need against a host of health problems from allergy to physiologic and pathological diseases, including the adaptation to weather emotional and psychological stress.  Ever wonder what it means to enjoy childhood outdoors?  Away from computers and malls?  Summer away from school? Many children look forward to the first rain in May, the kite-flying season, the next Scout Jamboree.  AVR
        -----------------------------------------------------------------------------------------------


4. The increase in population continues in geometric pattern.  It has reached 6.6 billion.  At its present trend, another billion people will be added in the next 25 years.  New settlements, bigger cities, increasing population density predispose people to various pathogens and allergens.

5. The general trend all over the world is exodus to urban centers.  Metropolises and megapolises with 10 to 20 million people ensconced under crowded condition are not uncommon. Meantime villages grow into towns and towns into cities. The ratio of rural dwellers to city dwellers will soon reach equal proportion, but soon it will favor the latter. People crowd subdivisions, condominiums, malls, schools, churches, parks, in great numbers sharing common lifestyles and socio-economic conditions.  Thus predisposing them to common health problems and vulnerability to disruptions (brownout, water interruptions, force majeure).

6. Destruction of the environment is a consequence mainly of increasing population and affluence, leading to the loss, not only the productivity of farms, but also loss of farmlands to industry and settlements.  It leads to the irreversible destruction of ecosystems like lakes, rivers, forest, and coral reefs. Loss of health of environment is loss of health of living things; and therefore, loss of environment is loss of life.


7. The ecosystems bear the brunt of development and progress. Wildlife is being reduced in size and biodiversity with species threatened to extinction as they are driven out of their natural habitats.  Or, that their habitats are forever lost. Our existence and quality of our life depends on a complex interrelationship of the living world, that by disturbing the balance of this interrelationship will affect us humans, so with all the members.  Ironically we also upset the balance of biotic and abiotic components of the biosphere. 

8. Meantime wildlife areas are being invaded by humans. As wildlife shrinks, its species are threatened or endangered.


Wildlife is also becoming a part of us, sharing with our homes, backyards and farms, transmitting deadly diseases like SARS, HIV-AIDS, Mad-Cow, FMDE, Ebola, and Bird Flu which can now infect humans, allergies notwithstanding.

Many diseases today are linked to the degradation of the environment, among them the effects of pesticides, diseases of animals that have crossed the barrier of defense in humans, physiologic and psychological ailments, notwithstanding.  These may not be readily expressed as to be diagnosed properly and early; they appear in many ways signs and symptoms of allergy.  Allergies make a floodgate of more severe and even life-threatening diseases. The inability of doctors to specify a strange disease may be tagged as a syndrome, as it was the case of Santiago’s Syndrome. Here’s an excerpt of a conversation of simple people confined for treatment in a hospital.

“Naku, you never saw so many doctors in your life,” Santiago reported, “a hundred, maybe two hundred. Many were visitors from the V. Luna Hospital, the Veteran’s Memorial, Far Eastern, Santo Tomas, even from Pasig and Bulacan. All of them talking about me for two hours, my blood pressure, my favorite food, my bathroom habits. See this tiny lump under my arm? They stood in line just to feel that, men and women, professors and interns. Two hundred physicians, attending just one patient.”

But Berto, who occupied a bed just across him, muttered: “That’s all very well, Tiago. But did they find out what medicine to give you to make you well again?”

“You don’t understand, Berto. First you have to identify a disease before you can treat it. My disease is so rare they have to study it some more. In that room this morning the doctors acted and spoke as if they had never seen anything like me. They don’t even have a name for it, so some professors got up there this morning and suggested that it be called Santiago’s Syndrome for the time being.”

                                                                                               AB Rotor. Santiago’s Syndrome

9. The “Good Life” has spawned obesity and other overweight conditions with millions of sufferers around the world.  In the US one out of five is an obese. The spawning ground of obesity is the city.

Victims suffer of complications in their health and difficulty in adjusting to a different life style. Because of their conditions they are merely spectators, rather than being participants, in games and other physical activities, thus exacerbating their plight.

10. Global warming is changing the face of the earth, shorelines are pushed inland, islands sink, lowlands turn to swamps, icecaps disappear, polar ice melts.  There ’s even a need to re-draw the map as sea level rises, and to review land use policy,  city planning and relocation. Adaptation is key to allergy resistance and immunity, but this cannot be done overnight; it takes a lifetime if not generations. Indeed displacement of settlements and change in living conditions predispose people to ailments and allergies. Here is a report of Time (  )

 “Physicians probably won’t be listing ‘global warming’ as a cause of death, but the burgeoning signs of climate change – swelling populations of pollen-producing plants and disease-bearing insects, warmer oceans, desertification, water-supply pollution – all add up to a deadly cocktail that will challenge health experts in the future. On allergies, plants that produce substances mostly grasses and other annual plants, to which many of people are allergic, will flourish under the warmer conditions that are a result of global warming.

“Scientists have tied local spikes in asthma and allergy attacks to increases in molds and emissions from diesel engines. Apparently, the molds attach themselves to diesel particles, which deliver them more efficiently deep into the lungs. Add a plentiful helping of dust storms and a rise in drought-driven bushfires, and you have a made-to-order recipe for increasing respiratory distress worldwide.

11. Globalization is the name of the game in practically all aspects of human activity – trade, commerce and industry, agriculture, the arts, education, politics, religion and the like. The world travels on two feet- communications and transportation. The world has shrunk, so to speak. Traveling from one place to another across latitudes and longitudes predispose one to unimaginable kinds of ailments, allergies, and discomforts, among them malaria.

“Malaria, borne by tiny mosquitoes, kills more than 1 million people each year. Scientists fear that hot weather and heavy rainfall could make global mosquito populations explode. xxx The tricky thing about predictions is that you can’t point to any outbreak or any individual’s death and say, ‘This occurred because of climate change.’ But we do know that good public health relies on a long list of factors – the availability of doctors and nurses, effective medicines, clean water, proper sanitation – and that even today, millions of people die every year of what should be preventable diseases. With global warming, we can expect the death toll to be even

12. Homogenization involves pooling of genes through inter-racial and inter-cultural marriages resulting in various “mestizos” like Eurasian, Afro-Asian, Afro-American, Amerasian, and the like.  Mélange of races is fast increasing in complexity as East and West continue to weld genetically. Native genes provide resistance to pest diseases, adverse conditions of the environment. Native genes through intermarriage may bring beneficial results, but are thinned out thus losing their resistance or immunity from gene pool. Mestizos of subsequent generations are likely to be affected. 

13. Science and Technology as the prime mover of progress and development has also brought doubt and fear to human’s future. The first breakthrough created the nuclear bomb, the second brought the globe to the size of a village with the microchip,  and the third, Genetic Engineering now enables man to tinker  with life itself.

In an article I wrote a few years ago,  A Search for Meaning in a Highly Scientific and Technological World,  I asked – ‘In our age of modern science and technology, of automation and computerization, of globalization and space travel, will we finally find the answer to this perplexing question? At its present rate, we are virtually grappling with the pole vault to cope with the leaps and bounds of discoveries and inventions, which are pushing us to change our ways, and our very lives.  It is no longer us who dictate science and technology; it is science and technology that dictates us.

Virtually there is no place to escape from our high tech world.  Imagine life if there were no cell phone, cable TV, video games, malls, hospitals, e-mail, and many more.  And if we think about today’s process in making the many products we use everyday – imagine computers and robots at work in place of man.”  

                                                                                                     AV Rotor, Light from the Old Arch

14. These three breakthroughs in science and technology vastly changed our lives in practically all aspects, and our regard to institutions which include politics and religion.   

·         Splitting of the atom - nuclear energy and nuclear bomb
·         Microchip - modern communication and transportation
·         Genetic Engineering – Genetically Modified Organisms, Cloning, Gene Therapy, biological warfare.

Each invention or discovery bears heavily on the way we live.
Human conditions too, have vastly changed. Radiation related death still occurs in Nagasaki and Hiroshima, more time is spent by our children with the computer than with nature, Gene Therapy – curing gene-link diseases before they are expressed – will revolutionized medicine. Naturally all these have repercussions on human health and welfare.

15. Revolutionary industries have been born out of these breakthroughs and related discoveries linking them with the business world and society, giving rise to in vitro fertilization or test tube babies, surrogate motherhood, Human Genome Project (HGP or gene mapping), multiple childbirth, DNA mapping, etc. The prototype human robot is born, and he is not defect-free.  In fact he is more dependent on medicine and could not possibly withstand the conditions of the natural environment as we do to the extent of pampering him. Indeed he  will lead a very dependent life.

16. Globalization is changing the concept of cooperation dissolving rigid walls of nationalism to give way to regional and international cooperation such as European Union, ASEAN, APEC, CGIAR with seven members such as ICRISAT, CYMMIT, IRRI and the expansion of the United Nations to include WTO, ILO, and others.
Fighting global diseases – so with asthma and allergy -  needs cooperation on all levels. In the same way a community fights Dengue, so with whole continents arresting the spread of HIV-AIDS, SARS, Bird’s Flu.
  
“Rising temperatures could – if rainfall and other conditions are right – result in larger mosquito populations at higher elevations in the tropics, which could in turn contribute to the spread of malaria, dengue and other insect-borne infections. The World Health Organization (WHO) believes that even the modest increases in average temperature that have occurred since the 1970s have begun to take a toll. Climate change is responsible for at least 150,000 extra deaths a year – a figure that will double by 2030,  according to WHO’s conservative estimate. As with so many public-health issues, a disproportionate part of the burden appears to be falling on the poorest of the poor. That doesn’t mean, however, that the comparatively wealthy – who account for more than their share of greenhouse-gas emissions – will escape harm. A look at three key factors affected by warming offers a hint of things to come.” (Time, Global Warming)

15. Revolutionary industries have been born out of these breakthroughs and related discoveries linking them with the business world and society, giving rise to in vitro fertilization or test tube babies, surrogate motherhood, Human Genome Project (HGP or gene mapping), multiple childbirth, DNA mapping, etc. The prototype human robot is born, and he is not defect-free.  In fact he is more dependent on medicine and could not possibly withstand the conditions of the natural environment as we do to the extent of pampering him. Indeed he  will lead a very dependent life.

16. Globalization is changing the concept of cooperation dissolving rigid walls of nationalism to give way to regional and international cooperation such as European Union, ASEAN, APEC, CGIAR with seven members such as ICRISAT, CYMMIT, IRRI and the expansion of the United Nations to include WTO, ILO, and others.
Fighting global diseases – so with asthma and allergy -  needs cooperation on all levels. In the same way a community fights Dengue, so with whole continents arresting the spread of HIV-AIDS, SARS, Bird’s Flu.

17. Green Revolution opened up non-conventional frontiers intruding the seas, deserts, watersheds, highlands, swamps. GR pioneered in Genetic Engineering, the splicing of genetic materials between and among organisms that may not be at all related, pooling desired traits. Thus the growth of GMOs and Frankenfood, and cloning experiments.
Aerophonics (farming rooftops), hydroponics or soil less farming, urban greening, reforestation, organic farming, are among the measures to bring nature nearer to settlements, and insuring people the bounty of nature.


18. Agriculture today depends heavily on Post Harvest Technology. To bridge the production source with the consumption end, the farm and the market, is no easy task, specially with perishable goods. Thus the proliferation of processed goods, supermarket, fast food chains, ready-to-eat packs, sophisticated culinary art.


Many food additives and adjuncts are allergenic, from salitre in longganiza to pesticide residue in vegetables, MSG in noodles to Aspartame in fruit juice, formalin in  fish to dioxin in plastics. 





19. Modern medical science is responsible in reducing mortality and in increasing longevity.  But it is also responsible for many ills today, from genetically linked abnormalities to senility related ailments. It made possible the exchange of organs and tissues through transplantation, and soon tissue cloning. 
Evolution culls out the unfit in all stages of life.  This is true to all organisms.  Only man, or his influence on other living things, can modify Darwinism. 

20. Exploration has brought man into the fringes of our world – the depth of the sea and expanse of our Solar System, ushering the birth of inner and outer space science, and preparation of man for interplanetary travel.
We are learning to live outside of the confines of our planet earth.  We have succeeded in probing the bottom of the ocean. We have put up a city in space - the Skylab.  Now we are aiming at conquering another planet – a long distant goal of assuring the continuity of mankind after the demise of the earth.

Dr. Arturo B Rotor’ s Short Stories
- Implications and Significance

What are the implications of these environmental issues in the occurrence of allergy cases, in diagnosing and treating them as viewed from Dr. Rotor short stories? As I went though his works, I arrived at these scenarios, which provide us a glimpse of his thoughts and philosophy.  I have taken liberty to use other references including mine to further  my research on this matter.

1. As we unveil the mystery of allergy, shrouded by a changing environment, there will be need of young, talented and dedicated people in the field of medicine and healthcare.  The number of patients that our doctor can attend increases everyday, with funds and facilities to use. In The Men Who Play God, the number of patients was reduced after screening the applicants.  The conversation goes like this.
             
“We are not going through the qualifications of 163 patients this morning are we?
“No, sir, we have done some preliminary screening and we have narrowed the choice to three.”

“Fine. xxx Well, let’s hear some opinions.  I understand some of you have investigated these cases carefully and have arrived at positive decisions.”

In the story one patient is a young girl, intelligent, just finished college and her whole life is before her.  The second patient is the sole bread earner of a family of five. The third patient is a hospital attendant who has spent 17 years of his life caring for patients.

The chairman was silent for a long time.  Idly he flicked the pages of the clinical charts in front of him, as if searching for words.  At last he faced his staff squarely.

     “Which one of you would like to play God today?”

 2. There will be new cases doctors will study before these cases can be properly diagnosed and treated, more serious ailments, some life threatening - apparently related to allergic conditions.  In Orchid of Five Wounds, this is how the attending doctor to a 16-year old patient felt.

Dr. Morales felt sympathy, compassion and respect for the blind patient. He even described the flower given to her by other patients, orchid of five wounds, that according to legend, it got its name from Christ nailed on the cross.  Some drops of blood from his wound fell on this plant, hence the name. What physician could remain absolutely objective towards a 16-year old girl, an orphan, struck down by an incurable disease in the spring of her life?

The doctor was quite up-to-date in the literature of his specialty.  xxx  so far he had not obtained any information or development that he had not known before. He had gone far afield, from chemotherapeutic agents, to radioactive substances, to the newly discovered interferon, but none mentioned of a cure; the most that the investigators promised was remission which was another way of saying a postponement of the inevitable.

In desperation the doctor had turned to non-medical or pseudo-medical literature… but he could not track down the original reports.  What was left – faith healer? Prayer meetings? Water from Lourdes?

Inday, the blind patient, followed the singing of visitors and friends who literally brought  Santa Cruz de Mayo into the hospital.  She joined prayers and had light moments with other patients, while being treated and observed. 

He told Inday about the promising result of her treatment. Inday turned her face quickly to him, “I shall see again? … I shall see my flowers, my aunt, my house and friends.  I know I shall see again.”
The following week the heads of Ophthalmology, of Medicine and Neurology visited Dr. Morales and his patient and found her condition fast improving. The occurrence of spontaneous remission of malignant tumors is very rare.  A case of arrested cancer is labeled a miracle.  Inday’s case could be a simple matter of an immunological response, or a hormonal reaction.  

Dr. Morales broke the good new to Inday, with caution , and not set her hopes too high. Xxx he stopped when he saw that she had closed her eyes tightly and that a few teardrops had escaped.  He got up to leave and she released her hand. “I shall see you tonight.”

Her voice, when she finally found it, was hardly above a whisper. “No – I shall see you – I shall see you.”

3.  Alternative medicine - or traditional medicine for its age-long history and custom-tested remedies, its quaintness to village communities, will continue to be the people’s way of obtaining medical treatment and attention, as the terms alternative and traditional imply. Mystery surrounding a disease may lead to faith healing, while formality of modern medicine often lacks of personal touch and attention that patients seek. 

Thus we saw in the excerpts of Orchid of Five Wounds, the way a doctor treated a patient who at first was a hopeless case.  Then, by miracle she made it through.
  
Inday would leave the hospital within the week – when would he she her again?  xxx  He saw her among her plants, talking to them, picking her flowers… Roses and maiden-hair fern  and orchid like butterflies … and she would be in the middle of colors and fragrance.  At first she would probably need thick corrective glasses, but these would gradually be reduced as her vision improved. He would bring her books and catalogues about plants and flowers … yes, the Orchid of Five Wounds – he had promised to tell her the complete legend of the miracle.

 The theme of Dr. Rotor’s story about caring, may be seen at the border of loving, which is strongly evident in Zita, the story of a city-bred young man assigned teacher in an island, and there he provoked a young heart from among his students. Parting, as in the same case of our story, is a painful one, and leaves the reader un uncertain epilogue. longing and p in this case  

4. As people build their lives around the amenities of modern living, their lifestyle in the countryside lured into transformation akin to city life, the more they are exposed to all possibilities of allergy and related ailments.   Here is a scenario of this so-called  Good Life, which I discussed as a chapter in “Light from the Old Arch.”

“A quartz clock awakens you. You switch on the light, tune in the TV or radio, open the e-mail, cook breakfast, read the morning paper, dress up, take the elevator, drive the car, etc. All this is not surprising to most of us who live in urban centers.

But hear this. The milk you drink is genetically modified (human embryo hormone was injected into the cow to produce more milk), the corn flakes you eat comes from BT corn (corn with a gene of a bacterium – Bacillus thuringiensis), your potato fries is likewise a GMO and like your onion rings they were irradiated to extend their shelf life, your lettuce carries a trace of dioxin, the deadliest toxin ever synthesized, your tuna carries a residue of mercury, the microwave emits rays that are not good to health, the paint in your condominium contains lead, plastic deteriorates and you may not know it’s the cause of your allergy, so with synthetic fabric you are wearing.  There  is nitrate (salitre) in corned beef and in tocino, MSG (monosodium glutamate) in noodles, aspartame in softdrinks, sulfite in sugar, potassium bromide in bread, antibiotic residue in poultry and eggs. And the list goes on, ad infinitum. Again we ask, ‘Where will all this lead us to?’”
                                                                                         
                                                                                           AV Rotor, Light from the Old Arch

5. Perhaps the least understood realm of allergy is in the area of genetic engineering, the progenitor of Genetically Modified Organisms – plants, animals, protists – a number of them dubbed as Frankenfood, which we eat everyday.  Already we have Genetically Modified soybean, potato, corn,, and GO milk, poultry and eggs.  And we have barely scratched the surface.  

“Genetic engineering is creating genes and genetic materials that threaten to pollute natural genetic pools worldwide.  Once an organism acquires a foreign gene – now a GMO  – it becomes a permanent source of genetic contamination and pollution. xxx Transgenic plants and animals will definitely contaminate natural gene pools, in effect creating blindly hybrids and crossbreeds from varying combinations of genes of both GMOs and non-GMOs.

“New bacteria, viruses, prions, other pathogens are more virulent, not only by their infective nature, but by mutation or reactivation of dormant and harmless ones.  Antibiotic resistant markers (ARMs) in GM plants and animals can be transferred to other bacteria, including the harmful ones. These resistant bacteria could become gene sources of virulent forms. xxx Genetic manipulation introduces proteins from organisms never used as food, many of which could be the source of new allergens.” 
                                                                            AV Rotor, Living with Nature in Our Times


6. Advances in our understanding about diseases, including allergy, may be thwarted by superstitious beliefs and ignorance, and by inaction on the part of government, particularly in remote communities. The case of The Boy Who Always Sneezed Three Times, illustrates Dr. Rotor’s view on this aspect.

It happened when the baby was but a few weeks old.  Mang Teban and Aling Doray and several relatives were in the room admiring the new baby. .xxx Suddenly the boy sneezed – three times.  It evoked excitement. It was sign of good luck and fortune. They predicted Baby Garcia would someday become rich and famous.

A measles epidemic struck the village. And many children came down with the familiar fever and skin eruptions.  Tigdas was nothing new to the people; it was part of growing up, unavoidable, and in fact of some advantage to the child. He gets it once and doesn’t get it again. The government sent the provincial health officer to investigate the epidemic was almost over; it was too late to vaccinate the children.

Baby Garcia was one of those who contracted the disease early, but Aling Doray recognized it only when hundreds of eruptions, as if a horde of mosquitoes had bitten him. She closed up one corner of their small bedroom, covering the door and window with thick blankets so that no light could enter.
Here she kept her baby, trying to make him eat, stroking his forehead and crooning him to sleep.  The fever and rash soon abated, but a dry cough.  When he was finally brought out of the darkened room, he looked like skin and bones His eyes were deeply sunk, his face shrunk like squeezed  orange.  He ate very little and did not pay attention to his surroundings. He was too weak xxx It seemed to take a long time to recover – and sometimes she doubted whether he would ever get well.

The one night as she dozed near the child she was awakened by his cry, which did not seem like the cry of a sick child.  The mother held her son nearer the light.  Suddenly he screwed up his face and sneezed – three times.
                                                                   AB Rotor, The Boy Who Sneezed three Times    


7. Man’s pursuit of knowledge, of affluence, of pleasure, are not necessarily of the ideals of sapiens (thinking), ludens (playing), faber (making) and spiritius (praying) that make him singularly rational.  His failure and indifference constitute the antithesis of his decisions and actions, of his gains and achievements, his inability to keep his role as guardian of nature.

Here is an excerpt from Dr. Rotor’s short story, The Clinical Trials.  It was the annual convention of the Society of Experimental Animals, the most important scientific event of the year, and every sector of society was represented: the guinea pigs, rabbits, cats, dogs, hamsters – even the pigs had their own delegation. And the subject is about human beings, not the other way around. Call it a fantasy, an allegory, science fiction, modern fable sort of.

   “The convention arrived at the conclusion that the best subject is Homo sapiens. Of all of God’s creatures, there is no species more guilt-ridden, confused and self-destructive than man. Fear, remorse and frustration underlie his basic behavior, probably as a result of his forbears having been driven out of the Garden of Eden. He kills not for food, he eats when he is not hungry, he mates in or out of season. His suicidal tendencies are unique. While the lemmings drown themselves as a result of reduced food supplies, man will willingly cultivate cancer of his lungs by smoking poisonous plants, convert his liver into a hobnailed, atrophic mass of dead tissue with alcohol, or remove himself from the control of his mind with narcotics.

“The genes bearing these characteristics have not been identified, but seem to be transmitted paternally and maternally. An important feature of his personality is that the more developed the creature and the more successful, the more likely is he to suffer from neurosis. While among all other species, infection heads mortality and morbidity lists, among Homo sapiens, neurosis is the underlying cause of ninety percent of all illnesses. As a matter of fact, in the big cities and centers of population, the archetype of the successful executive is the hypertensive, the ulcer patient, the tranquilizer-dependent. We believe that for an in-depth study of tension or anxiety, in all its typical and atypical manifestations, man is a better subject than the frog, mouse or rabbit.”

x x x The results are clear-cut and not unexpected, as far as Capsule A is concerned. However, Capsule B presents some problems. Capsule B contains nothing but milk sugar, and yet it produced the same result as Capsule A.

More theories were offered, each more complex than the preceding: telepathic communication, secondary visual and auditory organs located in the arms or shoulders, and extra-sensory perception. But none could fully explain why milk sugar acts like a food when taken as food, and sometimes like a tranquilizer when taken as an anti-depressant. The author of the report requested to clarify the technique used in the determination of the low-density lipo-proteins? xxx    

“The scientific forum was over. It had been stimulating, it had approved a new drug, and it had advanced medical knowledge. Except for one minor detail, it could have been one of the countless scientific meetings being held all the time everywhere in the world. By human beings. 
AB Rotor, The Clinical Trials
                                                           References

1. Ansorge R and E Metcalf et al (2001) Allergy Free Naturally Rodale Inc NY, Hampton JK (1991) The Biology of Human Aging, Wm C Brown Publishers

2.  Jacobson E (1964) You Must Relax, McGraw-Hill 270 pp

3. Miller GT Jr (2004) Living in the Environment 7th Edition, Wadsworth Publishing, California

4.  Radyo ng Bayan Lecture Series (May 2003 to July 2008) Towards Functional Literacy, DZRB 738 KHz. Philippine Broadcasting System, Bureau of Broadcast, QC

5. aven PH, Berg LR and GB Johnson (2003) Environment 2nd edition  Saunders College Publishing NY

6.  Rotor AB (1983) The Men Who Play God: A Collection of Short Stories Ateneo de Manila University Press

  1. Rotor AB (1983) The Wound and the Scar Cacho Hermanos, National Book Store

8.  Rotor AV (2000) Light from the Old Arch UST Publishing House

9.  Rotor AV (2003) The Living with Nature Handbook. UST Publishing House

  1. Rotor A V (2007) Living With Nature in Our Times, UST Publishing House
  2. Roseburg  AT (1958) Pathways to Philippine Literature Phoenix

12.  Time (2007) Global Warming (The Causes. The Perils. The Solutions. Then Actions: 51 Things You Can Do) Time Inc.

  1. Time Magazine cvrrent and past issues (2000-2008)
  2. wikipedia.org/wiki/Allergy
  3. www.nlm.nih.gov/medlineplus/allergy     
  4. www.medicinenet.com/allergy           
  5. www.allergyuk.org/