World Day of the Sick, February 11, 2024
Allergy, the Silent Epidemic of Our Times
Balanced Environment - Key to Allergy Control
Dr. Abe V. Rotor
LIVING with NATURE CENTER
San Vicente, Ilocos Sur
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Dr. Arturo B. Rotor Memorial Lecture 11th Biennial Convention, Sept 9, 2008, Philippine Society of Allergy, Asthma and Immunology. Theme: Understanding Allergies Across Specialties. Sofitel Philippine Plaza, Manila
Allergy, the Silent Epidemic of our times is masked by the Good Life. It is surreptitiously leading millions of people all over the world into various complications and diseases that may even lead to death.
Dr Arturo B Rotor (1907-1988)
To bring medicine to the understanding of the people, to make themselves well in their own capacity is perhaps the biggest challenge of medicine today. Thus, the three contending areas of medicine should work together like a tripod.
- Conventional medicine from which modern medicine grew and developed well into computerization and genetic engineering.
- Alternative medicine, being part of Filipino culture and closest to local remedies, time-tested and practical remedies - the mainstay of folk medicine which caters to the grassroots.
- Environmental Medicine, the most practical and original to the point of being primeval, if I may say so. Its rules are universal and as natural as Nature’s laws. It is dependent on ecological principles in the conservation of a clean and balance environment
Environmental medicine was born out of the rush of modernization and apparent lack of concern on our deteriorating environment. As we prosper economically we seem to have forgotten a basic equation of weighing the deleterious by-products of progress, and keeping them out of harm’s way. Basic as it is, we have forgotten the equation of oxygen-carbon dioxide exchange that keep the biosphere in balance, energy-matter relationship that maintains steady energy supply, organism-habitat balance that protects species and ecosystems, acid-alkaline balance that prevents formation of acid rain, and the like.
In fact we have grown too progressive – we call our era Postmodernism, as if we are living in the future. It has become difficult for us to distinguish – much more to separate – our needs from our wants. There seems to be no end of affluence. We want power, wealth, pleasure, in a materialistic way. But we have homogenized them too, with pollution, allergy, acid rain, AIDS, diabetes and many other sources that destroy our health and our environment. Through globalization we heat the atmosphere a frying pan, warming it up to spawn hurricanes, floods, cyclones – even tsunamis. We pierced a hole through the ozone layer as if the amount of sunlight entering the earth is not enough.
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How little would one give importance to ailments and discomforts, while fighting for survival, and loneliness and despair. People who are placed in such a dilemma may not even care, and they may not even know the difference between being healthy or sick, much less between colds and allergy rhinitis, simple indigestion from candidiasis, rashes developed from different causes. Phobia, anxiety, disease, malnutrition, loneliness, are difficult to decipher and separate when one is suffering of physical, mental and emotional distress. AVR
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Indeed our world has changed a lot in the past century, and continues to accelerate as towns grow into cities, cities into megapolises, opening settlements to an exponentially growing population. There could be no better conditions for allergy to flourish - modern living in the city. It is Pandora’s box.
It is the microcosm of many other cases, perhaps in lesser degree or worst, older or more recent, that prevail in many cities around the world where the same recipe of allergy is supplied by the by-products of industrialization, high-rise buildings, affluent living style, that characterize progress, and exacerbated by lack or inefficient Governance.
But this is the pulse beat of trade and commerce that has taken over the healthy and vigorous biological clock; it is the signature of modernity that capitalism has brought into the life of modern man. This is the circulatory flow of money and goods, men and ideas, survival and affluence reaching all levels, nurturing the organism, determining what we gauge as growth and development.
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Dr. Arturo B. Rotor, the first Filipino Allergist, tells us that the human being should be regarded holistically, therefore too, when it comes to attending to his health – body and spirit, psyche and intellect. And we realize that man is truly divine with these attributes: Man the Thinker (Homo sapiens), Man the Maker (Homo faber), Man the Player (Homo ludens) and the Man the Reverent (Homo spiritus).
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At this point allow me to cite the case of Germany, considered a classical case about allergy. For 45 years Germany was divided by a wall. Economic wise, West Germany was very progressive, while East Germany was poor. The West Germans enjoyed one of the world’s highest standards of living. They live in luxurious homes, drive Mercedes-Benz as they pleased.
The East Germans on the other hand, were living under extreme poor living condition, with housing and consumer goods always in short supply. They had to wait years to be able to buy a second hand automobile. In short West Germany was a capitalist Utopia, while East Germany was a socialist Third World country. It was a case of one people living on separate and unequal planets. Then in 1990 Germany was reunited. The Cold War was over.
Now, what has this historical event to do with allergy?
Scientists compared the two extreme environments and came up with startling results.
The Robert Koch Institute came up with a revealing finding: allergies were far more common among Germans from the affluent West. West German baby boomers were up to 83 % more likely than their East German counterparts to have allergic rhinitis (hay fever) and asthma. Since there was no such differences in allergy rates were found in German born before World War II, the researches suspected that West Germany’s postwar lifestyles had somehow sensitized its children to pollen, mold, dust mites, and other types of allergens.
West Germany represents a microcosm of a global Silent Epidemic, and countries that adopted the same lifestyle have more allergy cases than countries, which like East Germany, have remained, for one reason or another, underdeveloped.
What makes an affluent society have more allergy cases as compared to a marginal society?
Let me present twenty (20) scenarios of our changing environment. Which of these fall under West Germany’s condition? And which ones fit East Germany’s?
1. As the growth of industrialization increases, so with the amount of pollution. Pollution is the by-product of industrialization. Industrialization is key to modern living; pollution is its scourge. Pollution has no boundaries; it rides on water and wind, it moves on land. It contributes to global warming, stirs climatic change and severe weather disturbances, not to mention the thinning of the ozone layer, worsening effect of acid rain and many others.
Pollution allergy cases arise directly from garbage, smoke from factories and vehicles, acid rain contact, sudden changes in temperature and humidity, ultraviolet rays below and near ozone hole.
2. Modernization brought about affluence, first in industrialized countries, now in countries, which followed the path of development of Western economic formula. People want goods and services beyond what they actually need.
Living above and beyond necessity has tremendous impact on the environment in the form of depletion of natural resources and pollution. Affluence is wasteful living.
3. Population increases geometrically, it is now 8 billion. At its present trend, another billion people will be added in the next 25 years. New settlements, crowded cities, increasing population density predispose people to various forms of allergy.
4. As exodus to cities continues, the ratio of city dwellers to rural dwellers will soon reach equal proportion, and will favor the former thereafter. Already there are metropolises and megapolises, each containing as many as 20 million people ensconced under crowded condition. Meantime villages grow into towns and towns into cities.
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).
5. Destruction of the environment as a consequence of increasing population and affluence, leads to loss of not only the productivity of farms, but loss of farmlands to industry and settlements, ultimately resulting in the irreversible destruction of ecosystems like lakes, rivers, forest, and coral reefs.
Loss of health of environment is loss of health of living things. Loss of environment is loss of life itself.
6. The ecosystems bear the brunt of development and progress. Wildlife is reduced in size and in biodiversity. Species are threatened to extinction as they are driven out of their natural habitats. The worse is when their habitats are lost forever.
Our existence and quality of our life depends on a complex interrelationship of the living world. Disturbing the balance of this interrelationship also disturbs the balance of biotic and abiotic components of the biosphere, thus affecting not only humans, but all members of the living world.
7. As wildlife shrinks, species are threatened or endangered. They need shelter, a new home.
Wee are adopting wildlife species, sharing with our homes, backyards and farms. Unaware they are transmitting deadly diseases like SARS, HIV-AIDS, Mad-Cow, FMDE, Ebola, and Bird Flu which can now infect humans, allergies notwithstanding.
8. “Good Life” has spawned obesity and other overweight conditions to millions of people around the world with USA the most hit. 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. Many are virtually immobilized by their condition.
9. Global warming is changing the face of the earth. As sea level rises shorelines are pushed inland, islands sink, lowlands turn to swamps, icecaps disappear, polar ice melts. In fact, there is need to re-draw local maps, and the map of the world as sea level continues to increase, and glaciers are disappearing. More importantly there will be need to review and modify land use policy, settlement plans and relocation.
Adaptation is key to allergy resistance and immunity. Displacement of settlements and change in living conditions predispose people to ailments and allergies.
10. 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.
11. 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 is beneficial, but the benefit they carry may be thinned out in the gene pool. Mestizos of subsequent generations are likely affected.
12. 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.
A. Splitting of the atom - nuclear energy and nuclear bomb
B. Microchip - modern communication and transportation
C. Genetic Engineering – Genetically Modified Organisms, cloning, Gene Therapy, biological warfare.
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.
13. Pioneer industries are 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.
14. Globalization is changing the concept of nationalism dissolving rigid walls 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 COV-19, HIV-AIDS, SARS, Bird’s Flu.
15. 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, urban greening, reforestation, organic farming, are among the measures to bring nature nearer to settlements, and insuring people the bounty of nature.
16. 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, especially 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.
17. 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 any stage of life. This is true to all organisms. Only man, or his influence on other living things, can modify Darwinism.
18. 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. (Meantime we have yet to know the cure of the common colds.)
Let me present some cases of allergy that are commonly encountered. These were gathered from our radio listeners on Paaralang Bayan sa Himpapawid.
- Smoking. Drivers, office workers, mechanics, farmers, writers, teachers, name it, and the habit is widespread. I know one whose only bisyo is paninigarillo. He didn’t live long.
- “Canned entertainment” such as parties in fastfoods predisposes kids to various ailments and psychological trauma, and to certain kinds of allergy. It is devoid of the natural environment that builds resistance to allergy as the children grow up.
- Some common allergens are pollen from flowers of trees and annuals - kasoy, kupkupyes, macopa, and tapilan. Lipang Kalabao, a very itchy plant that grows into a tree. The sap of aldelfa and yellow bell may cause paralysis of the pharynx leading to asphyxiation.
- Mushroom Allergy. There are spores of fungi like Auricularia or “tainga ng daga” and wild tree mushroom even when they have dried up.
- Fowls and wild birds are common causes of allergy, from their feathers and parasites, to their droppings. The filthiest bird second to the vulture is the crow carries vermin from carcasses of animals and garbage. Allergy from reptiles – from skin casting to vermin attracted by their food and droppings.
- Don’t play with spiders. Spiders cause allergy with the hair coverings of their body, and web or silk of certain species. The Black Widow is one of the few poisonous species.
- Allergic to trees like Ipil-ipil? It’s due to “plant lice” like Psylla, a minute insect pest that wiped out ipil-ipil plantations in the seventies and eighties. They build dense colonies on a single tree, sapping its vitality until it dies.
- Mealybugs and scale insects (Order Homoptera) produce waxy covering layer for protection and camouflage, as well as casing of their eggs and young. Cottony mealybug (Pseudococcos) on guava leaf; the insect without waxy covering.
- Pesticide Residue in fruits. Fruits may carry pesticide residues of dangerous chemicals like Folidol, BHC and Malathion.
- Pesticide residues on vegetables, particularly on crucifers – cabbage, lettuce, pechay, cauliflower – register above allowable levels. Lack of monitoring may predispose consumers to the effects of pesticides.
- Kapok or Cotton Tree (Ceiba pentandra L) releases seeds covered with lint from the mature pod The fiber is gathered mainly for pillow. It is cool and preferred over synthetic fills. Dehiscence period is towards the end of the year.
- Fire Tree (Delonix regia) Both flowers and caterpillars attacking the tree may cause allergy. Higad or the hairy caterpillar of Tussock moth causes irritation of the skin which may last for days. A common remedy is to apply vinegar on the affected skin. If the sharp hairs are imbedded, apply candle drops and allow to solidify. Then peel off with the encased hair. Mosses, algae, ferns and short growing annuals may cause allergy, including their substrates that undergo transformation by weathering.
- Allergic to Termites? It may be the termite or the mushroom in farms in its chamber - or both - that cause the allergy. Termites work with lignin-breaking fungi that soften the wood. Inside their guts are protozoa that break up cellulose, aiding digestion – a classical case of symbiosis.
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of Asthma and Allergy cases around the world.
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- Pesticide Residues. Poisonous hydrocarbon and phosphate compounds find their way through the food chain – in the case of frog from sprayed insects that serve as its prey. Pesticide residues accumulate in its tissues and transferred to the its predators, including man.
- Are you allergic to native delicacies?
- Sinanglaw (left) is a favorite Ilocano dish from internal organs of carabao or cattle cooked in slow fire and heavily spiced with hot pepper, paminta and ginger. Pinapaitan and kilawin prepared from goat’s meat are a native delicacy in many parts of the country. Other delicacies include kaldereta and soup “number 5.”
- Tulingan or Tanggigiis a common cause of allergy to many people. It is a practice to drain the blood by cutting the tail, and carefully removing the entrails before the fish is cut and served raw or cooked. The danger worsens when the fish is no longer fresh. There People who are also allergic to tuna.
- Shellfish – tahong, talaba and halaan may harbor the red tide dinoflagellate is large quantity that may lead to Paralytic Shellfish Poison (PSP) in man.
- PSP symptoms may first appear as allergy, and may be lethal if not treated immediately.
- Allergy is caused by insects
- Banana and mabolo (left) attacked by fruit fly (Dacus dorsalis/cucurbitae). It attacks dozens of popular fruits and vegetables, including mango, citrus, guava, macopa, cucumber, ampalaya.
- The domesticated honeybee (Apis melifera) normally does not sting unless provoked, unlike the notorious African honeybee which threatens the US honeybee industry today. There are as many deaths due to bee sting as snake bites. People vary in reaction to bee sting, from swelling to difficulty in breathing.
- Millipedes (Class Diplopods) exude Cyanide gas to stun their prey as well as repel their predators. Thus children should warned not to play with the “diken-diken,” playing possum by curling its body into a tight ring.
- Off! Avoid obnoxious and annoying insects - all kinds of bugs, plant lice, aggressive Insects such as wasp and hantik ant. Hemipterans- the bugs – exude an obnoxious odor which is caustic to the skin and eyes, a chemical offensive that wards off would-be predators attracted by their brilliant colors and attractive designs.
- Perfectly camouflaged, these insects lie surreptitious to their prey and predator and people may be unwary of them. Lepidopterans – butterflies, moths and skippers – are covered with scales of of chitin, a very resistant cellulose-like compound. The practice of releasing butterflies in place of throwing rice on a newly married couple has been discouraged because of the danger the chitinous scales cause such as irritation of the skin and eyes.
- There are various allergic reactions to fowls and birds, not only for their feathers, but mites and lice belonging to two Orders Anoplura (sucling lice) and Mallophaga (chewing lice) - that reside in their bodies and nests.
- Ngarusangis is a very small bivalve that occurs in colonies in estuaries. The shells are gathered for food and for ducks in raising balot. Allergy cases have been reported by eating this favorite soup of the Ilocanos. Below, increasing lead pollution has forced the shutdown of many salt beds in the country. Salt made near cities and industrial sites may pose danger to health.
- Does radiation cause allergy? Radiation emitted by radio transmitters have been found to be the cause of a number of ailments from insomnia to sterility. It is also associated with cancer, abnormal blood levels and heart conditions which may be related to allergy or allergy symptoms.
- Danger lurks in murky water – diseases, vermin, etc. Heavily polluted waterways such as the Pasig River contain high levels of Hydrogen Sulfide, Ammonia, Methane, other gases, and toxic metals.
- Allergy to plastics and other synthetic materials. Stuffed toys may cause allergy, so with many things put into the mouth.
- Aflatoxin in peanut, corn and others go unnoticed with the preserved food.
- Believe it or not – kapre lives in old balete tree. Naan-annongan is different from nakasagsagid , but the symptoms are quite similar - profuse sweating and feeling of general weakness.
- Allergy from yeast and young wine.
- Are you allergic to fireworks, and on New Year’s Eve?
To what extent does nature provide immunity? Fortunately as children grow to maturity, particularly so under natural environment, they acquire the defense the body systems need against a host of health problems from allergy to physiologic and pathological diseases, albeit adaptation to emotional and psychological stress.
Homogenization is likened to Globalization – one economy, one media, one culture, one car, one MRT, one computer, one bank. There’s one thing we are missing – the environment. In fact we are missing Nature in our lives. Our children are now spending more and more waking hours with the computer as if it were man’s best friend. Come to think of the computer as the root of allergy and many ailments. Spending more time with the computer deprives millions especially children of participating in health promoting games and resistance-building exposure to nature.
It is a scenario that we see everywhere, a scenario of our own making. And yet, like artists before the canvas we have the power to create one that is beautiful and conducive to our well being. But we do not or we refuse to do so, although we are aware that a healthy environment is primordial to good health and a happy life.
Ever wonder what it means to enjoy childhood outside of the confines of air conditioned room? Many children look forward to the first rain in May. Boy scouts and girl scouts do. To the athlete, the naturalist. And many boys and girls wishing to play outdoor.
But our children are no longer children of nature; they are captives of education and media, of malls and cafes. They like to think that the mind is like the computer, that the more information it acquires the better of is the individual. This is not so. Not when it pertains to health, not with the ability to arrive at correct decisions, not when and where survival is the name of the game. And not when it comes to matters of love.
Which reminds me a story of a young man who was in love. So he asked the computer, “What is love?”
Whereupon, came a prompt answer – not only one or two, but in many definitions, technical and literary.
“How does it feel to be in love?” the young man continued.
This time the computer did not respond. He entered his query once more, and again, but still there was no response. After several attempts, the computer finally gave up. “I cannot feel.”
And here are our children spending most of their waking hours with an “intelligent” thing in the shape of a box, a thing that has no feeling at all! Even when the computer can tell us of all kinds of the sickness in the world, it cannot comfort you. Because a robot has no feeling.
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