Archie Kalokerinos - Medical Pioneer of the 20th Century. Dr. Archie Kalokerinos, an Autobiography - Acknowledgments and Introduction.

INTRODUCTION

............Usually, an autobiography follows an orderly sequence of events - one leading naturally to another until the author decides on a cut-off point where,
more often than not, readers can turn the final page and know that a lifetime of work is finished. I have found it impossible to follow this pattern because,
after a critical stage, everything became mixed with events, experiences and discoveries covering widely separated fields intertwined in a manner that
cannot be followed if described in a true chronological manner. This applies, particularly, to the chapters dealing with medical problems such as The Sudden
Infant Death Syndrome, Otitis Media, Vaccine Reactions, Shaken Babies and Zinc Deficiencies. Trying to understand and solve these conditions involved years
of observation, thinking, and research. Eventually, it became obvious that the only way to pass on the knowledge obtained was to simply deal with each disorder separately. They are, in fact, not separate disorders because nature has connected them in a fascinating manner.

My aim is not to claim total
originality or total personal credit, because many colleagues provided me with the support and information that eventually led to an understanding of what I observed clinically. I hope that what I have written will act as a stimulus towards a broader view of medicine, and take some of the stress away from physicians who are forced to deal so much with problems they cannot solve.

............Some academics will be critical and detail aspects where I display a lack of knowledge. There may also be some errors generated by this lack of knowledge. However, I believe that, if this is so, the errors are minor and do
not, from a practical point of view matter very much. I state this because I have been able to demonstrate clearly, and beyond any doubt, that what I have learned enabled me to achieve a dramatic drop in infant mortality rates and treat in better fashion many previously resistant disease patterns.

............The ‘technical’ chapter on opal acts as division between the two parts of my life. This study marked the end of what I call ‘my innocent years’, when the idealism of youth vanished and I was forced to face the fact that modern medicine had, in some vital aspects, gone off the rails and prevented progress.

Often, I long for a return to the psychological calmness of my youth but I know that this cannot be when I consider the trauma initiated by many bitter
experiences. On the other hand I know that I have been exceptionally privileged and supported by Australians, Greeks and people all over the world.

............Obviously, anyone reading this book will realise that Vitamin C is critical to most things that are important. Of course this is so, but for those who want to delve deeply I must suggest that the chapter on otitis media, if properly considered, opens the door to a new and better understanding of medicine. This, more than anything else, excites me and make me realise that life has, after all, been worthwhile.

Note: ............The following description of scurvy is important so that the reader of this book can more clearly understand many of the described clinical situations.

Understanding Vitamin C and Scurvy

Without this nothing makes sense. Know it and the practice of medicine will become easier, more productive, and certainly, far less stressful.

............The medical dictionary definition of scurvy is ‘a disease due to deficiency of ascorbic acid, marked by weakness, anaemia, spongy gums and mucocutaneous haemorrhages’. This definition almost certainly refers to the classically presenting acute symptoms of scurvy.

............However, scurvy is not a ‘pure disease’. The so- called ‘classical’ descriptions, found in text books, certainly exist but there is an almost limitless list of varieties that taper off into an equally limitless variety of other conditions that, normally, one would not even remotely associate with Vitamin C deficiency.

............Even the ‘pure’ disease is almost infinitely variable. Bone changes, for example, may be found in some cases but not in others. Rib changes may be found in all ribs or only one rib. Petechial hemorrhages may only be seen in some cases. Intracranial hemorrhages follow a similar pattern. And the list goes on and on.

............Much depends on precipitating factors. The classical example of this is scurvy precipitated by infections. In such cases there may be symptoms and signs predominantly due to infection, or scurvy signs may dominate. Needless to say, there is usually a complex mixture of the two pathologies.

............Some individuals have a predisposition to scurvy. That is; under similar conditions - as far as such can be estimated - one individual may suffer from obvious scurvy and another will not.

............The two major divisions of scurvy are acute (clinically presenting) scurvy and chronic (subclinical) scurvy.

............1. ............Acute scurvy. This presents with the classical clinical picture of scurvy as a result of extremely low, or absent, levels of Vitamin C. Bruising, bleeding gums, general aches and pains, and ultimately, major haemorrhaging. Once presented with these signs and symptoms, unless treatment is commenced urgently, convulsions and death invariably follow. These final stages of Vitamin C deficiency can be induced quite rapidly by major acute infections, massive trauma or by endotoxin. *Endotoxin is produced by gram-negative organisms (most often of gut origin) and is, particularly in infants, a painful and sometimes extremely rapid precipitating factor of scurvy. The final stages of scurvy, of course may also be reached a lot more slowly, but once Vitamin C levels are extremely low, or absent, the signs and symptoms of acute scurvy will be induced.

............* ............ Endotoxin is a breakdown product of the cell walls of gram negative bacteria such as E.coli, Proteus, Pseudomonas, Salmonella and Shigella. It therefore occurs both normally and under disease conditions in the body, but is generally controlled by a variety of molecules - including Vitamin C. Being a breakdown product only, endotoxaemia can exist without bacteraemia or septicaemia.
..Acute (clinical) scurvy presents differently in adults and infants.
............(a) ............Infantile scurvy. This presents differently from adult scurvy because of the active growth sites in infants and young children. Localised signs are tenderness and swelling most marked at the knees and ankles. A disruption of the epiphysis especially in the growth plate area results in extensive areas of rarefaction demonstrable on x-ray. Enlargement of the costochondral junctions produces the scorbutic rosary. Acute scurvy infants are also invariably fretful, show a loss of appetite, and exhibit pallour.
............ ............Petechiae (small red spots due to escape of a small amount of blood) and bruises are less common than in adults. Bleeding may, however, occur anywhere in the skin or from mucous membranes including the gums (especially from teeth that have recently erupted).
............ ............In infancy, intracranial haemmorrhages are rapidly progressive if treatment is delayed, and death may occur. Microcytic, hypochromic anaemia is common. Older children may develop characteristic perifollicular haemorrhages and hair changes seen in the adult.
............(b) ............Adult scurvy. Early symptoms are weakness, fatigue, shortness of breath and aching bones, joints and muscles, especially at night. These symptoms are followed by characteristic changes in the skin and hair. Acne, broken and coiled hairs and perifollicular haemorrhages are common. Frank bleeding is a late feature of scurvy, however, bleeding into viscera or the brain can lead to convulsions and shock; death may occur abruptly.
............2. ............Chronic (subclinical) scurvy. This does not present with the classical picture of acute scurvy. Instead, as a result of chronically low levels of Vitamin C, patients are in poor health and have low resistance to disease, poisons and other stresses due to the vital role of Vitamin C in supporting the immune system, detoxification and glandular function. This is probably the most common presentation of scurvy in the modern era.

General Discussion

............Mention acute scurvy to health practitioners and they will immediately think of debilitating sickness, bruising and haemorrhage.
............Chronically very low levels of Vitamin C may ultimately result in an acute presentation of scurvy. As Vitamin C is required as a cofactor in the manufacture of healthy, strong cross-linked collagen fibres, any deficiency in Vitamin C can manifest as poorly cross-linked, weaker, collagen fibres and/or lower levels of total collagen in the connective tissue. In either case the tensile strength of the connective tissue will be weakened. Perivascular mucopolysaccharide secretion may also be decreased in Vitamin C deficiency. The final result is capillary walls that are very fragile making the person much more subject to bruising and haemorrhage. In acute scurvy this can manifest as petechiae, generalised bruising and intracranial and periosteal haemorrhages.

............Vitamin C may also be involved as a cofactor in the coagulation cascade. The bleeding tendency due to fragile capillary walls will therefore be accentuated. Haemorrhage may be further increased by excessive circulating levels of endotoxin (endotoxaemia). Endotoxin in the blood stream is normally adsorbed by a host of normal metabolites including bilirubin and uric acid. Notably, Vitamin C is very important in the adsorption and inactivation of endotoxin. This adsorption can produce a rapid reduction in Vitamin C levels.

............Endotoxin, produced by gram-negative organisms (most often of gut origin such as E.coli) is, particularly in infants, a painful and sometimes extremely rapid, precipitating factor of acute scurvy. Excess endotoxin can induce widespread weakening of the endothelial lining of the capillary walls, weakening them and inducing haemorrhage. Vitamin C levels can quickly be compromised during this endotoxaemia, or their previously low levels may allow the endotoxin to act extremely quickly - which can exacerbate the bleeding tendency. Widespread haemorrhage and death can follow quite quickly.

............The amount of Vitamin C required to treat the life threatening symptoms (such as haemorrhages, convulsions and shock) of acute scurvy is in general, probably quite small - maybe of the order of hundreds of milligrams rather than grams. However, the amount of Vitamin C required to treat the underlying or resulting diseases of Vitamin C deficiency, may well be much higher - in the order of many grams/day for an adult. High levels of Vitamin C are notably very virucidal, detoxifying and a potent stimulant of the immune system. This is certainly a point of scientific debate but is based on over 50 years of clinical observations by myself and numerous notable physicians and scientists around the world including many published papers in credible scientific and medical journals. Additionally, time and time again, I (and numerous other physicians) have observed the ‘miraculous’ results of many grams of intravenous Vitamin C in treating, in particular, acute viral disorders. Furthermore, on many occasions, when high oral doses of Vitamin C did not work, I have found that under some circumstances 500mg or even considerably more injected intramuscularly into the buttocks of severely ill infants resulted in rapid resolution of their life threatening illness. The levels of Vitamin C required to maintain adequate tissue levels, under most circumstances can be obtained from oral doses - either through diet or through oral supplements. However, when the body is acutely stressed the need for higher levels of Vitamin C is increased. These high levels are difficult to obtain only through diet and/or oral supplementation, especially when gut absorption is poor (due for example to perasitic infection, diarrhoea or other inflammatory conditions). Under these circumstances the delivery of Vitamin C needs to bypass the gastro-intestinal tract and be delivered via intramuscular or intravenous injection. The history of my understanding of this phenomenon occupies much of the subject of this book.

Refs:
............1. ............Scurvy, Past and Present by Alfred F. Hess, MD, 1920, J.B. Lippincott Company.
............2. ............Vitamin C, Vols 1 to 3 by Professor Alan B. Clemetson, 1989, CRC Press.
............3. ............Handbook of Vitamins, 2nd Edition, Ed by Laurence Machlin, 1991, Marcel Dekker, Inc.
A CHALLENGE

............There has been (and still is) a tendency to ‘rubbish’ Vitamin C. Why this substance has been singled out, I believe, is riddled with complex politics. There, more often than not, is very little good quality science emenating from the opponants of high levels of Vitamin C supplementation.

............Now, I understand and empathise with all those medical doctors, nutritionists, and other health professionals (who have been taught at Universities and other institutions) that we require only 40 - 60mg/day of Vitamin C to prevent scurvy. So much more knowledge now abounds in the literature to demonstrate the rapid utilisation of Vitamin C under a whole range of stressful conditions - necessitating higher levels of supplementation to prevent chronic and acute scurvy.

............Why don’t the academics and general medical community recognise this? Well, the answer almost certainly lies in ‘funding’ of research.
............New, complex, exciting, exotic and patented drugs are required to make money for major pharmaceutical compaines. There simply is very little money in promoting Vitamin C as one of the most important fundamental nutrients in treating many, if not most, of the chronic and acute diseases of mankind.
............I challenge anyone to question the validity of my findings in this book. The implications of my discoveries (verified and validated by numerous physicians and scientists - including nobel prize laureate Linus Pauling) are far-reaching. Correct and maintain Vitamin C levels at all times as a primary fundamental treatment in virtually all clinical situations. Patients will benefit enormously! To not pay attention to this, as a primary method of treatment, I believe, with the passage of time, will become unheard of.

............Naturally, other supplements, drugs and methods of treatment may also be required. However, if anybody wishes to dispute my findings, the challenge I would like to make is that they come up with more than one peer reviewed scientific paper that have stood the test of time and not been invalidated subsequent to their initial publication.

STATEMENT

............To photographically depict or write about individuals who are dead is disturbing to many Aborigines. I respect the reasons for this and know that parts of this book will create resentment and sorrow.

............By fate and choice I have been burdened with the responsibility of doing what I can to improve the intolerable state of Aboriginal health in Australia. If advances are to be made it is necessary to make available details of the battles that have been fought and the deaths of those who have paid the price of being poor and black. I can recall many instances where publicity leading to public awareness and demands has saved lives. Often I look at a photograph of a sweet little girl, dressed in a pretty pink dress, and sitting wondering eyed on my office couch. Her ankles and elbows display the scars of medical intervention. She was there only because someone (a nurse) had read about my work and had the courage to apply the right treatment.

............There is, therefore, no need for me to ask for forgiveness for tearing apart some things that normally should remain in perpetual darkness. I ask only that people understand and utilise what we have learned rather than allow some who are alive today to die before their time.

Archie Kalokerinos.

A DISCLAIMER

............What is written in this book is not intended as a total replacement for standard medical procedures. Whenever a medical problem surfaces the standard process involving the taking of a case history, a physical examination, special investigations, if necessary, and referral to a specialist or specialist team, if necessary, should be carefully followed.

............Vitamin and mineral supplements, including intravenously administered Vitamin C, are not intended as total replacements for standard medications or standard treatments. Advice from a qualified and experienced practitioner is recommended in all cases.

............Self-diagnosis and self-treatment can be dangerous and is not recommended. If a conflict arises between a patient and a practitioner, and cannot be easily resolved, it is recommended that another practitioner be consulted.

A. Kalokerinos