In October, I was able to break away from publishing and doctoring for a brief visit to Israel. For a number of years, I had promised my wife, Deborah, that we would see my aunt and uncle in Tel Aviv, but I kept procrastinating. My uncle died in June, and our visit with Aunt Lucy became all the more important so that we could share her grief as family. In the weeks before we left, friends and strangers advised us to "have a safe trip." And it turned out to be a very safe and enjoyable trip! Our reunion with Lucy was hospitable and comforting and too short. Lucy shared her friends with us when we visited restaurants in Tel Aviv, giving us another reason to yearn to return. The experience almost was counterintuitive: how could a place so threatened with peril give us such a wonderful and invigorating experience?

Our stay at a hotel beside the Dead Sea could have been filled with spa treatments, but we opted just to soak in the warm mineral waters. Wading in Dead Sea waters is proffered as a cure, and we may have had some healing of our dry skin and nails. We also had a Bedouin driver who took us around to see the ancient Israeli fortress Masada. He shared with us his love for the desert. During one of his spirited impromptu demonstrations, he pulled his vehicle to the side of the road and had us jump out in the middle of nowhere to look at the desert flora. The scraggy, desiccated old plants were nothing to look at, but the driver exuberantly proclaimed that the desert life was right before our eyes, and to demonstrate, he poured water on the plants. We watched the seemingly dead buds of flowers open within seconds. I thought of how dried tomatoes in my kitchen take on a life of their own after pouring water on them, but the real spirit of this desert inhabitant, offering us a little science experiment on a tourist trip, made me reflect that we can find meaning and happiness in the simplest of things and in the most uninviting places. During our drive back to Tel Aviv a day later, our driver offered us lunch in his humble Bedouin home with his wife and family. He bridged the communication barrier for us – we spoke English, and his daughters and daughter-in-laws and grandchildren and wife spoke Arabic. We shared a meal on the floor of the dining area and found a common ground and love – unusual given the separateness created by Israeli security forces. Why can't we find that common ground and love to settle differences in Israel and the world-at-large?

The primary elections are scheduled to begin shortly. Christmas and the holidays are behind us, and while we put away the decorations and stow away or return unwanted gifts, we contemplate the difficulties that we face as Americans. Deborah and I did not experience ill-will as tourists in Israel. Yet the United States is perceived around the world as tarnished – ill-tempered and gun-happy. Our dollar, once treated as the monetary standard of the world, has fallen in value, not only to the euro, but also to the currency of Haiti. The credit crisis of the banks and the mortgage industry, the rising price of oil, and the relentless engagement of our troops in places where people do not want to see us is a formula for the fall of the American civilization. We need change, and the politicians seeking office are making all the promises. But are we ready to bridge the communication difficulties and find the common ground to settle our differences around the world? There may have been a time when the status quo – corporate mergers, the building of institutions, and the bottom line – was the most important thing in life. No more. We need to reconcile the differences perceived in Tehran, Islamabad, Cairo, Djakarta, and Jerusalem. We need to put an individual in office who will not only be respected and talked to in Washington and Des Moines, but also in Damascus and Pyongyang. If there were ever a moment for the US to bring common ground to the world, this would be that time. Let's hope that we can find the wisdom and fortitude to elect such an individual.

Lab Testing for the Alternative Medicine Clinic
When most people think about alternative medicine, they talk about herbal medicine, acupuncture, massage, traditional therapies, and healing through visualization and prayer. They usually don't think about laboratory diagnosis. But the laboratory has always played an important role in natural medicine. Examination of the sputum, stool, urine, and blood accompanied the medical examination even before the invention of the microscope. Primitive chemistry techniques assisted the medical diagnosis in the nineteenth century, and the early microscopic examination of bacteria set the groundwork for antibacterial detoxification approaches. High-tech instrumentation development in the last 60 years has brought about lab diagnostics frequently ignored in conventional medicine but openly accepted in naturopathy and alternative medicine. Perhaps the most ballyhooed diagnostic method embraced by alternative practitioners has been the hair analysis used to assay metal levels. Despite the fact that pathologists do not accept hair analysis as an appropriate means for diagnosing increased toxic elements or reduced essential trace minerals, such diagnosis is often employed in the alternative medicine office today. Hair analysis is used for recommendation of further toxic element screening and possible chelation therapy as well as supplementation of minerals and trace elements. Blood, urine, stool, and fingernail clippings are also now employed by alternative medical laboratories to assess toxic elements and trace minerals.

Many traditional healing techniques do not require laboratory examination: acupuncture diagnosis depends on an accurate palpation of the pulse and careful observation of the tongue rather than on lab testing. Homeopathy eschews the laboratory and depends exclusively on symptom presentation and analysis for determination of a homeopathic remedy. Yet these healing fields have been transformed by the advent of alternative laboratory diagnostics: electro-acupuncture is an innovative approach to acupuncture, using devices such as the Voll machine to diagnose acupuncture weaknesses and design electronically individual-specific homeopathic remedies. Traditional acupuncturists and homeopaths dispute the validity of using electro-acupuncture for both acupuncture diagnosis and homeopathic treatment. Yet those who employ such devices argue that they not only are able to offer innovative alternative treatments to their patients but that such treatments can be integrated with other therapies in conventional medicine as well as in naturopathy. Hence, alternative lab diagnostics offer a "second level" of alternative medicine treatment that deserves consideration in assessing unconventional therapies.

In this issue of the Townsend Letter, we focus on alternative medicine laboratory diagnostics. Christa Hinchcliffe, ND and Wendy Ellis, ND of the Tahoma Clinic in Renton, Washington examine the utility of urinary hormone lab studies. Hinchcliffe and Ellis pose the argument that hormone replacement therapy, particularly in women, is done without the benefit of laboratory diagnosis. Hinchcliffe and Ellis review the value of studying hormones in serum and saliva and compare both to measurement in urine. One of the compelling arguments they make is that urinary hormone studies permit the evaluation of "downstream" hormone metabolites in addition to the actual parent hormones. Frequently, the metabolites are increased to levels that are not appreciated with study of the sexual hormones alone. Alexander Bralley, Robert David, and Richard Lord of the MetaMetrix Clinical Laboratory in Duluth, Georgia are concerned with accurate assessment of organisms in the gastrointestinal tract. Stool cultures are useful for gross organism overgrowth with pathologic bacteria and parasites. However, in many situations, cultures are not capable of distinguishing normal from pathologic organisms. Bralley, David, and Lord review the benefit of using DNA methodologies to study gut microbiology. Such techniques are of benefit in the naturopathic practice that focuses on bowel detoxification, including detoxification through the use of colonic enema therapies.

Jonathan Collin, MD