clinical ecology


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clinical ecology

environmental medicine

Fringe medicine
A field that explores the role of dietary and environmental allergens in health and illness. The intent of EM is to identify toxins in the environment through elimination diets, skin testing, provocation/ neutralisation testing, electroacupuncture, biofeedback, and radioallergosorbent testing, and to reduce patient exposure to noxious agents in the environment. Environmental medicine (EM) is believed by its practitioners (clinical ecologists) to address a wide range of conditions.
 
The concepts and practices of clinical ecology (environmental medicine) have been evaluated by several professional bodies, including the American Academy of Allergy and Immunology; all have concluded that environmental disease has not been proven to exist and that clinical ecology (environmental medicine) is not a valid discipline. Although there is little data to support the efficacy of EM in peer-reviewed journals, the concept that low levels of noxious components in the environment may cause disease has been attractive to some workers.

Diagnosis
Neutralisation, a test of uncertain validity which consists of either subdermal injection or sublingual placement of the allegedly offending substance and evaluating the reactions; some clinical ecologists identify offending substances by crystals, pendulums, galvanometers and other devices.
 
Disease managed by environmental medicine
• Allergies;
• Cardiovascular (angina, arrhythmia, thrombophlebitis, vasculitis);
• Paediatric (bedwetting, chronic otitis, learning disabilities);
• Endocrine (autoimmune thyroiditis, hypoglycaemia);
• ENT (allergies, sinus headaches, vertigo);
• Gastrointestinal (bloating, constipation, gastritis, inflammatory bowel disease, irritable bowel syndrome);
• Gynaecologic (dyspareunia, premenstrual syndrome);
• Skin (angiooedema, eczema);
• Neuromuscular (epilepsy, headaches, migraines, myalgias);
• Psychiatric (anxiety, ADD/ADHD, bipolar disorder, schizophrenia, sexual dysfunction);
• Rheumatic (rheumatoid arthritis, systemic lupus erythematosus).

clinical ecology

A form of medical practice based on two concepts: that a broad range of environmental chemicals and foods can cause symptoms of illness (such as malaise, fatigue, dizziness, joint discomfort) and that the immune system is functionally depressed by exposure to many synthetic chemicals in the workplace, the home, or contemporary agricultural products. The premise of clinical ecology is that these exposures are toxic or that they trigger hypersensitivity reactions, or environmental illness.
References in periodicals archive ?
Clinical ecology. Annals of Internal Medicine, 111, 168-178.
Clinical ecology. Journal of the American Medical Association, 268, 3465-3467.
The third key concept of clinical ecology is that frequent exposure will increase the sensitivity to a given substance, and sensitivity is reduced by avoidance of exposure.
Some physicians regard clinical ecology as controversial and unproven, and they attribute the positive results achieved by clinical ecologists to the "placebo effect." This attitude reflects an ignorance of the available research, as well as a bias within orthodox medicine.
To the contrary, it has been discredited as unscientific, not only by traditional allergists, immunologists and toxicologists, but also by supporters of clinical ecology.(9) Even clinical ecologists admit that some of their numbers are using provocation-neutralization in ways that the science does not support.
There is general agreement among the wider medical community that the methods generally used to diagnose MCS are not scientifically sound and that MCS is not a valid, scientifically proved disease process.(11) One of the strongest criticisms of MCS and clinical ecology comes from the American Academy of Allergy and Immunology, the most prominent professional medical organization in this field.
The American College of Physicians, 1989: "The existence of an environmental illness as presented in clinical ecology theory must be questioned because of the lack of clinical definition." There is "inadequate support" for the basic beliefs of clinical ecology.
Stir in a fringe specialty like clinical ecology, and many doctors become derisive.
Clinical ecology in this respect is more analogous to veterinary than to human medicine.
Yet there's no such thing as being "allergic to everything." The theories of clinical ecology just haven't proved out.
They call for more scientific research into the tenets of clinical ecology and MCS in order to subject the numerous theories concerning these disorders to the peer review of evidence-based, controlled investigation.
American College of Physicians position statement: clinical ecology. Ann Intern Med 111:168 178 (1989).

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