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DR. JEAN-CLAUDE LAPRAZ AND DR. CHRISTIAN DURAFFOURD ARE FRENCH MEDICAL DOCTORS WHO, MORE THAN TWENTY-FIVE YEARS AGO, TOOK UP THE NATURAL METHODS OF PHYTOTHERAPY. AS ONCOLOGISTS AT THE HOPITAL BOUCICAUT IN PARIS, THEY RUN A SPECIAL CLINIC IN GENERAL SURGERY AND ONCOLOGY UNDER THE DIRECTION OF PROFESSOR REYNIER, USING PHYTOTHERAPY IN CONJUNCTION WITH CONVENTIONAL CANCER TREATMENTS, AS A SUPPORTIVE, RESTORATIVE ADJUNCT.
THE RESULTS OF THE PROGRAMME HAVE BEEN IMPRESSIVE.

In 1993, Professor J. F. Bergman et al. published an article in the British Medical Journal (27 November, 1993) which was quoted, among other places, in the Généraliste (No. 1.482). The aim of the article was to attempt to show that there is no fatigue associated with the use of antibiotics. Sixty persons, unscathed by any affliction, chosen from among a population of nurses and medical students, were subjected to a sequential treatment of eight days using the antibiotic, amoxicillin, followed by eight days of a placebo or, according to a randomized. double-blind list, eight days of the placebo followed by eight days of the same antibiotic. Collection of data took place in four stages : first, before any administration of medicine; second and third, at the end of each week of the administration of the drug or placebo; and finally one week following all treatment.

A single subject complained of some fatigue but only at the end of the week during which the placebo had been administered. The conclusions established the innocence of antibiotics and the authors thus brushed aside any criticism of fatigue that is made concerning antibiotics and which is often complained of by the general population when using them.

This article can be regarded as an open letter to Professor Bergmann. No, the experiment has not been proven that antibiotic therapy does not cause fatigue. There are at least five reasons why the conclusions published in the British Medical Journal are unacceptable from a scientific basis :

1. The protocol neither justifies such conclusions nor a so categorical a way. As for the size of the group of patients upon which the experiment was based, a group of only 60 is laughable.
2. The particular choice of medical students and nurses for the experiment, already prejudiced as they are by their medical education which has taught them that antibiotics do not cause fatigue, jeopardizes the accuracy of any result despite the use of a placebo.
3. In this context, the successive doses of drug and placebo, even in an uncertain order, leads to a negation of the double-blind element of the experiment, since each participant knows that he or she has received two types of medication.
4. The experiment deals with a single antibiotic only. It cannot have any validity for the whole drug family. Increasing numbers of molecules are involved in this type of action and a diversity of secondary effects is caused by each of them.
5. The conclusion is inaccurate because none of the subjects participating in the experiment was actually undergoing antibiotic therapy. They were not, in fact, "patients" or even subjects afflicted with an infectious illness.

Because it was not adapted to such a demonstration, this experiment does nothing to dispel the popular sentiment that "antibiotics exhaust patients who undergo such therapy". The only possible conclusion from this experiment is that in 90% of cases, amoxicillin did not provoke a fatigue syndrome after seven days when taken by healthy subjects.

Daily observation of reality leads to quite different conclusions. Over twenty years of practice in general medicine, focusing particularly on human beings who are ill, provides an appropriate study of a naturally randomized series. For us, it constitutes an experiment that is closer to truth than a number of those with scientific aspirations, with various criteria for inclusion and exclusion, ending up by being a very long way removed from the reality of daily life. And every day one assesses the disastrous consequences.

Let us take, for example, a very common pathology in general medicine : seasonal respiratory afflictions. These constitute one of the best series for reference as well as being a disputable indication for antibiotic therapy. Their uncomplicated, spontaneous evolution is a febrile reaction of three to five days. Their average duration is eight days. Their natural conclusion is complete recovery. An antibiotic treatment that is well conducted, achieves, in general, an amelioration in thirty-six to forty-eight hours, and complete resolution follows after the same term of eight days. With patients who receive a supportive treatment adapted to their own physiological disturbances, (which is the foundation of our practice, using, among other things, medicinal plant extracts, trace elements, and vitamins,) we observe a general improvement in seventy-two hours and complete recovery in the same period, eight days.

Thus, even if antibiotics give a certain initial illusion of rapidity of action, they do not modify the evolution of the illness as a whole. Its duration, if not the possible arrival of complications, is not influenced by any type of treatment. However, and in a way that is too repetitive not to be indicative of a relation of cause and effect, the observation carried on well after recovery, shows that the time of recuperation of the patient is directly related to the therapeutic modality adopted. Recuperation is assessed on the disappearance of the patient's complaints of feeling fatigue induced by the infection.

For an untreated subject. the time of recovery lasts for an average period of seven to fourteen days. In a case where antibiotics have been used, one can estimate, with great regularity, a significant prolongation of the illness ‹an average of between ten and twenty days. In addition, there is also a marked fatigue expressed, quite apart from the initial, directly related preliminary state of debility of the patient.

In the case of supportive physiological therapy with a high frequency, the time of recovery is reduced or even completely eliminated ‹on average from zero to seven days, and of a minimum of intensity, with the same corrections, very greatly diminished.

Certainly, fatigue has a subjective character; but it also has an organic reality and a biological significance. Mobilization, evolution then involution, and finally elimination of humeral and histo-lymphocytic material, are indispensable for the struggle of the organism against illness, and they follow a rigorous chronology. Respect for this cycle is indispensable to the initiation of the phase of restoration which continues after it.

Such spontaneous evolution depends equally upon the individual qualities and weaknesses of each patient. A supportive therapy, applied effectively to the terrain of each patient, attempts to respect the natural cycle and to correct, if possible, his or her qualities and weaknesses. This is something that cannot be accomplished by antibiotics with their specific mechanisms of action ‹all composed of mixed up molecules‹ in interrupting the development from the beginning, retarding or nullifying the function of recuperative phenomena. The symptom "fatigue", which is a sign of metabolic difficulties in the organism in coming to terms with the problem thus posed, is, therefore, quite logically, increased and prolonged.
Thus, the complaint of "fatigue" associated in the popular mind with antibiotics, reveals the actual reality.

The conflict between the results of the experiment undertaken at the Lariboisière Hospital and physio-clinical reality demonstrates the danger associated with interpretation of experiments derived from protocols which totally separate the human being from the illness from which he is suffering. "There lies the true reproach".

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