A medieval hermit, a religious nut and a mobile phone enter a pub……….

Posted on March 28, 2014

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Sometimes it is a very good idea to look at a problem from a completely different and sometimes unexpected angle. That’s what this post is all about.

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It’s about idiopathic environmental intolerance, or, in medical terminology “I don’t feel well and my doctor has no idea what it is, but I am pretty sure it’s this thing I am exposed to”. Often, patients claim this is caused by low-level mixtures of chemicals they get exposed to such as plastics, pesticides, scented products, petroleum products and such and the symptoms are vague and non-specific (fatigue, headaches, inflammation of joints, and the lot…). Another exposure that is often mentioned is non-ionizing radiation; be it extremely low frequency from power distribution, RF from the use of mobile phones or nearby towers, or even from smartmeters and the likes (yup, in a way that dreaded dirty electricity story again). Strongly implying, maybe unjustifiable, that the suspected causal agent is well established the most well known subgroups of the idiopathic environmental intolerance spectrum are also known as multiple chemical sensitivity (MSC) and electro-hypersensitivity (EHS); depending on the suspected (or well, known…depending on who you talk to) exposure. But if we go back to the broader ‘all-inclusive’ definition, then in summary idiopathic environmental intolerance describes people getting ill but nobody really knows from what (it could even differ from case to case), except for the sufferers who “know” what triggers the effect, and will often experience symptoms when they see the cause, such as a mobile phone, being used in their vicinity. It may be quite difficult to do these studies because the exposures may differ from case to case, very low concentrations may already be enough for effects to be triggered (like with an allergic reaction), and there may be a delay between the exposure and measurable effects….for example. However, the problem is that in what is generally considered as the “gold standard” in these kinds of cases – blinded randomized controlled trials – patients respond as often and as strongly to placebos. So that’s a bit unfortunate. And then there are the facts that its incidence seems t increase with media attention and that for at least for a proportion of sufferers respond to some form or another of psychotherapy, implying that this may be of psychological, rather than biological/medical origin.
Anyway, I don’t know the correct answer here….I don’t even know enough about the subject to make a useful educated guess about causality. I know things can get quite heated when MSC and EHS are discussed, so I will stay away from any claims. Luckily, you may remember from the first sentence that this was not what this post was going to be about…it was going to be about looking at a problem from a completely different angle. It’s about idiopathic environmental intolerance though, so I just needed to colour in the background a bit…

 

FlammarionI came across this 2012 study entitled “Taking refuge from modernity: 21st century hermits” by Boyd, Rubin and Wessely from King’s College London and published in The Journal of the Royal Society of Medicine. You can find the abstract and, if you have access to it the fulltext pdf here <link>. Instead of doing a randomized controlled trial, case-control, or other quantitative epidemiological study, or maybe go for the qualitative approach and interview sufferers, what struck them was that people suffering from MCS and EHS had stories that were not unique to recent times (more specifically, after the widespread introduction of electricity and, much later, mobile phones) but that they had striking similarities to stories from cases reported throughout history – just with a substitution of the purported causal agent. As it turns out, literature and historical texts have made reference to hermits and recluses who turned their backs on society for a multitude of reasons; including religious ones, personal events and societal dissatisfaction. The authors make the case that this may well imply that the underlying psychological processes in the isolation of oneself from society (eg the most severe sufferers from MCS and EHS) should, and I quote “be seen less as a unique and specific reaction to a hitherto unknown hazard, but more as part of a longer tradition of isolation from an impure world.” So to explore this they identified modern and historical cases to compare their views and beliefs. Pretty cool in my opinion, and an approach I did not see before…

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They identified 6 EHS and MSC cases from the late 20th and early 21st century and four historical cases from the 3rd, 5th, 17th and early 20th centuries. Case descriptions are found in the paper, but in short it includes one MSC case, 2 EHS case, and 3 MSC&EHS cases, while the historical cases were Noah John Rondeau (1929-1950; dissatisfied with society), Roger Crab (1652-1657; dissatisfied with society and religious reasons), St Simeon stylite (415-459; religious reasons) and St Anthony (275-356; religious reasons).
Although the contemporary cases all reported that an important factor for seclusion was the experience of symptoms, they also indicated that disquiet about the ‘ill’ society that resulted from modernity was an important factor; as such, one saw sufferers as ‘an early warning system’. The historical cases similarly described ‘unsatisfaction with the world and its trends’, problems with the ‘slavery of industrialism’, and earlier that ‘the body of England has become a monster’ and St Antony, who derided the world where ‘everything is sold at its price,…hermits-cookbook-monks-food-fasting-in-middle-ages
Both contemporary and historical cases also felt that they had no choice in making the decision to leave society, and that ‘nobody would like this is they had a choice’. While also they all felt they were in a constant struggle, whether against evil spirits (the more historical cases one would suppose), restriction of society laid out by those in power (everyone, really), or by ubiquitous chemicals or radiation (the contemporary cases).

Of course there are many methodological problems with this approach, most notably the small number of cases, but it is a very interesting, left-field approach to a question many people would like a definite answer to. I don’t know whether this could be helpful in other diseases, but I suspect it may well be something that only really works for EHS and MCS. The similarities between the MSC and EHS sufferers and the historical hermits are striking and may suggest some form of causality; if not for a biological/medical pathway.It may provide some leads for treatment of the most severe EHS and MSC cases, but definitely for more research.
Either way, luckily it’s also an interesting read – much more detailed then I have done here – so if you have a spare moment I would recommend it as a read (or, in a more contemporary way…if this was facebook I would have “liked” it).

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