What Is Medicine?


 

Dr. C. Orian Truss Helped Patients the Mainstream Gave Up On

What is Medicine? For centuries, doctors have grappled with the problem of defining it.  Increasingly, we are told that it is a science rather than an art; that our healing instincts must be strictly in line with orthodoxy – that whatever help you might provide is meaningless without hard science to back up your actions. Nothing should be done without the randomized controlled trial as a buttress.

Most of us have acquiesced to the demands of our time. We hesitate, or even fail to act without peer review or solid evidence. All of this makes it even more remarkable when one steps outside the protection of the medical mainstream and does something truly unique. Dr. C. Orian Truss was such a doctor.

After graduation from Birmingham Southern College, Truss attended Cornell University Medical College, and then served as a resident at Bellevue Hospital in New York. Hardly a rebel by nature, he was chief resident before serving his country as an Air Force physician. At Maxwell Field, Truss served as Chief of Cardiology and Assistant Chief of Medicine before returning to Birmingham to complete a fellowship at the UAB School of Pharmacology where he focused on the female endocrine system. He started his private practice in internal medicine without fanfare. A chance discovery during his training, however, would set his life on a unique path.

As he detailed in his book The Missing Diagnosis, in 1953 Truss rounded on a hospitalized coal miner who had been given up as a lost cause. A simple cut finger had become infected and after aggressive treatment with antibiotics and steroids, he had developed severe abdominal distress and appeared destined to die. Despite sputum cultures revealing vigorous growth of Candida albicans, it was viewed as an opportunistic infection and was largely ignored. Truss initiated treatment with Lugol’s solution as an antifungal agent and the patient miraculously recovered.

Truss did not immediately understand the significance of his chance discovery.  Nevertheless, he kept the case on a mental back burner while he completed his training and started his career. After his fellowship in female endocrine pharmacology, however, he was confronted with a stark reality: many patients, especially women, seemed to suffer from a constellation of symptoms that baffled medical science, and sometimes even caused their doctors to dismiss them as hysterical or worse. 

A meticulous clinician, Truss began to notice a pattern in these patients: a history of multiple clinically-apparent yeast infections, menstrual irregularities, irritability, lethargy, malaise, and other symptoms indicating the possibility of a subclinical infection of some sort. Unsure what to make of this, and careful not to cause more problems than he solved, he began to experiment with the use of nystatin powder (rather than gentian violet) to treat yeast overgrowth. Many of these patients began to experience nearly miraculous symptomatic improvements. 

In all, Orian Truss published six papers detailing his findings of improvements among patients with these symptoms when treated with nystatin. In 1985, he published The Missing Diagnosis to little fanfare. The next year, however, the book The Yeast Connection was published by Tennessee physician Dr. William “Billy” Crook, and the public began to take notice – especially those who had run out of options. 

For the next twenty-five years, Truss built on his experiences and formulated a theory: for some people with this unusual constellation of symptoms, it appeared that treatment of yeast helped. Truss believed that there was some sort of abnormal immune system response to the Candida albicans fungus, leading him to incorporate allergy desensitization methods to the nystatin treatment. Additionally, he placed his patients on a “low-yeast” diet that was somewhat similar to the low-carbohydrate diet developed by Dr. Atkins in the 1960s. 

In time, Truss’s clinic became flooded with desperate patients quite literally from all over the globe, seeking an answer to a problem dismissed by the mainstream. For most, Truss’s clinic served as a beacon of hope and for many, the site of their first and sometimes complete improvement. Truss’s mantra of sorts, “if it works, it’s right,” could hardly be listed as the motto of modern mainstream medicine. Nevertheless, it guided him to a career of helping people who had been abandoned by the mainstream.

Eventually mainstream medicine did take notice, of course. As one might expect, however, their opinion of Truss and his methods was almost uniformly negative, ranging from dismissal to vigorous opposition. An unassuming and non-confrontational man, Truss continued his work undeterred, never lifting a finger to defend himself, except to point out that the rejection of his work had occurred in the absence of any serious trials to back up that rejection. Science had apparently been abandoned in the effort to discredit him. Quiet but determined, he published the sequel to his first book in 2009 – The Missing Diagnosis II. A retrospective of all he had learned over his career treating the “untreatable,” it was to be a swan song of sorts for Truss.

C. Orion Truss passed to his eternal reward in 2010, leaving no apparent successor or protégé, joining his late wife and soul mate of 56 years, and leaving behind five children and thousands of grateful patients.

What is medicine? Science or art; knowing or helping; the question remains and the debate continues. For most of us, we will have to content ourselves with seeking our way through the gray landscape of medicine without a satisfactory answer. For a few, however, this question is answered by actions and successes. Perhaps someday someone will actually find the truth behind the syndrome Dr. C. Orian Truss – Birmingham son, reformer, consummate scientist and humanitarian – spent his life treating, apparently with great success. In the meantime, the fact that he was a superb physician in the most noble sense of the term makes him more than deserving of recognition and praise.

 

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