Over the past hundred years, medicine has made the most powerful leap forward in its history. One might get the impression that for most diseases, doctors know, if not the cure, then at least the cause. But this is not so: there are a lot of diseases in the world that still baffle science.
Disease of war
In 1991, nearly a million soldiers, led by 700,000 US troops, crossed the border of Iraqi-occupied Kuwait in Operation Desert Storm, also known as the Gulf War. This short but large-scale confrontation with the Iraqi army ended in a decisive victory for the international coalition and largely determined the further relations of the West with the Arab world. But apart from its historical significance, "Desert Storm" has become one of the most mysterious medical phenomena of the late XX - early XXI centuries.
Soon after returning to the United States, the soldiers began to complain about their health. These complaints did not add up to the whole picture at all. Desert Storm veterans' symptom complex ranged from vague and poorly defined dizziness, weakness, and memory problems to very specific joint, muscle and skin pain. Unity was not observed: some had a headache, some had a stomach, some had all at once.
It is not surprising that for a long time doctors refused to recognize for this heap of symptoms the title of a full-fledged disease or at least a syndrome, as something less clear is called, but still holistic in terms of causes, clinical picture and consequences. But when it came to tens and even hundreds of thousands of complaints, it was no longer possible to ignore the "Persian Gulf Syndrome". Similar symptoms began to appear among veterans of other countries participating in the operation in Kuwait.
For a while, doctors attributed the veterans' malaise to post-traumatic stress disorder (PTSD). At the present stage of development of psychiatry, this is not very different from the medieval custom of explaining all diseases with "bad blood." PTSD is a "bucket" into which doctors pour any malaise after any nervous shock: war, attack of a criminal, loss of a loved one.
If there is no clear definition, then there is no cure. For many years, they tried to treat the "Syndrome of the Persian Gulf" exclusively with psychological training.
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But the further, the more the situation worsened. Over the course of ten to fifteen years, many doctors and researchers have come to believe that stress is not just a matter. For example, Gulf War veterans have doubled the incidence of amyotrophic lateral sclerosis, a severe and incurable disease that, for example, Stephen Hawking suffers from. It is much more difficult to explain this with shattered nerves than dizziness.
Photo: depositphotos.com/ Stefanedwards1
The situation was fueled by the specifics of the social group, which was struck by this strange disease: the relations of veterans with governments are traditionally not particularly warm. In America, despite sky-high funding and the nominally privileged status of the military, dissatisfaction with Washington is almost a mandatory element of military training. Of course, almost immediately, conspiracy theories began to appear among the veterans: the government allegedly poisoned its own military and covered their tracks with the hands of corrupt doctors.
In 2009 alone, a Boston University committee of experts commissioned by the US government drew up a 450-page report on the disease and concluded that in light of the available evidence, "there is no question that Persian Gulf Syndrome is a real disease."
Five years have passed since this official recognition, but the causes of the syndrome remain completely unclear. Many scientists are inclined towards the version of poisoning. Chemical weapons, or, conversely, the poorly understood antidotes given to soldiers for prophylaxis, regularly appear in the lists of current hypotheses. But despite the plausible arguments of the supporters of this version, a specific poisonous substance that could lead to the development of the "Persian Gulf Syndrome" has not yet been found.
The disease of culinary conservatism
The Gulf War is a disease long considered fictional, but ultimately convincingly proven. There are also reverse situations: diseases that are considered real, in fact, may turn out to be fiction. This is the story of the Chinese restaurant syndrome. Despite the Asian theme and even the name of the protagonist, this story is eminently American. In general, Americans are very fond of going to doctors and inventing diseases.
In April 1968, Dr. Robert Ho Man Kwok wrote a lengthy letter to the influential New England Journal of Medicine. In it, he talked about going to a Chinese restaurant. To understand the situation, you need to assess the culinary context: in the 1960s, American cuisine was at the height of the era of microwave dinners and other industrial delicacies, completely devoid of flavor. If today Chinese restaurants are firmly integrated into the global fast food industry, then sweet and sour sauces and strange meat broths seemed to Americans an exotic flavor attraction.
Dr. Ho Man Kwok's visit to the Chinese restaurant did not go well. His neck ached, his arms and whole body were weakened. The author suggested - purely within the framework of an amusing hypothesis - that these sensations may be caused by the use of monosodium glutamate in Chinese cuisine.
Monosodium glutamate
Photo: depositphotos.com / flas100
This is where the ignorance of the 1960s Americans in matters of world cuisine becomes obvious. The fact is that glutamate has been used in Asian food for centuries and in huge quantities. It is found in many essential components of Chinese, Japanese, Thai cuisines - in soy sauce, seaweed, meat broths. Glutamate is one of the most abundant amino acids in proteins, and virtually all protein foods contain significant amounts of it. This is the biological meaning of the use of glutamate in food: as sugar is responsible for sweetness, so glutamate is responsible for "protein content" - "fifth taste", also called the Japanese word "umami".
Despite the fact that billions of Chinese people consume many times more glutamate than Dr. Ho Man Kwok without any problems, the hypothesis about the dangers of glutamate and the "Chinese restaurant syndrome" has gained unprecedented fame and still remains popular with ordinary people.
Meanwhile, for 45 years, the statement of Robert Ho Man Kwok has not found any confirmation. Numerous studies show that dietary glutamate has no effect on health or longevity, and the symptoms that people describe after eating Peking ducks are varied and difficult to describe.
The safety of glutamate and the lack of a significant connection between this substance and neck numbness today do not raise questions for the vast majority of scientists. But then what kind of disease has affected Dr. Ho Man Kwok and his many patients around the world? Today, doctors have no idea what the matter is, and indeed they doubt that the "syndrome" exists - according to some versions, it is simply a massive psychosis.
Perhaps the harm of monosodium glutamate would have remained the hypothesis of an eccentric doctor, if the next year - in 1969 - an article had not been published in the journal Science, which initiated the panic around this substance. The article demonstrated that glutamate can cause developmental abnormalities in mice. The American man in the street took this conclusion on faith, without going into details, and the abusive title of "chemistry" was fixed for monosodium glutamate, which is terribly dangerous to health. The man in the street did not take into account only one thing: the experimental animals in the ill-fated article were daily fed the equivalent of 300 g (in terms of human weight) of pure glutamate! In subsequent years, when the study was repeated with a more reasonable amount of the substance, no harm was found. Note that if the 1969 study used table salt instead of glutamate,the mice would hardly have lasted longer than a couple of days - it would not even have come to deviations in development.
Photo: depositphotos.com / Hackman
Disease of absence
The more mysterious the disease, the sharper the debate around it. If the doctors do not have an answer, then the layman begins to look for the answer himself - and this rarely ends well.
In 1943, child psychologist Leo Kanner described the strange but rather similar behavior of eight boys and three girls with whom he worked. Among them was, for example, five-year-old Donald, who “most of all liked to be alone, almost never ran to his mother, did not pay attention to his father returning home, was indifferent to his relatives when visiting … he walked with a smile on his face, repeating the same movements… twisted everything that was spinning… I perceived words exclusively literally, directly… Entering the room, I completely ignored people and immediately turned to objects.
During the year, a similar but slightly different description of several more children was published by pediatrician Hans Asperger. Unlike Donald, six-year-old Fritz "quickly learned to speak in whole sentences and soon spoke" like an adult "… Never participated in group games … Did not understand the meaning of respect and was completely indifferent to the authority of adults … He did not keep his distance and spoke without hesitation even with strangers … it was impossible to teach him to be polite … Another strange phenomenon is the repetition of the same movements and habits."
These two classic works defined what is today called the spectrum of autism, from the "basic" form described by Kanner to the more socialized, bordering on the downright bad form of the disease that is today called Asperger's syndrome.
The main controversy surrounding autism revolves around the central question: is the incidence of this disease on the rise worldwide? The number of children diagnosed with autism has increased in recent years. Much more: by some estimates, ten times. If the disease really spreads at such a speed, then this is a reason not just for alarm, but for full-scale panic: the cause must be looked for either in food, or in our habits, or in something else that could have changed dramatically in recent decades.
On the other hand, the surge in autism is observed against the background of an explosion of scientific activity and popular awareness in this area. In 1960, nobody knew about autism. Today this word is heard both in medicine and among people far from science. Since the late 1990s, the number of articles on autism has grown by the same tenfold. Scientists are convinced that at least most of the "epidemic" of autism is a consequence of improved diagnostics and simply increased attention to this problem.
Apparently, autism has always existed, just before it was not called that. Therefore, it is not at all necessary to look for its cause in vaccinations or in pesticides sprayed by the world government. Moreover, a recent large-scale statistical study completely refuted the link between autism and vaccination. This, however, does not negate the question of what, after all, causes autism, and whether there is generally a single reason for the strange behavior of both the Donald's with their preference for objects to people, and the Fritz with their insensitivity to social rules. Another thing is not clear: is it possible to somehow increase or decrease the likelihood of developing autism in your own child?..
It is known, for example, that young parents have autistic children less often than older ones. How and why this happens, no one knows for sure. According to one of the versions, the point is not even that elderly parents produce “defective” children in principle. It is possible that people who are themselves prone to autistic traits marry later. This tendency can be passed on to offspring, therefore, on average, "late" parents have more autistic children.
The same applies to other factors that affect autism, such as air pollution or medication during pregnancy. Hundreds of works show the connection of certain external influences with certain forms of autism, but none of them can be considered necessary or sufficient.
Most likely, there is simply no single external cause for autism. But modern medical science, rapidly advancing towards documenting and cataloging every molecule in the body, may soon at least answer the question of what autism is. And this is already a serious step towards treatment.
Today, there are two different points of view on the nature of autism. According to one of them, this disease has clearly defined boundaries: patients stand out from the norm, not just quantitative, but qualitative characteristics. On the other hand, the "spectrum of autism" is so blurred that there is simply no sharp transition between healthy and sick. One of the most prominent proponents of this theory, British psychologist Simon Baron-Cohen is known for his research on the mathematical and logical abilities of autistic children. In the 1990s, Baron-Cohen first drew attention to their penchant for a "mathematical" understanding of reality: autistic children, for example, are often interested in cars, calendars, numbers, and rotating objects. According to the psychologist, autism is simply an extreme, painful form of love for order,in which a person can navigate only in rigidly set, logically grounded rules, and is not able to delve into such meaningless subtleties as social norms and rules of etiquette. This, he believes, explains the increased likelihood of having an autistic child in parents with a high IQ: a geek is already half autistic.
Photo: depositphotos.com
Disease of the winter winds
Autism is a disease of the nervous system, one of the most complex and mysterious in our body. In this regard, only the immune system can compete with her - and she also regularly presents inexplicable surprises to doctors.
Kawasaki disease is an inflammatory disease that occurs almost exclusively in Asian children. The immune system, in a fit of inexplicable rage, attacks the vessels throughout the body, damaging their lining - with potential complications in the heart. The inflammation usually lasts for several weeks.
This disease, although extremely unpleasant and dangerous, is quite rare and would hardly have come to the attention of the best minds of medical science, if it were not for an offensive snag: scientists do not understand at all what turns the immune system on like this.
The epidemiology of Kawasaki's disease is nowhere stranger. First, it is oddly distributed around the world. Most of all, the Japanese are ill with it, followed by the Americans, and mainly the inhabitants of the Hawaiian Islands. A very similar but not identical disease occurs in Europe. Most scientists are inclined to believe that these two diseases are one: judging by the historical evidence, the mysterious pathogen first appeared in Europe and only then, in a slightly altered form, reached Asia, where it is now most abundant.
Second, the incidence of Kawasaki disease varies greatly from person to person. Asians - regardless of geography - get sick much more often. Relatives of those who have recovered also have an increased chance of becoming infected. In other words, genetics affects susceptibility to an unidentified pathogen. Because of this, it is extremely difficult to study the disease: it has features of both hereditary and infectious diseases, and neither one nor the other is yet clear.
Third, Kawasaki disease is seasonal. But here, too, there is no certainty: in the "hot strip" (Japan-USA-Europe), the peak incidence clearly falls in the cold season, and in other parts of the world - as necessary. Scientists have been trying unsuccessfully to explain this whole damn thing for fifty years. Only in recent years did the first hints of a possible solution begin to appear. In 2011, an international team of scientists from Japan, USA and Spain made an amazing discovery. If the case concerned any other disease, then the researchers would most likely have to convince skeptical colleagues for years of the veracity of their data. But Kawasaki disease is not "any."
As it turned out, the map of its geographical distribution is amazingly accurate falls on the rose of the world winds. In winter, a strong wind blows towards Japan from Central Asia, which exactly coincides with the annual outbreaks of Kawasaki disease. A similar dependence on wind is observed in Hawaii and San Diego, where scientists measured. Apparently, whatever causes Kawasaki disease, this "something" is carried between continents by the wind.
Finally, in May of this year, another step was taken towards understanding the causes of Kawasaki disease. According to researchers from the University of California, the source of all troubles must be found in China. More precisely, in the agrarian regions of the north-east of the country. Scientists suspect the disease-causing toxin may be contained in microscopic Candida fungi, whose DNA was found in meteorological samples.
Microscopic yeast-like fungi of the genus Candida
Photo: flickr.com / Yale Rosen
But for now, these are only guesses. Some researchers are sharply opposed: they argue that Candida is not suitable for the role of an elusive pathogen, because it is usually more in summer, and this is contrary to epidemiological data. One way or another, it seems that the mysterious disease has already fallen into the networks of stubborn scientists. Finding the culprit is a matter of time.