Psychiatry

Yesterday (1950)
and Today (2007):

From Despair to Hope with

Orthomolecular Psychiatry

Abram Hoffer MD PhD FRCP(C)

 1

Schizophrenia, Yesterday (1950) and loday (2007),

From Despair to Hope
With Orthomolecular Psychiatry by Abram Hoffer

Acknowledgments
Onfor this book unlUxr at #ww.ituTon!xiMn/07-2!:fl1
or cm ml unli.'iSgir tiffLild-L-Liffl

Mmq Treffoid cJilks ate aJjo avaiLabtc ar major online book retalforv,

© Copyright 20OB Abram Holfcr

To my daughter Miriam Hoffer for her skillful careful editing,
AH rights merved. No pan of chii pubhratfon maty b* rcpnxlnujJ. ltutul in a retrieval fact checking and typing of the manuscript
system, or tramsmcrtwl. in any form or by am- tnemi*. dectftmk, mechanical, phtKocopyLnf,
rvnwilcng-orwlwwi)*;, wiiluiu die wrkica prior peamsiion of she author,
Kenneth Whyte', publisher and editor-in-chief of
Nf*ie firf Ubfiitlans: A tataloguijig rceotd for this book Ls avai lable from Library
and Archives Canada at www.collmfonranad».u-aJimiUi*foiLWi-c.luin] Macleans Magazine in Canada, defended a cover story from
the previous week. In that story Professor Philip Slayton, a
isbn: ^78-1-4251-55S3-4 former dean of law at the University of Western Ontario,
accused his profession of failing to live up to its cherished
We tJi Trafford btlitvt that ir B fhr respo nubility of mi aU, us hath irith viduali
.sad litrptiftitiiiit!' to make choices that are nsttirortmenHilly artdstwialiy nwitrf, ideals and instead working to the detriment of society,
Y»u. in turn. jot suppor/itip this mpmnlbfo rendu ft rm:h Haw you pay a hum a
Ttajftird bant, at rnakt uir efatt r publishing service. To find cut how ye a tirr
Whyte commented, "Mr, Slayton has done the Canadian
helping. pif St sc vim ttm/ar. ttttjfiard.rsrmt'rr,pamihIff!itb fit hitig.himt legal profession a service by going public with his concerns
Our mission is so ejfisitruly provide iht world's finest* most comprehend rr that one of the problems ot the Canadian legat profession is
i/itoi- fiMsbirtZ lerrire, enabling rjvery aniline in experience success.
To find out bew to publish vokt bock, your it'ay, end hew if &wlh$l»tr that legal professionals are more interested in maintaining a
worldwide, visit m ontirse at 1 vw w; trafford ttm/l05l0
lucrative status quo than in confronting the need to reform."
Replace the word legal by the word psychiatric and you will
www. trafford .com
anticipate the contents of this book.
Norfb Amcrina fli tiitirriidliDiul
tLdl-fcet- I &HK 232 4444 {USA fit Canada!
plume: 250 303 Wi(H 1 fa*: 250 38i5 fj8(K 1 entail: infogtuaffhfd.com Slayton-' wrote, "in Canada, lawyers are allowed to run the
lhe Untied Kingdom di Europe legal profession as they see fit The only possible [ustification
phone: +44 (0) 16(55 487 &S * t«*l rate: 0845 230 96QI
facsimile: +44 {0)1865481 W7 ■ email inftt.u

10 9 tt 7 ft 5 1 Whyte K. Counterpoint Lawyers Behaving Badly. The National

Post, Toronto, August 2,2007
2 Slayton R Why Should Lawyers be Allowed to Regulate
Themselves? The Globe and Mail, Toronto, August 3, 2007
2 3

for this legislative gift is that it is in the public interest. But is

it?" Then after listing the detects in the present legal system
he points out that other countries including Great Britain
are developing a better system which is focused on placing
the interests of the consumers at its centre. The two key
changes are that the legal profession will be overseen by a
new board with a lay majority and secondly that complaints
will be investigated by an independent office. "Law and (he
legal system belong to all Canadians." Slayton's views are
elaborated in his book.3

I raise the same questions with respect to the medical

profession. Et is also self- regulated, through its medical
colleges, a legislative gift from the provinces, with the aim of
protecting the public. This it does to a limited degree, but in
Section One
my opinion the medical profession is much more interested
in protecting its own turf. I think that when you have read
this book you will come to the same conclusion. The medical
profession has devoted itself too much to protecting itself and
has been so conservative that il has been one of the mam
hindrances to research and new developments m medicine
and in psychiatry. As Mr. Slayton suggests for the legal
profession, medicine belongs to all Canadians, not to t he
medical profession.

i Slayton P, Lawyers Gone Bad. Money, 5cx and Madness in

Canada's Legal Profession, Viking, Canada, 200Z
/
4 5
Chapter One
Introduction to Psychiatry
My 57 years of psychiatry have convinced me that the
four most important elements of any good medical and
psychiatric treatment must include shelter, food, civility and
orthomolecular therapy. As t review these years I will refer
to these important aspects of treatment, asking if they have
changed and if so, have these changes been for the worse or
for the teller.
Several years ago a very angry young woman stormed into
my office eager to tell me her story. She had been discharged
from a psychiatric ward after three days by a psychiatrist
who told her that she was no! schizophrenic. Since she was
a borderline personality disorder, he told her, they would not
treat her, as they had no treatment for personality disorders.
She had been taken to the hospital by the police after
living on the streets for about Iwo weeks. She fled from her
apartment and husband when during a rage she trashed her
apartment. She realized what she had done, became very
fearful that her rage would return and fled to prevent any
further damage. After she was given that dismal diagnosis and
prognosis she looked up the definitions of schizophrenia and
of borderline personality disorder in the American Psychiatric
Association Diagnostic DSM IV. She identified herself with the
description of schizophrenia.
After reviewing her history and mental state I concluded
that she was right. She suffered from hallucinations (voices
and visions), was very paranoid, found it difficult to think and
to concentrate and she was very depressed. She said to me
very emphatically, "1 am not a borderline personality disorder.
I am schizophrenic," And she was.
Borderline personality disorder is often a euphemism
used by modem psychiatrists when they are reluctant to
diagnose schizophrenia. Often it is the last diagnosis in a
series of readmissions if their patients do not respond to
treatment. True personality disorders who have no underlying
schizophrenia do not respond to orthomolecular therapy. But
she was indeed schizophrenic and I started her on a program
of proper food and vitamins. After three months she was
much better and after a few more months she was normal.
When l last saw her she was still normal and planning on
writing about her experience In the psychiatric hospital. She
was very frustrated and as I listened to her story so was I as
I could visualize her future if she had accepted the incorrect
diagnosis. Her schizophrenia would have undoubtedly
gotten much worse and eventually the steady progression
of the illness would have forced her back into hospital. She
would then have received the correct diagnosis and placed
on modern powerful drugs which control symptoms, do not
lead to recovery, and cause brain damage it maintained long
enough. On the other hand, I could see what happened to her
after receiving proper treatment for schizophrenia. The correct
diagnosis and the correct treatment brought this intelligent
young woman back to normal to become a useful member of
society. 1 have heard many similar histories over the years as
most of the schizophrenic patients I have seen were referred
to me after failing to respond to the usual psychiatric therapy.
 6
During August 2005, I saw two patients whose diagnosis
gradually changed from bipolar to schizophrenia, to
schizoaffective, to border fine personality disorder {BFDl In
each case they had not shown any response to a large variety
ol drugs, i he BPD diagnosis allows the treating doctors to
understand why the drugs failed. They could not imagine that
they were using the wrong treatment. One of these patients
had been sick 12 years, had been admitted to hospital 19
Ifrnes, and had cost the province nearly one third of a million
dollars m hospital and drug costs. She stopped all drugs a
year before 1 saw her and, after a horrible period of severe
withdrawal, stabilized, stili paranoid and hallucinating. After
Ihree months on the vitamin program she was on the way to
recovery and both she and her husband were ecstatic at her
newly regained ability to think and reason and to feel almost
normal again. Her hallucinations had receded, and were less
intense and less frequent.
The December 2, 2001 issue of the Times Colonist in
Victoria, British Columbia described rhe tragic history of
Shannon Hollingworth. The title of the article, "Lost in rhe
Cracks is very apt and the subtitle succinctly tells us what is
happening in Victoria: "Shannon Hollingworth is desperate
so desperate she has tried to kill herself numerous times in
order to gam attention. She wants 24 hour protection in a safe
facility where she can battle the problems that send her out
* CLontr°r BlJt thesQ days there's no place for the Shannons
of the world/' Shannon is well known to the community
that pari of the community which deals with the mentally ill,
the police, social workers, psychiatrists, courts and more. In
the past tew years she has been in the emergency ward 120
times, has tried to kill herself frequently and in order to be
admitted has behaved very inappropriately.
7
Shannon's mistreatment or lack of I real men! is the result of
a hypothesis that was forced upon the public many years ago
which w'as that the mentally ill were better off on the streets
no matter how terrible the situation was compared to the
mental hospitals no matter how good they were. The mental
hospitals were terrible but even then were probably better
for patients than are the streets of modern cities. Shannon's
life-lime career trying to get help for her illness represents
what would have happened to my angry patient who came
to see me and is now well Shannon never had the chance
to become well because orthomolecular treatment was not
provided for her.
The reporter wrote/ '"She is one of a growing number
of people with mental problems who end up in the criminal
justice system,* One of the prosecuting lawyers who tried to
find some help for her said, "1 don't think the criminal justice
system is designed to deal with people suffering from mental
disabilities or disorders, but unfortunately we've become the
depository for it because there is no appropriate alternative/'
]udge Ernie Quance said, "In a society as wealthy as ours
I here has to be a place for her," A probation officer said she
had "overtaxed police, hospitals, mental health care homes
and other services, often in an attempt to get things her
way," What did she want? She wanted treatmenl in a 24 hour
secure institution. Everyone working with her recognized
that she was very Ell and needed help. No one raised the
most important queslion of all. With all the techniques
available to modern psychiatry why was she not getting the
help she needed? The answer will be dear later on. She was
getting some treatment. She was not getting orthomolecular
treatment.
1 Wested K. Lost in the cracks. Times Colonist, Victoria, British
Columbia, December 2, 2001
 8
9

treatment possible. This is orthomolecular treatment and

This is a universal problem, not only in British Columbia or means public legislation like the bill passed in 2000 by King
in C anada. The newsletter of The Schizophrenia Association (bounty which may introduce better treatment into their state
of Great Britain (SAGBi reports in the 200!) summer issue that hospital system.
nine out of ten prisoners are mentally ill and/or affected by
drugs or alcohol on entering prisons. This is the conclusion
of the director general, Mrs. Gwynneth Hemmings, Mrs.
Hemmings organized SAGS many years ago and has been a
careful observer and dedicated worker in this field. Similar
observations have been reported from the United States,

My frustration arising from the many patients I have seen

over the years has at last compelled me to record my views
ot what has happened to psychiatry since 1950 when i first
became a resident in psychiatry at the Munro Wing of the
Regina General Hospital in Regina, Saskatchewan. There was
no effective treatment at that time.

The percentage of schizophrenic patients who recover

today is no better than it was in 1950, even though the
symptoms can be controlled more quickly and effectively, in
1850 the English doctor John Conoffy reported a fifty percent
recovery rate. Recovery to me means patients are free of
symptoms and signs, are getting on well in the community
and with their families and are paying income tax and
working in produclive roles. At a hearing in King County
Washington, in 2000, a psychiatrist testified that of the 10,000
patients he had treated, none had recovered. This is a tragedy.

We are never going to get better treatment for these

patients until the public demand is so strong that it can no
longer be ignored by the psychiatric profession. The change
will not come from the drug companies. It will come when
the pubic realizes what is going on, and demands that the
conditions of treatment be vastly improved by using the best
ID 11

introduced by the Quakers over 150 years ago consisted of

I he first Ihree components of the ideal program.

Chapter Two
1. SHELTER
The Basic Treatment Elements The Mental Hospitals

! was appalled at what I saw when I first studied the

mental hospital in Weyburn, Saskatchewan in 1950. It would
turn one's stomach until hardened by daily exposure to it.
INTRODUCTION
Shelter is obviously absolutely essential for every
Treating schizophrenic patients to recovery can be as easy
person, and Ihe amount of attention that must be given lo
as giving them one vitamin for a few months, or as difficult
shelter depends upon the conditions of the environment.
as spending 25 years using a total comprehensive program
It varies from the homes in easy climates in which many
which includes orthomolecular treatment, shelter, nutrition,
of us live, such as my home in Victoria, British Columbia,
and tender and loving care by family or by others equally
to the rigid environment carried around the bodies of our
motivated to do so. To make a valid comparison between
astronauts when they' travel in space. People are prepared
psychiatry in 1950 and psychiatry in 2007 I will examine each
to pay enormous sums of money for what they consider
of these four important modalities.
to be the correct shelter, traveling first class, living in very
expensive homes, staying in first class hotels, living in areas
The ideal treatment components of a total program
surrounded by many other people who help them look after
include: (1) Shelter (2) Optimum nutrition (3) Civility which
their interests, and in geographical areas surrounded by light
means Decency, Understanding, Support, Safety and
borders guarded by their best military means.
Privacy1 and (4) Orthomolecular treatment. These are not
listed in the order of their importance as they are equally
Only our psychiatric patients have been denied the
important. The effect of each variable on the response to
absolute needs of shelter from times when they were
treatment varies with the adequacy of these factors. Thus
banished from their communities, in places where they were
treating schizophrenic patients in a very good home will
handcuffed to trees in the forest, when they were forced to
be more successful than treating them on the grates of the
wander about on the streets (even now), when they were
streets of Toronto or New York. Moral treatment of the insane
incarcerated in foul dungeons and herded into inhuman wards
given less attention than farmers give their prized animals.
About 150 years ago the first good mental hospitals were
1 Hoffer A. The importance of privacy in building human values built. Dr Conolly in England was superintendent of a hospital
into the community. Community Planning Review 1969; 19:13-16
12
that provided proper shelter, This was when he reported the
fifty percent recovery rale. The Dorothea Lynd Dix hospitals,
built mainly in the United Slates with one in Toronto, were
substantial struclures providing l he better elements of
shelter. But as the era of profound pessimism spread into
our psychiatric system these hospitals had been allowed
to degenerate into foul prisons by 1900. They were called
asylums but they did not offer any asylum, or proper shelter.
The mental hospitals that I remember before 1950 were
hased upon deceit. They were impressive structures and it
would naturally be assumed that the care and treatment would
be equally imposing. But the public facade hid institutions
that did not know' how to care for patients, did not have any
useful treatment, and were fearful that the community would
understand what was happening. They were not asylums or
shelters. The word asylum by then was such a fearful word
that it had become customary for these mental hospitals to be
given innocuous names such as the Saskatchewan Hospital
in Weyburn. U was hoped that the stigma of the word asylum
would be avoided but it was not and the stigma carried on
no matter what these institutions were called. They were
custodial, designed more to protect the public than to treat
and recover patients.
But I did not know what these hospitals were really like
until I joined the Department of Public Health, Psychiatric
Services Branch, on July 1, 1950 and began to visit these
hospitals. My contact with the hospitals became closer when
Dr. Humphry Osmond arrived from England in the fall of 1951
and we began to meet frequently either at the psychiatric
hospital in Weyburn, where he was clinical director, or In
Regina where I was working at the Munno Wing.
13
In 1950, the Psychiatric Services Branch in Saskatchewan
operated two large mental hospitals, one in North Battleford,
about 100 miles northwest of Saskatoon, and one in
Weyburn, about 70 miles south of Regina. A tew years later
it opened the Training School for the mentally retarded in
Moose Jaw. The one psychiatric ward in a general hospital
was the Munro Wing, in the Regina General Hospital. The
hospital in North Battleford was built about 1913 and the one
In Weyburn a few years later. Each hospital was designed
to house 1200 patients. Before the hospital was built in
North Battleford, the government of Saskatchewan sought
and received advice from doctors from New York who must
have been very progressive in their view of hospital design.
They recommended that it should consist of separate units,
each one to be no larger than needed to house 300 patients.
This was based upon experience in New York State. They
believed that larger buildings that housed more than 300 were
too difficult to administer and that the distance between the
patients and administration would be too great However
the architects retained to build these buildings advised the
government that it would be too difficult to heat separate
buildings and instead recommended one building. By the
time I arrived each building was terribly overcrowded, each
hospital housing about double the recommended number of
patients.
The Training School in Moose law was built to remove
the overflow from Weyburn. it was called Training School
because the philosophy of that day was that the mentally
retarded needed special education much more than they
needed medical attention. Mental retardation was judged
by the intelligence quotient, the IQ. There were three main
categories, using terms such as idiots, morons and imbeciles.
Intelligence quotients were given a lot of attention and
palients with an IQ under 70 were candidates for the Training
 14
School In the United States some of these schools for the
mentally deficient were called campuses. When the Training
School En Moose Jaw was completed many hundreds of
patients were moved there from Weyburn. North Battleford
was in somewhat better condition than Weyburn because it
was not quite as badly overcrowded.
My sister F.H. Kahan provided an excellent description
of the history of mental health treatment in Saskatchewan.2
I recommend that this important document be read by
everyone Interested in the fate of the mentally ill.
The two mental hospitals were located well away from
the main centres of population perhaps for security reasons
following the general belief thal these patients were very
dangerous. Also there would be fewer relatives who would
visit, those who might protest at the kind of treatment their
relatives were getting. Visiting was actively discouraged. You
had to be a relative in order to be allowed in. The hospital
in Weyburn was located one mile away from the town.
This hospital was the town's main industry. The hospital in
North Battleford was in the northwest part of the province.
Saskatchewan is a large province about 30 Q miles from west
to east and the Inhabited area runs about 300 miles north of
the United States border. |j a patient was admitted from the
southeastern part of the province his family would have to
travel 250 miles to see him and with I he usual poor dirt roads
and very poor train connections it was extremely difficult
to visit. As a result there were few visits and gradually there
was complete alienation of the patients from their families.
However they were not discharged anyway and it probably
2 Kah*m F.H, Brains and Bricks. The History of the Yorkton
Psychiatric Centre. White Cross Publications, Saskatchewan Division,
Canadian Mental Health Association, Regina, 1965
15
was for the best for the family to try to forget that one of their
members was in hospital
The grounds were spacious and contained several
buildings, the main building, service buildings, houses for the
medical staff and barns for the horses and cattle. The hospital
operated a farm with patients as the wrorkers. The main
building was about three stories high, a bng rambling building
with an imposing entrance. From the outside it looked like a
very attractive building and one could hope that the treatment
and care given inside was equally attractive. But it was not,
I he top floor was the nurses' residence. After one parked the
i ar and walked to the front door the first thing that greeted
you was the shouting and noise coming from the open
windows of the building. These were psychotic patients crying
their frustration, their delusions and fears to the world. After
tranquilizers were introduced one enterprising United States
mental hospital installed a noise meter in one of their wards
and recorded the amazing decrease in noise as the ward
became fully tranquil!zed.
The front hall was very large and grand with an imposing
staircase straight ahead going to the wards. On the left hand
side was the superintendent's office and other administration
offices, and to the right was a private dining room for the use
of the superintendent and his guests. I had several meals there
with the superintendent. As soon as one went through the
locked doors the environment was totally different. The whole
hospital was divided into large moms with a nurse's station
and immense numbers of patients of various types. There may
have been a few single rooms but I can noi remember ever
seeing any. The dining rooms were large and communal. The
basement rooms were the worst and had holes in the concrete
floors. One ward had BO women of all ages and most of them
refused to keep their clothes on.
16
In 1954, Dr. John Weir, the Medical Director of the
Rockefeller Foundation, visited us in Regina after we had
requested a research grant. I drove him to Weyburn and with
Dr. Osmond we showed him I he entire hospital. On the way
back he was very quiet for a long time. Eventually I asked him
what he thought about the hospital. He replied very quietly
that he had seen only two worse in the whole world. Out of
curiosity I asked him where and he replied, "One in Egypt and
one in Jamaica. * According to him our hospital in Weyburn
was among the three worst in the world of the many that he
had seen. Apparently he had not visited any mental hospitals
in Japan. A recent report describes I heir hospitals today in
terms reminiscent of what we had in 1950A
The Psychosocial Environment
After admitting us, one or two nurses, usually female,
would escort us through the ward. We would immediately
be surrounded by patients clamoring for attention. They were
no! aggressive. They were supplicants demanding one thing
or another. The fact that one or two nurses could command
control over such large crowds indicated that these patients
were not dangerous and were probably less aggressive than
a similar crowd on the streets. Some of the crowd would drift
away as we continued our walk but many would be with
us uni II we left the ward. We were probably one of the tew
exciting events of that day for these unfortunate patients.
The nursing staff had not been I rained to deal with
psychiatric patients but soon after Dr. D.G. McKerracher
arrived in 1946 as the director of the Psychiatric Services
3 Tokyo, Hospitals lor the Mentally Ill Badly Need To Reform. The
Economist, November 24th, 2001
17
Branch of the Deparlment of Public Health, he started
a 1 raining program eventually leading to the degree ot
Psychiatric Nurse. It was different from the training received
by RNs, There were too few doctors, none who had had
psychiatric training. What they knew they had to learn
from experience. The superintendent had been a patient in
the hospital because of his drug addiction. This addiction
apparently came under control, and he began to work with
the medical staff, eventually being promoted to the senior
administrative position. This was really the case where an
inmate eventually ran the entire institution.
There was a remarkable failure to get the patients to
interact with each other. On several occasions i watched the
nurses take a ward of patients out to an enclosed field for
exercise and attempt to foster some interaction between staff
and patients and between patients. Normally when you place
50 people in an enclosed area they do not separate from
each other so that there is an even distribution of patients, like
molecules in a gas. After a tew moments groups will form and
one will find singles, but also doubles, triples and even larger
groups and the distribution of these groups is uneven. The
groups will be actively interacting with each other. However,
when these patients were placed in the enclosed area they
did not interact. The whole field was occupied by solitary
individuals equally distant from each other. I could only
marvel at the striking impact of this chronic disease which
removed from the patients I he need or ability to interact. I
think it is because they are so sick they are overwhelmed and
can only live in their inner world of fantasy and psychosis.
This was shown several years later when one of the
more optimistic psychiatrists on staff began to conduct
group psychotherapy sessions with a number of chronic
schizophrenic patients. He was convinced at the beginning of
18
this experiment that palients would eventually learn to behave
like normal people in these groups. But after two years of
regular meetings I he degree of interaction at the end of (he
study was no better than it had been at the beginning. The
patients still did not talk to each other or to the psychiatrists
running the groups. His hypothesis was derived from a current
view being examined by many psychiatrists that fostering
interaction would cure these patients. The nurses also tried to
foster interaction between patients and staff by playing games
with them. They used large balls and would throw them for
the patients to catch and to return to them. This did not work
very well either. It may be that the patients' spreading as
far from each other as possible was a reaction to the forced
proximity within the wards of the hospital where they were
always in each other's faces. For this reason they could not
join in a group protest or rebel against their incarceration by
staging riots. Dr. Osmond used to marvel at the fact that there
had been no recorded episodes of schizophrenic patients
staging a break out as would be the case with prisoners of
war, or with psychiatric patients who were not schizophrenic
such as psychopaths, as they were known then (personality
disorders is what they would be called today). I do not suggest
that this is a general symptom of being schizophrenic. I think
it is a product of the disease and incompetent treatment over
many years.
These huge hospitals were designed to hold 1200 patients
and yet contained double that number with no provision for
privacy of any sort, t he inmates, as they were called, were
managed by a gradually improving standard of nursing care,
medically supervised by doctors who gained experience while
working there and administrated by bean counters whose
main concern was saving money. This is understandable
since Saskatchewan had just begun to recover from the Great
Depression and a series of disasters that had hit the province*
19
Between 1932 and 1940 the province experienced great
plagues of grasshoppers, destruction of wheat by the disease
rust, terrible drought, low world prices for all their produce
and huge unemployment. With the war in 1939 the situation
began to improve. The weather got better, the drought was
over and farmers learned how lo deal with the other natural
disasters. As welt, the province was starting to recover under
the direction of the socialist government led by T.C Douglas.
Fortunately for the mentally ill in Saskatchewan Premier
Tommy Douglas had been a student minister intern for a few
Of months at the hospital in Weyburn and never forgot what
he had seen. When he became premier he also made himself
Minister of Health and took a special interest in psychiatry.
He would joke about his experience in the hospital especially
after becoming premier. The Joke had to do with a patient he
met on the ward. The patient asked him "And who are you?"
Douglas replied, "I am the Premier of Saskatchewan/' The
patient replied, "You too!"
Conditions Within The Hospital
Our hospitals lhat Dr. Weir considered among the worst
three he had ever seen were overly crowded, with poorly
trained medical and nursing staff. They provided custodial
care for palients from all over a very large province so that
most families lost contact with them. It was a system which
had grown with little planning, had stopped growing during
the great depression between 1932 and 1950 and which did
not take into account the needs of the people of the province.
The public was not aware of what went on in the mental
hospitals and probably, except for a few very quiet families,
did not care.
Mentally ill palients face the stigma of being mentally ill as
also happens with some physical diseases. Diseases which are
20
not understood and for which we have no effective treatment
tend to be stigmatized. So it was with tuberculosis many years
ago. Families were very fearful of this condition because there
was no effective treatment and patients had to be taken to
sanitariums for many months or years of treatment. Today
even though there is reason to be fearful of the resurgence
of this dreadful disease there is no stigma attached as we
have effective treatment for it. Syphilis is another example of
a disease which was abhorred and stigmatized- But with the
introduction of the proper antibiotics and with a change in
moral sexual standards it appears to have no stigma attached
to it Special treatment centres were created in hospitals for
the diagnosis and treatment of this disease although there
were separate entrances away from the front entrance of the
hospital. A very recent example is HIV/AEDS which carried
the same severe stigma 20 years ago, most of w hich has
dissipated.
For the same reasons the mentally ill, especially those who
did not recover were stigmatized and schizophrenia still is.
Schizophrenics were said to have nervous breakdowns and
these were discussed in hushed tones hy families and friends
and whispered ahout to each other even though no one knew
what having a nervous breakdown meant. And the institutions
where these patients went for help soon were enveloped by
the same stigma. Strenuous efforts have been made over the
past 100 years to remove the stigma first by changing the
name of the institution and over the past 50 years by trying
to educate I he public that this is a disease just like others. But
in fact it is not and the public was not fooled. Schizophrenia
would be a disease just like other diseases if it were generally
recognized as an easily treatable biochemical disorder with an
excellent high recovery rate when treated by orthomolecular
methods.
21
The earliest term for the old mental hospitals was asylum.
I am sure that Dr. Con oily back in 1850 was happy with the
term asylum being applied to his hospital where he was able
to get a 50 percent recovery rate. But as the character of the
hospitals deteriorated until 1900 the stigma of unrecovering
patients became so bad that the term asylum was dropped. It
meant that anyone in an asylum was mentally ill. The Oxford
International Dictionary of The English Language defines
asylum as follows: (1) A sanctuary for criminals and debtors
from which they can not be forcibly taken without sacrilege
(2) A secure place of refuge or shelter (3) A benevolent
institution affording shelter to some class of the afflicted,
the unfortunate or destitute (5) Lunatic asylums. I think the
word is a good word and ought to be resurrected and asylum
should be given, if necessary for life, for patients who have
been so badly damaged that they will never be able to live an
independent existence. Meaning #5 is the proper use of this
word but without the adjective lunatic.
To counter the stigmatized word asylum it was
dropped and an innocuous term was used instead such as
Saskatchewan Hospital in Weyburn or Spring Grove State
Hospital in Maryland. This did not help for the stigma which
had enveloped the original structure would not leave no
matter how hard any one tried to blow It away. By 1950
another attempt was made by simply describing the location
of the psychiatric wards within the hospital. At the University
Hospital in Saskatoon it was called 5DL, an accurate
description of the location of our wards on the fifth floor in
wings D and E. It soon became obvious that patients from
the rest of the hospital did not want to go to SDL and it, too,
carried the same stigma, \ believe most psychiatric wards are
still called psychiatric wards and a few places have names of
their own to honour certain political persons such as the Eric
Martin Pavilion in Victoria named after Eric Martin, it has the
 22
same reputation that any other psychiatric hospital has. It is
not very good and patients resent and fear going there. There
h only one way to remove the stigma and that is to show the
public that patients with schizophrenia recover and become
useful members of society, that it is not an unbeatable
disease.
The orientation of the staff after Dr. McKerracher
arrived was quite different The earlier staff had worked
almost entirely in the mental hospital and tended to be very
conservative about the nature of schizophrenia although not
so conservative about introducing new treatments into the
system. They were general practitioners. As there was no
efiective treatment they were not restricted by any ideology
and tried new treatments as they were developed. Within a
few years of the development of electroconvulsive therapy
(ECO it was being used in Saskatchewan. Within a few years
of the development of insulin coma therapy it, too, was being
used. These treatments were not very effective but they did
provide some hope that biochemical biophysical treatment
might have some value and needed only to be perfected.
It is much more difficult to introduce new therapies today,
unless It is a new drug, since modern psychiatry adopted
the stance that only drugs have any value. Psychiatry has
gradually gone through a phase of psychotherapy (especially
analysis) as the only valid treatment, has forsaken that and
now considers that drugs are sufficient while paying lip
service to psychotherapy in conjunction with drugs. Keith* in
an editorial in the American Journal of Psychiatry asks, 'Are
We Still Talking to Our Patients With Schizophrenia?" And
he answers his own question, "1 hope so." But he points out
* Keith 5. j. Are We Still Talking Lo Our Patients With
Schizophrenia? American journal of Psychiatry 2006; 163:361-364
23
there is a very low level of interest. The new doctors had no
preconceptions and quickly adopted the new ideas of cause
and treatment which were predominately psychological. Bui
when drugs were introduced in 1955 they were adopted even
more quickly because their effect was so dramatic.
The Saskatchewan plan was conceived and developed by
Dr. McKerracher. The original plan envisaged small regional
hospitals across Saskatchewan. Seven were to be built and
the large mental hospitals were to be replaced. With three
large hospitals it was very difficult for families to keep in
contact with their relatives especially during the long winters
when most roads were closed to motor vehicle traffic. It
was much more difficult to make realistic plans for patients
to be discharged. As I've said, Saskatchewan is a very large
province, with a very small population and only a few large
cities. The large distances plus poor roads meant that visiting
relatives was a two day excursion for many people. Neither
Regina, the capital, nor Saskatoon, the first city to have a
university had any psychiatric facilities. According to the
Saskatchewan plan the seven smaller hospitals would be
scattered across the province so that patients were no more
than 60 miles, one hour driving time, from their home. The
second main reason was that it would be easier to administer
small units and management would be less alienated from the
patients. Two of these hospitals were built eventually, one in
York ton, in the eastern central part of the province and the
other in Prince Albert in the north east part of the province.
This Saskatchewan plan was the forerunner of the massive
program of deinstitutionalization which was a corruption of
the original Saskatchewan plan. Deinstilutionalization swept
 24
across North America leading in Jarge part to the terrible
shelter situation we have todays
The New York rimes" featured the condition of the
mentally ill in their city. In their reports the main emphasis
is on inadequate housing and inadequate care. None of the
ihree basic principles of humane and effective treatment are
followed; Patients are given inadequate shelter, Inadequate
food and are not treated with dignity and respect, but we
now need another journalistic investigation to examine the
inadequacy of modern psychiatric treatment which depends
only on medication. The situation is no better In Canada.
Recently Nunes and Simmie7 described the plight of the
mentally til in Toronto and used primarily the histories of
patients who had done fairly well or had recovered. Most
of these survivors of the mental health system suffered from
depression or from bipolar conditions. The same patients
who also had schizophrenic symptoms did not do nearly
as well and most remained impaired and damaged hv their
experiences.
Or. McKerracher was facing very severe problems with
the administration of these institutions. The patients were
warehoused, not receiving any useful treatment and usually
stayed in hospital forever. But the administration appeared
to have accepted this as one of the symptoms of chronic
schizophrenia and hefieved that there was nothing that could
be done.
5 Hotter A The Current Mental Health System for Schizophrenic
E-Yiiients Canadian Journal oi Community Mental Health 2000 19144-
146
6 Levy t J. For Mentally III, Death and Misery, New York Times
April 28, April 29, April 3U and May 5,2002
7 Nunes J. & Simula S, Beyond Crazy. Met.elland and Stewart
I Id., Toronto, 2002
2.^
Dr, Osmond as clinical director of the hospital In
Weyburn had as his main mission to bring into being a
modern administrative structure which could cope with the
vast problems of this old inadequate hospital. But he laced
resistance from Ihe start by members of the psychiatric staff
and by the superintendent of the hospital. He could not
introduce changes that he fell should be Introduced and thus
for several years he concentrated on studying the problems.
On Ihe positive side it left him much more time Io work with
me on our joint research.
Dr, Osmund became interested in the impact of the
environment on patients. He had taken mescaline and LSD
several times and was aware of the perceptual changes
induced by these hallucinogenic compounds. The drugs
induced temporary changes in the experiential world. But
schizophrenic patients had to live with these perceptual
changes for years if not forever. Osmond wondered whether
one could design wards thal would minimize these perceptual
abnormalities. The typical hospital consisted of large wards
and long corridors. What is the impact of walking down a
long corridor when there are no symbols on the floor or walls
that indicate that one is making some headway? Modern
buildings are aware of this and corridors which lake this into
account are much more pleasant for walking and are not
nearly so monotonous. Ideally patients would be asked lo
describe the impact of Ihe rooms they were living in but very
lew patients were either well enough or verbal enough or
sophisticated enough to describe the impact of any changes in
their environment.
By this time joe Iztmni, a bright young architect known for
some of the buildings he had designed, was retained to carry
out some remodeling of the wards at the Weyburn hospital.
 26
He knew about our research with LSD and he was intensely
interested. He volunteered to take LSD so that during the
experience he could walk through i he wards of the hospital,
spending time in the various rooms to see what the impact
would be on him during this experience. We agreed that
this would be interesting and could be valuable. Humphry
gave him LSD at the hospital in Weyburn and later I gave'
It to him in Saskatoon at the University Hospital, l or the
following month he studied the impact LSD had on him and
following that he designed a hospital that he thought would
minimize the impact of perceptual symptoms on patients.
The building" he built in Yorkton won a silver medal from
t e American Psychiatric Association. A second building was
built jn Prince Albert. No more were constructed because
I he newly introduced tranquilizers filled the psychiatric
community with the expectation that a cure for schizophrenia
Pact at last been found and no more hospitals would be
needed. The Saskatchewan plan was shelved but moved
south into the United States in a corrupted form that led to
deinstuutotalization which has been so harmful to patients
ramifies and their communities.
Between 1955 and 1967 I trealed my patients in the
University Hospital, now called Royal University Hospital in
Saskatoon, Saskatchewan. I had been one of the advisors to
Dr. McKerracher, Chair of the Department of Psychiatry at
the University ot Saskatchewan, before I he wards were built
We were given the outside dimensions and had to design the
interior This was the best psychiatric facility in the province
with a large ratio of staff (nurses, psychologists, social workers.
s Izumi K- & H. Osmond. Community Mental Health Center/
research-oriented situation 34-61, In Architecture for the Community
MasmTVv1 “ «-“« Materials Center, In^
SSKSSg 1967 Y°fk l0°10' ^-sCatsfoguc
27
aides and doctors) to patients. Our budget was al least four
limes the budget per patient for our two mental hospitals,
about 80 dollars per day. (Remember that this was between
1955 and 1967.) A research study by my assistant director ot
psychiatric research, Dr. C Smith1" in cooperation with Dr,
McKerracher, of the treatment results of our ward in Saskatoon
and the nearest mental hospital in North Battleford showed
that the results of treatment were about the same.
Between those heady years when tranquilizers became
available and 1987, the race was on ail across North America
to see which hospital could empty itself the quickest. This
process was called ddnstitulionalization and was supported
by every group or agency interested in the welfare of the
mentally ill A rallying cry was used: The worst home in
the community is better than the best psychiatric ward.
Governments loved it because they were promised that
total cosl would go down. It was assumed that the dramatic
response to these drugs was in fact a cure and that the
patients would not ever have to come back again. Our
superintendent in North Battleford proudly showed us a chart
showing the dramatic decrease in the total population of his
hospital year by year.
The communities had become aware of the desperate
condition of the patients in mental hospitals and demanded
that the psychiatrists do a better job. The invariable response
of every superintendent tn every hospital wras that they were
short of money and if the community would give them more
staff, more doctors, more nurses, more social workers and
aides then they would do a much better job, I became very
dubious about this automatic response especially after the
9 Smith CM., McKerracher D-G-, McIntyre S. Care of the Certified
Psychiatric Patient in the General Hospital. The Saskatoon Project.
Can Med Assoc] 1963; 88:67-74
26
results of the Colin Smith study became known, I decided to
test it En a crude way on my own.
In 1967 I resigned my two positions from the university
and governmem and entered private practice with admitting
privileges to the local general hospital, City Hospital, in
Saskatoon, A nursing home company announced they were
building a new nursing home in the city for the physically
handicapped. I approached a friend involved with this
company and asked whether I would be allowed to admit
patients to his nursing home. They would be chronic
schizophrenic patients from the United States and Canada
who had failed to respond to any previous treatment. \ had
been treating these patients at the University Hospital with
some success. The nursing home was to he built following the
model of motels then very popular. Each patient would have
his/her own room. There would be one nurse in charge, no
other professional workers, but the usual amenities of nursing
homes would be provided. The place was bright and dean
with a large central living area where patients could meet.
They all ate together in a large dining room. The cost was 20
dollars per day, i.e. 25 percent of the cos! at the University
Hospital. I would be in charge of treatment and would give
ECT if needed. There was no compulsion; patients were there
voluntarily and could leave at any time. The difference in cost
represented the difference In the number of staff. The quality
ot the food was the same but my patients at the nursing home
did not receive any psychotherapy from nurses or other staff.
But the staff were friendly and kind to them and they got
along very well with the physically ill patients. The nursing
home agreed to admit my patients, whom I saw several limes
a week. I was using the moral treatment introduced by the
Quakers m 1650 without knowing about I heir work. These
patients were given good shelter, were treated with respect,
and received good food and proper medical treatment with
29
medical and orthomolecular methods as needed. My patients
in the University Hospital received the same four components
of the ideal treatment. 1 was able to treat about 100 patients
Over the next eight years.
I then compared the outcome of my treatment at the
hospital and at the nursing home and found that it was the
same. The shelter and additional care given at the hospital
which cost four limes as much did not improve the efficacy
of my orthomolecular treatment. I found to my surprise that
the mix of young schizophrenic men and women in a nursing
home with chronic invalids, who were mentally normal or
senile, was very good. My young patients added life to the
institution. They volunteered to help in pushing wheelchairs,
talking to the mentally normal but physically infirm patients,
serving etc. Only one patient left and he was promptly
discharged. He went back to his parents in the United States.
Only one chronic schizophrenic patient who was also an
alcoholic would not cooperate. Nor would his father support
what I was trying to do, even though his mother tried very
hard to get him to stop drinking. His father did not support
my advice that he must not drink. From this I concluded
that although shelter was very important one did not need
to go to extremes to provide adequate shelter and that more
important than shelter alone was the addition of the correct
orthomolecular treatment.
No one will disagree that shelter is vital but society
appears not to understand that it is also vital for psychotic
patients. One can judge l he overall sense of decency and
humanity of any society by the kind of shelter it provides lor
its mentally ill population, A decent and humane society will
treat their people in hospitals and other shelters that live up
to the standards established in 1650 by (he moral treatment
introduced by the Quakers. A less decent and less humane
 30
society will treat them rn prisons as is happening today or
wiff allow them to languish on the streets. This has little to do
with industrialization but everything to do with attitude and
belief. Psychiatry has not convinced society that it can treat
schizophrenic patients successfully in spite of the protestations
of the remarkable effect of modern drugs. I believe that only
when society is convinced that these patients can be treated
successfully and restored to the community as normal people
will it take seriously the need to provide proper shelter. It can
be done now and modem hospitals are fully equipped and
know what to do but it is not available to these patients due
to policies that have been developed over the past sixty years
all arising from the deinstitutionalization fiasco that started
in Saskatchewan in 1955. Had the Saskatchewan plan not
been corrupted by the excessive enthusiasm generated by the
tranquilizers we would not have the fiasco we have today.
In the United States™ a report by the U.S Justice
Department showed that 280,000 or 15 percent of the entire
jail population was mentally ill. The total in 2007 is 300.000,
A news report proclaimed that, "Jails Become Nation's New
Mental Hospitals." Another 200,000 people are homeless.
An even larger group is probably just on the edge of entering
these two populations il their circumstances deteriorate
more^ About 60 percent of the psychotic population of
over 5 million is not receiving any treatment whatsoever.
However this may be an advantage for some considering
the high natural recovery rate when It is allowed to operate,
I he situation is not any better in Canada. Philip1 reported
that there was a problem in organizing a mental hospital for
the inmates in the prison system. At the same time as the
11 M hospital-jail Offers Hope for the Merit nil v III, GJobe
and Mail, Toronto, Nov. 4, 2002
31
psychiatric hospitals have been shutting down their beds the
number of patients who need the kind of care they could
offer is going up and will have lo be supplied by the prison
system. A survey ten years ago showed that provincial jails
in Ontario had 350 mentally ill prisoners and of those 130
were certifiable. The same survey last year showed that there
were 600 mentally ill prisoners. The reason is that the mental
hospitals have the power not to admit patients and in this they
are assisted by the state mental health laws while the prisons
do not have the luxury of denying admission to people sent
there by I he judicial system. There is a gradual swing over
and care is forced onto the prison system while liberating the
health system outside of the prisons from having to deal with
it. I can not think of a worse place to treat psychiatric patients
than in a prison hospital except that since only drugs are
being used in both types of hospitals the results will probably
be the same, not very good.
The television program. Sixty Minutes, on July 22, 2007
devoted one-third of its program to the condition of the
mentally ill in the prison menial wards in the United States.
Timothy Souder, age 21, was a manic depressive in one of
these prisons. He had become different in his late teens, with
strange behaviour, anxiety and depression and in prison he
tried to kill himself three Limes. In his cell he was chained
to the cement floor for up to 17 hours with only the video
camera recording his torture. He died alone lying on the floor
of his cell from dehydration.
All elements of the ideal treatment are essential to build
and maintain self respect and morale. There can he no
argument about these being important Patients are sick
people, and they must be treated with decency and respect it
we want them to recover. All (he elements of civility improve
the patient's natural recovery possibilities. The best example
 32
was the hospital in England supervised by Dr. Conolly and the
Dorothea Dix hospitals in New York State, Connecticut and
Pennsylvania. I read (he first annual report of these hospitals.
This annual report fater became the present day American
journal of Psychiatry. They reported a 50 percent recovery
rate of these insane patients. They had no medication, no
psychiatric drugs, I assume they provided good food not yet
• t>Y modern technology. They provided shelter and
treated (heir patients with civility. EE was common in these
hospitals to have Saturday night parties attended by palients
and staff together, just these three elements of the treatment
process alone aEfowed half the patients to recover. I think that
schizophrenia has a high natural recovery rate if patients are
allowed to use their natural recovery processes by providing
the elements of good treatment. The best recovery rate today
with the most modern tranquilizers and other drugs is under
10 percent. By recovery I mean patients are well enough to
earn a living, to engage in normal activities and to pay income
tax. On modern drugs it becomes impossible to pay income
tax unfess the wealth has been inherited.
The erticacy of any treatment regimen is directly related to
the adequacy of shelter, but I do not think the relationship is '
linear. The optimum level is reached when it is approximately
what an average family has, excluding those families that are
on welfare or on very low incomes, increasing the standard
above that will not increase the efficacy of treatment very
much. The relationship is curvilinear. When one pfots level
of shelter against efficiency of treatment the curve will rise
sharply from zero (on the streets, chained to trees) to the
average level and after that it will rise slowly, slowly reaching
its maximum. In 1950 most psychiatric institutions did not
provided adequate shelter. Today most institutions do not
provide adequate shelter long enough to do any good.
33
2. OPTIMUM NUTRITION
The food served in 1950 in these hospitals was not much
different from the food the general population ate. But like
most institutional food it was too rich in refined carbohydrates
and did not provide enough vegetables and protein. During
the previous years of economic depression the die! in
institutions was probably better than I hal of many people
who were living at home. Costs were kept as low as possible
but the hospitals had their own kitchens and cooked their
own food. The large hospitals also grew some of their own
vegetables. This food was probably similar to the food that
was served in 1850. By 1900 in the northeastern United States
the food budget of mental hospitals had become abysmally
low. One superintendent prided himself on the fact that he
could feed his patients on 19 cents a day. Not surprisingly the
discharge rate decreased from 50 percent in 1850 to almost
zero in 1900. The mental hospitals always served enough
calories. No one starved in hospital and many got fat.
The commercialization or deterioration of our food started
after the last war. In 1950 in Canada 15 percent of the food
was processed. In 2007 it is closer to 85 percent. Only In
the past decade has much, if not all, of the food given to
patients been prepared outside the institution and brought in
precooked. Kitchens are absent from modern hospitals. This
was alt done to save money. In some hospitals less money is
spent on food than on bandages and casts. Not only has the
nutritional quality of modern foods deteriorated it has also lost
much of its flavour.
But the deterioration of the food served to patients is no
longer a major factor since they are seldom kept in hospital
long enough. They would be much healthier on a good diet
but a good diet for a few days does not do much for a street
 34
person who spends [he rest of their time on the streets. Food
not considered an important factor in modern psychiatric
theory and practice. And the reason is simple. In Canada
most medical colleges give their students about one hour of
nutrition over four years with the exception of the University
ot Toronto and McGill. But chronic patients who cannot be
discharged will si ill suffer from the deteriorated diei of modem
institutions.
In 1950 staff running the mental hospitals knew little about
nutrition and the importance of food, and they were forced to
consider cost as a major factor in preparing their meals, but in
t is t ey were not much different from the general population
outside of the institutions. In 2007 much more is known about
the vast importance of proper diet and food in treating the
mentally ill, but the staff of psychiatric hospitals are equally
ignorant and I hey are generally providing food to their palients
which is less nutritious than that of the general population.
And when there are rare hospitals that do recognise these
tacts the patients are not in hospital long enough to benefit
from this knowledge. In terms of feeding patients the mental
hospitals of 1<J50 did a better job than the psychiatric hospitals
do in 2007.
3. CIVILITY
Many adjectives can be used to describe the desirable
relationship between people. Five adjectives in particular -
decency, understanding, support, safety and privacy can be
combined into the term civility,1' And inasmuch as cjvilfty
is desirable for relationships between equals it is even more
l* A The of privacy in building human values
o me community. Lominunily Planning Review 1969; 19:13-16
35
important in the relationships between dominant and less
dominant people e.g. doctors and their patients. The doctor
patient relationship especially must be described by the
adjectives that make up the term civility. I have seen many
palients who complained about the way they were treated
by their doctors, their psychiatrists and hospitals. Had the
physicians respected these principles of civility there would
have been no complaints from their patients. The five
adjectives describe the doctor patient relationship as I think
it should be practiced. I will use the term civility hereafter to
cover these essential values.
Diagnosis
Civility must include being scrupulously honest with
patients in telling them what is wrong with them, what the
treatment plan is and the anticipated outcome or prognosis.
Patients should aEso understand the reasons why Ehey have
been admitted into hospital. This depends upon the symptoms
anti signs of the disease. They must be given the information
they will need for true informed consent. Today in mental
hospitals informed consent does not exist for certified patients.
Schizophrenic symptoms can be divided into two sets: (1)
those that force patients into hospital, (21 those that permit
patients to live in the community. The first set of symptoms
is what 1 call I JOT symptoms and the second set is COOL
symptoms. Hot symptoms include severely abnormal or
criminal behaviour such as shooting people at random,
burning down buildings, shouting at people in the streets,
running around nude, talking about severe paranoid ideas,
or severe depression or mania, these are symptoms which
normal society cannot tolerate. Cool symptoms are equally
devastating to the patients but are much more tolerable to
the community. They include moderate depression, paranoid
 36
ideas that are not shared, and hallucinations that are kept
secret. An example is the man who had been sick in his
parent s farm home for two years. He sat quietly in the kitchen
and did not say a word for the whole time. His family was
able to tolerate this abnormal behaviour. However one day
he began to hop on one foot and did so for three days. On
the fourth day he was admitted to ihe psychiatric hospital.
Tranquilizer drugs decrease the intensity of the hot symptoms
and convert them into cool symptoms but they in essence
do not cure the basic biochemical process which keeps on
burn mg as intensely if more quietly than before. They convert
the one-foot-hopping-patlent back to his original quiet non¬
talking patient state.
Diagnostic criteria have changed over the past fifty years.
In 1950 it was relatively simple. The vast majority of patients
were divided into psychoses, neuroses, and behavioural
disorders or psychopathy and intelligence levels were
determined by paper and pencil tests. There were three main
types of psychoses: schizophrenia, manic depression and the
organic psychoses. There were four types of neuroses and
several types of behavioural disorders. All these diagnostic
groups were based on clinical descriptions of the patients,
not upon cause or outcome of treatment and there were no
specific treatments so that ft did not matter that much except
that the psychotic patients were much more apt to wind up
incarcerated in hospital or prison.
Today the fourth edition of The Diagnostic and Statistical
Manual of Mental Disorder (DSM-IV) lists hundreds of distinct
diagnostic mental conditions.1' In a hard hitting editorial
opinion piece in the Los Angeles Times, January ]f 2006, Drr
I Savodnik, psychiatrist and philosopher at UCLA writes, ''The
13 American Psychiatric Diagnostic Manual DSM IV
37
Association specializes in turning human frailty into disease.
In Ihe last year ads have been appearing in psychiatric
journals ahout possible treatment of shyness, a syndrome
nut yet officially recognized as a disease You can bet the
association will include it in the next edition of the Diagnostic
and Statistical Treatment Manual of Mental Disorder. As it
turns out the Association has been inventing mental illness
for the fast 50 years or so. The original diagnostic manual
appeared in 1952 and contained 107 diagnoses in 132 pages,
f>y my count. The second edition burst forth in 1968 with 180
diagnoses in 119 pages. In 1980, the association produced a
494 page tome with 226 conditions. Then in 1994 the manual
exploded to 886 pages and 365 conditions, representing
a 240 percent increase in the number of diseases over 42
years." Does this mean that in fifty years there has been a
real prof iteration in the number of psychiatric diseases from
several handfuls to many hundreds? It does not. It does mean
that the system of diagnosing has become manic, has run
out of control has very little meaning except legally and for
insurance company purposes, it means that the minutiae of
human differences has been coded with diagnostic numbers
so that even the slightest variation means a new diagnostic
number must be assigned. It means that one of the rare
delusional systems believed by schizophrenic patients is
dignified by a special name called Capgras syndrome which
is dealt with as if it were a special disease, when aEl it is, is a
description of this rare type of delusional thinking.
In my opinion, modern diagnosis is no better than it
was but much more complicated. Please read Making Us
Crazy by Herb Kutchins and Stuart A Kirk11. Herb Kutchins
14 Kutchins H. and Kirk A K. Making Us Crazy, D5M: the
Psychiatric Bible and the Creation of Mental Disorders. The Free
Press, New York, 1997. Also, The Belling of D5M. The Rhetoric of
Science in Psychiatry. Hawthorne, New York, 1992
 .38
is professor in the School of Health and Human Services at
California State University, Sacramento and Stuarl Kirk holds
the Marjorie Crump Chair in the School of Public Policy and
Social Research at UCLA. See Also Walker1' and Hobson &
Leonard.1 & The creation of so many diagnostic categories has
not improved the lot of the mentally ill and for many it has
been catastrophic as it could have been for the young woman
who was wrongly called borderline personality disorder when
she was in fact schizophrenic, if they happen to be pigeon¬
holed in the wrong category DSM-IV is included in the list of
things that drive psychiatrists to distraction. This is based upon
a poll ol 200 psychiatrists from around the globe. Containing
every psychiatric diagnosis, it h criticized for reducing
psychiatry to a checklist, "If you are not in DSM-IV, you are
not ill. It has become a monster, out of control."17
In general, early treatment of disease is much more
effective than later treatment when the disease has been
well established with resulting impairment of function. That
was why Dr. Osmond and I concentrated on early cases,
called acute. These were patients who had been sick for a
short time, or who had responded lo earlier treatment and
had subsequently relapsed. They were not mild cases. All
the first 8 patients we treated were very psychotic and had
not responded to the treatment of that day including ECT. All
our controlled trials were with early onset patients. We soon
discovered that schizophrenic patients who had been sick for
a long time also responded but much more slowly.
York '?9%er IIJ 5 A °0Se ”fSanity' J°hn Wiley ,ind Sons ^ Neu
Hobson |-Allan and Leonard, Jonathan A. Out of Its Mind,
svl i a try in Crisis, Perseus Publishing, Cambridge, Mass., 2U01
I7 tThe Independent. March 19,2001. Ten Things that Drive
Psychiatrists to Distraction".
39
1 also became aware that the diagnosis of schizophrenia
was not always the first one tagged onto a patient. Either the
symptoms were not very clear, or the diagnostician failed
to look at them closely enough. The diagnosis was very
unstable with recurrent admissions. Patients were diagnosed
as depression, or manic-depressive, or personality disorder on
first admission; later this was changed and finally, often after
several admissions, they were clearly recognized as having
schizophrenia. Many years ago it was rare for the diagnosis,
once it had been established, to he changed to something
else but in modern psychiatry this has become very common.
The same patient may see several different diagnosticians and
receive a different diagnosis from every one of them. Too
often bias against the term schizophrenia or fear of the disease
will make It very difficult lo diagnose patients. 1 have seen too
many unfortunate patients who, after repeated admissions,
have finally been diagnosed as personality disorder simply
because they behaved in a way that was not acceptable or
because they had not responded to the current anti-psychotic
treatment,
in our book How to Live with Schizophrenia™ Hotter and
Osmond described the early and developed stages of this
disease so that it would be easier to diagnose. Practically in
modern psychiatry il doesn't matter since no matter what the
diagnosis Is the same drugs are used one after the other in an
altempi to find that combination which will help. But many
years ago the diagnosis did matter and helped decide the
treatment as is the case for all of medicine.
18 Hoffer A & Osmond H, How To Live With Schizophrenia.
University Books, New York, NY, 1966 Also published by Johnson,
London, 1966. Written by Fannie Kahan, New and Revised Ed, Citadel
Press, New York, NY", 1992, Revised Quarry Press, Kingston. ON 1999.
I loffer A. Healing Schizophrenia. CCNM Press Toronto, 2004
 40
Etirly in our research in Saskatchewan we were aware of
the need to have accurate diagnosis and we were (coking
for objective methods of diagnosis. Our studies of the
hallucinogenic experience produced by LSD, mescaline,
adrenochmme and other substances made us familiar with
the experiential world of the patients without us needing to
become schizophrenic fora long period of time. We realized
that the experiential world of our patients was similar to what
we and many others had experienced from the use of these
drugs and we were able to formulate a series of questions
designed to test this similarity.
John Conolly1 in his remarkable book defined insanity
{the term schizophrenia was invented 70 years later) as a
disease of perception combined with the inability to tell
whether these perceptual changes were real or not. The
presence of both conditions is essential for the diagnosis to
be made. Perceptual changes such as visual hallucinations
{visions) or auditory hallucinations (voices) when present
alone do not establish the diagnosis. Normal people may
have these phenomena but as long as their judgment about
Ihe reality of these events is intact they are not psychotic.
Patients can be taught not to accept (he phenomena as
real. In the Schizophrenics Anonymous group I started in
Saskatoon in the late 1960s, members learned to discuss Ihese
hallucinations. Often they would greet each other, ‘Greetings
and Hallucinations. And who are you today?" and laugh.
In England and in a few other countries the Hearing Voices
Network for people who hear voices was created From (he
account reported in the New York Times, menders of this
group do not consider that the voices are symptoms of mental
illness. Many ol the members were psychotic at one time and
Conolly J, An inquiry Concerning the Indications of Insanity,
1830, 1964 London, Dawsons of Fall Mail
41
are on medication but some are apparently well white still
hearing their voices. This group has many ideas with which i
can not agree but their basic philosophy is correct. They need
an organization in which they can freely talk about these
phenomena. This undoubtedly eases a lot of pressure. The
tragedy is that the members are totally unaware that many
of them could be relieved of their voices if they were treated
with orthomolecular methods.
We developed the Hoffer Osmond Diagnostic Test
(HGD)7fU1-2Jn This is a very simple card sorting test which
I have found very valuable in diagnosing schizophrenia. It
is based upon examining the perceptual world of patients
by having them answer True or False to a number of
specially targeted questions. But the test has not caught
on. It never became popular except among chiropractors
in the soulhwesEern United States. In my opinion it is one
of the best, simple and accurate diagnostic tests and ought
to be used for assisting in deciding whether schizophrenia
is really present or not. Since schizophrenia is a perceptual
disease every diagnostic test ought to include these kinds of
perceptual questions.
At the same time we had discovered a new compound
in the urine of the majority of schizophrenic patienis that
was not present in normal people and which was present to
20 Holler A & Osmond H, A card sorting test helpful In making
psychiatric diagnosis. J Neuropsychiatry l%i;2:306- 330
21 t loffer A fit Osmond H. The relationship between an unknown
factor (US) in the urine of subjects and HOD test results, J
Neuropsychiatry I96I;2:36S-368
22 Hotter A. Maivaria, schizophrenia and the HOD test. Int ]
Neuropsychiatry 1965^2:175- 177
23 Hotter A, Kdm I I fit Osmond H. The Hoffer-Qsmond Diagnostic
test, RE Krieger Fub Co. Huntington, New York, 1975
 42
a much lower degree in mentally III patients who were not
schrzpjphrenic. We called it the mauve factor and it was later
identified as kryptopyrrofe* This strange compound is being
examined worldwide. According to Dr. W. McGinnis24, 25 it
is an indicator of oxidative stress. As we suspected in 1952,
schizophrenia is characterized by excessive oxidation. We
examined many patients for the presence of this factor Its
presence correlated very highly with the scores of the HOD
test. This increased the potential validity of both these tests.
This test for the mauve factor also is not used widely but a few
laboratories are using it with success.
Recently Bota et al^ examined 24 schizophrenic
patients" history of interaction with psychiatrists. They found
substantially what I had observed fifty years ago. Frequent
diagnoses before the final diagnosis were impulse disorders,
ADHD, and bipolar disorder Patients showed evidence
of illness 44 months before final diagnosis. They write,
"The incipient experiential changes were described by the
patients as ill defined dissociation phenomena, feelings
of unreality, ambivalence regarding day-to-day decisions,
decreased tolerance to normal stress, increased emotional
reactivity leading to conflicts, and decreased ability to initiate
and maintain social contacts... fcVentually their perceptual
24 McGin n is W R Uri na rv pyrrole (Mauve Fa rtor): m etric for
oxidative stress in behavioral disorders. Poster presentation at
the Diet and Optimal Health Conference, Linus Pauline Institute
Portland, May 21,2003
25 McGinnis WR, Audhya I, Walsh W). Jackson JA, McUron-
Hisward |, Lewis A, Lauda P Bitnis DM, Jurnak Fr Lietha R, Floffer A
Discerning the Mauve Factor. Alternative Therapies in I teaith and
Disease. Part One 200B;14:40-5L Part Two 2tK)S;14r5F-63
Bota RG. Sagduyu K and Munro JS. Factors Associated in the
Prodromal regression of Schizophrenia that Influence the Course of
the Illness. CN5 Spectra ms. 2005; 19:937-942
43
disturbances will become the basis of the developing
delusional system."
Until 1960, and perhaps much later, psychiatrists rarely
it tkl their patients their diagnosis if they were schizophrenic, in
il occurred to me that psychiatric patients had as much
right to know their diagnosis as did patients on the physical
side of medicine. I could not think of a single good reason
why not, even though Dr. Karl Menninger had published a
paper in which he demanded that psychiatrists not tell their
patients that they were schizophrenic Dr. Menninger was
convinced that telling patients would make the situation
much worse. In 1960 I began to tell every patient what I had
concluded was their diagnosis but if they were schizophrenic
I would immediately follow that with the statement that it was
a biochemical disease, and that it had not been caused by
their mother. The bad mother or schizophrenogenic mother
hypothesis was very powerful at that time. I was not surprised
and was delighted when my patients accepted their diagnosis
and appreciated knowing it. I remember two cases. One
was a teen-aged boy who came with his mother, I told them
both (at I hat time this was another psychiatric no-no since
no one but the patient was supposed to be in the room with
the psychiatrist) what the boy had and then told his mother,
"And you did not make him sick." She immediately burst into
tears. Then she told me that I was the first doctor who had not
blamed her for making her son psychotic. I he second case
was a man in his early twenties who was both schizophrenic
and alcoholic. He came with his priest who waited in I he
waiting room. I told the patient what I thought. The next visit
the priest came in with him. He sold me that when the patlenl
had gone back to the waiting room after the first visit he asked
him what Dr. Hoffer had said. The patient replied, "He said I
have schizophrenia, I do not know what that means but 1 sure
44
feel better" Alter seeing ever 5000 patients since then I have
had only one complaint
But just giving patients the diagnosis is not good enough
because most people either know nothing about that strange
term or disease nr if they have heard anything it is usually
ali bad, I tell my patients that schizophrenia is not a mental
disease, meaning that it has not been caused by mental
stresses, evil mothers, or evil societies, but that it is caused
by biochemical abnormalities with a genetic basis and that
it can be treated successfully by biochemical means. Most
psychiatrists today agree that schizophrenia is biochemical but
they don't realiy understand it because their only treatment
is with xenobiotic drugs. {Xenobiotic means strange and
therefore is opposite to orthomolecular which means natural
Although they don't have to be, xenobiotrc substances are
usually toxic.)
For the past five years I give additional information. I tell
my patients that I wish I had schizophrenic genes but hastily
go on to explain. It's not that I wish to be sick but thal I
believe that schizophrenic genes or some of the schizophrenic
configuration of genes in healthy individuals have great
value. This applies to their first order relatives and even to
themselves once they have fully recovered, Huxley el aLa*
Invariably I see a sense of relief and even an increase in
self-respect in the patient and in the relatives who are there
with them. The physical benefits include a more youihlul
appearance with aging with less gray hair, more tolerance to
pain, more resistance to bacterial infections, fewer somatic
allergic manifestations and, most important, a major decrease
in the incidence of cancer. Out of over 5000 patients, 1
27 Huxley J, Mayr E, Osmond H & Hoffer A, Schizophrenia as a
genetic morphism. Nature, 1%4; 204:220-221
45
have seen 10 who developed cancer, but everyone made a
complete recovery with standard Ireatment and of course the
orthomolecular program they were on as well. I am not aware
of a single schizophrenic patient under my care thal died from
cancer. The inverse connection between schizophrenia and
cancer is confirmed by a major study in Finland.-5
Decency
According to the Oxford International Dictionary of the
English l anguage, decency is defined: fitness, seemliness,
propriety, what is appropriate, orderly condition of civil or
social life.
These descriptions of decency are all culturally based.
What I mean is that one cannot judge whether an idea is
paranoid unless one knows the culture from which the patient
has come. In some countries some ideas are normal without
being paranoid but when transposed inlo Canada might be
considered paranoid. One can only judge the appropriateness
of ideas from knowing the basic culture and whether the
patient has adapted to the new culture in which he is now
living. Doctors practicing in cultures foreign to the one they
were raised in must be aware of these differences.
Decency means being respectful, honest, polile,
courteous, ethical, non-judgmenlal and concerned. The main
consideration is to do no harm. During interviews all attention
must be given to the patients, to their history or anecdote
which is all important to the patient and during that interview
must be all important to the physician. Decency does not
include being rude, shouting at the patient, making them feel
28 Lidhermann D, ] Ekclund, E Pukkala, A Tanskanen & J
Lonnqvist. Incidence of Cancer Among Persons With Schizophrenia
and Their Relatives. Arch Gen Psychiatry 2001; 58:573-578
 46
demeaned or inferior. Decency means (hat (he doctor must
nol discriminate by gender, sexual orientation, or age, or on
any other grounds.
I am appalled at the way many doctors treat their patients.
The stories my patients tell me are spontaneous as I never ask
diem how their psychiatrists treated them, in August 2007 I
received this brief message from a client I had seen. She had
had a three day relapse into manic behaviour and had to
be admitted to hospital. After discharge she wrote, "He had
me repeat after him, I have bipolar affective disorder I have
bipolar affective disorder He did not make me count to ten
or spell my own nameT It ts obvious she did not appreciate
being treated like a child.
Understanding
Understanding is defined as being capable of judging with
knowledge.
T he doctor has two functions during the anecdotal part
of the interview. The first is to come to a tentative conclusion
about the diagnosis, caffed the differential diagnosis. Bui
equally important is the ability to empathize, to put yourself
into the shoes of the patient, trying to understand what is
happening and the impact it is having on the patient and
hrs family. Most doctors can empathize with depression
or anxiety because they have almost all experienced these
symptoms. However very few are able to empathize with
hallucinations. How many doctors know what it is like to
see visions or to hear voices? This is why in so many cases
psychiatric histories do not contain descriptions of these
symptoms. I have often asked my patients if they have ever
told anyone else about (heir voices and if they reply they
have not and I ask them why, (hey reply that they were not
47
asked. If voices are a main symptom and the doctor does not
ask if they are present, the patient will lose confidence in the
doctor or conclude that hearing voices is so awful that even
I he psychiatrist will not talk about It* From a diagnostic point
! T view these patients are often misdiagnosed as bipolar since
all the emphasis has been on their moods and mood disorder
,md the perceptual or experiential world has been ignored.
Psychiatrists and nurses who have experienced the effect of
LSD under a proper setting are in my opinion much better
doctors and nurses thereafter when they are working with
schizophrenic patients.
Understanding depends upon the ability to empathize and
even more on knowledge, on training, and on experience
in working with patients. It helps to read books written by
recovered patients who describe in detail what was the
impact on them of these phenomena.
Support
The Oxford Internationa! Dictionary of the English
Language, 1957, defines support: the act of backing up or
taking a person's part, assistance.
Very often schizophrenic patients are on pensions or
welfare because they have not been treated early enough
and well enough to continue without this type of support.
Often they are at the mercy of bureaucrats working lor
government or some agency. Too often my patients have nol
been treated with dignity and respect and when this was
brought to my attention I did what l could to help, even if
it meant writing letters on their behalf. One of my patients
saw me every two to three months but he lived En Vancouver
and it takes a day to come to Victoria by ferry and bus.
This is expensive. We had a good relationship and over the
48
years he slowly improved. Although he did not get well lie
had not had to go back to hospital over this period. I or the
first few years Social Services provided him with travel fare
but latterly they began to resist and to question him every
time he came. They became very unpleasant to him and he
in turn often frightened them. This was making him more
paranoid. Eventually 1 wrote to the Minister of Social Services
demanding that this practice of demeaning him cease,
pointing out to the Minister that the word "civil" ought to have
some meaning and that people working for the government
must be civil to their clients even if they are paranoid and
schizophrenic. The worker mainly responsible was moved to
another position and that problem was solved. This does not
happen often but is something I think all psychiatrists should
do to support their patients. ! was often told by civil servants
who came to me as patients that they had been advised by
the department not to see me. J am not popular with the
government which is an indication to me that I am doing my
job well.
Safety
Safety is defined: the freedom from danger, exemption
from hurt or injury.
This applies mainly to patients in nursing homes, I would
visit my patients, especially elderly patients in nursing homes,
frequently, to make sure they were not being mistreated and
that they were safe. Since 1999, hospitals have recorded
a major increase in patient attacks on workers. These are
usually dealt with by seclusion and excessive medication. The
United States government has recently ordered every mental
institution to eliminate most restraints and seclusion or risk
losing federal funding. Mental heallh officials agreed that such
49
violence traumatized mentally ill patients and made recovery
more difficult.
Privacy
Privacy is defined: a sEate or condition of being withdrawn
from public interest, secrets.
Normal people value their privacy and are willing to pay
lor it. That is why people pay to travel first class in a plane
wen though it costs much more to go exactly the same
distance. It is why private dubs charge a fee. Privacy must not
be confused with enforced privacy as it would be for a person
in prison or under house arrest
Patients want their freedom and to be treated with respect
but they equally need to have and deserve privacy. In any
hospital unless you pay for a private room, privacy is limited,
but the physically ill never have to surrender as much of their
privacy as do psychiatric patients. The term Intensive Care
Unit of psychiatric wards does not convey the real meaning
of what it means to throw a patient into these rooms with no
bathrooms, no beds and no comfort and to be kept there until
the powerful anti-psycholies they have been given by force
have begun to work. Privacy is absolutely essential to respect
every patient.
The Doctor Patient Relationship
The impact of a positive doctor patient relationship cannot
be emphasized enough, it is important in a doctor's office and
should be present in a research setting. However, in double
blind controlled experiments all human factors of the doctor
patient relationship are eliminated because of the use of
placebo. Placebo is a dud that cannot have any biochemical
 50
effect on the body. It is given to research subjects to test a
hypothesis that a test substance has some effect compared
to an inert compound. One of my main criticisms of the
double blind technique is that it removes the human factor
and therefore removes one of the most important therapeutic-
aspects of treatment, ft is impossible to treat anyone in the
absence of the doctor patient relationship which instills hope,
expectation and trust. This relationship is a very important
aspect to healing and if it does not exist then the physician
ts derelict in his or her duties. The relationship is more than
simply handing out pills while lying to the patient about
their value. Giving placebo pilfs in fact destroys the doctor
palient relationship as it creates doubt in both patient and
doctor. The patient can no longer trust that doctor to place
his interests first, and the doctor can not forget that he is lying
to his patients by not telling them they are getting placebo.
Truly double blind experiments are fraudulent since the
patient is not aware that what they are taking cannot have
any therapeutic value. The placebo has been given altogether
too much value. But this practice is being questioned. Thus
Hrobjartsson and Gotsche-' concluded that there was little
evidence that placebos had powerful clinical effects and that
outside of the setting of clinical trials there Is no justification
for using them.
fo summarize, the therapeutic response is directly related
Eo the optimum use of civilify. I have defined and explained
the elements of civility as decency understanding, support,
safety and privacy when the doctor patient relationship is sef
at its optimum level.
23 Hrobfartsson A and Gotsche PC. Is the Placebo Powerless? An
Analysis of Clinical t rials Comparing Placebo with No Treatment
New kngland J of Medicine 2001, 344: 1594 1602
51
4* ORTHOMOLECULAR TREATMENT. THE FOURTH
COMPONENT
The pellagrologists in the United States were the first to
use vitamin B-3 supplements when they got access to the anti-
pellagra vitamin. One hundred years ago up to one-quarter of
the admissions to the southern United States mental hospitals
were pellagrins but I he doctors could not distinguish many
of them from schizophrenic patients until the pure vitamin
was made available. If a patient recovered in a few weeks
on vitamin B-l he was labeled as having pellagra. If not, he
was labeled schizophrenic. This prevented the doctors from
realizing they had a very valuable treatment for schizophrenia.
Under my direction in Saskatchewan we were the first
research group to study the therapeutic effect of niacin and
niacinamide on early and, later on, chronic schizophrenic
patients. By I960 we had completed six double blind
controlled trials, the first in psychiatric history. Since then
every investigator who repeated our work using our method
tor treatment found the same recovery rates. This vitamin is
now one of the standard vitamins used by orthomolecular
physicians to treat their schizophrenic patients. Bui other
nutrients have been found to be very useful including
pyridoxine, vitamin C and, for many, zinc.'0,J1,12 Medical
treatment also includes the optimum and skillful use of drugs
as described for psychiatric treatment.
3Q Pfeiffer CC Zinc and other micro-nutrients. Keats Publishing,
New Can£«n,Conn 197&
3J Pfeiffer CC Menta l and c lementai nu t rients. Keats Publish iJig,
New Canaan, Conn. 1975
32 Pfeiffer CC & UMola, 5. Zinc and manganese in the
schizophrenias, J. Orlho. Psychiatry 1983: 12:215-234
52
The following table summarizes my views of the efficacy
of the four treatment modalities.
Response to Treatment, Improved and recovered
Shelter, Food, Civility About 507«
Drugs alone Less than 10%
Shelter, Food, Civility and Drugs Not tested
Orthomolecular and Shelter, Food, Civility
(a) Early cases About 90%
(b) Late chronic cases About 75%
Prodromal i.e. pellagra About 100%.
Pellagra almost vanished over 60 years ago with the
fortification of flour with niacinamide introduced by the
United State government. This is one of the greatest public
health measures ever taken and follows Dr. Gotdberger's
extremely important research into the cause, prevention and
cure of pellagra. There is no doubt that modern psychiatrists
it confronted with a psychotic patient with pellagra would
diagnose that patient as schizophrenic or bipolar. This public
health measure is comparable to the British Navy introducing
lemon juice into their daily rations around 1790 to prevent
scurvy. Napoleon could not invade England because his
sailors were not similarly protected.
53
(>utcome of Treatment
1950
Between 1900 and 1950 the first three components of
(he ideal treatment were almost totally neglected. Recovery
was so rare that if one did recover it might lead to a book
describing that recovery. Admission to one of the two mental
hospitals in Saskatchewan by 1950 was almosi a life sentence
since so few were ever discharged. These hospitals provided
very crude shelter, very low quality starchy food designed to
save money and very little personal care and respect. These
hospitals wiped out the natural remission rate of about 50
percent which would have occurred had these three essential
principles been followed as they were in the 1850s in a few
places.
At the Munro Wing, a part of the General Hospital in
Regina, the results were better. Shelter was belter, the food
was the same as that provided by the rest of the hospital
and in 1950 it had not yet been corrupted by modern food
technology. I would often have lunch in the hospital cafeteria
and can recall that the food was pretty good and nutritious.
The Munro Wing patients were given a lot more respect
and dignity, following Dr. McKerracheds lead of believing
in the Moral treatment of the insane. And our recovery rate
was much better even before I began to use orthomolecular
treatment. After Humphry Osmond became clinical director
of the Saskatchewan Hospital the results of treatment also
improved in his hospital.
Before the introduction of tranquilizers the discharge rate
was a good measure of response to treatment in hospital
because if patients were discharged before they were ready
they were soon re-admitted. But after the introduction of
 drugs which apparently "cured" the patients, they were
discharged before they were ready and it was not recognized
that drugged patients now had to contend with two major
p rob ferns, the original psychosis still burning internally and
the superimposed tranquilizer psychosis. This soon led to the
revolving door common to all modern institutions and to the
iact that hospital discharges have no connection to whether
the patient is better or not. They are used primarily as first aid
or filling stations, to fill the patient with the drugs designed
to keep them from getting back into the hospital. I think our
hospitals in Saskatchewan represented the mean of all North
American hospitals, some much worse, a few better but even
the psychiatric wards al university hospitals do no better than
the mental hospitals.
A research study by my assistant director of psychiatric
research, Dr. C Smith33 compared the results of treatment at
the University Hospital in Saskatoon and the nearest mental
hospital in North Battleford and found that they were ihe
same. The major difference was that the staff to patient ratio
was much higher at the University Hospital. Shelter, food
and civility were much better at the University Hospital but
patients not under my care were getting the same xenobiotic
treatment *
lhe response of chronic schizophrenic patients treated in
the nursing home were the same as the University Hospital
where dally costs were four times as high, The major
difference was that the staff to patient ratio was much higher
at the University Hospital. Ail the other components of ihe
ideal program were the same.
3.3 Smith CM, McKerracher DC. McIntyre 5, Care of the Certified
Psychiatric Patient in the tieneral Hospital. The Saskatoon Project
Can Med Assoc J 1963:88:67-74
2007
There are no mental hospitals in Canada or the United
Slates that provide all four components of the idea! program,
with the exception of one psychiatric ward headed by an
orthomolecular psychiatrist and a private institution in New
jersey called Earth House, which was started by Carl Pfeiffer
many years ago and is still functioning. The treatment resulls
for chronic patients are very good.14 I predict that if there
is any institution that yields lhe fifty percent recovery rate
achieved by lhe Moral treatment of 1850, they are using the
first three modalities of the idea! treatment and pay much less
attention to the use of drugs.
Orthomolecular medicine developed over the past fifty
years has been enveloped in conflict from its beginning. This
cannot be understood if the context of discovery in medicine
is ignored. Progress in medicine does not follow a smoolh
curve with one finding leading to another. It is more like
quantum leaps with each quantum a major reconstruction
of the previous quantum. These states of hypotheses and
data are called paradigms. A paradigm is a system of ideas,
often derived from previous ideas and facts which has gained
major acceptance from the theoreticists and practitioners of
that science and which remains the main faith, almost like
the dogma and doctrines of any church, until it is in turn
overthrown by the new paradigm-
34 Fitch L & La Roche R. Earth House: an alternative for persons
suffering from the schizophrenias. Journal of Orthomolecu lar
Psych iatry 19H5;l4:136 -142
56
Chapter Three
Orthomolecular treatment for
schizophrenia.
1. THE DIET
Before recommending supplements it is essential to
analyze the dietary program in order to get dues as to
whether the illness might be the product of a nutrient
deficiency or dependency. Physicians specializing in allergic
reactions caused by the environment are called clinical
ecologists. 1 his idea has not been well received and the food
industry has stoutly resisted this concept. October 2002 saw
the report by Evenson in England entitled "Food Additives
Cause Tantrums,'' The lead paragraph saidr "Food additives
used to colour many popular children's foods can cause
temper tantrums and disruptive behaviour in up to 25 percent
of toddlers, a British government study has found/' Food
colourings were used in 78 percent of children's desserts,
93 percent of candies, 24 percent in cheese marketed for
children and 41 percent of children's drinks. More recently, on
September 6, 2007, The New York Times reported on research
financed by Britain's Food Standards Agency that showed
that food additives and colours increased hyperactivity in
I Evenson B, Food additives cause tantrums. The National Post,
Toronto. October 26, 2002
57
children. The Agency advised parents to watch their children
for this effect. Ben Felngold, at last, has been vindicated- This
recommendation wilt probably be ignored since it was not
a double blind study. This is a good example of the massive
cost to society of waiting for double blinds and ignoring good
observations labeled anecdotal.
Frofessor Roger Williams-, 3, 4 demonstrated the physical
and biochemical uniqueness of individuals thereby explaining
their need for a food supply to which their bodies have
been adapted. Thus a vegetarian diet that is ideal for many
may make others sick, and conversely a diet rich in animal
products may be optimum for some but not all. There is no
panacea diet. Beware anyone claiming that one diet is optimal
for everyone. One can better assess a person's optimal diet
by determining their nutritional and ethnic background and
seeing whether they have deviated from it. Thus if the person
comes from a group which has traditionally used fish as half
their diet while they consume a diet overly rich in sugar and
refined foods, it should not be surprising if they are not well.
One may also have to consider the principle of adaptation.
1 mean by this the process which has gone on since liie
started whereby l iving organisms have had to adapt to I heir
food supply over many thousands of years. A huge change
in our diet occurred about ten thousand years ago with the
introduction of agriculture and it is possible that there are
some people whose digestion never completely adapted.
I use three simple food rules:
2 Williams RJ. Nutrition Against Disease, FLiman Publishing Co.
New York, 1971
.1 Williams RJ. You Are Extraordinary. Random House, Inc, New
York, 1967
4 Williams Kj Physicians Handbook of Nutritional Medivine,
C.C .Thomas, Springfield, IL, 1975
 SB
1. Avoid all foods containing added sugar when this is
possible. About 125 pounds of all sugars per person
per year are consumed in the United States and
Canada* The same foods which contain added sugar
also contain other food additives* Eliminating sugars
improves the nutritional quality of the food,
2* Remove all foods to which the person is allergic.
3. Take individuality into account.
2* VITAMIN SUPPLEMENTS
The problem is to determine which vitamins are going to
be needed and in what amount.
{a) Niacin and niacinamide,6/;*9,10 (vitamin B J). This
vitamin is a major player in orthomolecular psychiatry and has
a historically important mle for i| was the first vitamin to be
approved by the United States Food and Drug Agency (FDA)
tor a non-deficiency condition i.e, for lowering cholesterol
levels. It is also credited with opening up the vitamin-as-
5 differ A, Osmond H, Cdlbeck MJ & Kahan I. Treatment of
Schizophrenia with Nicotinic Acid and Nicotinamide, J Clin Exper
Psychopath#] 1957:1&13M58
6 Hotter A Niacin Therapy in Psychiatry. C, C- Thomas,
Springfield, 1L, 1962
/ Osmond 11 & Hof far A, Massive Niacin Treatment in
Schizophrenia. Review of a Nine- Year Study, Lancet 1963; 1:316-320
8 A &■ Osmund H. Treatment of Sehizophren ia with
Nicotinic Acid- A Ten Year Follow-Up. Acta Psychiat Stand
1964:40:171-189
9 Hotter A. Vitamin Hi-3 and Schizophrenia: Discovery, Recovery,
Controversy Quarry Press, Kingston, ON, 2000
10 Hoffer A. Orthomolecular Treatment For Sthizophren ia. Keats
Lincoln wood, H, 1999
59
treatment paradigm. In biological matter niacin is present
t briefly as nicotinamide adenine dinucleotide (NAD), the
active anti-pellagra vitamin. The usual dose of niacin (also
called nicotinic acid) is 1.5 to 6,0 grams daily, best given in
three divided doses. But many patients have required much
more. In November 200.5 a female patient was referred
to me. She had had two major episodes of psychosis over
the previous Swo years. The first one was diagnosed as
schizophrenic and the second bipolar. She was determined
she would not take drugs and after her second discharge
she started to take niacin. When I saw her she was taking
50 grams of the vitamin in the morning and 30 grams in the
evening* I was astonished thal she was able to take that much.
She told me she preferred to swallow 120 of the 500 milligram
pills each day of niacin rather than remain on medical ion*
She was normal. I advised her physician to work with her
and see if they could gradually decrease the dose to a more
common level. She had no side effects. Carlson11 showed
that for the treatment of pancreatitis associated with type V
hyperlipidemia, 10 to 20 grams of niacin per day are needed.
With this treatment the triglyceride levels become normal
and the attacks of pancreatitis disappear The largest dose
I am aware of was that taken by a leen-aged girl. After her
psychiatrist told her she had been made sick by her mother
(the old delusion about schizophrenogenic mothers) she fled
from home and joined a group of wandering hippies. One
day in a drug store she ran across the book Megavitamin
Therapy; She read about the connection to niacin. With a
sudden flash of insight she went home to her mother and they
both began to look for a physician who would monitor her
treatment. They could not find one. She began to take the
vitamin herself* She did not become nauseated and when she
11 Carlson LA, Nkotinic Acid: the flroad Spectrum Lipid Drug. A
50th Anniversary Review, J. Internal Medicine 2005:258:94-114
 60
eventually reached 60 grams daily her hallucinations suddenly
vanished. E saw her at a meeting i addressed in the United
States two years later. She wfas normal and had reduced the
dose to the usual three grams daily. I think I have erred in not
going high enough for many of my chronic patients.
Schizophrenia is not a multivitamin deficiency disorder.
VVe suspected in 1952 that we would have to use large doses
of vitamin B-3. From our first publications in 1954 Osmond
and I emphasized that large doses are needed. Unfortunately
the vasodilatation caused by niacin when it is first taken
causes a flushing reaction. This is a minor problem when used
by doctors who know what they are doing, bur it has given
niacin a bad name and even today most doctors are more
fearful of this vitamin, which kills no one, than of the major
atypical anti-psychotics which kill many. I had hoped that the
results I have published with hundreds of case histories and
which have been confirmed by every physician who used the
same protocols that I published would by now be comfortable
with niacin. But unfortunately this has not happened.
SCHIZOPHRLNIA 15 NOT A MULTIVITAMIN
DEFICIENCY DISEASE. IT IS IN FACT THE DISEASE
PELLAGRA, A VITAMIN B-3 DEPENDENCY DISEASE, IT
WELL NOT BE TREATED SUCCESSFULLY NO MATTER HOW
MANY DOZENS OF VIT AMIN PILLS ARF GIVEN IF THESE
PATIENTS ARE NOT GIVEN THE CORRECT DOSES OF THES
VITAMIN. YOU CAN GIVE PELLAGRINS EVERY KNOWN
NUTRIENT BUT IF YOU DO NOT GIVE THEM B-3, THEY
WILL STILL REMAIN PELLACRiN.
Nowhere in our reports have we suggested that
schizophrenia was a multivitamin deficiency disease. We
have always maintained that it was a vitamin B-3 dependency
disease and that large and sometimes very large doses of
61
the vitamin were needed. Within the past few months three
patients consulted me. They had been treated for up to
ten months by competent orthomolecular psychiatrists and
had not responded to treatment. But on looking over the
treatment they were on I was astonished that I could not find
any vitamin B-3 En that list. They were taking large numbers
of pills containing nearly every known nutrient but as they
were schizophrenic and not suffering from a multivitamin
deficiency disease they were not healed. In one case a young
man who was making substantia! and steady progress was
taken off the B-3 and started on some other natural products
whereupon he promptly relapsed. On resuming his vitamin
B-3 intake, he continued to recover arid has now been well
several years.
I can not believe that doctors could have failed so
miserably to realize that while all the vitamins are helpful in
restoring health, this will not occur if the schizophrenic patient
is not given the B-3 they must have. Give a patient with
pellagra tons of vitamins and she will not recover until the
right amount of B-3 is added. If the patient is schizophrenic
give him vitamin B-3, but in the right doses. In mosl of those
cases of patients failing Eo get well, they were taking an
exorbitant number of pills containing amounts of vitamins
that can he found in food. Not only do patients not recover,
but if treated with multivitamins, and not enough B-3, the
establishment will be correct in its conclusion that there is no
connection between niacin and schizophrenia and the use
of this valuable treatment will be set back another fifty years.
For a complete review of the benefits of niacin see Hoffer and
Foster,1*
12 Hoffer A & Foster HO. Feel Better, Live Longer With Vitamin B-
3. CCNM Press, Toronto, ON, 2007
62
Njactn is 3 strong vasodilator when it is first ingested. No
one should take ft until they have learned about this reaction
or they will be very fearful and this aggravates the flush. The
red or pink flush begins in the forehead and works its way
down (he body, usually stopping before reaching the legs,
but it may involve the whole body, it is itchy and burns and
has been mistaken by unaware nurses for a serious rash
which it is not It is usually gone within a few hours but rarely
lasts longer With each succeeding dose the intensity of the
reaction recedes until it is a very minor problem or does not
appear at all. I have been taking niacin for TO years and do
not flush unless I stop taking it for several days. It should be
taken right after eating, preferably with a cold drink. The flush
can be inhibited by taking aspirin several days in advance or
by using any anti-histamine. Niacinamide (nicotinamide) does
not cause flushing in 99 percent of people but about one in
one hundred will also flush with this vitamin. These people
must be able to convert the niacinamide very quickly into
niacin in their bodies. The flush produced by this form of B-3
is generally unpleasant while the niacin flush is liked by many,
who will stop taking the vitamin for a few days in order to
reactivate the flush. The usual dose range is 1.5 to 3 grams
daily. The upper limit for both forms is reached when the
patient develops nausea and if this is not controlled, vomiting.
As soon as nausea k felt the dose must be lowered. In these
dose ranges this vitamin is safe and is generally considered
non-toxic.
1 he incidence of jaundice is so rare it is impossible to
determine whether the vitamin was a cause or whether it was
coincidental. Over the past fifty years there has been one
death attributed to niacin out of hundreds of thousands of
people who have taken it. Nicotinic acid was originally used
by orthomolecular physicians for the treatment of psychiatric
diseases such as schizophrenia, alcoholism, and behavioural
63
and learning disorders in children. Over the past five years
it has been used much more extensively for the treatment
of high blood cholesterol and low high density lipoprotein
cholesterol {HDD since it was proven to decrease mortality
and increase longevity.31, 1 have been using it since 1952 for
all of these conditions and more.11
Parsons,1* the first physician to confirm our niacin
cholesterol claims, concluded that niacin was not hepatotoxic
(toxic to the liver). The increased levels of liver function tests
did not indicate that the liver was damaged. Recent studies
by McCarty17 suggest that giving betaine will counteract the
increased need for methyl groups and thus prevent some of
the niacin side effects. He talks about liver toxicity but l object
to this term since it has not been shown to be hepatotoxic.
The psychiatric conditions for which niacin is indicated
are: schizophrenia, schizoaffective disorders, some
depressions, learning and behavioural disorders in children,
alcoholism, premature senility (Non Alzheimer's type), and
Huntington's disease.
J3 Canner PL, Berge KG, Wenger N K, Stamler J, Friedman L,
Priweas Rf & Friedewald W, Fifteen year mortality in Coronary
Drug Project Patients: Long Term Benefit With Niacin. J. Am. Colb
Cardiology, 1986;8:1245-1255
U Hoffer A and f oster HD. Feel Better, Live Longer With Vitamin
B-A CCNM Press, Toronto, 20U7
15 Ahschnl R, Hof ter A & Stephen JD. Influence of Nicotinic Acid
on Serum Cholesterol in Mar. Arch Biochem Biophys 1955;54:558-559,
16 Parsons Jr WB, Cholesterol Control without Diet. The Niacin
Solution- William B- Parsons Jr. Lilac Press, Box 1356 Scottsdale,
Arizona, 1998
J7 McCarty MR Co-administration of Lquimolar Doses of Betaine
May Alleviate the Hepatotoxic Risk Associated with Niacin Therapy.
Medical Hypothesis 20G0;55:189-194
64
Medically, niacin may be used for lowering total
cholesterol and elevating high density lipoprotein cholesterol,
relieving cardiovascular disease, including arrhythmias (in
combination with folio add), preventing strokes and coronary
disease, healing cancer and arthritis, and preventing diabetes
mellitus in susceptible children.
(b) Pyridoxine (vitamin B-6), The usual recommended
dose of pyridoxine is less than 500 milligrams daily. Almost
all of my patients take up to 250 milligrams a day if I
determine I hat they need it* Doses of over 1000 milligrams
have been associated with peripheral neuropathy which
cleared when the vitamin was discontinued. The studies in
which neuropathy was shown are not very good* They were
not double blind prospective clinical studies* They found
six people who were taking 2 to 6 grams daily without any
indication whether they were taking any other vitamins
or whether they were on any peculiar diets. It is certainly
possible that these large doses might have some effect. But
to claim that pyridoxine is toxic is equivalent to claiming that
wafer is toxic because many people drown in it. loxicity must
always be related to the recommended doses as is the case
with every medicine used. In my experience with pyridoxine
going back 30 years in doses below 500 milligrams I have
seen no toxicity although I have seen a few children become
more irritable. Dr E, Leyton similarly found no toxicity,19
Children should be given magnesium when taking pyridoxine
to prevent an increase in irritability.
Psychiatric indications for the use of pyridoxine include
schizophrenia, infantile autism, premenstrual tension and
depression* Dr, Bernard Rimland was a co-worker in the
IS Leyton K* let ter to Editor* Fear of Large Doses of B-6
Unfounded* The Medical Post fan 25, 1994
65
first double blind prospective controlled experiment which
showed that pyridoxine was therapeutic for children who
have infantile autism. Dr. Rimland stated/*' "There are now
17 published sludies—all positive-showing that high dosages
of vitamin B-6 and magnesium are a safe and often helpful
treatment for autism. Thousands of parents are using B-6 and
magnesium to help their children. Almost 50 percent show
worthwhile improvement and the vitamins are immeasurably
safer than any drug/' There were behavioural improvements
and positive changes in the EEC and in urinary metabolite
measures. These studies were done by different investigators
and conducted in several countries. But there appears to be
no interest in the psychiatric or pediatric establishment,
(c) Folic Add, Folic acid is a safe water soluble vitamin.
It has been used in doses up to 100 milligrams daily. There
has been a report that this dose caused gastrointestinal
disturbances, but in another study with the same dose
this was not seen. Most patients do not need more than 5
milligrams. Recently the idea has become acceptable that folic
acid will decrease the incidence of spina bifida and similar
neural tube defects (NTD) if pregnant women take 1 milligram
daily, I generally recommend 5 milligrams daily. But for
depression and bipolar conditions I use up to 25 milligrams
daily. Many physicians are still fearful of folic add, thinking
that it will mask the symptoms of pernicious anemia, I have
never seen this, nor has it been reported in llie literature very
often. However giving any one of the B complex preparations
which contain vitamin B-12 will prevent this from occurring it
in fact it is a real problem.
19 Rimland B, Recent Research in Infantile Autism. J. of
Operational Psychiatry 3: 35,1972 and Autism Research Review
International 7: No 2, 1993
 66
The deficiency of folic acid is clearly related to
psychopathology. Young and Chad!nan20 reviewed the
medical literature. They found that folic acid deficiency was
high in patients with depression, senility and schizophrenia,
and in epileptic patients on Dilantin. It is also low in women
who lake birth control pills. Medical patients with folic acid
deficiency suffered more from psychiatric symptoms. The
addition of folic add to these patients produced substantia!
improvement They recommend, "...that all patients in certain
diagnostic categories should receive vitamins/' However
they recommended very small doses only. In sharp contrast.
Dr. Kotkas-1 used larger doses with success and without any
evidence of toxicity.
□r. Paul Godfrey, from the institute of Psychiatry in
London, reported that folic acid speeded recovery from
depression. One-third of his depressed patients were folate
deficient. The overall outcome was impressive. Everyone
improved to some extent. The best results were obtained
in three to six months, Abou-SaJeh and Copper^, found
that lolic acid deficiency is common in psychiatric patients.
Patients given 10 milligrams daily responder! in 2 to 3
months, but gastrointestinal and neurological symptoms were
improved in five months on 10 milligrams weekly. It is clear
that orthomolecular therapists will have to give much more
attention to this important vitamin.
PM Young SN & Chadirian AM, Folk Add and Psychopathology,
^rog. Neuro-Psychopharma col and Biological Psychiatry 1989; 13:841-
2' J Kc!tka& 1 B12 and folic add in treatment of some psychiatric
AnnuaE meeting, Canadian Schizophrenia Foundation, June
Till, 19/8,
22 Abuu-Saleh Ml & Copper, A. The biology of fntale in depression:
implications tor nutritional hypotheses of the psychoses, J. Psychiatrk
Researeh 19S6^0:91-K51 J 23
67
I have given more attention to folic acid because it is
only now coming into prominence in general medicine as
well as in orthomolecular medicine. The B vitamins already
described have been written about In hundreds of articles in
I he literature, primarily in the orthomolecular literature,
(d) Ascorhic acid (vitamin Q. This is one of the major
vilamtns in orthomolecular therapy and has been reviewed
in many excellent publications. Dr. Linus Pauling's71 classic
report in Science gave a scientific explanation why mammals
stopped producing vitamin C when it was available in
adequate quantities in their food. This report made l he world
aware of the vast importance of vitamin C. Pauling provides
an excellent description of the uses and importance of vitamin
C.
The dose range for vitamin C is enormous ranging from 1
to 100 grams per day. The optimum dose is highly individual
and depends upon a large number of factors including life
style, level of stress, disease, age, etc. The optimum dose can
be determined by increasing the vitamin until stools become
loose and too much gas develops. The dose is then decreased
below this level. Vitamin C DOES NOT CAUSE KIDNEY
STONES, DOES NOT DESTROY VITAMIN B-12, DOES NOT
CAUSE PERNICIOUS ANEMIA, and DOES NOT DESTROY
KIDNEYS. These are all myths.
Pauling L. Orthomolecular Psychiatry, Science 1968; 160:265-271
 68
3. ESSENTIAL FATTY ACIDS
rhe ess*ntfel F-atty acids play a very important role in
the etiology of schizophrenia and not surprisingly in its
treatment. Dr David Horrobin and his associates were the first
to demonstrate this. Indirectly Horrobin helped Dr Donald
Rudin^ by publishing his paper in Medical Hypotheses in
1982 when this type of research was very unpopular. Rudin's
studies showed that the addition of omega 3r present in fatty
fish and flax seed oil, was therapeutic for the psychoses
including the schizophrenias. He hypothesized that essential
fatty acids were needed as precursors of the prostaglandins
and that schizophrenia was a deficiency of these important
transient molecules In the body. Therefore a deficiency of
these essential fatty adds would lead to a deficiency of the
prostaglandins. But the conversion requires vitamins and
minerals such as vitamin B-3, Therefore even if patients had
adequate amounts of these fatty acids they would still suffer
from a deficiency if they could not be converted into the
prostaglandins. He reasoned that there were two types of
pellagra, one caused by the deficiency of vilamin B-3 and one
caused by a deficiency of the essential fatty acids. The type
caused by a deficiency of vitamin B-3 would he a vitamin
or enzyme deficiency pellagra while the one caused by a
shortage of essential fatty acids would be a substrate type of
pellagra. This is a very valuable hypothesis which was already
being examined by Hormbin and his associates. The value
of omega-3 essential tatty acids is sweeping into mainstream
-4 Rodin DO. The dominant diseases of modem ized societies as
fatty acid deficiency syndrome; substrate pellagr
Medical Hypothesis 1982^:17 P S
69
psychiatry. Eicosapentaenoic acid (ERA) may be one of the
most important essential fatty acidsP,ilJ
4. MINERALS
(a) Copper and zinc. These are best treated together since
ihey are inversely related in the body. Increasing zinc levels in
the blood will decrease copper levels and vice versa.
Zinc deficiency causes a large number of symptoms
including stria, i.e. stretch marks, in both men and women,
white areas in the nails, and acne. It can be responsible
for premenstrual tension, increased blood pressure, joint
pain, retardation of wound healing, loss of taste and smell,
psychiatric symptoms and acrodermatitis enteropathies. Dr.
C. C. Pfeiffer carried out the best research relating zinc and
copper to human health and disease.271 have found the
presence of zinc deficiency symptoms extremely valuable in
deciding whether patients should be given extra zinc.
Serum zinc levels tend to be very stable. In a large series
of patients 1 analyzed for the presence of copper and zinc I
saw that there was no change in zinc levels with increasing
age whereas copper levels went up significantly after age
50. Recently I saw a patient who has been coming to see
25 Enisle y K, Myburgh CJ, Gosfemizen P, & Van Kcnsburg Sj.
Randomized, Placebo- Controlled. Study of Ethyl-Eicosapentaenoic
Acid as Supplemental Treatment in Schizophrenia. American Journal
Psychiatry 2002;159:1596-1598
26 Feet M, Horrobin DF. A dose-ranging exploratory study of
the effects of ethyl- eicosapentaenoate in patients with persistent
schizophrenic symptoms, foumai of Psychiatric Research 2002;36:7-18
27 Ffeiffcr CC & LaMola, S, Zinc and manganese in the
, :
schizophrenias. J. Ortho. Psychiatry 1983 12 215 - 234
 70
me every year or two. I saw her first in 1986 when she
complained she had lost her sense of taste, that food tasted
aSLTll ne r'd 5mdl Pr°Per,y- She found eating
almost intolerable. I suspected she hati a zinc deficiency
and started her on zinc supplements using zinc sulfate 220
milligrams daily. After two years she was no better. | replaced
foe tab'ets with a liquid zinc and manganese preparation
e ope ay Dr. Pfeiffer (10 percent zinc sulfate and 1/2
Lhl0ride!' Two ^ears ,a,er Ehe was much
better. Now over age 92 she is still mentally well although
physically infirm. When I saw her last she told me that she
enjoyed eating. One of her new problems was she was a little
too heavy. She was cheerful and relaxed and was still on the
zfnc manganese preparation.
Zinc deficiency is associated with eating disorders.
Schaussr summarized the research since 1934 which
established a relationship between zinc deficiency and
ea mg disorders, obesity, pica, anorexia nervosa and bulimia
nervosa. Between 1985 and 1990 several studies showed that
most eating disorder patients are low in zinc and that when
they are supplemented with liquid zinc 25 to 110 milligrams
atly they get better. Occasionally they had nausea which
was controiled by pretreating them with vitamin B-6 Dr
Pfeiffer lound that the combination of vitamin B-6 and zinc
was more efficacious than either one alone. A zinc deficiency
which oS,tPreSen‘ ll "1e ***** tlnds a sulfate solution,
wh ch ought normally to taste bitter, to have little or no taste
at all. Rita Bakun,- a psychologist at St. Paul's Hospital in
Vancouver found that adding zinc to the diet of anorexia
M*d “15^ diSOTderS' lnl' BiOSOdal
L T™ t0 dHfic,en^ - 31
71
Patients helped them to regain weight. Vegetarians are more
if it to be anorexic and they are also more often low in zinc,
I find the connection between zinc and vitamin B-6 very
interesting since it originated from some of our research
m Saskatchewan over 45 years ago. The mauve staining
substance that we found in the urine of schizophrenic patients
was identified as kryptopyrroie. Dr Pfeiffer50 and his group at
liie Brain-Bio Center in Princeton discovered that too much
mi I his compound caused a double deficiency of vitamin
B-6 and zinc. This condition that we had called malvaria,51
they termed, more appropriately, pyrolleuria. The treatment
included ample quantities of zinc and vitamin B-6. While
most schizophrenic patients have this factor it is also present
in a smaller proportion of non-schizophrenic patients such
as people with depression, anxiety states, alcoholism, and
behavioural disorders. It may well be present in patients with
eating disorders as well.
Copper is needed for the formation of hemoglobin. The
body contains about 125 milligrams, On the average we
ingest 3 to 5 milligrams in our diet but we need only about 2
milligrams so there is some accumulation. Dr, Pfeiffer found
no cases of copper deficiency in 20,000 patients. Many
vitamin and mineral preparations contain copper because
of the widespread belief that copper deficiency is a serious
problem. In certain areas where copper in soil is deficient and
babies are ted cow's milk, a copper deficiency may develop.
Copper tends to accumulate if the diet is too low in zinc or
where there is too much copper in the drinking water, usually
due to copper plumbing and very soft water. But the danger
30 Pfeiffer CC Zinc and other micro-nutrients. Keats Publishing,
New CanaanConn 1978
Hotter A & Usmnnd H, Malvaria: a new psychiatric disease,
Acta Psyduat Scand 1963; 39:335-366
 72
rrom too much is greater Dr Pfeiffer considered copper to be
a toxic element. Excess copper is associated with post partum
psychosis, depression from birth control pills and cancer. The
best measure of copper and zinc status is the ratio of serum
copper over zinc.
Excess copper is also associated with a schizophrenic
syndrome and with senifity. [ have found that copper levels
increase substantially with age and that pre-senile and senile
patients have the greatest increase. Excess copper is treated by
increasing the intake of zinc using Pfeiffer's solution, Ziman
drops (ten percent zinc sulfate and 1/2 percent manganese
chloride), ascorbic acid, high fibre diet, selenium and, if
necessary, copper chelators such as penicillamine and EDTA.
Excess levels will be detected by dietary history, hy blood
tests and by hair analysis.
(b) Manganese.
The body contains 10 to 20 milligrams of manganese.
About 45 percent is absorbed from food and 4 milligrams
is excreted daily. The diet provides 2 to 9 milligrams.
Manganese deficiency is associated with growth impairment,
abnormalities in bone, diabetic-like carbohydrate changes,
incoordination, tardive dyskinesia and convulsions. Zinc
alone increases copper excretion in schizophrenics threefold.
Adding manganese increases the excretion even more.
Giving zinc alone may induce a manganese deficiency. The
nutritional importance of manganese is discussed by Dr.
Free! and-Graves^.
32 Freeland-Grave* JH, Manganese: an essential nutrient for
human5. Nutrition Today 13 -19, Nov/Dec 1988
73
Tranquilizers create a major loxic reaction called tardive
dyskinesia. This is a motor disorder which can be irreversible.
About 25 percent of patients on tranquilizers long enough
will gel it However it does not occur when orthomolecular
regimens are used. Dr. R. Kunin 3i found manganese to be
very helpful in removing tardive dyskinesia very quickly. The
tranquilizers bind manganese, carrying it with them as they
are excreted, Ihus causing a deficiency.! have seen the same
positive response to manganese in the few patients who have
come to me with this toxic condition. Patients I have treated
since 1955 do not get tardive dyskinesia. Manganese also
plays a role in seizure disorders not related to drugs.
Doses up to 30 milligrams are safe but are seldom needed.
I usually use less than 50 milligram datiy doses. If drug
companies would put manganese into every tranquilizer tablet
tardive dyskinesia would disappear, 1 have recommended this
to one company but nothing has been done about it. Good
natural sources are tropical fruits and tea. Perhaps English
schizophrenics do not get tardive dyskinesia as often as
American patients. They drink much more tea,
5. DRUGS
Chbrpromazine was first used in France and from there
it swept around the globe. Since then new drugs have been
developed and every decade new drugs are proclaimed to
be better and freer of side effects. For many patients the
drugs are necessary but I always aim to gel them off them
as soon as possible. I call drugs essential evils because
they are essential for many patients during tine treatment
33 Kunin, RA. Manganese and niacin in the treatment of drug-
induced dyskinesias. J Orthomolecular Psychiatry 4-27

74
process although the consequence of using them without
an orthomolecular program is so evil because they cause
dangerous side effects and deterioration of life. T he most
modern drugs are addicting. Patients are seldom able to work
when on these drugs.
In 1952 I first heard about this French drug wilh
remarkable properties in treating psychotic patients. It had just
become available in the United States via Canada from Rhone
Poulenc of France. The Canadian representative of this drug
company tried to peddle the drug to United States companies
starting with the largest and working his way down to the least
significant. He was rejected by all the companies with the
exception of a one-product company whose medical director
had the vision to realize the importance of this compound.
The drug, Chlorpromazine in Canada, became Thorazine in
the United States. That company today is one of the largest
We had not yet formulated the ad renochrome hypothesis
of schizophrenia or its offshoot that vitamin B-3 might be
therapeutic for schizophrenia and I was interested in obtaining
this drug. But I could not obtain any until the Canadian
subsidiary of Rhone Poulenc made it available commercially.
It was the first major tranquilizer, discovered by the French
surgeon Henri Laborft and tested by French psychiatrists.
Dr. H. Lehmann in Montreal soon confirmed the European
reports, as did the medical director of a United States
company. They both submitted papers at about the same
time. Dr. Lehmann reported his din leal observation on a
small series of manic depressive patients (now called bipolar)
and I he other physician reported on a much larger series of
schizophrenic patients. Dr, Lehmann's paper was accepted
immediately while the other paper was sent back for some
revision. Dr. Lehmann's paper appeared first and he became
75
known as the father of tranquilizers in North America; the
other doctor remains unknown.
The rest of the tranquilizer story is history. The need
for this type of drug was great, the potential tor profit was
immense, and the combination of need and greed soon
propelled this and similar drugs onto the market And they
were very successful in controlling psychotic behavior. It was
assumed that this meant that patients were also recovering
from the illness. Farsighted psychiatrists realized from the
beginning that patients who took these drugs paid a major
price. Dr. A. Meyer-Gross, author of an impressive text on
psychiatry in the late fifties, claimed that these drugs merely
converted one psychosis into another. However necessary
they were, these drugs made possible the ill-conceived
corrupted deinstitutionalization of patients because they were
so good at coding hot symptoms, making psychotic behaviour
more tolerable to the community even if the patienls did
not get well. Thus began the revolving door process where
psychiatric hospitals became first aid stations for ref Lie ling the
patients with drugs-much as cars get refueled at gas stations.
The major difference is that cars and fuel are perfectly
adapted and the cars run well.
This first drug, Chlorpromazine, marked the new paradigm
of treatment in mental illness using powerful drugs that were
not narcotics. But they were not curative and the race was
on to find better compounds that would be more effective
and less toxic. This search still continues. The modern drugs
are effective with fewer milligrams of chemical per day and
they have different side effects. But the efficacy of the new
class of drugs is really not much better than the efficacy of
 76
She old drugs. Geddes;< analyzed fifty-two therapeutic trials
involving over 12,600 patients. He found that; compared
with conventional drugs at a moderate dose, atypical anti¬
psychoties caused fewer side effects but had similar effects
on symptom reduction. In a recent report3" ii was shown that
over a two year period schizophrenic patients treated with
these drugs suffered a 35 percent readmission rale. It has been
accepted for many years and is standard psychiatric teaching
that one-third of these patients recover, one-third do not and
one-third continue to relapse.
The main advantage of the newer atypical drugs is that
one has more choice. Of course this also applies every time
any new drug comes onto the market. There will always be
patients who do not respond to older drugs, who will respond
to newer ones and so on. Dr. Geddes recommended that the
conventional drugs should be used as the initial treatment,
i see patients who do well on Chlorpromazine and do very
badly on any of the new drugs. Whereas the old drugs such
as Haldol caused extra pyramids I side effects which were
easily controlled by other medication, the newer drugs are
less prone to do so, but have a major effect on obesity,
on disturbance in blood sugar levels, and in causing brain
damage with long term use. But there is one side effect that
worries me more and more. I am not in principle opposed to
using drugs especially as pari of orthomolecular treatment.
In orthomolecular therapy we use drugs to control the hot
symptoms of psychosis. I am very concerned about the
34 tieddes Jr Freemantie Nr Harrison P, liebbington R Atypical
Antipsychotics in the Treatment of Schizophrenia: Systematic
Overview and Meta-regression Analysis RMJ 2000; 321:1371-1376
35 Rahiiiowttz J, L.ichtenberg Pr Kaplan Zet at. Re hospitalisation
Rates of Chronically HI .'schizophrenic Patients Discharged on a
Regimen of Risperidone, Olanzapine, or Conventional Antipsyc holies.
Amer J Psychiatry 2001;158: 266-269
77
Increasing number of chronic patients who are tranquilized
with the new atypical drugs who do not get well, and 1
ihudder to think what they will be like twenty years from now.
Harrow and Jobe16 published the results of a fifteen year
lollow-up study comparing drugs against no drugs. Forty
percent of schizophrenic patients not on drugs showed
periods of recovery and better functioning compared
in only 5 percent of the patients on drugs. A study at
the Massachusetts Mental Health Center compared t wo
cohorts of patients treated between 1945 and 1949 before
tranquilizers were introduced, against a cohort between 1955
~ and 1959 after these drugs were in use. The earlier cohort was
better off since more of them were employed and fewer were
dependent on welfare.
In order to prevent relapses and further need fur
treatment in hospital, modern protocols call for continuing
ihe use of medication. The American Psychiatric Association
recommends prophylactic treatment for about one year after
the first episode and for up to five years after two or more
episodes. These are sensible recommendations. But in my
experience very few modern psychiatrists accept these and
as far as I can tell want the patients to remain on medication
forever. Chan and Ungvari37 reviewed the studies dealing
with outcome and prophylactic treatment and concluded that
because of side effects long term medication should be re¬
examined.
36 Harrow M and Jobe TH. Factors Involved in tlutcomo
and Recovery in Schizophrenia. Patients Not on Antipsychotic
Medications: A 15-Year MultifoUow-Up Study. Journal of Nervous and
Mental Disease 2007;195(5):406-414
37 Chan SSM & Ungvari C5. Maintenance Therapy in
Schizophrenias: a Critical Comment, international Journal of
Ne Liropsychopha onacology 2fl02;5:275-2R l
 78
79

the same level of control. It one lakes much more than the
1 am ^ very worried about I he difficulty in taking recommended level there are major side effects and no
patients off the new drugs compared to the conventional
increase in therapeutic power.
ones, in orthomolecular therapy it is always the objective
to have patients drug tree without any relapse, and this was
Modern anti-depressants also are addicting. The company
not very difficult with the ofder drugs. As soon as the patient
that makes Paxil has been sued in the United States, with the
had shown major improvement the amount of medication
money obtained being used to set up withdrawal treatment
w'35 slowly decreased If there were any signs of recurrence
centres to help people who are having trouble getting off
or symptoms the dose was increased again for awhile and
the drug. In my opinion the early anti-depressant drugs were
then the process was repeated untif most patients were drug
not as bad. If patients went off them they usually lelt better
free or needed so little medication that there were no side
as the toxic effect wore off, and there were no withdrawal
effects. Medication which is effective and free of side effects
symptoms. However, if the depression did recur, which
is equivalent to not taking the medication. The usual response
can and does happen after several weeks, the medication
was relief as the drug effect wore away, but if the patients still
would have to be renewed. This is totally unlike the action of
needed the medication it would become more noticeable
addicting drugs such as morphine, heroin etc. and the modern
after one or more weeks. It was never noticeable the first day
anti-depressant and tranquilizer drugs. Ritalin, the most
after the medication was stopped. But with the atypical anti¬
commonly used drug for children with behavioural disorders,
psychotic* it has become an enormous problem. For example, induces changes in the brain which continue after the drug
with Risperidone it is not too difficult to reduce the dose from
is discontinued. The gene called "c-fosM is changed. It is the
high levels to more moderate levels, but when one gets down
same gene changed by amphetamines and cocaine. Perhaps
to lower levels even a 0.25 milligram decrease may cause
the modern anti-psychotics will be found to have the same
a surge of symptoms. These drugs behave as if they were
effect.
addicting drugs. With the addicting drugs, such as heroin, as
soon as the dose is decreased there is a marked relapse. So it
I would not object to these addictive properties if patients
Is with these atypical drugs. It takes much longer to reduce the on the new atypical psychotics were able to function as
medication and when it is down to 3 milligrams daily I cannot normally as they can with orthomolecular therapy. But
decrease the dose by more than 0.25 milligrams. I never saw fewer than 10 percent of patients on drugs alone are ever
this with the conventional tranquilizers. The question that able to pay income tax from earned income. I am also very
puzziesmeis whether these drugs are also attracted to the concerned about long term effects of brain damage which
addictive centres in the brain that bind morphine and heroin. according to some studies becomes progressively worse with
Haldol was conceived by splitting the morphine molecule
increases En dose and duration of treatment The older drugs
into two and preparing a structure very similar to one of
prescribed in moderate doses also increase the relative and
these components. But Haldol is not nearly as addicting. The absolute risk of sudden cardiac death. Similar results might be
atypical anti-psychotics, however, do differ from narcotics
expected from the newer drugs and this should be taken into
because one does not have to increase the dose to maintain account in patients with cardiovascular disease.
 80 81

Tranquilizer drugs must be used only as crutches. If they

are made part of the permanent program they become the
problem. They produce a tranquilizer psychosis. They make
Chapter Four
schizophrenic patients sick.

In a recent report Madsen et aP6 found a significant A Comparison of Schizophrenia and

association between the amount of tranquilizers taken over the Tranquilizer Psychosis
years in grams and cerebral cortex atrophy. The estimated
risk of atrophy increased by 6.4 percent for each additional
10 grams of tranquilizer drug (In chforpromazine equivalents)
prescribed. Gur et aP reported that tranquilizers increased SympKMns/Signs Schizophrenia Tranquilizer Psychosis
subcortical volumes rn schizophrenic patients. These changes Perception Voices, Visions, Illusions Same, to a lesser
were not present in patients not on this medication. They degree
suggested the changes were In response to receptor blockade Thought Paranoid, Delusional, Not as intense
and could decrease the effect of treatment. In other words, Disorder: Content Ideas of reference
these drugs damage the brain and decrease the odds these Process Blocking Not as intense
patients can ever recover. Are we preparing the ground for Memory, Concentration Same or worse
the next major pandemic of illness with millions of chronic Mood Depression Same
schizophrenic patients becoming more and more brain Agitation Less
damaged as they are forced to remain on their tranquilizers? Anxiety Less
And when it is fully upon us what are we going to do about it? Apathy, disinterest
Behaviour Hot Cool

Physical Toxicity None Tardive dyskinesia

Nausea
Weight gain and
diabetes
Sudden death
impotence
Neural tube defects

Brain Damage None Yes, severity limited to

38 Madsen A, Keiding N, Karle A, Esbjerg S & Hemmingscji R, lifetime dose in grams
Neuroleptics in Progressive Structural Abnormalities In Psychiatric
Illness. The Lancet 1998;352r p784 only
3S Gur RE, Maany Vr Mozley PDr Swanson C Bilker W & Gur RC The diagnosis of tranquilizer psychosis Is found in the
Subcortical MR I Volumes in Neuroleptic Naive and Treated Patients American Psychiatric Diagnostic Classification. Section
With Schizophrenia. American J of Psychiatry 199S;155;1711-1717

J92.11 refers to sedative, hypnotic, anxiolytic psychosis with
delusions white section 292.12 describes sedative, hypnotic
anxiolytic psychosis with hallucinations. The Merck Manual
16"' Edition, 1992, lists anti-psychotic drugs under the heading
anti-anxiety drugs or anxiolytics.
tranquilizers thus convert a natural psychosis to an
iatrogenic (treatment caused] psychosis, the tranquilizer
psychosis. They convert hot into cool symptoms which are
much more tolerable and allow the patient to be cared for
at home, to be discharged from hospitals too soon, and to
make available the city streets tor their care and shelter. But
the objective of therapy should be to cure the patient in the
sense that one cures diabetes, that is, to remove symptoms
and signs, to make it possible tor the patient to get along
reasonably well with family, to permit the patient to get on in
the community properly housed and reasonably comfortable,
and for the patient to pay income tax. I estimate that fewer
than 10 percent of all schizophrenics treated in North
America ever achieve this state of well being with or without
tranquilizers w'hen this is the only treatment.
There is another serious problem. Since these drugs
produce a different type of psychosis any improvement
brought about by the use of supplements and diet wifi not be
evident. As long as the dose of drug remains high any benefit
Irom orthomolecular treatment will be masked. Niacin does
not treat tranquilizer psychosis. Therefore any double blind
study which maintains drugs at their original therapeutic
level will not show improvement unless and until the
amount of drugs is reduced as the patients begin to recover,
1 Koren Cr Cohn T, Chitayal D, Kapur B, Remington G, Reid DM,
Zipursky RE. Uso of Atypical Antipsychotic* During Pregnancy
and the Risk of Neural Tube Defects in Infants. American Journal
Psychiatry 2002; 159:136-137
83
The investigator will then conclude that there has been no
response to the vitamins. It must be stated over and over that
drugs are to be used carefully with the objective of gelling
patients down to very low non-toxic levels or off I he drugs
completely.
This, then, is the dilemma. How can one benefit from the
moderate improvement induced by drugs while not becoming
psychotic from them? The usual way is to withdraw' the
drug, but in most cases the original psychosis recurs and this
process is repeated over and over. Or one can very slowty
decrease the amount of drug, but in most cases the same
disease recurs. There is no escape because when the drug
dose is so small that the side effects are gone, its therapeutic
effect is also gone.
Orthomolecular psychiatry does provide a third pathway,
a pathway toward health. Nutrients have no side effects in
their recommended doses. They gradually start the process
of real recovery in most cases, but they do so slowly. It takes
at least two months before they kick in. But once they are
effective the disease seldom recurs as long as the nutrients
are taken. This means that one can combine the therapeutic
effect of nutrients, which is slow but enduring, with the rapid
therapeutic effect of the drugs, and as the patients begin to
recover the amount of drug is slowly decreased until the
dose is nil or so dose to it that there are no side effects. I
have several patients on Haldol 1 milligram daily and they
remain well on this very small dose. Xen obi otic psychiatrists
provide their schizophrenic patients with two choices: remain
psychotic without drugs or became psychotic with drugs. Et
is not surprising so many patients have to he legally forced to
take their drugs. They do not like the tranquilizer psychosis
and often will go to any lengths to be free of it.
 84
Chapter Five
The transition from bipolar to
schizoaffective to schizophrenic
psychosis
Many people have asked me whether I have ever written
about bipolar psychosis and ortho molecular treatment,
f his I have not done mainly because I have focused on
the schizophrenias (Hoffer, Osmond, CaJlbeok and Kahan,
1957). We started our research in Saskatchewan in 1952
and discovered that the results of any treatment program for
these patients was much better if one included the optimum
doses of vitamin B-3. We did nut explore the use of this
vitamin tor manic deprcssives as they were then called
because it was a different category of illness. Over the years
ihe distinction between manic depressive and schizophrenic
disease gradually vanished and ! am now convinced I hey are
both forms of I he major disease pellagra. Pellagra is caused
by a deficiency of vitamin B*3 in the diet of people who
have normal needs for this vitamin, whereas these major
psychotic diseases are deficiencies of the same vitamin clue
to internal factors which generate an increased need for the
same vitamin. When the deficiency 3s primarily in the diet
it is called a deficiency and when the need is a result of a
biochemical problem in the body it is called a dependency.
85
Rut the psychoses in both condiI ions are identical1- . Logically
these psychoses should be called pellagra, schizophrenic type
or pellagra schizoaffective type or pellagra bipolar type.
I propose that there is a continuum between manic
depression (hereafter called bipolar) and schizophrenia with
an in-between stage called schizoaffective psychosis. I suggest
that a bipolar patient who never has perceptual changes
even in the manic phase differs from schizophrenia in the
oxidation of adrenaline to adrenochrome, it there is excess
adrenaline this may be a causal factor for the manic state if
the adrenaline is not converted into adrenochrome. If the
manic state is characterized by perceptual change (sensory
illusions and hallucinations) and thought disorder, more of
the adrenaline has been oxidized into adrenochrome. There
are several oxidized derivatives of the catecholamines such
as dopachrome from dopamine and noradrenocbrome from
noradrenalin. When 1 use the term adrenochrome I refer to
any or all of these oxidized derivatives. There is a continuum
from no conversion or very little conversion of adrenaline Into
adrenochrome in the bipolar patients, to more conversion in
the schizoaffective state to a lot more in the schizophrenic
state.
The Continuum: Bipolar to Schizoaffective to Schizophrenia
Clinical research in a non-research oriented psychiatric
ward is never easy* For our double blind controlled
therapeutic trials in 1952 we tested I he activity of the two
vitamin B-3 forms, niacin and niacinamide, against pLicebo,
This study was on schizophrenic patients only. As Director
1 Merck Manual, 16th Edition, Merck Research Laboratories,
Merck and Co. Tnc., Rahway, N.J, 1992
2 Hoffer A & Osmond H. The Hallucinogens., Academic Press,
New York, 1967
 86
87

OfPsych,„lric Research I did not make the first diagnosis

the Department of Psychiatry at Columbia University and
That was made by the treating psychiatrist but I would not
Iris research psychologist Dr Piotrowski. They followed
accept subjects into the study unless I agreed that they
70 patients and came to the same conclusion as ! had. Dr.
were schizophrenic. That meant that at least three doctors
1 ewis was one of the most distinguished psychiatrists in
were involved in the diagnosis: the treating psychiatrist, his
psychiatric history. His Interests were eclectic and ranged
penor and me. From counting the proportion of patients
from psychoanalysis lo pathology. He was even interested in
, Cn f to lh,s lvard 1 expected that it would not take very the effect of mescaline which he had taken. Dr. Lewis was
long to have enough patients. But to my surprise once the
chair of the Dementia Praecox Committee of the Scottish
study got underway the number of patients diagnosed with
Rites Masons. Dr. Osmond and I were invited to one of their
schizophrenia suddenly decreased. It was obvious the treating
meetings in 19.S2 held in the Canada Room of the Waldorf
doctors did not want their patients placed in this treatment §
Astoria Hotel where we reported for (he first time our new
hypothesis about adrenochrome and schizophrenia. Dr, Lewis
had nourished the slender efforts being made by American
I became interested in the long term stability of
psychiatrists to prevent being swamped by psychoanalysis
tagnosts. Did a manic depressive remain manic depressive
which was galloping into North America. We became
on subsequent admissions and did a schizophrenic remain
good friends and later he wrote the foreword to our first
so after many years? As Director of Psychiatric Research I
American edition of How to Live with Schizophrenia. Our
had free access to all patient files. I started to keep track of
first application for a grant from Ottawa to test our hypothesis
pahenls to study this effect. I found that manic depression
was turned down by the three Canadian professors of
was not a stable diagnosis meaning that, with subsequent
psychiatry on the committee then vetting federal grants. But
admissions, and often there were many, there was a gradual
2 ^mcdepressive to
schizoaffective to schizophrenia
diagnoses But the reverse was not true. Once a patient was
we were given a small grant after Dr. l ewis reviewed it and
recommended that we should get 20 years of support not just
for the two we had requested.
diagnosed schizophrenic he remained so on subsequent
admisstons except he would eventually be called chronic
A!! their patients had been diagnosed with manic
Schizophrema was stable but the diagnosis, manic depression
depression on (heir first admission. But by following them up
was not. The meaningless term borderline personality disorder
for several years they found that half of them eventually were
given to schizophrenic patients that are not iiked or who do
re-diagnosed as schizophrenic* This raised the question, had
not respond to treatment had not yet been invented.
the condition really changed its nature or had the diagnosis
been missed in the first admission? They found that had
i did not do a formal study but fortunately did not have
the original diagnostician taken seriously the presence of
to as it was done by Professor Nolan D.C. Lewis', Chair of
hallucinations they would have been able to predict accurately
those patients who eventually were dearly schizophrenic* The
3 Lewis NDC, Piotmwski ZA. ClinicaTdi^nosis of manic-. difficulty with this diagnosis was that these patients showed
(«* ™ H„ch„| Zubin), 1954:25- schizophrenic features, usually when they were in a manic
 88
phase and seldom when they were depressed or normal.
They analyzed the symptoms and signs present in the first
admission history. They found ten factors which if they had
been taken into account would have accurately predicted the
manic depressive* who eventually became schizophrenic.
Half of the factors were perceptual. This research by Lewis
and Piotrowski must be read by every psychiatrist but most
of them are not even aware it has been published. Here are
some of their conclusions.
a) I he essential psychological trait of schizophrenia
is a defect in the patient's criterion of reality. If this
is normal the patient does not have schizophrenia.
(Remember Conolly's definition of schizophrenia as a
disease of perception combined with an inability to
judge whether these changes are real or not.)
b) The diagnosis of manic-depressive psychosis {bipolar)
can be made only by the elimination of the diagnosis
of schizophrenia,
c) The practice appears to be to diagnose schizophrenia
only when the schizophrenic features are predominant
and to ignore the diagnosis when the schizophrenic
features are not prominent as in spurious manic
depress! ves.
d) Lven a trace of schizophrenia is schizophrenia. Many
patients with few and mild schizophrenic signs and
with a strong affective element far! to improve and
spend years m institutions.
In about 1952, Dr. Karl Menninger, pre-eminent physician
who had become a psychoanalyst (Menninger Clinic), gave us
a series of seminars in Saskatchewan, He had with him a little
89
manual he had written describing in a logical and systematic
way how lo do the mental state examination. During those
I wo weeks he was in Saskatchewan my wife Rose and I
played a lot of bridge with him and his wife. When he left he
gave me this manual which t cherished but unfortunately ! lent
it to someone and, as is too often the case, it never found its
way back to me.
Dr. Menninger listed four areas of mental activity that
needed to be examined* These are perception, thinking, mood
and behaviour. Perception covers the senses by which we are
aware of the world and of our own bodies* It includes vision,
hearing, taste, touch, and smell. Examples of visual changes
include hallucinations. Examples of auditory changes include
hearing voices. Thinking may be disordered. Delusions
would be an example of this whereby the process of thinking
as well as the content of what is heing thought about is
compromised* Mood may be high or low' or inappropriate and
the same applies to behaviour which may be overly active,
too passive or inappropriate. These are all described in detail
in our book How to Live with Schizophrenia. Dr. Menninger
had a remarkable scheme for examining the mental state
and it ts one l have used ever since I read his book, but it
appears to me that very few psychiatrists are aware of this
work. Menninger's ideas of the value of perceptual changes
in diagnosing schizophrenia have been given short shrifi in
diagnosis while tori much weight has been given to mood.
This is a pity as it has been known for several hundred years
that perceptual changes are the key to many of the bizarre
changes in a patient's behaviour*
90
Smith4 5 6 found that a substantial proportion of normal
people bear voices and do not believe that they are sick or
need treatment. And many are correct. Had he been aware
of l he Conolly definition of insanity he would have been
less puzzled since hearing voices is only half of the correct
definition. The person hearing voices must also believe they
are real and may or may not display psychotic behaviour by
acting upon them. The mere act of hearing voices does not
indicate than he person is schizophrenic,
Osmond and Smythies" originated the hypothesis that
the experience induced in normal volunteer subjects by
mescaline, the active ingredient in Peyote, in many ways was
a model for what happened in schizophrenic patients, that
there was a relationship between adrenaline, a catecholamine,
and mescaline in chemical structure. In other words this
suggested that toxic substances which had the hallucinogenic
properties of mescaline (or of LSD and similar substances)
and might be related to or derived from adrenaline could be
found in the body of these patients. We did not know enough
about transmethylation of adrenaline and its derivatives
to pursue this any further. It was generally accepted that
transmethylation could not occur in the body. But the basic
idea was extraordinarily sound and productive leading to our
adrenochrome hypothesis*.
The hallucinogenic experience, whether it was
psychotomimetic (bad) or psychedelic, almost always
4 Smith DB, Muses, Madmen and Prophets, Penguin Press 2007.
Reviewed in New York Times by PD Kramer, April ft, 2007
5 Osmond H and Smvlhies J. Schizophrenia. A New Approach. J
Ment Set 1952:98: 309-315
6 Hoffer A Osmond H & Smythies J. Schizophrenia: a new
approach. U. Results of a. year's research. J Merit Science 1954; 100:29-
45
91
impressed the volunteers by the striking changes they felt
in their perception. This immediately drew attention to the
perceptual symptoms in this psychosis. Osmond and I read
many books written by patients who had recovered from their
illness. We read hundreds of patient charts and the more we
studied this phenomenon the more convinced we were that
perceptual changes were extremely important if we were
to understand what il was like to be schizophrenic* 1 his led
to the development of the Hoffer Osmond Diagnostic Test
(HOD) which we standardized on thousands of patients at
four different hospitals in Saskatchewan. These results were
announced in the journal of Neuropsychiatry. Dr, Meduna,
Lditor-in-Chsef, gave us the entire August 1961 Volume 2
issue.
The HOD test is a simple card sorting test of 145 cards,
each one containing a statement or question, Sixty-two cards
test the subject's experiential world and perceptual changes,
39 cards deal with thinking and its disorders and 44 are
concerned with mood changes. It is really an examination
of the way subjects experience their sensory world.
Schizophrenic patients and subjects under the influence
of hallucinogens get very high scores when doing this test.
There is a very close correlation between the diagnosis of
schizophrenia and the scores. But it is not a diagnostic lest
for schizophrenia. High scores suggest that schizophrenia
should be considered seriously but they can also be high in
other conditions. We found that most schizophrenic patients
when sick scored high and as they recovered the scores
decreased. During a relapse the scores go up again. But we
also found that up to one-third of other psychiatric groups also
scored high. This is not surprising considering the difficulty
of clinical diagnosis. The manic depressive patients of Lewis
and Pietrowski would have scored high with this card sorting
test. It is really a very good simple test easy to give, Il does not
92 93

tire the patients and may be used as often as one wishes, li is

an excellent test to measure relapse before the patients even
become aware of it. It is also cross cultural It is being used
successfully in Japan. Professor Kakitani described its value in
diagnosis and in treatment.
Chapter Six

The HOD test

Following is a report on his experience with the HOD test

by Professor Masaki Kakitani1 of the School of Psychology,
“Rissho University in Japan.

"I came to know somehow the work of Dr. Hoffer when

I was a graduate student in the United States. I stayed in the
United States from 1968 through 1978. The McGovern Report
came to my notice in 1978. Through ihis report I became
interested m problems caused by hypoglycemia. Then 1
encountered with KYB (Know Your Body) Club and met Dr.
Kaneko I joined a tour sponsored by KYB Club and I mei Dr.
Hoffer in New York City. Since I had known I he existence of
HOD test, I approached Dr. Hoffer and got his permission to
translate it into Japanese. I am a clinical psychologist teaching
Choice Theory, Reality Therapy, Quality School, and Lead
Management. I train graduate students to become clinical
psychologists. 1 would [ike to share some of my experiences in
which I used HOD tesl.

1 Kakitani M, My experience with HOD test. Personal

Communication, 2007
94 95

Case 1: Thirty five years old man. Single, under medications.
The client had been diagnosed as schizophrenia two
years before he came to me for counseling. He was under
medications. He was given risperdal (risperidone), artane,
miradol, lupox, and I exotan. I asked him to take HOD test
and he agreed. He took it three limes altogether at different
occasions. The results are shown at table 1.
Table 1
April 7, lune 22, July 3Q
Case 2: A female college student, 20 years old. Single,
She came to a school counselor before summer vacation*
After checking the HOD test results the school counselor
asked her when she felt this way first lime. She said that she
fell like this since her grade school. The school counselor
talked to her parents and got iheir informed consent. She
started taking Vitamin C and Niacin 3 grams each per day,
and some Zinc, She came back to school after summer
vacalron and took HOD test again. She was found to be in a
normal state. The results are shown at table 2.

TS 69 35 13
Table 2
PerS n 5 1

PS 5 ? 1

DS a fi 0

RS 8,6 5.8 2.6

7 3 1
SF
In April he began to take 3 grams of Niacin and 3 grams
of Vitamin C per day while maintaining medications, fn May
Vitamin B complex (B1 level 150mg/day) was added. In June
Vitamin Bfi (250mg) was added. The sign of improvement was It was fortunate that she had not received any medications.
shown at the fable 1. He described his conditions saying he She was free from some possible complications from
used to function 30 percent level but now 60 - 70 percent medications.
level. He was able to ask his doctor to reduce medications.
Medications were changed to three from rive kinds and doses
were also reduced. The final medicine was risperidone which
was most difficull to secede from.
 96
Case J: A man of 96 years old. Single. Under medications.
He was referred to me by a counselor. He was under
medications. He took HOD test. I asked him to take the test
indicating his current conditions and recall the worst time
which was two years before, and answer his worst conditions
The results are shown at table 3,
Table 3
His guess at worn time March 7,
s caused a deficiency of pyridoxine and zinc, we treated those
47 JO
PerS 3 0
PS U
0
05 7 3
RS 6J
3.5
5F 5 0
In case three I am rather confident through HOD test
results that he should ask his psychiatrist to reduce his
medications. He would be fine if he could maintain his
conditions without brain drugs. He would be starting his
supplement and reducing his medications.
These three cases show that HOD test is a useful tool for
monitoring the progress as well as diagnosing schizophrenia in
Japanese culture. The HOD test has not been standardized in
Japan yet. We have no intention to do so now since the most
of the questions on the test seem to appeal similarly to people
with different cultures. The counselor is able to determine the
level of confusions the client is having by looking at the HOD
test results. I can say that it is a very useful psychological test."
97
The lest results also correlate very significantly with I he
presence of the mauve factor in the urine of patients, the
syndrome Osmond and I called malvaria, as the mauve factor
was not yet identified {Hotter and Osmond, 1963). Patients
with malvaria were those who scored high on the HOD test
l.e had a lot of perceptual changes, had the mauve factor in
their urine and, when treated with vitamins, responded as if
they were schizophrenic no matter what the clinical diagnosis
was. Until Cart Pfeiffer (1975) showed that the mauve factor
patients with the mauve factor with vitamin B-3. But the
addition of these two other nutrients greatly improved the
treatment results and decreased the need for as much vitamin
B-3, The dose needed for each of pyridoxine and zinc is less
than one gram per day. These vitamins are also useful for
some patients with severe premenstrual tension. Pfeiffer found
that patients with pyrroleuria (what we had called malvaria)
had distinguishing signs such as white areas in their fingernails,
stria, pain in their knees, changes in their skin and PMS. He
also found that if patients improved, the amount of the mauve
factor (kryptopyrrole) went down to normal or very low
levels. A relapse in their condition was usually preceded by a
recurrence of the urinary factor. Very few laboratories test for
this factor. I look upon these people with malvaria as having
a form of peiiagra. I have found that mentally ill patients who
score high on the HOD test, or who have above normal levels
of the mauve factor in their urine or both respond best to a
program which includes vitamin 6-3.
The clinical diagnosis of schizophrenia is so imprecise
and variable that nothing can be correlated with it, Bui if
one day by consent physicians agree to diagnose depending
upon the results of a laboratory tesl then the correlation will
be high. Syphilis used to be diagnosed by clinical evaluation
98
and as often misdiagnosed an til a blood test for diagnosis was
developed.
When it was identified in collaboration with Carl Pfeiffer
the term mauve factor was changed to kryptopyrrole. They
are dose but not identical. Kryptopyrrole is closer to OHHPL
fhydroxyhemoppyrrotin-2-one). It is a member of the pyrrole
family and may be correctly referred to as "urinary pyrrole/'
Today this compound is being studied by many investigators.
Dr. Woody McGinnis heads a large study group. It appears
to be a measure of oxidative stress. There is no doubt that
many patients who are mentally ill suffer from oxidative stress.
These include schizophrenic patients, autistic children, and a
substantial proportion of other diagnostic groups.
Dr. Con oily described insanity as a disease of perception
combined with an inability to judge whether these changes
are real or not. This is a remarkable working diagnosis
which I have found most helpful. Not only is this definition
valuable but it also helps to understand why schizophrenic
patients have delusional symptoms or signs. For example,
if the individual lost Ns sense of taste (zinc deficiency) and
everything tasted flat or bitter he might ascribe this to poison
being put into his food. This is a very common delusion
caused by a taste misperception. It is a pity that modem
psychiatry ignored Con oily's description and definition of
insanity in favour of the Bleulerian definition which played
down perceptual changes and emphasized thought disorder.
Ironically most modern psychiatrists while paying lip service
to Bleuler still depend upon gross auditory and visual
hallucinations before they will diagnose schizophrenia. But
the modern trend is to give ever more emphasis to mood
and whenever patients are depressed they are immediately
called bipolar and the gross perceptual changes are missed
or ignored. The history of schizophrenia over the past one
99
hundred and fifty years would have been very much different
and in my opinion much more positive if Conolly's diagnostic
criteria had been accepted.
The Three Main Psychotic Disorders
Schizophrenia is characterized by the combination of
perceptual changes and thought disorder. The mood changes
which are almost always present are due to the biochemical
changes in the body and the psychological reaction to this
very serious disease. The mood disorder must be secondary to
the perceptual and thought disorder.
Bipolar disorder is characterized by a series of mood
swings from mania to depression with normal in between.
The cycle varies tremendously from once a month to once
every few years. Modern drugs will distort the typical cycle
and in many cases convert depression into mania. When
normal or depressed, bipolar patients do not suffer the typical
schizophrenic symptoms but when they are manic they may
often hear voices and see visions which dear as the mania
clears. We therefore have at least two types of bipolars: those
who never have any schizophrenic symptoms and those who
do when they are manic. What are we then to call them?
Psychiatry got around this. When the diagnosis is not clear
and it is doubtful how to name the patient, they are called
schizoaffective.
Schizoaffective disorder is present when the perceptual
and t hought disorder changes are present during the manic
phase of bipolar. Bipolar disorder is present when there are no
perceptual or thought disorder changes. The HOD and similar
perceptual tests will alert the clinician to the presence of any
perceptual changes.
 100
Bjpolars and schizoaffective people respond differently
Eo orthomolecular therapy. The non-schizophrenic bipolar*
need mood stabilizing treatment while Ihe schizoaffective
patients need these and also treatment for the schizophrenic
component of their disease, I find that schizoaffective patients:
are much easier lo treat than are bipolar patients and their
response is much better.
Diagnosis can be very difficult and often this depends
more on the orientation of the diagnostician than on the
disease itself. The diagnosis, schizophrenia, is so dismal and
carries such a poor prognosis that many psychiatrists prefer
not to even think about it and if their patients have mood
swings, minor or major, they will call them bipolar. A large
proportion of the schizophrenic patients who are referred to
me were originally called bipolar and their perceptual changes
had been either not elicited or were ignored. In a major recent
study WeiserJ found that nearly 30 percent of a schizophrenic
population had been diagnosed with depression during
adolescence compared with only 7 percent in a general
population. This contirmed what I have been seeing for the
past fifty years having seen over 5000 schizophrenic patients*
The Adrenochrome Hypothesis
Are the three main types of psychotic patients-mood
swinging bipolar*, schizoaffective* and schizophrenics related?
The adrenochrome hypothesis provides an explanation.
Hoffer, Osmond and Smythies hypothesized that
l Weiser M, Reichenberg A, Rabmowilz J, Kaplan Z, Mark
M, Bodmer E, Nahon D &. Davidson M. Association Between
Nonpsychotie Psychiatric Diagnoses in Adolescent Males and
Subsequent Onset of Schizophrenia. Arch Gen Psychiatry 2001
58^59- m
101
schizophrenia was caused by the formation of adrenochrome
in the body. Adrenochrome is the oxidized derivative from
adrenaline. The reaction is activated by oxygen, accelerated
by oxidizing enzymes and by copper or iron. Our research
division showed how to synthesize pure crystalline
adrenochrome, which later was identified in blood and
other tissue and can be measured, usually by its conversion
to adrenolutin, We showed that it is an hallucinogen. And
finally we based our vitamin 8-3 trials on the hypothesis that
anything that might inhibit the formation of adrenochrome
from adrenaline would be therapeutic. But adrenochrome is
only one member of a class of chrome indoles that is readily
made from the catecholamines: dopachrome from dopamine,
noradrenochrome from noradrenalin and adrenochrome from
adrenaline.
The amount of adrenochrome that can be formed must
depend upon the amount of adrenaline that the body
can make. That means that under stress when adrenaline
secretion is greatly enhanced much more is available. And
since adrenaline must be removed very quickly because of
its dramatic effect on blood pressure the body will convert
as much as possible to substances that do not increase
blood pressure, Adrenochrome is toxic to dividing cells, and
probably provides one of nature's methods for controlling
excess growth like cancer and for destroying bacteria. It
is toxic to heart muscle and is toxic lo neurons as are all
hallucinogens. Schizophrenic patients are more prone to heart
disease.
I suggest that bipolar patients excrete large amounts
of the catecholamines but do not convert as much into
adrenochrome. They will not suffer the usual changes induced
by this hallucinogen. Schizoaffective patients produce
loo much catecholamines in the manic phase. They are
 102
under extreme stress and that is why it is only in that phase
that they will make enough ad renochrome to cause the
schizophrenic symptoms. Patients wilh severe heart failure
have increased amounts of adrenokitin in their blood. In
blood, adrenodirorne is converted into adnenolutim The
Schizophrenic group on the other hand makes too much
adrenodirorne as long as they are sick whether ihey are
manic or depressed.
The main prodromal symptom of oncoming mania is lack
of sleep, When the patient is getting only 4 hours of sleep or
less he is in grave danger of going manic. I advise my patients
of this and discuss with them what they can do to prevent this
from occurring. One of my patients under very good control
wenl to Las Vegas. He got swept up in the gambling, did nol
go to bed (a very bad idea) and after 36 hours was wildly
manic and had to be shipped back to Victoria once more
psychotic.
I think that one of the functions of sleep is to destroy and
to remove from the body products of metabolism that are
no longer needed or are harmful I think that the chrome
indoles are examples of these harmful products. Normally,
if deprived of sleep long enough, people become psychotic
and have hallucinations. Sleep deprivation is well known as a
harbinger of bad news. And is it not interesting that visual and
auditory hallucinations during sleep are called dreams and are
considered to be perfectly normal? The great psychoanalyst
Dr. Karf Menninger once wrote that schizophrenia was like
a dream, a condition from which one did not awaken. There
is some relation between hallucinations and dreams. 1 have
seen in many patients how daytime voices go away. They
recede into dreams and the voices heard while awake vanish.
It is more normal to hear voices while dreaming. I suggest
103
that it takes a minimum of 5 hours of sleep to be rid of excess
ad renochrome and similar chrome indoles.
There are other oxidized derivatives of adrenaline
and other catecholamines. Adrenolutin is as toxic as
ad renochrome. But when adrenochrome is treated with
ascorbic acid under certain conditions some of it is converted
into 5, 6 dihyroxy M methyl indole that is called leuko
adrenochrome This substance has anti-tension or anti-anxiety
properties.
For a more elaborate discussion of the relation between
the catecholamines and mental disease you should read Foster
and Hoffer145 Smythies and Smythies and Calzigna.9
3 Foster HD & Hoffer A, Schizophrenia and cancer: The
adrenochrome balanced morphism. Medical Hypotheses 2004; 62:415-
419
4 Foster HD & Hoffer A. The two faces of L-Dopa: benefits and
adverse side effects in the treatment of Encephalitis lethargies,
Parkinsons' disease, multiple sclerosis and amytrophic Literal
sclerosis. Medical Hypothesis 2004; 62177-181
5 Foster HD and Hoffer A. Hyperoxidation ol the Two
Catecholamines, Dopamine and Adrenaline: Implications for the
Etiologies and Treatment of Encephalitis Lethargic, Parkinson's
[Disease, Multiple Sclerosis, Amyotrophic Lateral Sclerosis, and
Schizophrenia. In Oxidative Stress and Neurodegener alive Disorders,
Ed ti All Qureshi and S Hassan Parves, Chapter 16, 363-376, 2(K]7
6 Smythies JR. Oxidative reactions and schizophrenia: a review-
discussion Schizophrenia Research 1997; 24:357-364
7 Smythies J. Recent advances in the neurobioJogy of
schizophrenia. German Journal of Psychiatry 1998; 1; 24-40
8 Smythies J. Hie adrenochrome hypothesis of schizophrenia
revisited. Neurotoxicity Research 2002; 4:147-150
9 Smythies J & Galzinga L- The oxidative metabolism of
catecholamines in the brain: a review. Bioehjjnica el Biophysics Acta
1998; 1380:159-162
 104 105

Orthomolecular Treatment
1 hope this experiment will be done, for bipolar and
The orthomolecular component of treatment of schizoaffective patients might respond well to high doses of
schizophrenia is described by HofferKI and in the case niadn. The dose should be increased at the first indication
histories written by IB patients, Hoffer11. This was that they are moving into a hypomanic and later manic phase.
the treatment protocol developed on the basis of the
adrenochrome hypothesis. Bipolar disorders where
ad renochrome appears to play no role will need different
treatment with much more emphasis on dealing with the
excessive production of the catecholamines. Drugs are used
to control mania and they are very helpful, especially lithium.
These drugs are xenobfotics and difficult for the body to deaf
with. They should be used with great care, in the lowest
possible effective dose and not forever.

I think we should consider using much larger doses of

niacin to control both schizoaffective and bipolar disease
since it is one of the best antagonists to adrenaline. Certainly
niacin is much safer than lithium or any of the drugs currently
in use. II Is impossible to poison oneself with niacin because if
the dose is too high nausea and vomiting will soon persuade
anyone to cul the dose down. I have already mentioned the
2 pal tents who, on their own, took 60 grams of niacin a day
with no side effects. Saul77 reported that "over a twenty-
three year period, vitamins have been connected with the
deaths of a tolaf of ten people in the United States. Poison
control siatisties confirm that more Americans die each year
from eating soap than from taking vitaminsAbout half the
population of the United States takes vitamins.

Kt Hotter A. Treatment Manual. Internationa I Schizophrenia

Foundation, Toronto ON, 2007

Ji Hoffer A. Mental Health Regained. International Schizophrenia

Foundation, Toronto, 2007

12 Saul A. Orthomolecular Medicine News Service, Feb. 27, 2007

drsaui@doc lory oursel f. com
Section Two

Chapter One
Problems With Traditional Psychiatry
The problem with psychiatry is that it does not treat
the schizophrenias successfully. This is the conclusion
of almost every published analysis. Thus Mafia et af\
following a very thorough examination of published studies,
conclude, "Outcome in regard to functional measures such
as employment and community and social adjustment are
predicted not only by delay in treatment but also by cognitive
dysfunction, residual symptoms and adherence to medication.
Pharmacological and psychological intervention show a
promising effect In terms of either delaying or preventing
conversion to a syndrome level of ultra high risk individuals,
but the evidence is not yet at a level that can be applied in
practice." Plainly pup Mafia and colleagues concluded that
although there was some evidence that early intervention
might improve some of the treatment results, they presented
no data that showed (hat early onset patients were any better
off with treatment. There is no mention of the number that
actually became and remained normal. And these early
onset patients are (he best prognostic group, the group that
responds the best to orthomolecular treatment.
1 Malta AK, Norman Ross MG, and foober R. First Episode
Psychosis. Early Intervention and Outcome; What Have Wc Learned?
Can J Psychiatry 2005; 50:881-891
109
A very recent report emphasizes this conclusion.2 The 18lh
European College of Neuropsychopharmacology Congress
j! am one of the founding members of this organization)
discussed the probability of achieving remission in the
treatment of schizophrenia. But nowhere in this report is there
any reference to recovery, to paying income tax. The report
included which symptoms to measure for assessing remissions:
delusions, conceptual disorganization, hallucinations, unusual
thought content, mannerism and posturing, blunted affect,
social withdrawal and lack of spontaneous conversation.
These are exactly the same symptoms we used to analyze
the disease in 1950 when we also did not think recovery was
possible.
Jobe et aP confirm the poor results. They conclude
schizophrenia is a "poor-outcome disorder" and I hey warn
that more attention must be given to suicide and early death.
It does not say much for anti-psychotic drug treatment that
after 50 years all psychiatrists write Is merely a rehash of what
has already been written.
But we should not be surprised. Apart from the Quakers
and a few dedicated psychiatrists, the general consensus
for the past 200 years has been that schizophrenia is not
treatable and that the best that can be done is to isolate such
patients from society in terrible mental hospitals and, in the
last 50 years, to control the worst aspects of their behaviour
by using toxic chemicals which do not cure. Around 1900
the differential diagnosis for dementia praecux (now called
schizophrenia) included pellagra, scurvy and syphilis oi
the brain. Adding nicotinamide to white (lour eradicated
2 18ftl European College of Neuropsychopharmacology
Conference, Amsterdam, The Netherlands, October 22-26,2005
3 jobe TH and Harrow M- Long-Term Outcome of Patients With
Schizophrenia: A Review. Can J Psychiatry 2005; 50:892-900
 no
Ihe pellagra psychosis. Curing scurvy cured the scorbutic
psychosis, arrd penicillin cured syphilis. As the cures for
these types of psychotic reactions were found these patients
were promptly removed from psychiatry and became part of
genera! medicine, The term dementia praecox was replaced
with the name schizophrenia, which remained unbeatable,
and so schizophrenia was left with psychiatry. The mental
hospitals became depositories for all unwanted people
who created problems, but not enough to have been sent
to prison. These mental hospitals developed such a well-
deserved terrible reputation that governments began to shut
them down. Instead of converting them info asylums, real
hospitals, government officials were seduced by the opinion
of a large faction of society dealing with the mentally ill,
including the psychiatric profession, into thinking that these
sick patients were better off If they were left in the community
in which they had gotten sick in the first place. The hospitals
with their horrible reputation for brutality and lack of care
began to disappear Not their inmates, however, who began
to dog up the prison system. Some of the largest mental
hospitals are operated hy prisons in the United States. So the
same patients who were warehoused In terrible institutions
were dumped into prisons and their even worse mental
wards. The psychiatric profession which should have been
fighting for better care and treatment for the mentally ill did
nothing. It preferred to treat non-psychotic patients as much
as possible because they were usually less trouble. Mental
hospitals are the storage warehouses for the mentally 111 and
the psychiatrists who treat them are the wardens. The global
idea held by psychiatrists that schizophrenia Is not treatable
remains inviolate, and as long as they persist in not using
adequate treatment they will remain correct.
The term "successful" has to be analyzed. If all one wants
Is to subdue some ot the symptoms while allowing others to
111
remain and to grow, modern medication is very successful.
So was permanent incarceration in 1950. If your main interest
is in keeping patients out of expensive hospitals, the modern
use of medication with legal sanctions, which force patients
to take medication against their will, is very successful, 11 you
do not care about the pain and suffering endured by patients
and their families, then modem drugs are very successful. On
the other hand, if you want your patients to really become
normal, to take up their role in society, to be useful members
and lo pay income tax, then modern drugs when used alone
are a dismal failure. The general fear and attitude of the
public toward the word schizophrenia is adequate proof l hat
psychiatry has failed. Diseases which are preventable and
curable do not carry any major stigma. The schizophrenias
are preventable and curable but the public does not know ibis
since the profession refuses to use treatment that will eradicate
both the disease and the stigma.
By my definition of wellness which is freedom from signs
and symptoms, good relationship with family and community,
and gainful employment paying income tax, fewer than 10
percent of drug-only treated patients ever achieve that state.
If you doubt my conclusion ask your psychiatrist friends how
many of their schizophrenic patients ever pay income tax on
money they have earned. Ask them how many have been
able to become doctors, lawyers, teachers, business people,
writers, poets, painters and more. You will be surprised at
the answers. Ask them why Big Pharma still spends billions
of dollars and earns even more billions of dollars searching
for profitable drugs which are not more effective, are just as
unsafe because of serious toxic side effects and which cost a
lot more. The life span of a drug patent is about fifteen years.
Every generation witnesses new blockbuster drugs which are
touted as better and less toxic, but we have not seen this. The
112
most recent drug, Zyprexa, is a good example. It is no belter
than Chbrpromazine which was created fifty years ago.
Basically psychiatrists may, in self-defense, maintain that
these are totally unrealistic goals and therefore there is no
point reaching for them. The public is not fooled and that
is why the stigma of the name schizophrenia still remains
a major problem. And the profession remains uncertain
about diagnosing. They do not understand how it affects
patients. Modern psychiatry has failed in the treatment of
schizophrenia. That failure is not due to ignorance of better
ways of treating. It is due to professional resistance against
using any therapy that does not keep the major drugs at the
central core of the treatment program.
Recovery from schizophrenia is not considered a
reasonable objective by psychiatry. The word cure has never
occurred in any psychiatric dictionary. In 1957 when we
first issued our reports in the medical literature about the
results we were getting we were attacked by the Canadian
Mental Heafth Association led by Canadian psychiatrists
because, they said, we had claimed we cured our patients,
in fact we never did make that claim but we did talk about
recovery lasting one or two years. Even though recovery was
not expected, psychiatry did accept that about one-third of
patients with no treatment whatever would recover. These
were called natural recovery rates. Is this really true?
The earliest studies of natural recovery used readmission
statistics. Any patient discharged and not readmitted was
classed recovered. This led to the usually accepted 33 percent
recovery rate. But f have seen hundreds of these patients
who had been in hospital once or twice or more and who
thereafter, for a variety of reasons, never had to be readmitted.
They were not well or else they would not have been
113
referred to me. They suffered from a variety of symptoms of
depression and anxiety and very often with ill defined signs
of thought disorder and paranoia. They were not sick enough
to be readmitted and not well enough to he considered
well. I have therefore used much more stringent criteria for
recovery. To me a patient is recovered when he or she is free
of symptoms and signs, getting on well with their family and
community and when they are productive, employed and
paying income tax. These criteria are so clear that one does
not have to be a physician to decide whether or not a patient
has become and is well
~~ II es also necessary to define what is meant by natural
recovery rate. A true natural recovery rate would be one
in which a patient would remain in the environment in
which he or she had become ill There would be no change
in life style and no treatment given. This also applies to
cancer. Spontaneous recovery from cancer, at one time,
was considered so rare as to be non-existent, but many
such recoveries have been described. Foster1 in a study of
spontaneous recovery from cancer found that in most cases
the recovery was not natural at all In these patients something
had been done to or with the patients but that something was
not the standard treatment for cancer. The same applies to
schizophrenia. Many years ago a mother called to report that
her son had been diagnosed schizophrenic but had ret used
to take any treatment. His mother eventually realized that
whenever he drank milk he seemed to be worse and took him
off all dairy products. He recovered. His would have been
considered a natural recovery but it was not. Something had
been changed.
4 Poster HD. Lifestyle Changes and the 'Spontaneous' Regression
of Cancer: An Initial Computer Analysis. International |ournaJ of
Biosocial Research, 1988; 10<1):17'33
114
Recovery rates were nearly zero percent tor the treatment
given in the mental hospitals between 1900 and 1950. The
patients did not receive the three basic conditions (shelter,
food, civility} required for recovery. The Quakers, with
their moral treatment of the insane, claimed in 1850 that
fifty percent of their patients recovered. The usual quoted
recovery rate depends entirely on the figures obtained from
patients who have been in hospital. But in my experience a
large number of patients have not had to be admitted. They
have been called nervous breakdowns and this also includes
people with depression. Since many patients do recover it is
impossible to guess what the real recovery rate is. We will
never know how many are schizophrenic until we have an
acceptable biochemical test for schizophrenia.
Actually these essential principles of any treatment
program were used by Asklepios, Dr Erik Paterson, an
experienced orthomolecular physician wrote, "In his
Asklepiads, he removed the sick people from their stressful
environments (long before Parsons coined the term "Sick
Role"), gave them fresh air, clean water, good food, a
modicum of rest and exercise, a modicum of spirituality, and
Time (hence "patient"}. Remarkably (not to us orthomolecular
physicians) such a large proportion of patients completely
recovered ibai the Greeks made Asklepios into a god
— hence ^sculapian Authority. It is one of the most serious
condemnations of modern (pseudo ) psychiatry that orthodox
psychiatrists cannot achieve anything remotely like the
recovery rate of what they would regard as an ignorant Greek
3,500 years ago!"
Perhaps we should honour Asklepios by using that term
to describe the basic three elements but I prefer to list them
separately. Many other factors can be teased out and studied
115
but I think these three, shelter, food and civility (SFC) are
necessary.
I prefer to drop the term natural and to talk only about
recovery rates. The recovery rate for the schizophrenias is
a function of shelter, food, respect and treatment which
may be drugs only, as is the standard practice today, or
orthomolecular treatment described in this report.
When the first three elements of recovery are not used the
recovery rate will be very low. When they are used at their
optimum level the rates will be at least fifty percent. This may
explain the curious finding, to North Americans, that patients
w ho become schizophrenic in less developed countries like
Bangladesh have a better prognosis than similar patients who
become ill in Canada or the United States,
My conclusions of the results of orthomolecular treatment
are based upon our double blind controlled trials, my own
personal experience of treating over 5000 patients since
1955, and on the results of numerous studies published by my
cot leagues over the past three decades. (Most of these studies
were published in the Journal of Orthomolecular Medicine
because establishment journals would not take them. They
thus remain unknown to physicians who depend only on
Medline.)
1 conclude that the recovery rale using orthomolecular
treatment is about 90 percent for patients sick less than two
years (or having been sick and recovered, have relapsed and
then been sick less than two years), if treated for up to two
years. The recovery rate for patients who have been sick
longer than two years is not nearly as good, I have found that
about 50 percent of chronic patients sick over 7 years and
treated for at least ten years, recovered.
116 117

Psychiatrists must learn to use their dangerous drugs in a way

Table Showing Recovery Rates that benefits the patient.

Estimated Recovery Rate The Journal of the American Medical Association reported
that adverse reactions to drugs are the fourth leading cause of
death. Reactions to prescription and over-the-counter drugs
Orthomolecular Drug only
kill more people than all illegal drugs do. CohenV excellent
SFC Yes No Yes No book summarizes the massive evidence and discusses the
part played by Big Pharma in creating this terrible situation.
Percent 75-90% 35-50% No data <10 He points outthat drug companies deliberately over-estimate
the amount of drug patients should be given daily and make it
difficult to give smaller doses. Null, Dean, Feldman and Rasio*
conclude their report as follows, "When the number one kilter
Recovery rates looked at another way:
in a society Is the health care system, that system must take
responsibility for its shortcomings. It's a failed system in need
Mental hospitals 1900 to 1950 0 response
of immediate attention."

Modem psychiatry under 10%

Moral treatment insane (SFC) 50%

Orthomolecular and SFC 75-90%

Modern drugs are very toxic and dangerous. This means

that they must be used carefully and in optimum doses,
Pataracchia,1 There is really nothing more dangerous than
insulin infections since the toxic dose is only a small amount
larger than the therapeutic level. Yet insulin is used with
success for treating diabetes mellitus and children can be
taught how to inject themselves. The medical profession has
had decades in which to learn how to use this dangerous
product in a productive way. Danger is an important issue.

2 Cohen JS. Over Dose; The Case Against the Drug Companies.
Jeremy F Tarcher, Putnam, New York 2001

1 Pataractrhia RJ. Optimal Dosing for Schizophrenia. Journal 3 Nul IG, Dean C, Feldman M, Rasio D. Death by Medicine. I
Orthomolecular Medicine 2005; 20^3-99 Orthomolecular Med 2005^0:21-34
118 119

the drug could be released and no one could later hlame

the government agencies. This not only took away major
responsibility from government agencies but made them
Chapter Two careless, since no thinking was needed. I know that almost all
investigators will disagree with me but under my direction my
research group did the first double blind trials in psychiatry
Why Psychiatry Has Failed beginning in 1952 and f have been a student of the method
ever since.

Based on a very large number of double blinds costing

When governments undertook to vet the efficacy of drugs
billions of dollars a lot of evidence has accumulated which is
as well as their safety they bit off more than they could chew.
taken as gospel and has been used to prepare evidence-based
Permission to allow drugs to be advertised and sold carried
guidelines. But Is this evidence reliable? McAlister et al1 do
with it enormous responsibility. For if a wrong decision were
not think so. They reported on what they had found from a
made and the new drug killed too many patients (no one has
study of Ihe literature. "Evidence-based medicine guidelines
specified how many is too many) someone would have to
are not necessarily based on high quality evidence." How
bear the responsibility. It was much simpler when bureaucrats
reliable are these guidelines if they are based on faulty
had only to decide whether a drug was safe, as this was done
evidence?
by determining lethal doses for animals and then extrapolating
to humans. No double blinds were or are still needed to
The original double blinds that we did before 1960 will
measure how toxic a drug is. It became very important to
never be repeated. We did not use any drugs and today these
have a method that could be used to make these decisions so
are mandatory, 1 doubi I could find any psychiatrist willing to
that bureaucrats would not have to take the blame.
undertake a trial without these drugs. Secondly our controlled
trials were part of an over-all treatment program which
The double blind method came along at the right time
provided decent shelter, good food not yet corrupted by
and became the hallowed method used by all government
modern tood technology and decent and humane treatment
agencies, by all investigators, by editors of journals and by
of patients, I doubt there are any institutions today that follow
granting agencies. An arbitrary standard was selected. If
these principles. And clinical studies, which any physician
the drug being tested was better than no drug or placebo
or non-physician orthomolecular therapist can do, will not
with a probability of 0,05, It was assumed that the drug was
be accepted by standard medicine as evidence if they are
efficacious. This is based on probability hypotheses which
not double blind. The psychiatric establishment has a perfect
themselves have never been shown to be valid for human
excuse not to try to duplicate our results and need not worry
trials. Now the bureaucrats were in the clear. If a company
wanted to get approval for a new drug they would merely
1 McAlister FA, Van Djcpen S, Padwai RD, Johnson JA, M.ifiinul.u
have to run enough double blind controlled trials to find
SR. How Evidence-Based Are the Recommendations in 1 iv'idem *■
a few' where the holy 0,05 p value was exceeded. Then Based Guidelines? P!o$ Aug, 7/2007.

1
120
at all until they are found to be superfluous when general
practitioners take on the treatment tor schizophrenia and no
more patients are referred to psychiatry. There have been
many physicians who have already taken on the treatment
of schizophrenics* One lost his medical license because this
made the local psychiatrists so angry.
Students of the history of medicine will have to examine
this issue very carefully and one day we will have on
record all the factors which have been used in suppressing
orthomolecular information from the public and the
professions.
121
Chapter Three
How to Use Drugs Safely
Chlorpromazine was first used in France and from there
it swept around the globe. Since then other drugs have been
developed and every decade more drugs are proclaimed to
be better and freer of side effects. I call them essential evils.
For many patients they are very essential during treatment but
1 always aim to get them off as soon as possible. They are evil
because of the dangerous side effects and because the most
modern drugs are addicting and patients are seldom able to
work as long as they have to take these drugs. They are very
helpful crutches but not as safe as wooden crutches which
only become a weapon when someone threatens to use them
as such.
Are The Newer Antipsychotfcs Any Better?
A reasonable person would expect that new drugs that
have the same general therapeutic characteristics as do older
and existing drugs would have additional properties that make
it sensible to replace the older ones. They should be more
effective, they should have fewer and less serious side effects
and in my opinion should be cheaper and easier to use.
When U comes to the newer antipsychotics these reasonable
expectations fly out the window. The modern atypical
antipsychotics are not mure effective, they have the same
and even more serious side effects and they cost ten times as
much. Obviously the possibility of driving the costs up has
122
been the main determining factor. Big Pharma has gained,
everyone else has lost*
Gardner et ah' compared the modern antipsychotic drugs
to the original drugs. Olanzapine is an example of a modem
drug and Haldol is an example of one of the early drugs.
They referred to 95 reports dealing with the entire spectrum
of positive and negative drug activity They concluded that,
"Modern antipsychotic drugs offer useful therapeutic options
and the risk of some extra pyramidal symptoms is generally
lower with these drugs than with older antipsychotics. As
a group, modern antipsychotic drugs vary greatly in their
pharmacology and in their risk of specific adverse effects.
With I he exception of Clozapine, they do not represent
major gains in effectiveness or tolerability. Some present
potential important adverse effects associated with weight
gain, including diabetes, hyperlipidemia and hypertension.
As a group, they are much more expensive than the older
antipsychotic drugs, some of which are available as generic
drugs." But the newer drugs are rapidly replacing the
older drugs simply because of the billions of dollars spent
advertising them. Merit is the least important variable,
Gardner et al write, "It is reasonable to consider both older
and newer drugs for clinical use and it is important to inform
patients of relative benefits, risk and costs of specific choices."
I agree with the authors' conclusion in this thorough sludy-
there is no real advantage to the newer drugs, there is a major
increase in cost and patients must be allowed an informed
choice. This kind of thinking is very rare in modern psychiatry.
2 Gardner DM, Baldessarini Kj and Warskh F- Modern
antipsychotic drugs: a critical: overview. CMAJ 2005; 172:1703-1711
123
Physical Toxic Side Effects:
The metabolic syndrome
This syndrome is characterized by weight gain,
hyperlipidemia, hypoglycemia, and increased risk of
diabetes. Not surprisingly there is also an increased risk
of cardiovascular disease, increased blood pressure and
kidney damage. The increase in weight is not trivial for many
palients. Some have gained 60 pounds in a few months and to
see .300 pound patients who formerly weighed less than 150
is not uncommon. Schizophrenic patients tend to be more
susceptible to cardiovascular disease than normal people and
the use of these toxic drugs greatly increases this vulnerability.
Neurological side effects
These include extra-pyramidal symptoms. When the
newer atypical antipsychotic* were released the major claim
was that the side effects, often troublesome with the older
drugs, would not be as serious or frequent. This is true only
to a minor degree. Orthomolecular practitioners hardly ever
had to deal with side effects from the older drugs since it was
possible to use lower doses that did not induce them. Modern
atypical antipsychotics do have the same side effects however.
Other neurological side effects include restlessness and
anxious agitation.
Results of Treatment
Treatment with optimum (large if necessary} d< ol
vitamin B-3 began rationally. It was not serendipitous, nor
trial and error. I do not know of any psychologic .il psyi hlalrii
treatment that originated in the same way, Prufessi >r Ugo
Cerletli in Rome got the idea of using electric shot k from I he
124
information be received that shocking animals in abattoirs
caused a convulsion. Mussolini bad mandated this be done
because he wanted the animal's death to he painless. Insulin
coma originated from a clinical observation that there was
an incompatibility between schizophrenia and epileptic
convulsions. Phis has not been established but it created one
of the early biochemical treatments that had some success.
Our work was based upon the adrenochrome hypothesis
which when examined carefully called for the use of
substances that were anti oxidants in order to decrease the
oxidation of adrenaline to adrenochrome. Orthomolecular
therapy was the first treatment to be brought in following
carefully controlled double blind therapeutic trials. There is
an enormous amount of literature documenting this, with a
large proportion of the reports coming from the Saskatchewan
Research Division of the Department of Public Health,
Psychiatric Services Branch and from my colleagues and
me. I will not list all these important papers. Had there been
any real interest in looking up this data it could have been
exposed to the usual follow-up studies and would have been
shown to be superior to treatment with drugs used alone.
Our first trial used small groups, meeting Do D.
HorrobinV demand that large scale studies be discontinued
and replaced by small scale targeted studies. The first account
of our early trial appeared in Hoffer, Osmond, Cal I beck
and Kahan.3 4 5 A complete review of the clinical value of
orthomolecular treatment is given in Hoffer,1
3 Horrobin D. Are Large Clinical Trials in Rnpidlv lethal Diseases
Usually Unethical? The Lancet 2003; 36T695-697
i Hoffer A, Osmond H, Callbeck MJ and Kahan t. Treatment of
Schizophrenia with Nicotinic Acid and Nicotinamide] Clin Exper
psychopathol 1957; 18:131-150
5 Hoffer A. Vitamin B-3, Schizophrenia, Discovery, Recovery,
Controversy. Quarry Health Books, Kingston ON, 1990
125
The Schizophrenias
The quality and rapidity of I he response to therapy
depends upon the intensity and duration of the illness. From
our research we concluded that patients who were suffering
their first episode or, having recovered from one and having
relapsed, responded the best. After iwo years of treatment
over 90 percent of this group was well. Chronic patients, all
treatment failures, responded more slowly and if they had
been ill for many years were so badly damaged by the illness,
by the treatment given them, that they would never be fully
normal even though they would be much happier and more
comfortable. In my practice on hundreds of these patients
when treatment was continued ten years or more fully 60
percent were normal. But many were not able to meet my last
criterion; they were not working or paying income tax. The
prolonged illness before they were placed on orthomolecular
treatment made it impossible for them to find employment
and our society has not yet developed (he syslem that allows
them to be retrained and re-employed. Here is an example.
In December, 2005, I received a card from a patient I
first saw 20 years ago. This was in response to my telling him
that I would no longer be able to see him as 1 was retiring.
He wrote, "Thank you for the wonderful 20 odd years of
treatment for schizophrenia and nutrition. 1 will be reading
your latest books so I will be continuing with your program.
Long life, happy memories and the best of health to you." He
was referred 20 years earlier with the diagnosis of paranoid
schizophrenia. He was so paranoid that he had lost 12
different jobs. He had been trained as a nurse and ambulance
driver. But no one could stand his paranoid Ideas and his
hostility. He was in fact black-balled and would never be able
lo get a job in the health area. The first day I saw him his

paranoid ideas and hostility were so intense he would have
frightened most people.
I started him on the orthomolecular program and in a
couple of years he was well But he was not able to find a job
and when he applied he was asked to see another psychiatrist
for a second opinion. They did not tmsl my judgment that
he was fit to work. The psychiatrist he saw totally ignored
his present state and reported that he was not employable
on the basis of his previous record. I had been seeing him
every 3 months. He had carved out a very useful life for
himself. He was a warm, pleasant and kind man who did a
lot of volunteer work driving people about, helping them with
their shopping, eic, He established a very good relationship
with his family and was in dose contact with them. But even
though he could have been working he was not allowed to.
His card reminded me of a letter I received in 1960 from
Dr, Ted Robie, a psychiatrist from Boston who had been
practicing for over forty years. In December Ted wrote that
he was impelled to write to me because for the first time in
his career his paranoid patients had become friends. In a
two-page handwritten letter he described how in the pasi he
had never had a good relationship with his paranoid patients
who remained paranoid and hostile, but after he started
giving them niacinamide the paranoia gradually vanished
and they became friends. He wrote to thank me. He was the
first United States psychiatrist to become an orthomolecular
psychiatrist and was convinced by I he results he witnessed
in his own practice. But in 1960 Big Pharma had not yet
occupied all of psychiatry.
127
Chapter Four
Modern treatment illustrated
The following letter illustrates the modern standard
treatment program In action.
"July 20, 2005
Good Day!
Last year my daughter was diagnosed with schizophrenia.
She is now 17 years old. She was 16 when she experienced
the initial "acute episode." My daughter, A, was (is) a brilliant
child. She excelled in academics, music, and athletics. She
made A's in instructor classes, when the instructor insisted he
did not give A's* She played not only I he violin, but the flute
and the piccolo, as well. We are residing in ***** She ran
cross country for her high school As grueling as the race can
be, she ran with a smile on her face, loving ever minute of it.
She was looking at a bright future. Then this horrible, horrible
ailment affected her.
Our experience with the psychiatric arena has been
totally unacceptable* They bullied my wife and me intf i
accepting treatment that was based on trial and error, with
the most powerful drugs on the market to dale, they saw
her "in passing," because they were busy with other patients,
and going on vacation. Nevertheless, they got paid bul my
daughter did not get better!
U8
The doctors told my wife and me that my daughter
would never be the same, and that she would have to take
their medication for the remainder of her life. 600 dollars a
month for the rest of her life. These drugs are guaranteed to
cause pyramidal side effects. Guaranteed!! A week after I
got A. home, she began to show signs of tardive dyskinesia.
I immediately got rid of the drugs. I took her to a nutritionist.
He recommended a strict diet and vitamins. It has been three
months. My family is taking this day-by-day.
She shows little emotion or motivation (negative
symptoms). Nevertheless, when I ask her to dean the
kitchen, or her bedroom, she does an excellent job!
Sometimes she laughs out of place, like someone is telling
her a silent joke (positive symptoms), but she insists that she
is hearing nothing in her head. She is only remembering
a past experience that caused her to laugh. She goes to a
private academy where the teachers are sympathetic to her
condition. She has 6 more credits to graduate. The problem
is that she is very, very sensitive to what my wife and I say to
her, as well as how we say it! This is an issue! Because even
though my wife and l can deal with this, someone she doesn't
know will respond differently, and that might cause her stress.
I am coming to the realization thal perhaps I might have lo
consider the drugs, because that is all that is available But,
what a loss!"
More such stories are available from the International
Schizophrenia Foundation. They were written by patients or
by members of their families.
Learning and Behavioural Problems in Children
On the basis of the two thousand children under age
14 I have treated since I960 I have concluded that over
129
90 percent will become norma! if treatment is continued
long enough. This may require several years.’ A few of my
patients did not respond but in those cases it was impossible
to gel the child's or the parents' cooperation in the treatment
program. Most parents are determined to help their children
get well, I remember Dr. Alan Colt's presentation of an
interesting case at the last meeting of the Huxiey Institute of
Biosocial Research held in the Roosevelt Hotel in New York.
Mayor Koch opened this meeting with over 500 people in
attendance. He introduced three people: a tall young man,
his girhriend, quite a bit shorter, and his mother who was the
smallest. The mother told us how sick her son had been as a
seven year-old child and that he would not take the pills that
Dr. Cott had recommended as part of the orthomolecular
program. At last in desperation she adopted a rather heavy-
handed technique. Lach time he refused to take his pills, she
sat on him until he agreed to swallow them.
Then the young man spoke. He told us that he wanted to
publicly thank his mother for having forced him to take his
vitamins and for his present state of good health. His girlfriend
stood by his side smiling. This was a very dramatic scene.
The applause was deafening, Anolher mother told me that
her son would not take Ills pills. She discussed this with his
teacher who weighed dose lo 200 pounds. Pretry soon he
was taking them without any problem. Whenever he refused
to take them the teacher wouid sit on him. When parents and
patients were cooperative the results were almost entirely
good and no one got worse. I have described many of these
cases in my publications.
1 Huffer A Healing Childrens Attention find Ri-hmdor I >inorilv^
CCNM Press, Toronto ON, 2004.
130
t find the multiple diagnostic categories developed by the
American Psychiatric Association for children totally useless
and use them only for insurance or legal forms. They do not
in the slightest degree indicate what treatment should he used.
Yet this should be the main function of diagnosis.
Any treatment not recognized by the leaders in any field
stands on its own. If the schizophrenic patient is placed upon
medication only, that is acceptable. If the patient relapses and
has to be admitted to hospital, the treatment in hospital will
be continued and the opinion of the specialist who started
it will be respected. The entire resources of the psychiatric
community will be available to help that patient. This will
include counselors, psychologists, welfare support, payment
for drugs and support to the families. But it the same patient is
started on orthomolecular treatment the pathway to recovery
is very much different.
The first problem faced by the patient and family will be
to find physicians willing to use the treatment or even to refer
them l.o someone who will. Often these referrals are made
grudgingly after an attempt has been made to dissuade the
patient from coming. This is usually accompanied by many
comments and statements that indicate that the doctor asked
to make the referral had a very low opinion of any doctor
recommending that kind of treatment. Patients I saw who
passed these hurdles told me some of the statements made
about me. They were told that l was dead, I was too old,
1 was senile, I was kicked out of the College of Physicians
and Surgeons, I charged too much, l would make them
immediately stop all their medication and force them to take
vitamins only, I was incompetent, I diagnosed everyone as
schizophrenic, I lost my hospital privileges, and that vitamins
are too dangerous. When the patients learned these were all
lies they quickly changed doctors.
131
If they passed that first firewall and started on treatment
he or she and their family were on their own. If there was
a relapse and the patient had to be admitted to hospital
the orthomolecular treatment was promptly stopped with
comments about how ridiculous it is to think that vitamins
could be of any use. In a California court a patient was
being examined by the judge in order to determine whether
she should be forced into hospital. The psychiatrist gave his
evidence that she should be and one of the points he made
was that she was delusional. She believed that vitamins
could help. This to his mind made her delusional, in hospital
patients will be forced back on medication they may not like
since informed consent does not exist in mental hospitals,
even though this is against the law in Canada. If this law
were enforced, psychiatrists who no longer had the power to
order patients to take drugs would be forced to persuade their
patients of the value of the drugs and they would necessarily
be more considerate and kinder to them. If they did that most
patients would be cooperative.
Patients are discharged just on medication, and if they
come back to the orthomolecular therapist they will have
to start all over again. Many patients are so determined lo
stay with the program that they find ways of keeping on the
vitamins while in hospital. Parents bring them in and give
them to them when they are alone. One of my patients hid
his vitamins in his open top cowboy boots and stayed on
the program while in hospital. In some cases whenever they
have a home visit they take them. But due to legal sanctions
if the psychiatrist determines that the patient, now in the
community, will refuse to lake his medication or if the doctor
knows he is also taking vitamins he may order the police to
bring that patient back into hospital. This compulsory system
reminds me of dictatorships. It is totally against the spirit of

democracy when people have no rights whatsoever. And
if and when the system no longer harasses the patient and
allows them to stay on the orthomolecular program, they
are denied services available lo patients on drugs alone.
Their vitamin costs are not covered by any drug plans
whereas drugs are. They are denied access to counseling and
psychological services. The pressure can be so great that they
will contemplate suicide, and in one case a patient caught in
this web was so fearful of the system that she did kill herself.
She was afraid to see me as the psychiatrist who had last
treated her in hospital had told her that if she did, she would
be forced back into hospital under his care again.
Doctors who might be interested are denied access to the
information, Medline, the most powerful system for making
the results of medical research available to the public, has
determined it will not cover the journal of Orthomolecular
Medicine. This is one of the most blatant examples of medical
censorship by a United States government agency. And the
governing bodies which control the professions frown upon
and suppress I he use of these treatments, as they are outside
the box and not acceptable to the psychiatric profession.
No church loves its heretics. It is amazing that patients on
orthomolecular treatment do as well as they do with all these
forces and resources working against them and their recovery.
The Idea! Orthomolecular Psychiatry
The ideal treatment solution would be to use the best
of what is available today. It would be a combination of
the Quaker model i.e. adequate shelter, good food, and
civility, with orthomolecular treatment that is accepted by
the community and by the professions* If this were in effect
today I predict that there would be an amazingly quick turn
around in the oullook of schizophrenic patients and that
133
within a short time the stigma of the disease would be gone.
The following letter illustrates the orthomolecular program In
action,
"July 20, 2005
Dear Dr Hoffer,
1- Since we came to see you the second time on July 5,
Z has been taking his vitamins regularly including the
1,000 mg niacinamide and 1,000 mg vitamin c, three
times a day.
2* 1 have been noticing improvements but over the past
two days, (in fact exactly one year since he had his
florid psychosis,) it has been like a miracle. I am getting
my old enthusiastic son back again. He is so motivated,
calling his friends for a planning meeting, discussing his
career and actually doing so much. He now feels that
the program he has been attending at university is not
for him but for people who are "sick." He wants to get
on with his life and pul his illness behind him.
3* You did tell me on July 5 that he would be better in 3
months so ! can't wait to see the further Improvements
in September. He has a nice acting job lined up to start
on September 26 and I was worried before about this
but f know now that he will be just fine* Let us wait
until next month and until the job concludes at the end
of November He will be acting on Stage at the Vogue
in October and November
Thank you, thank you again. I know the vitamins are
working and Z is also taking his Risperidone but as you said
eventually he could be weaned off this or continue on an
extremely low dose. You can be assured that by the end of
134
this year I will be spreading the message of orthomolecular
treatment tor early psychosis and schizophrenia. I look
forward to continued progress. Even if Z maintains his present
disposition, this will be a huge success story. Thanks again,"
Why Has Orthodox Drug-Only Treatment Failed?
The reasons are very clear and simple. Modem psychiatry
has failed because it has ignored the basic principles of good
medical practice such as shelter, food and civility and because
ti has become totally dependant upon the use of modem
medication.
Shelter
Modern psychiatry pays little attention to the shelter needs
of their patients. Patients who have responsible and caring
families and good homes are very lucky. The ones living on
the streets of our cities are being deprived of one of the basic
necessities of life and cannot and will not recover unless that
shelter is improved to the point that they can restore their
own inner psychological and biochemical resources. Modern
hospitals can and do provide good shelter even if one may
have to pay several thousand dollars each day in order to get
it. But the modern revolving door method ensures that even
though these shelters are available they will be used very
sparingly because the community has been persuaded that
they cannot afford to pay for them.
Food
Modern hospital food is no better and probably is worse
than the food that was provided En 1950. It is better than what
the homeless schizophrenic patient gets on the streets or on
welfare living in run down rooms or group homes hut again,
135
due to the revolving door policy, patients are not allowed to
eat well long enough for it to do them any good.
Civility
Modern psychiatry has become too much like a business
and too little like a vocation. This is certainly not true for
many very good psychiatrists who are interested in helping
their patients but have been handicapped by not being taught
how best to do so. Perhaps the McGill medical school En
Montreal may have set the process in motion to correct this
hasic shortcoming. It has announced that it will be starting to
teach their medical students how to become healers, I gather
they mean that they will teach the importance of the doctor
patient relationship, the need to understand their patients, the
need to be civil and to take seriously the ancient dictum "Do
No Harm*
I may be biased rn my view of modern psychiatry because
the majority of my patients who were schizophrenic or
bipolar, or had other conditions that had not responded to
treatment, told me as pari of the history what had happened
to them at the hands of their previous psychiatrists, and also at
the hands of other doctors to whom they had gone for help,
1 think medical schools would do well lo follow the McGill
example. Here are a few examples to illustrate what has
occurred.
In October, 2005, a middle-aged woman appeared
covered with sores and open lesions on her skin, complaining
that she had suffered from this condition for many years with
itching and depression. She had consulted nine different
dermatologists. No one was able to diagnose or help her,
and toward the end it was decided that she was causing the
harm lo herself. A clinical conference concurred with ibis.
She was advised that she must stop hurting herself and one
dermatologist spent a half hour telling her husband lhat he
must prevent her from doing so. She protested bitterly that she
was not and that the lesions were appearing even on her back
where she could not possibly reach to scratch herself. It was
obvious that they considered her a personality disorder. The
diagnosis devastated her and her husband and added to her
depression decreased her morale even more and she spent
days sitting tn the bathroom crying. Her referring doctor did
not agree with any of this and eventually referred her to me.
As soon as I saw her I recognized that she had the skin
lesions typical of pellagra. She started on the B vitamins
including niacinamide and in one month she was clear and
well. Her depression was gone and she had gone back to
work. To both the patient and her husband this was a miracle.
A few weeks later her husband appeared and complained that
over the past two years he had developed symptoms which
had been diagnosed as multiple sclerosis. He was 60 years old
which is rather late for this disease to appear. They had moved
to this area 2 years earlier. Where they had lived before he
had been exposed lo sunshine as he was active in sports. In
Victoria we lack ultraviolet for B months of the year and it is
now recognized that one of the factors in the development
of multiple sclerosis is lack of ultraviolet and vitamin D-3.
He told me he had just seen a neurologist. The doctor told
him, "You have multiple sclerosis. Good bye. You will be in
a wheel chair in three months-" I started him on a program
for multiple sclerosis which l have been using for 50 years but
added large amounts of vitamin DT! and assured him that he
would probably not wind up in that wheel chair. When I tell
this story to my close friends they are horrified. This family
was not treated with civility decency or understanding, and
were given no support by any of the specialists they had seen.
Even worse they were not helped and the ancient Injunction
DC) NO HARM was not observed.
Several years earlier a young woman and her father came
from Vancouver She had been diagnosed with schizophrenia
and had achieved fair control with Haidof. About this time
Olanzapine came on the market and her psychiatrist had
agreed to get this product and place her on it. Within 6
months she had gained 60 pounds. She had turned from
an attractive looking 19 year old girl into a fat, shapeless
mess and she was totally depressed. She pleaded with her
psychiatrist that she wanted to go back on the Haldol but
he was determined that she would not and told her bluntly
''Better fat and well than thin and psychotic/' Jn fact he was
wrong because she was now both fat and psychotic. I have
seen a profound lack of respect for the metabolic syndrome
(hat is a common feature with modern anti psych of ics, as if the
treating doctors had no concern about what these changes
were doing to their patients. Some patients gain 100 pounds,
In this they are not being treated civilly because there is no
understanding, no support and their safety is jeopardized.
Since schizophrenic patients are slightly more susceptible to
the metabolic syndrome, the drugs create biochemical havoc
with these unfortunate patients. The death rate from non
cancer causes has gone up.
i nere is no end Jo these stories. If you want lo learn ..
ask any of your relatives or friends who are schl/ophrmtli or
schizoaffective to tell you what has happened to them
Orthomolecular Treatment
Modern psych iatry rejected orth o nri< ■ I ■ m u |, h n i j I m<1 i i I
without examining the data on which il tmlhmi developed,
and it still continues to do so. This is h.istnl mm tin Amerli an
138
Psychiatric Association Task Force Report on Megavitamins
and Orthomolecular Therapy in Psychiatry published in 1973.
This report is as accurate as would be a report released by
Saddam Hussein to account for his behaviour. But it has been
accepted as a bible even though I doubt more than 1 percent
of the present membership of the APA has ever read it. Our
reply was ignored. It is available at http://www.iahf.com/
orthomoiecular/reply_to_apa_tfr_7.pdf. This is described in
Chapter 17 in my memoirs "Adventures in Psychiatry"*,
Dependence on Antipsychotic drugs
As t have stated, these powerful drugs can play a
significant role in treating schizophrenic patients, but when
they are used alone they do not allow patients to get well.
They have all the hall marks of the perfect drug from the point
of view of the drug companies. They help but do not help
enough, and they are addictive. The last decade witnessed a
surge in new drugs which it was claimed were more effective
even though they were not compared in double blind
controlled trials to drugs already in existence. They only had
to be a little better ihan placebo if the sample size used was
large enough. It was also claimed that they had fewer side
effects. After J became familiar with these compounds it was
obvious to me that they were no more effective and I hat they
had as many toxic side effects, probably more dangerous than
those of the earlier drugs such as Haldol and Chlorpromazine.
Orthomolecular psychiatrists seldom saw any tardive
dyskinesia because by using orthomolecular treatment they
needed smaller doses of drugs. The older drugs did not as
often cause the metabolic syndrome which is much more
dangerous in the long run than were the muscular side effects
2 Hotter A. Adventures in Psychiatry, The Scientific Memoirs of
Dr. Abram 11 offer. Kos Publishing. Toronto, 2U05
139
which only appeared with large doses and which were easier
to control with other medication.
Lieberman et aIs found that Perphenazine, one of the
original antipsychotics was as effective and free of side effects
as the modern antipsychotic drugs and it cost only ten percent
of the new drugs. This should be welcome news to the drug
plans that pay for these drugs.
Modem psychiatry fatted the population of schizophrenic
patients by paying no attention to the most vital treatment
factors: shelter, food, civility and orthomolecular therapy.
Increasing the number of psychiatrists, the number of
hospital beds, or the number of new drugs will not do a bit
of good. One naturopath, not trained in psychiatry but using
orthomolecular methods, will get much better results tre^iting
schizophrenic patients than one thousand psychiatrists not
using the method and depending only upon drugs. It is about
time we moved on from the mustard plaster type treatment
for pneumonia ] was given as a child to modern specific
treatment in use today.
The message in this book is very simple. The most
effective treatment for the schizophrenias must include
shelter, food, compassionate care and respect as well as
orthomolecular treatment. None of these were used in 1930
and the results of treatment were dismal. Patients were
incarcerated rn overly crowded inadequate institutions,
given minimal quality foods, minimal respect and care and
no orthomolecular treatment. None of these iactors was
considered important The main reason for incarceration was
to protect the public. Admission was a life sentence with no
3 Lieberman JA, Stroup TS. McEvoy JPct at. Effectivenes!) of
Antipsychotic Drugs iii I'atienls with Chronic Schizophrenia, New
England J Medicine 2005;353:1209-1223.
140
time off br good behaviour. Fifty years later the situation is
no fetter. The only essential difference is that incarceration in
buildings is not used. Instead we use chemical incarceration
by legally sanctioned palliative psychiatric chemotherapy.
The patients who were locked up within walls now have
their brains locked up with toxic drugs. Many years ago
when companies were looking for a laboratory measure of
anti psych os is they used the catatonic test. If a drug made
animals catatonic, it had antipsychotic properties. It is
unbelievable that there has been no progress in fifty years in
spite of billions wasted on research. Perhaps the word wasted
is the wrong term since it has benefited many, especially Gig
Pharma and the huge medical pharmacological industrial
complex. Modem antipsychotics are superb at controlling
behaviour. They have little value in restoring health when they
are used alone as is the case with modern psychiatry. Has any
other branch of medicine been as progressive (regressive) as
psychiatry?
Modern psychiatry no longer needs much skill in
diagnosing, treating or prog nosing. What is available is dozens
of powerful drugs which are used more or less at random by
trial and error. You try one and if the patient complains you
try another or you try various combinations and permutations.
With the number of drugs available today the number of
combinations that can and are being used is enormous. And
since it takes time to assess each treatment protocol one can
play this game for a lifetime, the players being the therapists
and their unfortunate patients and families.
Here are two more cases to illustrate what E ve been
saying. These patients had the first three requisites of any good
treatment program. Their families were able to provide shelter,
food and care and compassion either at home or in private
institutions, but they had not been given orthomolecular
141
treatment. As l have pointed out all of the four components
are necessary, but orthomolecular therapy is most important.
RA, born in 1975, was first admitted to hospital when
she was 15. She began to hallucinate in her late teens.
These visions were both visual and auditory and were
frightening. Since then she had some of the best available
non-orthomolecular treatment, spending almost ten years in
private mental hospitals. She returned home about six months
before E first saw her. Her chief complaint was anxiety arid a
great fear of seeing and hearing things. Her mother placed her
on a good high protein diet and she lost 35 pounds. A dietary
history showed that she was getting about half her calories
from dairy products. Her psychiatrist recorded that she was
free of psychosis. Apparently she did not tell him about her
hallucinations. She was on an enormous number of modern
antipsychotic medications. These included:
Effexor 300 mg
Seroquel 600 mg
Clozaril 600 mg
Buspar 40 mg
Clorwepan 1,5 mg
When her family asked about giving her niacin the
psychiatrist replied that 100 milligrams might be safe bul that
anymore would be dangerous!!!!! Will someone explain to me
how any physician could assume that over 1500 milligrams of
some of the most toxic modern drugs is safe while more than
100 milligrams of niacin will be toxic?
KT was born in 1979. Ten years before I first saw her she
became depressed, and could not concentrate. Early in 2001
she became delusional and had to be admitted to hospital
for five months. The next year she was treated with ECT and
medication. Since then she had been in several treatment
institutions and had been given the following medication In
142
various co mb [nations: Depakote, Haldol, Cogentin, Ability,
Geodone, Seroquel, Risperdal, Lexapro, Lametta I, and
Clozapine. I have seldom seen a young patient as sick as
she was. She heard voices constantly. At home she stayed in
bed day and night She was obsessed with food and would
only answer questions about eating something. Her lace was
contorted with grimaces and random movements from the
multiple toxic effects of l he drugs. Her mother s home had In
essence been converted into a surrogate mental hospital and
her mother was forced to provide nursing care equivalent to 4
nurses.
What did these two unfortunate patients have in common?
They were schizophrenic and treatment was started early.
They received the best of modern psychiatric care which
did not include orthomolecular treatment. They were treated
with a large number of drugs one after the other. They did
not recover and after years of treatment were damaged by
the disease and the side effects of the toxic drugs they were
given. They share these common features with the majority of
schizophrenic patients treated today. Their history represents
the type of patient I have been seeing tor decades, refugees
from standard tranquilizer treatment. I started these iwo
patients on a vitamin program and expect they will recover,
I thought I would end the book with these 2 exa lit pies
of how modern psychiatry fails patients but I have changed
my mind, I receive so many letters from former patients who
tell me how well they are doing that I thought I would share
one of these optimistic stories with you. We have too much
unhappiness in our world.
Richard consulted me in 1977 when he was 34 years old.
As a child he had been very hyperactive and very intelligent.
When he was 26 he became depressed and paranoid and his
143
behaviour became eccentric. He was committed to hospital
for about six months where he was given several series of
ECT. He had a stormy course after that and a few years
later was again admitted to hospital for about 1ft months.
He began to improve gradually after having been started on
a vitamin program but came to see me for a program that
would decrease his chance of relapse. When I saw him he
was still paranoid and suffered a few minor illusions. I started
him on nicotinamide 1 gram after each of three meals, the
same amount of ascorbic acid, a multi mineral preparation and
a B complex preparation. Two months later he was normal.
He has remained well, overcoming a severe accident for
which he needed surgery. Fortunately his family persuaded
the hospital to keep him on his orthomolecular program
while he was m hospital. Here is what his family wrote to the
hospital about him. "Richard is, as I am sure you were told by
his wife, a diagnosed schizophrenic. It began In his twenties
and he spent many years in institutions and received every
available conventional treatment including psychotherapy,
drug treatment and when the treatment did not work he
received numerous sessions of electric shock treatment.
None of that was of any assistance. We learned of some
success with mega-vitamins and we wanted for Richard to try
that approach. We and he had nothing to lose. Incredibly It
worked and Richard has since married and had a steady job
and lived a normal life He began using these vitamins about
25 years ago," This letter was very persuasive. As of August
2Q07 he is still well and adhering to the program, He is
symptom free, gets on well with his family and the community
and pays income tax. He was fortunate in that he was given
the ideal treatment: shelter, food, living with a warm and
supportive family and receiving orthomolecular therapy I lb
recovery saved the province between one and two million
dollars.
144
The following history summarizes the major change rhai
has occurred from psychiatry in 1950 and orthomolecular
psychiatry today. In June, 2007 a forty year old man came
to see me wilh his brother. He was a very busy and skillful
artisan. He told me that he had suffered from anxiety and
depression most of his life, and latterly from a delusional
disorder; he would become extremely suspicious of any
girlfriend he had, believing her to be unfaithful. This always
broke up the relationship, hive years ago he was diagnosed
with schizophrenia, but recently was given a more esoteric
diagnosis of "Othello's Syndrome" by his psychiatrist, For this
he was prescribed Risperdal 3 milligrams per day. Risperdal
makes him more anxious and he is depressed most of the
time. He denied having experienced visions or voices. He
had been in a psychiatric ward twice, the last time for five
days at the end of April. He had been abstinent from pot and
cigarettes for the past two months.
There was dear evidence that he was allergic to dairy
products. He was advised to follow the following nutrient
program;
Niacin 1 gram three times a day
Ascorbic acid 1 gram three times a day
B-complex 100 milligrams once a day
Vitamin D 4000 IU per day during the four summer
months and 6000 IU the rest of the year
Zinc citrate 50 milligrams per day
Selenium 200 micrograms per day
R-G 250 milligrams once a day
Salman oil 1 gram three times a day
Apple cider vinegar 1-2 tbsp in water with meals
Two months later he was normal "Othello" had vanished,
driven away by a few simple vitamins. Had he gone for help
in 1950 he would have been offered deep psychotherapy
145
preferably psychoanalysis weekly or more often if he could
afford it for up to ten years because it was believed that
paranoid ideas arose from unexpressed homosexuality. At
one of our conferences a presenting psychiatrist described
a similar case and then told us the patient was homosexual
When I asked what the evidence was, the doctor replied that
of course he was homosexual since Freud had shown this in a
book be had written about one paranoid psychotic judge. He
was paranoid which proved he was a latent homosexual. The
odds are that this patient would eventually have wound up in
some chronic mental hospitaf ward and later if he survived
would have been driven into the streets as is the case wilh so
many of these patients today.
This recovery shows that in this person no psychological
complexes were involved; he did not need any psychotherapy
He was given the information every doctor must give to their
patients. He did not have Othello's syndrome whatever thal is.
I! is another example of a psychiatrist attempting to develop
fancy diagnoses by describing (he expression of the illness in
more and more detail and by attaching a name to it that gives
il more cachet. The patient was another example of a pellagra
psychosis, the vitamin B-3 dependency, which can take
almost any clinical form. When modern psychiatry becomes
better informed ft will depend upon simple laboratory tests
and I he response to vitamins to make the diagnosis. No one
diagnoses syphilis by describing the clinical symptoms. It
is done by laboratory tests. In brief, in 1950 there was no
treatment. Today there is - what a difference.
 Made in the USA
313&7564RG0084
Sari Bernardino. CA
□S March 3016
Advances in modem medicine - with the exception of psychiatry - are fantastic.
Who would accept I he surgical techniques of 1950, today? Which hospital would
allow a surgeon fully trained in 1950 to even enter a modem surgical suite? In
psychiatry, modem treatment does no belter than it did in 1950. Psychiatry has the
worst record of any medical specialty. This assessment is based on my observations
from 1950 when I began in work in the mental hospitals in Saskatchewan. At
that time patients were locked up in awful buildings placed far from centers of
population. The treatment used by the Quakers In 1840, which yielded fifty percent
discharge recoveries, was forgotten. Admission to mental hospital in 1950 was a litr
sentence, with no time off for good behaviour.

The situation is different today. Pa bents are no longer locked up, but their
brains are imprisoned by powerful, toxic chemicals from which they can not and
are not allowed to escape. Orthomolecular treatment, which developed before
these toxic drugs were found, has been ignored Modem psychiatry uses only drug1
and ignores the three most important elements of treatment, i.e. shelter, food, and
treatment with civility and respect. The evidence is provided an this book. The
optimum treatment in 1350 when drugs were not available yielded fifty percent
recovery; today it is less than ten percent if the criteria are Freedom from symptoms
ability to get along well with family and the community, and paying income tax.

Abram Hoffer PhD MD RNCP is Internationa Ely recognized as the founding father
of orthomolecular psychiatry and medicine, and was a practising psychiatrist until
his retirement at the end of 2005.
For over fifty years his discoveries have been instrumental in establishing link-,
between malnutrition and mental illness, in diagnosing and treating schizophrenia,
in using niacin to lower cholesterol, and in the use of nutritional therapy in the
treatmenl of disease. He is President Emeritus of the International Schizophrenia
Foundation, and h Editor-in-Chlef of the Journal of Orthomolecular Medicine.
He is the author of more than 500 medical articles and fifteen clinical nutrition
books, including Healing Schizophrenia, Healing Children's Attention and Behavior
Disorders, Healing Cancer, co-authored by Linus Pauling, and Feel Better, Live
Longer With Vitamin B-3, co-authored by Harold Foster.
September 2007 he received the Community Addiction Recovery
Association's first Abram Hoffer Lifetime Achievement Award. November 2007
he was honored by the Lotte & John I techt Memorial Foundation, receiving the
inaugural Dr. Rogers Prize for Excellence in Complementary and Alternative
Medicine for his work using nutrition and vitamins to treat disease, shared with Dr.
Alastair Cunningham, a Toronto cancer researcher, December 2007 the Nutrition
Business Journal announced he had won their Scientific Achievement Award,
Today, as president of the Orthomolecular Vitamin Information Centre
in Victoria, Canada, he is a private consultant in nutrition, continues to write
extensively, and to educate the public of the vital importance oF nutrition and
nutrients in the treatment of disease and the maintenance of health.

ISBN 142515563-^
mi mu mi Ill I 111 IIIII lilll