During 1996, at the age of nineteen, Jordan Rubin of Palm Beach Gardens, Florida had arrived at death's door, suffering from the most severe symptoms of Crohn's disease. This condition is a chronic, inflammatory, abnormality of the bowel showing overlapping clinical,epidemiologic, and pathologic findings. But medical science has determined no definite cause for the condition.
It produces numerous, serious discomforts by exhibiting four common and characteristic disease patterns: (a) inflammation with pain and tenderness in the right lower part of theabdomen; (b) recurring acute intestinal obstructions that bring on deeply painful spasms of the intestinal wall, swelling of the abdomen, persistent diarrhea, and vomiting; (c) inflammation and chronic partial intestinal obstruction causing subtle but serious malnutrition and chronicdebility; (d) abnormal channels (fistulas) with many pus-filled pockets of infection (abscesses) that produce fever, painful masses in the abdomen, and severe weight loss. Jordan Rubin showed all four of these disease patterns.
For more than two years the young man experienced between twelve and 30 usually bloody bowel movements per day. They came on all night too, allowing him to sleep no more than one hour at any given time.
Laboratory tests showed that Jordan had no iron in his blood, and his serum measurement for albumin indicated muscle wasting (cachexia). By laboratory standards, this patient's blood was like that of a dead man. His body was affected by candidiasis, amoebiasis, cryptosporidiosis, extremeintestinal dysbiosis, acute electrolyte imbalance, elevated C-reactive protein, anemia, chronic fatigue, arthritis, diabetes, hair loss, and leukocytosis. The chance for recovery by conventional treatment methods remained discouraging, because Jordan also exhibited malabsorption syndrome for food nutrients. He could not assimilate the nutrients in food even if he had any appetite, which had been lacking for him for over a year. Jordan had dropped so much weight, from 180 to 104 pounds, he looked like a survivor of a Nazi death camp.
Jordan Rubin's quality of life was nonexistent. To find some viable therapy, he consulted over 70 health practitioners worldwide and tried more than 200 different nutritional products, including several probiotic preparations. As he explained to me, "During the two years of myillness, despite my ongoing search for treatment, I was never granted even one day of reprieve from the symptoms of Crohn's disease. The excessive amounts of emotional, physical, and mental distress caused me to want to die. All I could do was pray to a compassionate God that the cure forCrohn's disease would someday be found.
"And then," he added with a smile, "it happened!"
The Cure for Crohns Disease Comes to Jordan Rubin Most people are unaware of the groundbreaking findings of Nobel laureate Elie Metchnikoff, PhD, the Russian bacteriologist who more than 91 years ago documented a direct link between human longevity and the necessity of maintaining a healthy balance between those beneficial andpathological microorganisms residing within the human gut. Dr. Metchnikoff's 1908 Nobel prize in physiology had been awarded for his discovery of phagocytes and other immune system components, but his accurate description of vital elements in the body's intestinal flora is equallyimportant.2
Dr. Metchnikoff came to believe that human beings could live to the age of 150 years if they kept the organisms within their intestines in a state of homeostatic balance. This, he said, could be accomplished by consuming live, fermented foods. Such a concept expressed way back in 1909 bythis great scientist forms the foundation for the cure of Crohn's disease that came to Jordan Rubin.
Jordan was able to regain his health by supplementing the small amount that he could eat with homeostatic soil organisms(HSOs™) which reversed the degenerative process of his Crohn's disease. The HSOs™ detoxified Jordan's intestinal tract, increased his ability toabsorb nutrients from food, and boosted his immune system, especially in its ability to phagocytize viruses and bacteria. Moreover, the HSOs™ turned really aggressive against pathological molds, yeasts, fungi, and parasites of all types which permeated his gut. They stimulatethe formation of lactoferrin (the iron-binding protein found in neutrophils which exerts antimicrobial activity by withholding iron from any harmful microorganisms that the patient ingests).
Homeostatic soil organisms are super probiotics (the opposite of antibiotics). They restore balance to an autointoxicated gastrointestinal tract in a specific manner.Upon being swallowed, the HSOs™ activate and bring about gut restoration by attaching themselves to theintestinal mucosa. On the gut wall they reproduce to form colonies along the course of "receptor sites" which had previously been established by harmful bacteria and other pathological microorganisms. These pathogens are crowded out or eaten up by the probiotics so that symptomsof illness they had been producing tend to terminate eventually. The time factor for symptomatic healing is dependent upon the volume of pathogens lodged at the gut's receptor sites. No matter what the number of bad bacteria or other pathogens, HSOs™ implant themselves andbring about gut restoration.
Medical journalist Ann Louise Gittleman, MS, like myself a proponent of supplementing with HSOs™, affirms that once colonized in the GI tract, these super probiotics eventually balance the colonic pH to set the stage for restoring all body systems. She assures us that thesurvival of some of the gut's most important resident microorganisms such as Lactobacillus acidophilus depends on the visiting HSO™ byproduct and the HSO-produced acidic colonic pH.3
Ingesting HSOs™ allows people to achieve optimum health by supplying them with the nutrients they would ordinarily be receiving had they eaten food derived from nutrient-dense soil. HSOs™ are beneficial bacteria which live in pure, nutrient-rich soil and are responsible forproviding plants (vegetables and fruits) with those nutrients they require. The HSOs™ are absorbed by plants and become their protectors against harmful invaders. In that way the HSOs™ keep plants healthy and loaded with nutritional components as a source of foodfor humans. The same thing occurs for humans when we ingest the friendly organisms as nutritional supplements. These friendly organisms keep the human GI tract in a state of homeostasis by increasing intestinal absorption and keeping it free of parasites, yeasts, molds, other fungi,harmful bacteria, viruses, and additional pathogens such as spirochetes, rickettsiae, chlamydiae, protozoa, and helminths.
In large measure, the probiotic content of each person's gastrointestinal tract is an integral part of his or her immune system. While not generally known by the average individual, probiotics are absolutely essential for effective functioning of the gastrointestinal system. Theysynthesize the B-complex vitamins, crowd out yeast and parasites, help regulate blood cholesterol levels, and produce antibiotic compounds.
The Original Reason for Jordan's Two Years of Misery How Jordan Rubin's gastrointestinal tract came to be so out of balance to bring on his affliction is no puzzle. As occurs with so many young people who leave home and head out on their own, Jordan's two years of misery were probably brought on inadvertently by a bad diet and stress.
"Crohn's disease began for me during my first year away at college. I did not take care of myself. While I had grown up under the supervision of my dad, Herb Rubin, DC, an advocate of holistic health who never allowed processed food or refined sugar in our home, on my own his foodrules were forgotten. I stayed up late to pursue my studies or to carouse with the guys. Sleeping was a waste of time. But then I came under much scholastic stress - constantly on the run - and for the first time ate lots of junk food," Jordan admits. "My body wasn't able tocope, and it broke down."
During that first college year, this student followed the lifestyle patterns of most people in the United States which cause them to develop a disproportionately high ratio of bad to good bacteria in the gut. While the normal ratio of friendly microorganisms to harmful ones usually runs at85 to 15%. Jordan's wrong proportions probably ran in the opposite direction. In fact, stool analysis does show that the average resident of North America possesses a pathogenic gut content of about 55%, so that he or she remains in a subclinical state of disease. Symptoms may not show up,but illness lies waiting to manifest itself just under the surface. Eventually, abdominal dysfunction flares up in response to any stress that tips the balance further into the pathologic realm. Check your local pharmacy and count the vast number of commercial products used for digestiveproblems.
The good and bad microorganisms fighting it out in a person's gut get out of balance because of a series of unhealthy lifestyle practices. To name just a few: (a) too much alcohol; (b) eating foods impregnated with pesticides, herbicides, antibiotic residues, and hormonal pollutants; (c)the overconsumption of sugars and other refined carbohydrates; (d) the distress of too much stress; and (e) the lack of nutrition from living fresh foods grown in nutrient-rich soil. Such conditions are the precursors for assorted GI tract dysfunctions such as malabsorption syndrome,celiac disease, lactose intolerance, polyps, intestinal obstruction, colon cancer, diarrhea, constipation, inflammatory bowel diseases, diverticular diseases, irritable bowel syndrome, appendicitis, ischemic bowel disease, fistulas, fissures, hemorrhoids, peritonitis, hernia, smallintestine dysbiosis, leaky gut syndrome, and more.4
Development of a New and Potent Probiotic Product When I first interviewed Jordan Rubin over the telephone during the spring of 1997, he had gone through two full years of misery attempting to control Crohn's disease. He succeeded! The young man had cured himself by supplementing daily with HSOs™. From ages nineteen to 21, hisappearance changed in a highly remarkable manner.
My medical journalist article resulting from our interviews was published in the August/September 1997 issue of the Townsend Letter for Doctors & Patients. It was illustrated with Jordan's before-and-after photographs which became an inspiration for readers from allover the world.5 People suffering with bowel disease contacted him by the thousands. The readers communicated by sending over two thousand requests to buy HSOs™. All of them wanted to know where and how to acquire this truly effective probiotic food supplement.
One such inquiry came from a chiropractor who had been stricken with intestinal polyps, renal carcinoma and degenerative arthritis affecting his back, left shoulder, and neck. He was additionally burdened by avascular necrosis of the left jaw and left shoulder. Moreover, the unfortunateman also had three damaged vertebrae which had been injured from violent spasms arising out his abdominal cramping from end-stage Crohn's disease. The patient's Crohn's disease left him with nerve damage in the left leg and right hand plus a crushed lumbar spine. He lost 51 pounds and waswritten off by numerous attending physicians who agreed that he could not possibly live past another year. The former chiropractor (who no longer practices as a DC) is Scott G. Robinson, PhD, LRC, DC, of Vista, California (a suburb of San Diego). Currently Dr. Robinson's occupation is as ahome-care trainer for the chronic and terminally ill under the auspices of the Eastern Orthodox Church in Duluth, Minnesota.
Dr. Robinson had refused chemotherapy for kidney cancer at the University of Southern California Medical Center and used natural and nontoxic therapies instead. He went through the two Gerson Institute clinics in Tijuana, Mexico and Sedona, Arizona and became not only a patient at the Tijuana Gerson hospital but also accepted a position as a therapist. Thereafter, Dr. Robinson gave up his professional license under California law in order to work with cancer patients.
"While still working at the Gerson Institute facility in 1997, I read an article in the Townsend Letter for Doctors & Patients which you wrote, Dr. Walker. I still reproduce it for patients to read when they suffer from gastrointestinal tract problems," says Dr. Robinson."Learning about homeostatic soil organisms back then led me to search out these very special probiotics. Within about three days of taking them, all the pain I had been experiencing from Crohn's disease spasms just vanished, and they've not returned. The Gerson therapy had helped meto get rid of my cancer tumors, polyps, cysts, and parasites, but it's the HSOs™ that completely control my gut pain.
"When I counsel cancer patients now, especially if they have undergone radiation or chemotherapy, I advise them to ingest the HSOs™. These patients must replace the friendly gut bacteria which have been destroyed by conventional cancer treatment. As for me, now I am allbetter," affirms Dr. Scott Robinson. "I am happy with my health as maintained by the HSOs™."
Picking up the story about introducing his HSO™ product, Jordan Rubin continues: "All those queries from that first Townsend Letter article forced me into manufacturing the product that got me well. I worked directly with the original developer of HSOs™ andincorporated some of my own concepts for making people healthier; they have proven highly advantageous. Included in the formulation are 15 homeostatic soil organisms with product improvements being made all the time.
"Currently," he advises, "the probiotics comprising part of my formula are Lactobacillus acidophilus, Lactobacillus bulgaricus, Lactobacillus delbreukii, Lactobacillus caseii, Lactobacillus caucasicus, Lactobacillus fermenti, Lactobacillus plantarum, Lactobacillus brevis,Lactobacillus helveticus, Lactobacillus leichmannii, Lactobacillus lactis, Bacillus licheniformus, Bacillus subtilis, Bifidobacteria bifidus, and Sacchromyces boulardi."
So, in some way Crohn's disease did Jordan Rubin a favor, for it offered him the opportunity to share his gift with others. The young fellow's interest in his own health maintenance caused him to study nutrition, eventually becoming a certified member of the National Association ofNutritional Consultants (a CNC), a participant in the American Academy of Sports Medicine, a certified nutritional instructor, and the author of numerous magazine articles.
When recently I met Jordan in Boca Raton, Florida, five years after the termination of his illness, he had improved his appearance still further. Now, at age 25, he is completely free of Crohn's disease or any other illness.
Based on experiences that had brought him to perfect health, he has been researching, manufacturing, and distributing a variety of new food supplements to health product wholesalers, health professionals, natural food stores, and medical consumers seeking to overcome a variety ofillnesses. His newest product is the first and only protein powder made from goat's milk. The HSOs™ product that brought him a cure for his gastrointestinal dysfunction remains the cornerstone of his health program. He has given his thoroughly researched, ever-improving andevolving new and potent probiotic, the name Primal Defense.
Prominent Physicians Use Primal Defense™ During my investigations of this product, I interviewed 31 complementary and alternative medicine (CAM) professionals who use Primal Defense in their practices. Those interviewed included medical doctors, chiropractors, naturopaths, osteopaths, acupuncturists, nutritionalcounselors, colon hydrotherapists, and other CAM practitioners. Case reports and other positive statements from the osteopathic physicians and medical doctors were uniformly positive. Repeatedly, these doctors testified as to the product's therapeutic excellence.
James Privatera, MD, of Covina, California, a medical doctor for 30 years, says, "I use quite a bit of Primal Defense™ for tough cases of bowel toxemia and irritable bowel syndrome. My patients like it, and I attest to Primal Defense™ being a superior productfor enhancing gut metabolism."
From Payson, Arizona, the highly respected physician, Garry F. Gordon, MD, affirms, "There is magic in Jordan Rubin's idea about the actions of his Primal Defense™. I employ this product personally to great advantage; for instance, it definitely changed my propensity tointestinal gas. I've tried all types of products from around the world but nothing else has helped me to overcome bloating and gas like this combination of HSOs™."
Osteopath Joseph Mercola, DO, of Schaumburg, Illinois states, "I have put literally thousands of people on Primal Defense™ which is incorporated into a full detoxification program. The product is an incredibly potent and effective agent for the treatment of inflammatorybowel disease (IBD), and most especially for this condition's subset, Crohn's disease. I recommend it to all of my IBD patients."
Dr. Mercola's associate, board-certified gastroenterologist Joseph Brasco, MD, also of Schaumburg, Illinois, says: "I believe Primal Defense™ is applicable as a food supplement for everyone, whether a person is sick or not.... Where people specifically find advantage inusing Primal Defense™ is in situations involving chronic disease of gut origin. Since my expertise lies in the area of gastrointestinal disorders, this product is the primary therapy that I utilize on a routine basis. It is one of the main tools I employ for treatment ofpatients suffering from inflammatory bowel disease."
The Primal Defense™ Delivery System and Its Components
Primal Defense™ is designed to supply the consumer with all of the living nutrients present in pristine and healthy soil. There are three components:
(1) The beneficial bacteria from both soil and plant life which include HSOs™ combined with very hardy plant-based probiotic organisms. They are designed to resist chlorine, fluorine, ascorbic acid, hydrochloric acid, heat, cold, and extremes of pH. These beneficial bacteriaare extraordinary and can't be destroyed the way ordinary probiotics are. Upon reading the label of Primal Defense™, you may notice that there are no bacterial counts or Colony Forming Units (CFU) listed. That is because the probiotics contained in Primal Defense™are integrated within the whole food substrate. These microbes are so hardy that no need exists to include billions of CFU in order to get the job done. In this case, it's not quantity; it's quality.
(2) These HSOs™ are delivered in a base of whole food concentrates, particularly green foods such as phytoplanktons and cereal grasses, which turn out to be an excellent medium for the probiotics. Thus, the probiotics in Primal Defense™ are not isolated but ratherthey grow within the whole food as not only the medium for growth, but also a rich source of nutrients such as minerals, vitamins, amino acids, and chlorophyll. These green plants are predigested in this manner so that they are 100% absorbable by the human body. Moreover, live enzymes arecreated as part of the product's delivery system.
(3) Present are quantities of PhytoSterols and Sterolins, which are plant lipids that aid the immune system to function at its peak level. These PhytoSterols/Sterolins are indispensable to attaining optimal health, but seldom do people ingest sufficient amounts of such plant lipids. PrimalDefense™ furnishes the required optimal quantities of them.
Instead of using three separate sets of nutritional components, this probiotic product delivers all of them together as one live food matrix.
Leitia Devine, OMD, LAc Enjoys Using Primal Defense™ "My clinical results with the use of Primal Defense™ for the relief of patients with intestinal diarrhea, constipation, or bloating have been excellent. I really enjoy employing that product because it works so well," says Leitia Devine, OMD, LAc, a doctor of OrientalMedicine and licensed acupuncturist practicing in Newhall, California. "Right now I'm finding it beneficial in the treatment of a chronic intestinal flu strain in the population of my area. Very little of what's out there, including herbs, are touching the current strain of influenza,but Primal Defense™ has become my product of choice for its treatment.
"Let me qualify my praise for the product, however; it's not knocking out this rare strain of flu all by itself, for adjunctive remedies are needed too. But those unique HSOs™ and other food stuffs in the PrimalDefense™ formula do stop any recurrence of my patients' infections.
"As for therapy against Helicobacter pylori infection - as a cause of gastric ulcer, nothing works better for its eradication than Primal Defense™. And these probiotics are so muchsafer for my patients than taking antibiotics," says Dr. Devine. "The product's friendly bacteria immediately coat the stomach's lining and stops patients' heartburn, stomach pain, nausea, and bloating. Plus, PrimalDefense™ is absolutely a God send for the elimination of Candida albicans infections. There is nothing I know of that could replace the HSOs™ for destroying those two particular organisms, one a bacterium and the other a fungus.
"To be perfectly frank, I own an herbal company which manufactures my own set of remedies," Dr. Devine admits. "But I've been unable to formulate a competitive product which relieves my patients' intestinal gas, bloating, belly aches, and other symptoms of gastritis as well as does Primal Defense™."
Dr. Irv Rosenberg Counsels on Taking Primal Defense™ "I have personally been taking Primal Defense™ for over two years, and I am sure that is the reason I have perfect functioning of my gastrointestinal tract. It is quite evident to me that havingregular, comfortable bowel movements comes directly from daily ingestion of HSOs™," says Doctor of Pharmacy Irving Rosenberg, proprietor of The Apothecary, a compounding pharmacy located in Bethesda, Maryland.
"Each week I counsel up to 20 cancer patients about appropriate nutritional practices for restoring their health, and the ingestion of Primal Defense™ invariably is among my firstrecommendations," Dr. Rosenberg states, "It is my intention that these cancer patients should maintain or improve their quality of life, and this product helps them accomplish it for themselves.
"The product works well for people suffering from the yeast syndrome, too. Their improvements are subtle but steady. They get better. Since 1981, I have been counseling clients who are beset by candidiasis, and I was called a quack and heretic by the media, but that's not the case anylonger. Now I'm referred to as a visionary quite simply because products like Primal Defense™ have come on the market and my pharmacy makes them available. One of the wonderful parts about getting older isthat we live the history of this evolving holistic health field," says Dr. Rosenberg, who recently reached his 70th birthday.
"More than eight million dollars of my compounding pharmacy's sales involves nutritional products. Jordan Rubin's Primal Defense™ has been reaching for the top of the market. It's among mynutraceutical best sellers, and it has achieved that status in a very short time," the pharmacist added.
"In my opinion, these homeostatic soil organisms should be taken routinely by all persons interested in preventive medical practices. For example, if you are about to travel to a third-world country, Primal Defense™should be started as a food supplement about a week before your journey as a prevention against getting 'Montezuma¹s revenge.'
It does a fine job as a repellant for parasites such as Entamoeba histolytica, Giardia lamblia, and the amoebic protozoa which causes dysentary," Dr. Irv Rosenberg states. "For such prevention, take one or two doses twice daily. Although containing probiotics,these pills don't need refrigeration since they become activated upon coming in contact with acidic liquid in the stomach."
More Parasite Defense offered by Sheldon Nelson, DO Speaking with me from Warren, Michigan, Sheldon Nelson, DO, does a lot of soft tissue manipulation for his patients, but nutrition prescribing comprises most of his treatment, especially for chronic illnesses. "Almost all people who consult me for the treatment of irritable bowelsyndrome, leaky gut syndrome, chronic fatigue, candidiasis, Lyme disease, or infections get their gut flora changed to healthier consistencies by my prescribing Primal Defense™ for them," advises Dr.Nelson. "I invariably use one of the lactobacillus preparations, and the HSOs™ of Primal Defense™ are the top of the line, the ŒCadillac' of lactobacilli. It does more than justrecolonize when I prescribe it for my patient.
"As the patient's body undergoes its detoxification, a kind of Herxheimer's reaction often sets in along with increases in bowel function. I have this patient drink large amounts of water, at least the number of ounces equivalent to half his or her body weight in pounds. Take thepoundage, divide by two, and realize that those are the ounce equivalents of water that should be drunk. A 200-pound man would therefore need to drink 100 ounces of water, about three quarts daily," says Dr. Nelson. "Taking so much water combined with PrimalDefense™ in quantity will lead them to good solid bowel movements and a normal gut.
"The HSOs™ are particularly effective for the treatment of parasites, since they work to enhance that whole cleansing function. One family had come to me en mass six members for the elimination of their hookworm," Dr. Nelson says. All of them took PrimalDefense™ in amounts ranging from six a day for the teenagers to 20 daily for the father. They finally got rid of their parasites.
"In another situation, Harriet Clauson visited me for the treatment of her chronic fatigue, systemic candidiasis, obesity, and the stress of raising eight young children. Having no energy and experiencing overwhelming depression, she was at the point of collapse. Mrs. Clauson realizedthat she was eating junk foods which kept her malnourished despite being grossly overweight," states Dr. Nelson. "She was on antidepressants, prescription drugs to calm her gut, and antibiotics as therapy for recurrent bacterial infections of the sinuses and the ears and theskin. My treatment program included Primal Defense™ in a dosage that advanced in quantity each day, until she reached twenty-two daily. She stayed at that dosage for a month until she could back off thelevel of therapy to only two a day.
"Harriet Clauson's improvement steadily took hold so that she no longer needed antidepressants or other prescription drugs. She is eating correctly and liking the good food which allows her to lose excessive weight in a healthy manner. To this point, Mrs. Clauson has lost 40 poundsand regained her energy." Dr. Nelson assures us. "Parasites which were once thriving in her gut have left her body in well-formed stools. There is no longer diarrhea or constipation for this patient, and it is due to the excellence of therapy that comes from taking HSOs™faithfully," affirms Dr. Sheldon Nelson. "I see the same results in a lot of people." Natasha Campbell-McBride, MD, Uses Primal Defense™ for Her Son's Autism Two years ago, through her contacts with the Autistic Society of Great Britain, registered nutritional counselor, Natasha Campbell-McBride, MD, medical director of the Be Healthy Nutritional Consultants Clinic of East Anglia, a suburb of Cambridge, England, learned of Primal Defense™.Parents attending this autism support group revealed that HSOs™ had become an important part of their children's diet. Dr. Campbell-McBride's seven-year-old son Normie, had been affected by autism from the age of three, and his condition was complicated by recurrent diarrhea.So, from another mother at the autism society, this physician acquired capsules of the HSO™ probiotic organisms specifically to relieve her son's loose bowels, which they did do. Simultaneously, she observed that the HSOs™ also slowly but steadily rid Normie of hisautistic symptoms shown by his improvement in social interaction, the development of peer relationships, elimination of his use of repetitive language, and the stopping of repeat motor mannerisms.
A mother as well as a physician, Dr. Campbell-McBride is enthusiastic for Primal Defense™ as an autism treatment. "Children with autism do not have normal gut functioning," the physician explains. "Often they are infected with Candida albicans and clostridium,and the metabolites of these cultures cause havoc with the gastrointestinal tracts of these autistic children.
"Such infected children fail to develop normally. But if the parents put their little patients on a dairy-free diet and supplement their food with Primal Defense™, much improvement in their communication skills occurs," Dr. Natasha Campbell-McBride assures us."By use of these probiotics, parents of autistic children will see a change for the better. Many symptoms of their autism disappear and do not return. This happened for my son."
1. The Merck Manual of Medical Information, Home Edition. (Whitehouse Station,N.J.: Merck & Co., Inc., 1997), p. 528.
2. Encyclopedia Americana, International Edition. (New York City: Americana Corporation, 1966), Volume 18, p. 712.
3. Gittleman, A.L. Beyond Probiotics. (Los Angeles, California: Keats Publishing division of NTC/Contemporary Publishing Group, 1998), p. 20.
4. Balch, J.F. and Walker, M. Heartburn and What to Do About It. (Garden City Park, New York: Avery Publishing Group, 1998), pp. 31-44.
5. Walker, M. "Soil-based organisms support immune system functions from the ground up." Townsend Letter for Doctors & Patients 169/170:85-92, Aug./Sept. 1997.