The Tomato Effect, Part 1

Docotr spoke to the 7th International Symposium on Functional Medicine about the ‘Tomato Effect,’ the tendency for academic medicine to reject certain effective therapies because they do not fit into the current theories in place.

Dr. Goodwin is chief of Geriatrics at the University of Texas at Galveston. In 1984, he and his wife Jean Goodwin published the landmark paper “The Tomato Effect,” in the Journal of the American Medical Association 1984; 251:2387-2390.

Dr. Goodwin introduces the subject by describing how, when the tomato was discovered in the New World, it was brought back to Europe, and it was grown as an ornamental plant, the “love apple.” For several hundred years, the Italians ate tomatoes, but in Northern Europe and in North America they were not eaten at all, because “everyone knew” that it was poison. Finally, in 1820, after Edward Gibbon ate a tomato in the courthouse steps in Salem, N.J., and he did not die, people started to eat tomatoes.

Dr. Goodwin draws a parallel with medical treatments and the tomato. He tells the history of the use of colchicine and aspirin, and describes the attitude of modern medicine toward vitamin supplements.

Colchicine is an extract from the Autumn Crocus plant, colchicum, which has been commonly used for gout. It was used consistently by the upper classes and nobility (who got gout more often than the peasants due to consumption of meat and alcohol and from water pipes) from the 7th century until the 13th century. It was very effective for this very painful condition, and it was also known to be toxic in large doses. It was also used then as a purgative, according to Galenic and Hippocratic theories, since it gave diarrhea in large doses. Islamic physicians also used it for gout.

Why then did colchicine drop out of use in the 13th century? Renaissance medicine went back to the classic theories just like the arts at that time. Medicine then held that disease was caused by an imbalance of humors, not too different from Chinese Traditional Medicine, and treatments focused on ways to balance the humors. It did not include extracts from plants and potions, which were considered witchcraft. Those were the times when thousands of people were being burned alive for supposedly being witches. Herbs were not a part of academic medicine. Gout was treated by bleeding and by raising blisters.

Colchicine was rediscovered by Baron Von Stork in 1763, and was included in his patent medicine L’eau du Sang, among other ingredients. The King of England and the King of France used it regularly, but the medical community did not accept it, and the Parisian physicians banned the Baron from Paris. In 1830, the famous French writer Trousseau stated that colchicine was bad and that it did not work. Colchicine came into general use not by way of the medical community.

Aspirin and salicylates had a similar history in their use in rheumatoid arthritis. In the 1870′s and 1880′s, controlled trials reported in major medical journals such as JAMA and the Lancet showed the effectiveness of high dose salicylates in treating rheumatoid arthritis. At first they were derived from Willow bark, but later synthesized salicylates in 1870, and aspirin in 1880.

How then were the salicylates totally rejected by academic medicine in the early 20th century? The germ theory was coming into vogue, and rheumatiod arthritis was then considered to be an infectious disease. They were totally rejected by Sir William Osler’s textbook of medicine in 1910, and by 1930, there was no mention of salicylates in the medical textbooks in regard to rheumatoid arthritis.

Cecil, in writing his first textbook of medicine in 1929, asked the opinion of 16 arthritis experts, and none of them mentioned any drug, let alone aspirin, in the treatment of arthritis.

It was 1957 before the salicylates began to be used by standard medicine for this condition. For several decades before, it was not accepted because it did not fit the theory of the disease.

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