The McDougall Newsletter
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From July/Aug '98

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Interview: HENRY HEIMLICH, M.D.

The Man Who Has Saved More Lives Than Anyone

McDougall: You and I have known each other for a long time. Several years ago you came to my clinic at St. Helena Hospital for your health. You're one of two people I’ve met that are so interesting I can hardly wait until the next word comes out of their mouth (The other person was Nathan Pritikin). What do you think it was in your life that made you such a challenging person, willing to stand up to so many people?

Heimlich: I think it was probably my father. Dad was a social worker in the prison system in New York state. A lot of his work is now law. He conceived of what really became the parole system. And also, one of his principles was that he'd keep families together. A prisoner who was in Attica and whose family was in New York, he'd see if he could get them transferred. And he'd try to get them jobs when they got out. Well, anyone who had these concepts ran into many, many conflicts. He was highly respected and deeply loved by everybody. But he always fought for what he thought was right. And I think that rubbed off on me as the natural way to live. If you're right, fight for it.

McDougall: The reason you're known as man who has saved more lives than anyone else is because of the Heimlich Maneuver. How did that come about?

Heimlich: I happened to be reading a New York Times magazine on accidental deaths in about 1972. It said that choking to death--on food or whatever--is the sixth leading cause of accidental death. You’d read about it occasionally when a famous person like Ethel Kennedy's sister or Tommy Dorsey choked to death. I was known as the leading esophagus surgeon in the world, so I just realized that I ought to be able to do something about these deaths.

The first thing was to look at everything that had been done--all the literature. I found that every single scientific paper going back 30 years said, "never hit someone on the back, if they're choking, because you'll drive the object tighter into their airway and cause their death." Then I saw that the Red Cross had been teaching for about 35 years to slap someone on the back if they were choking. I realized that if what they were doing was driving the object tighter into the throat, you had to have a method that would always take the choking object and move it from the throat and the airway out.

Being a chest surgeon, I conceived of the possibility then of compressing the lungs and causing a flow of air out to do this. I did some studies where I tried it in different ways. It just didn’t work by pressing on the chest. So I did it under the diaphragm. Pushing the diaphragm up diminishes the volume of the whole chest cage, and so you get a uniform pressure on the lungs. My residents and I made measurements by putting a mouthpiece in our mouths connected to a tube and then to a recording respirometer. I measured the rate of pressure developed, and it was remarkable. You got an average flow rate of 205 meters per minute, which I knew would be enough to drive the object out.

I published our results in a medical journal, but I said I didn't know if this would work. Of course, you couldn't experiment with it on people. I said the alternative is to slit the throat--do a tracheotomy. This was picked up by a newspaper writer, and the story went out nationally. Within a week, we had saved the first life. As each life was saved the newspaper would run a big front-page story.

McDougall: Of course it was accepted by the medical establishment immediately, wasn’t it?

Heimlich: The Red Cross fought it for 14 years before they admitted that their back slaps were wrong. After a couple of years, they were forced to do it, to accept it, because it had gotten all around the world. But they covered themselves up by recommending giving four back slaps; then they said, "do the Heimlich Maneuver, after you loosen it up with a back slap. I fought them on it. This was a terrible fight, because I knew it would kill somebody--and I thought the Maneuver would be blamed.

What finally happened was a terrible thing to a school child. The teacher followed the Red Cross’s recommendations and hit the child’s back. Initially, the child was just partially breathing, then the teacher hit the back four times and the object went tighter into the windpipe, and the child fell unconscious. Finally, a nurse came in and did the Heimlich Maneuver and the object flew out. But the child was brain damaged and lived for years in a coma before he died. This story was in The Washington Post.

The family had sued the school, unfortunately not The Red Cross, and the school had to settle for the largest amount that had ever been granted. This was in the city of Harrisburg, Pennsylvania. The Red Cross was called to task and it finally changed. It adopted the Heimlich Maneuver first, maintaining, however, there was still nothing wrong with back slaps.

McDougall: Are there any other uses for the Heimlich Maneuver?

Heimlich: Yes, the Heimlich Maneuver is now widely used to save drowning victims. The largest lifeguard service in the country--the one that services 950 waterparks--Disney World, Disneyland, and Six Flags--uses the Heimlich Maneuver as the first thing to do to save the life of drowning victims. They have 53 million admission a year in their parks, and they haven't had a death from drowning since they've been using the Heimlich Maneuver as the first step. What the Heimlich Maneuver has been proven to do is get the water out of the lungs. You don't need anything else because you're pushing up on the diaphragm, which stimulates breathing.

The Red Cross, again, had done the wrong thing. This time for 40 years. Since 1960, they've said do CPR for drowning victims with mouth-to-mouth--you've got to get the air in. What they forgot is that the lungs are filled with water when you drown, and therefore, you can't blow air in. You're wasting time. As a matter of fact, in one 10-year study that was done at public pools in Seattle, they found that in their public pools with a lifeguard present 42%, almost half, of the children who were pulled out of the water died with the Red Cross method. When the Heimlich Maneuver came out for drowning, they did the same thing. They said give mouth-to-mouth first, then do the Heimlich Maneuver.

What was even worse is that the Red Cross adopted the Heimlich Maneuver again after four mouth-to-mouths. As far as we can tell the Heimlich Maneuver for drowning has never appeared in any of their manuals. And in many areas of the country they go out of their way not to teach the Heimlich maneuver, even as a second step. So they're responsible for any death that would occur.

McDougall: I hear you also use it for asthma.

Heimlich: That's the newest thing. We found out people were using the Heimlich maneuver for asthma attacks. We didn't even think of it. This is important because every single day in this country 14 people die of acute asthma attacks. The thing that causes an asthma attack is spasms of the breathing tubes, the bronchi. Also, the lining of breathing tubes is always thickened, inflamed, and plugged with mucus. The Heimlich Maneuver dispels these trapped mucus plugs. They cough it up and can then breathe in immediately. So it will immediately stop an acute asthma attack.

In addition, we are now having people use the Heimlich Maneuver two or three times a week to expel trapped mucus and prevent the asthma. I think that's going to become the most widespread use of the Heimlich Maneuver because there are at least 15 million asthmatics in the country--most of them are children, and their numbers are increasing rapidly.

McDougall: What are you spending your talents on lately?

Heimlich: We have an AIDS project now in China. We presented the results in 1996 at the National Institutes of Health and then at the AIDS Conference in Vancouver. As a matter of fact, UCLA has just joined with us on this project.

No drug has really been favorable in treating a virus disease, especially one where the virus mutates. They are now reporting that their failure rate for AIDS drugs is extensive. It's now being admitted at the Geneva Conferences that the drugs not only were too expensive for 96% of the world to use, but that they are now unfortunately failing. The next thing they're talking about is a vaccine, which is 10 or 20 years away.

We have taken a completely different tack on AIDS. Here, you're dealing with a disease which destroys the immune system of the body. Our method is designed to enhance the immune system and let the immune system then take care of eliminating the virus. It sounds complicated, but isn't.

There was once no treatment for syphilis when it invaded the brain, as it extensively did years ago in millions of people. The antibiotics were of no value because they couldn't pass the blood-brain barrier. So neurosyphilis--syphilis of the brain--would kill patients in about two to four years. In 1918, doctors realized that when people with neurosyphilis got another disease that caused a fever, it would kill the syphilis bacteria. They soon got the idea of giving a curable form of malaria to cause this fever reaction. Malaria was injected, the patient got malaria for two to three weeks and by that time they had been cured of the neurosyphilis. The treatment continued for 60 years. The Public Health Department provided the malaria to treat the patients.

About 12 to 15 years ago I started reading reports that showed that malaria actually stimulates the immune system. It stimulates interferons, interleukins, and tumor necrosis factor. And these are the things that are lacking in AIDS patients. The Centers for Disease Control followed 112 AIDS infected children in Africa. Of these 112, 41 also had malaria. At the end of two years, of those who didn't have malaria, but had AIDS, 35% had died. None of those who had malaria and AIDS had died. And there were other reports that showed that AIDS did not occur in malaria infected areas of the world. Excellent research studies done by the U.S. Navy and a major university showed that in the malaria areas people had HIV antibodies, but they never got actual AIDS. When you got out of the malaria area in the same country, they had AIDS.

We have treated a small group of patients. This first group were given just two or three weeks of malaria, then the malaria was cured--it's 100% curable, this form of malaria. The patients were followed for two to three years. At the end of the malaria treatment, their immune cells--the CD4s, the T cells--had markedly increased--and without any further treatment, the immune cells stayed at high levels for the next two to three years.

McDougall: Can you say they're cured?

Heimlich: We can say that the immune cells, which fight off the virus in AIDS, but ordinarily gradually diminish year after year, have increased and stayed increased. Now, with UCLA working with us doing viral loads, measuring the actual virus. Within the next five to six months we should know that answer. The patients are in China, the blood is being analyzed at UCLA. We want to treat the next 100 patients immediately. We are now seeking funds, grants to do that.

McDougall: How do you see this malaria treatment relative to cancer patients?

Heimlich: The same thing holds for cancer patients. Their immune system lacks the tumor necrosis factor. Their immune system degenerates. You and I are hopefully sitting here without cancer because our immune system is killing off cancers that may develop.

Interestingly enough, when cancer patients got severe febrile diseases, the cancer, which had otherwise found to be incurable, often disappeared. We collected 700 cases like this in the medical literature going back to the turn of the century. We have treated a few cases of far advanced cancer. We found improvement in a few breast cancer and melanoma patients, and one Kaposi’s sarcoma patient, where we had marked improvement.

McDougall: There are lots of people out there with advanced cases of Lyme Disease, which is caused by a spirochete, just like syphilis. Are they good candidates for malaria therapy?

Heimlich: They would be. But there are relatively few patients to test. And we would need the money to do the studies.

McDougall: It's unfortunate that it all boils down to money, isn't it?

Heimlich: Well, no. It's unfortunate where the money goes. The money goes to drugs, which is fine when they work. There's one problem with malaria therapy. Malaria therapy is relatively cost free and could be done in any country in the world. There's no money to be made in it. So no company is going to push it. We could hopefully get a large company interested in taking the substance that is causing the immune system to become strenghtened--to secrete the interferon--from the malaria--and then create a substance that would duplicate the response. That might make the matter somewhat different.

McDougall: Do you think money or truth will win out?

Heimlich: Truth will win out. Because the money is going move toward the truth. Money is going to move out of tobacco. Nutrition was a no-no for years, but that’s changing. The money is going to be in what the people are learning they should have. They learn it so quickly today with TV and news. Absolutely, the truth will win out.


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From July/Aug '98

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