**please note. I have google Adsense on my pages, I cannot control the content that always shows up. I DO NOT agree with the negative ads showing here for marijuana.**

Source: http://pr.cannazine.co.uk/20080205147/cannabis-news/marijuana-replaces-ritalin-in-treatment-for-add/adhd-video.html

Dr Claudia Jenson, who is a consultant pediatrician from USC, has come up with a novel way of treating ADD/ADHD, WITHOUT any of the unwanted side effects which can result from using popularly prescribed medicines.
Attention deficit Disorder, or attention deficit hyperactivity disorder (ADD/ADHD) is a biological, brain based condition that is characterized by poor attention and distractibility and/or hyperactive and impulsive behaviors. It is one of the most common mental disorders that develop in children. Symptoms can continue into adolescence and adulthood.
If left untreated, ADHD can lead to poor school/work performance, poor social relationships and a general feeling of low self esteem.

The normal course of treatment for a child diagnosed with ADD/ADHD, is a course of methylphenidate, better known as Ritalin.

Methylphenidate (MPH) is a prescription stimulant commonly used to treat Attention-deficit hyperactivity disorder, or ADHD. It is also one of the primary drugs used to treat the daytime drowsiness symptoms of narcolepsy and chronic fatigue syndrome. The drug is seeing early use to treat cancer-related fatigue.

As always there is a flip-side to these prescription drugs, and in the case of Ritalin, substance abusers have found various ways to ingest the drug recreationally, which gives an effect similar to cocaine or amphetamine so the use of ritalin is to be closely monitored.

For the child diagnosed with ADD/ADHD, the side effects of using Ritalin, are many, including psychosis (abnormal thinking or hallucinations), difficulty sleeping, stomach aches, diarrhea, headaches, lack of hunger (leading to weight loss) and dry mouth. In some cases, the use of Ritalin has led to death.

If Ritalin or its side effects, are causing your children problems, ask your doctor about using marijuana as an alternative.

Check the video out for what Dr. Claudia Jenson, a Consultant Pediatrician from USC has to say on the subject.

http://www.youtube.com/watch?v=yj72e5q61Fs&feature=player_embedded

**please note. I have google Adsense on my pages, I cannot control the content that always shows up. I DO NOT agree with the negative ads showing here for marijuana.**

If you ask me….

SOURCE:http://www.adhdmarriage.com/content/hallowell-against-use-marijuana-treat-adhd

Hallowell Against Use of Marijuana to Treat ADHD

A quote in the New York Times on November 21 misled some people into believing that Dr. Ned Hallowell thinks that using marijuana to treat ADHD is a good idea.  Just the opposite, he thinks it is a very bad idea and has said so for many years.  Here is his response to those who had questions about this:

“I am trying to correct misunderstandings of what I was quoted as saying in the Nov. 21 NY Times. Many people came away believing I am in favor of people who have ADHD using marijuana as a medication.  THIS IS NOT AT ALL TRUE!!!!  In fact, it is the opposite of what I believe.  I am TOTALLY opposed to the use of marijuana for two practical and important reasons.  First, it is illegal.  Using pot can cause major trouble with the law.  Second, it can lead to a dependency such that all a person wants to do is smoke pot all day.  I have spent many hours trying to help people give up marijuana.  It is cruelly ironic that my words should be so misconstrued.  Please understand, I am a fervent opponent of the use of marijuana, especially by people who have ADHD.  It can cause huge life problems.”

Ok, First let me point out that Dr Hallowell DID NOT say that marijuana was not EFFECTIVE, he said he didn’t agree with it, or advocate it, because it was illegal. Which in fact is true, in the USA, where he is.

Second let me point out, that though Dr Hallowell was trained as an allopathic doctor, is an author, and  is credited as a “leading expert in ADHD of today…he is not an expert in all things. Being a doctor who has seen people “addicted” to marijuana makes him no more an expert in the effects of marijuana than a mechanic who specialized in BMW motorcycles would be an expert in snowmobiles.

He states that it is addictive and therefore “dangerous” as fact by his implication, and that is simply false. Not everyone who uses Marijuana becomes addicted. I base my opinion on MANY studies I have read ( done outside of the USA) on the effects of Marijuana on people with ADHD, as well as personal experience. I used marijuana in my teen years to be “cool” and could take it or leave it, mainly because I’m ADHD and it doesn’t get me “high” but rather regulates my brain, and allowed me to focus better. Being focused at a party where everyone else was buzzed is kind of pointless.

I point out that I base my info on  studies done outside of the USA because USA is FAR from impartial when it comes to marijuana given the political stance of it since before Dr Hallowell was even born.

Do keep in mind that Dr Hallowell grew up and studied to be a doctor in a time where he was being taught by the generations that were brainwashed to believe that marijuana is addictive, and terrible, and a “gateway” drug. His personal opinion is colouring his professional opinion, and therefore is not impartial to say the least.

I’m not “for” people being buzzed all day. But I recognize as a herbalist the benefits the cannabis plant can hold for people with neurological based imbalances in their chemical makeup. Used properly under the guidance of a experienced herbalist or naturopathic doctor etc, people with ADHD can find a lot of benefits from the use of the drug, just as many find benefits of drugs like Ritalin and Concertta etc.

Also, the side effects are far more minimal with marijuana than with prescribed medications, which are Meth ( speed) stimulant based/related.

Just as caffeine is a beneficial substance when used properly, it can and is overused, in our gluttony society, so too is marijuana.

Yes it is illegal in most of North America, so if you chose to experiment with the use of marijuana, you need to exercise caution and take responsibility for any legal ramifications that come about from it. All ramifications are soley your own. Dr Hallowell is covering his ass by disclaiming any implied acceptance or endorsement of the medication. If anyone was charged with possession of Marijuana and they said they used it medically because the top leading Dr. in ADHD who has been on the likes of Dr Phil, and who’s face is all over book covers about ADHD, he could be questioned and held partially responsible for advocating an illegal “illicit” drug, and his medical lisence would be on the line.

I don;t have a medical lisense. so mine isn;t on the line, and I’m telling you, as a Herbalist with 5 years of study, and over 15 years of experience as an apprentice using all types of herbs for medical purposes. Marijuana can and IS being used as a ligitimate beneficial medication for people with ADHD, bi Polar, depression, Oppositional defiance, and sensory integration problems.

It should not be smoke, it should be used in an alcohol based tincture. A tea won’t work becasue it is not water soluble. Making it into a butter or alcohol tincture is effective, and small doses can and should be be taken at a time to determine if and what the best dose for any certain individual may be. Just as with any chemical not found naturally in your body, people CAN be allergic to marijuana as well as any other herbal remedy.

When smoking marijuana, you are effectively overdosing on a herbal medicinal plant by the method of introducing it to your body ( too fast), not to mention wasting the herb. The same kinds of things would happen to a person with ADHD if they chewed their slow release Ritalin or Concertta.

If a person has an addictive personality,  whether it be marijuana or prescribed speed, there is potential for addiction.

The fact is… ANY chemical or drug whether illegal due to idiotic laws, or prescribed by a Dr. can be abused. It doesn’t mean it doesn’t have benefits for the people who use it responsibly.

In fact there are statistics out there ( I will post them when I find them again) that say people with ADHD who have used illegal drugs to self medicate and become “addicted” are at a higher risk and should be closely monitored by their doctors, for  signs of RX addiction as well.

It is the PERSON, not the medication, Dr Hallowell, and I respectfully must say, that though I admire a great deal of what you do for people with ADHD, you are FAR FAR off the mark on this one.

As a Herbalist who has advised countless people on how to use medical marijuana properly and safely ( not smoking it) and who has studied greatly the effects it has on ADHD characteristics  in people, I respectfully 100 percent disagree with you.

By Sara Bingham

With the winter months coming it means that cold season is on its way.  This may be a time when middle ear infections are on the rise with our little ones as well.  The first 4 years of life are critical for the development of language. Early literacy skills also start to develop during this time.  Information regarding ear infections and speech and language development is important for parents.  Can the use of American Sign Language help during cold and ear infection season?  Yes!

Often if a child is experience otitis media or middle ear infections, it means that their inner ear, the area behind their ear drum, there is a build up in fluid that may be infected.  Otitis media is very common in young children.  Hearing infections are only second to the common cold in preschool children.

Tiny bones in the middle ear carry sound waves / vibrations to the inner ear so that we can hear.  Fluid in the middle ear, due to otitis media may make it difficult for these tiny bones to carry the sounds waves or vibrations which may result in a temporary hearing loss.  Toddlers and preschoolers with repeated ear infections or otitis media may have times that they have difficulty hearing and processing language because of repeated inner ear infections and then temporary hearing loss due to these plugged inner ears.

These temporary hearing losses may make it difficult to understand spoken speech.  Imagine a little one with a cold, an ear ache and they can’t hear your instructions – they’ll definitely have a right to feel grumpy!

Signs of otitis media may be what appears to be inattentiveness, but this is not intentional since their ability to hear is lessened.  If you notice that your child wants the television or music louder than usual, this may be a sign of an ear infection.  Your child may also seem to be pulling or scratching their ear more often and may seem in general, more tired, listless and irritable.

If you notice your little one has any of these signs, talk with your family doctor.  As well, routine visits with your local audiologist will be helpful in keeping an eye on those little ears.

With ear infections, sounds may be muffled and unclear. This may, temporarily, have a negative effect on understanding language but it may also have a negative effect on learning letter sounds and phonemic awareness. This can be frustrating for parents, educators and the child.

I’ve found that signing with young children, teaching them basic American Sign Language (ASL) vocabulary has been very helpful around times they may have hearing difficulties. Lisa Hinz Lach of Central Jersey, NJ adds that, children who may have a ear infection, “may be able to use sign language to tell you that they HURT or feel SICK.”
The use of American Sign Language, combined with speech, with a toddler or preschool child who is learning to read and print is helpful because it presents information to the child in three ways: visually since they can see the signs; auditorily because/when they can hear your speech and motorically because as they practice they can feel the differences in the signs with their own hands.  The use of signs with little ones may also help get and keep their attention.

As well, parents and educators who sign and speak (and who aren’t fluent in ASL) tend to slow down their own speech and repeat their words more often.  Anyone learning a language, written or spoken, benefits when what they are learning is presenter in a slower fashion and repeated.

The use of sign language with young children learning to read presents information to them in three ways (visually, auditorily and kinesthetically) and naturally encourages their teachers to slow down and repeat their speech.  These are all great ways to foster literacy skills in young children!

As my son gets a bit older, he is now showing that it is possible the “adhd” symptoms are in fact CAPD & Sensory Integration Dysfunction.

All neuro issues can mimic each other, but upon closer looking, and as he grows it is becoming more clear. He CAN focus and seems a lot less ADHD than he did when he was younger…now it would seem his hyper tendancies are due to a deep need for vestibular stimulation for to being hypo sensitive in his own skin.

My son has classic symptoms of hypo sensitivities in over all senses, and is requiring vestibular stimulation ALL THE TIME. ( spinning, climbing chairs to jump off, sitting on the couch upside down on his head to watch tv, rocking the rocking chair to the extreme, tipping chairs at the dining table and falling off them. running from one end of the room to the other and banging off walls, doors, furniture and even people. Running his hands along shelves in stores and hiding in clothes racks to feel the textures.

He is very clumsy, and also has days where gross motor skills are terrible. ( weak leg muscles, cranky and tiring easily)

He also has hypersensitivities in areas like sounds at too high a volume or pitch that would not bother other people. but he is hypo sensitive to telling when he’s full and is ALWAYS hungry and thirsty.

Most days I’m about ready to lose my mind by bedtime with him.( and that’s just HIS issues, never mind my sprectrum daughter’s issues too)

He does not grasp “indoor voice” at all. he yells everything. he needs CONSTANT stimulation or he is yelling, singing, and SCREAMING while climbing, jumping, falling, bumping. I have “spiderman” proofed the house, only to find him SCALING THE COUNTERS! at 10 months old before he could walk he was able to haul himself up my step ladder in the kitchen and balance and rock on it, and not be able to get down alone.

He’s causing me to grey prematurely! lol

I’m terrified one day he’ll break a bone and not even feel it. I am always VERY careful to check his bumps and falls for worse than he acts pain because he is very under sensitive to pain. He’s a daredevil in every way, a “rough and tumble” boy.

My father has auditory neuropathy. His hearing got worse over years from nerve damage due to job choices and no hearing protection. He had a cochlear implant 9 years ago, and went from almost completely deaf to being able to hear again well enough to talk on the phone to me now! he had never heard a computer dial up modem before and freaked when it happened… and he heard bacon fry for the first time in 20 years and was amazed.

I have uncles have varying degrees of neurological deafness on my dad’s side. My youngest brother was VERY much like my son as a child and has many many signs of APD as well.

my son ( 4 years old) shows the signs of it with his speech. He says “optadog” for “octodog” etc…common mistakes of m and n mixups, b and p’s etc.

I had speech therapy as a child as well.I alwasy complained about being “jumpy” to noises and bothered by noise, and very soothed by rhythmic music. But was never officially Dxed because I learned to compensate well at a young age with reading lips, and having a deaf father meant growing up in a home where communication was geared toward those issues anyway.

if you know sign language…keep it up. but encourage speech a LOT. STOP baby talk now, no matter how cute it is, because they are hearing it that way & need it corrected to get it right. NEVER assume they “heard” you. “you’re not listening” is NOT true. they ARE listening, their ears get it, but the nerves jumble it up and the brain receives it wrong. or they hear the first part of what you said and not the last part, or vice versa.

Even if they nod or say un huh…always ask for repeat of what you said. ( not rudely, just establish that that is good communication) Don’t give multi step instructions. Give one step at a time, written if possible for older kids.

Kids ( even adults) with APD THRIVE on pictures.We are often visual learned to the extreme, hands on kind of people. Label your child’s dresser with ad pictures from flyers of certain clothes so they know where things go. kids with sensory issues and APD often have other learning disabilities, and or ADHD as well & a low tolerance for frustration and can use the extra guidance of picture instructions.

Bathroom hand washing signs in your own bathroom etc. are great. My son LOVES them. bedtime routine charts with pictures help him as well.

If your kid shows signs of C/APD ( Central/Auditory Processing Dysfunction) tap them on the shoulder to get their attention before you speak to them, speak slow, and clear, don’t yell. loud noises are harder to understand. Speak even, normal and even exaggerate your pauses at end of sentences and breathes for breaks like where a comma would go in the sentence you are speaking.

Talking over music, kids on a playground, a tv, store loud speakers, wind outside are all issues for people with APD. For kids bend down to be at their eye level so they can learn to lip read faster and sooner face on. Let them wear ear plugs ( wax ones are great to form to their ear) to lower decibels if they are sensitive to sharp loud sounds. my son uses them to watch movies, as do I.

let them do homework, chores etc with music on, it helps sooth the nervous system for auditory input.

but…If there ever was a parent expert on ADHD and neurodiversities without needing a university degree. It would be me.

I have ADD. My daughter has been preliminary DXed with ADD and my son is HYPER like bull in china shop, unaware of consequences of ANYTHING he does, breaks a lot of stuff in the house and tests my patience EVERY waking moment ( and makes me laugh a lot too)

AD(h)d is the hyperactive subset. ADD is the non hyper subset, often in girls more,they are daydreamers, BIG worriers, full of anxiety often show signs of oCd and ODD, and have higher chances of suffering from depression as they grow up. very scatterbrained, disorganized, forgetful and full of anxiety.they can “hyperfocus” on things for HOURS. Seem “wise beyond thier years” and have adult size worries in life.

Some people can have a combination of both subsets.

SOME people can have “comorbid” traits, and show ADHD with ODD. Very often though, if your HYPER child shows any of or al of these signs…clumsy, spins a lot, climbs a lot, bangs into stuff a lot, has food texture issues, sock issues, clothes tags issues, certain material on skin issues, sensative to light , sound, smells and tastes of certain types, watches tv upside down on the couch, then complains about “being too tired” they probably have SID ( sensory Integration dysfunction) they could have both adhd and SID. but meds for ADHD won’t necessairly help the SID stuff. Kids with SID and Auditory disfunction often are misdiagnoased as ADHD. Get a second opinion, especially if meds don’t help.

if you truly want to help your child understand themselves better and find ways to allow them to “be themselves” while maintaining your sanity, and teaching them to integrate into our conformist society with their neurodiversities there ar a TON of books you could read to help you understand better. I ‘d be happy to let you know what some of them are.

I have ADD, non hyper, scatterbrained subset with comorbid Anxiety, Audio processing issues, and some sensory issues. and yes it is genetic. I can look back to parents, grandparents and siblings, uncles and cousins and see it clear as day…people today who are being DXed with these things often come from families with a lot of drug and alcohol “abuse” because without the advance understanding of neurological “difficulties” and differences, people just did what they needed to do to cope. self medicating with drugs like pot, alcohol, even cocaine and speed are all ways to try to medicate the diverse brain and make it act more “typical”.. which in today’s society is proven by the fact that prescribed “speed” is the main treatment regime for ADHD in concerta, ritalin etc. Anxiety meds, are a “downer ” like alcohol. and Marijuana studies show to calm Bipolar brains, ODD traits, and even make people with ADHD drive better because they focus more. These drugs do not have the same effects on a neurodiverse brain as they do on a neurotypical brain.

Trust me I should know. Smoking pot in my teens was always a “buzz kill” for me as it made me more focused and able to think clearer. grade 12 was the best year of school for me grades wise!

the one and only time I took street speed. I was clear headed and CLEANED and organized my house! oh boy what a “high” that was…pffft. today I take DXed script “speed” in the form of concerta in slow release to function “normally” through the day.

Most days I plug away…i do what needs to be done, and I do the best I can, and enjoy the good moments, no matter how many bad moments they are separated by.

Being a family of two disabled parents with kids with neurodiversities who homeschool, live rural, in a 180 year old house that needs a lot of work, and NO money to pay for the jobs to be done by someone else means we NEED to find ways to a) freecycle or barter and buy CHEAP the parts we need. b) find the energy & time to do them between both our health issues, and c) deal with two homeschooled kids who CONSTANTLY interrupt you, need your attention for necessities and argue and fight with one another as many moments they are awake as they get along.

Most days I count my blessings, and be in the now.

Most days I am thankful for what we have, and think ” it could be worse.”

Most days I don’t mind needing to try and be creative with a limited grocery budget because that’s where the “extra money” needs to come from to make the purchases we make.

Most days I smile, and sing while I’m working.

Most days I somehow find the patience to deal with my daughter spectrum and ADHD traits and freak outs.

Most days I remember that her foods cannot touch each other or she won’t eat it.

Most days I can handle that my 4 year old son is hyper from the moment he wakes until he passes out from melatonin induced bedtime ( otherwise he’d be awake all night)

Most days I can guide him and deal with the fact that he is like a bull in a china shop and bangs into EVERYTHING for stimulation because he has sensory integration dysfunction and he is hyposensitive to everything and needs to have the rough impact of slamming into doors and flipping on couches and chairs, and tipping chairs backwards on the kitchen table chairs for “therapy” Most days I can redirect him.

Most days I can handle that he breaks a lot of stuff like our kitchen table and chairs from tipping and slamming and banging and standing on them. Most days I say “hey we can fix that, and be ok with it since we can’t afford new furniture.

Most days I can handle that everyone here NEEDS me to do a LOT of the physical stuff operating a home on a daily basis takes.

Most days I can see the glass as half full

Most days….

but some days…..some days I cry

and some days I cry HARD.

Hard that it is not easier.

Hard becasue we apparently make living on less than $2500 a month disability pension for a family of 4 LOOK easy, and people often do not realize just ow hard we struggle.

Hard because I can’t afford to take my kids to the science centre, and they LOVE learning. ( or ever take them to Disney or the local amusement parks to drive go carts or whatever)

Hard because my husband needs to spend up to 14 to 18 hours a day in bed resting and therefore I have to deal with the kids neurodiversities alone, and I’m totally mentally drained by the time they go to bed at night.

Hard because of OCD traits in my daughter, and germaphobic traits in my son.

and HARD because I tap myself out of the reserved patience I have for it all.

yes some days I cry…

and today is someday.

When EVERYONE worries it makes the ones who really need to worry seem like part of the flock of sheep going nuts over H1N1 because the media is playing the public like a finely tuned fiddle.

I’m not addressing people who have other illnesses and get flu shots in past years etc… I’m talking about the general public who couldn’t have cared less before all this crap.

More people will die in Canada of the regular flu this winter, then the number of people who have died of H1N1 in all the world so far.

it’s the FLU PEOPLE! GET A GRIP!

Have you had the flu before? ya it sucks.

DID you worry this much and consider it worth the effort of going out to get a vaccine for the “regular flu” in years past? if your a regular healthy person, chances are no… then why in the hell are you flipping out now that you are gonna die of the flu THIS year? cause it has a cool name and the media is going apeshit over it purposely picking out cases to highlight to show how scary it is!? then sorry, you have a far worse ailment…. it’s called the UR1SHEEP Virus. the only cure is removing your head from your ass and actually TRYING to UNDERSTAND something about viruses in general and how your body works.

it doesn’t take a medical degree… before the H1N1 came along, anyone could get a flu virus and even possibly die from it, if THEIR body can’t fight it off. but it is rare by actual statistics!

More people will die in Canada this winter of the regular old flu virus, than ALL the people in the WORLD who have died of H1N1 so far…so…calm down!

People die from the flu all the time, but before this media frenzy, did you care? Did you think about washing your hands so much, or think twice about shaking someone’s hand? DID you think about NOT taking your kids out for Halloween? did you think about the fact that Halloween has ALWAYS been in the height of cold and flu season EVERY year before the swine flu got it’s 15 minutes of fame that bored media outlets decided was the next big thing?

Please…CALM DOWN!

Avoid touching lots of doorknobs in public places.. yuck! wash your hands often ( you should be ANYWAY) avoid touching your face with your hands as much as possible. SLEEP well, EAT well, drink lots of fluids, get some sunlight everyday and exercise, and go about your business. Just as you should ALWAYS do.

ok. before I get off my soap box…

Some info for you from BMJ.com ( a medical Journal)

ABOUT BMJ.COM :

The BMJ is an international peer reviewed medical journal and a fully “online first” publication. Our publishing model—”continuous publication”— means that all articles appear on bmj.com before being included in an issue of the print journal. The website is updated daily with the BMJ’s latest original research, education, news, and comment articles, as well as podcasts, videos, and blogs.

All the BMJ’s original research is published in full on bmj.com, with open access and no limits on word counts. We do not charge authors or readers for research articles, nor for other articles arising from work funded by open access grants. The BMJ’s vision is to be the world’s most influential and widely read medical journal. Our mission is to lead the debate on health and to engage, inform, and stimulate doctors, researchers, and other health professionals in ways that will improve outcomes for patients. We aim to help doctors to make better decisions. The BMJ team is based mainly in London, although we also have editors elsewhere in Europe and in the US.

Reach and impact

About 1.3 million unique users download 5.9 million pages from bmj.com each month (ABCe audit, October 2008). The BMJ’s Impact Factor is 12.827 (ISI Web of Science, 2008).

We audit the performance of BMJ research articles, using a wide range of indicators to assess their impact on readers and their dissemination to the wider world.

The print BMJ has a long history and has been published without interruption since 1840, when it began as the Provincial Medical and Surgical Journal. The print BMJ is now published weekly in three editions that vary only in their advertising content. Together, their weekly circulation totals about 122 000 copies, of which 10 000 are distributed outside Britain. International editions reach another 55 000 readers. The BMJ is printed on 100% recycled paper and mailed in a recyclable wrapper.

In May 1995 the BMJ became the first general medical journal to launchitself into cyberspace as bmj.com going on to win Best Business Product or Service at the PPAi Interactive Publishing Awards 2000, Best Integration of Media at theAOP UK Interactive Publishing Awards 2002, and to be voted one of the web’s five most useful health sites by Guardian Online readers and contributors in 2004. Continuous daily publication on bmj.com started in July 2008, with all content appearing online before print publication. We abridge many articles for the print BMJ, including all research.

In July 2008 the BMJ was named Medical Publication of the Year at the Medical Journalist Association’s awards in London. BMJ News Editor Annabel Ferriman was jointly awarded Health Editor of the Yearaward, and Susan Mayor was named Medical Journalist of the Year.

Owner and publisher

The BMJ is published by BMJ Publishing Group Ltd, a wholly owned subsidiary of the British Medical Association. The editor of the BMJ is Fiona Godlee.

The BMA grants editorial freedom to the editor of the BMJ. The views expressed in the journal are those of the authors and may not necessarily comply with BMA policy. The BMJ follows guidelines on editorial independence produced by the World Association of Medical Editors and the code on good publication practice produced by the Committee on Publication Ethics.

The BMJ’s sources of revenue

The BMJ receives revenue from a range of sources, to ensure wide and affordable access while maintaining high standards of quality and full editorial independence. The sources of income include subscriptions from institutions and individuals; classified advertising for jobs and courses; display advertising for pharmaceutical and non-pharmaceutical products; events (exhibitions, sponsorship, and visitor fees); sale of reprints, rights, and royalties; and sponsorship.

Separation is maintained between the editorial team and the advertising and sponsorship sales teams. Where sponsorship has been obtained for any BMJ content—for example, as a result of an unrestricted educational grant—this is clearly indicated.

The BMJ archive

Every BMJ article published since the journal’s firstissue in October 1840 is available online from bmj.com.This was launched in 2009 and achieved by digitally scanning 824 183 pages of theprint journal. It cost about $1 (£0.68; Euros 0.76) a page andwas made possible by the extraordinary generosity of the USNational Library of Medicine (NLM) and the United Kingdom’sWellcome Trust and Joint Information Systems Committee. All BMJ research articles are openly accessible to all online and,on PubMed Central, allnon-research articles from 1840 until April 2006 are also availablefree, without registration. On bmj.com, all non-research articlespublished during this period are available free but requireregistration.

To see five films that explore and discuss the BMJ archive, please visit http://www.bmj.com/video/

The BMJ published the first centrally randomised controlled trial: Medical Research Council. Streptomycin treatment of pulmonary tuberculosis. BMJ 1948;2:769-82. The journal also carried the seminal papers on the causal effects of smoking on health including: Doll R, Hill AB. Smoking and carcinoma of the lung. BMJ 1950;221(ii):739-48; Doll R, Hill AB. The mortality of doctors in relation to their smoking habits. A preliminary report. BMJ 1954;228(i): 1451-55; and Doll R, Hill AB. Lung cancer and other causes of death in relation to smoking. A second report on the mortality of British doctors. BMJ 1956;233(ii): 1071-6.

Eugene Garfield and colleagues searched the Science Citation Index for the 101 most cited papers 1955-1985, with the top slot going to Kay A W. Effect of large doses of histamine on gastric secretion of HCL. Brit Med. J. 2:77-80, 19.53, and the most highly cited from 1945 to 1989 with the same article still the winner. The most cited BMJ article since 1994 is: UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ1998;317:703-13.

The BMJ follows guidelines on editorial independence produced by the World Association of Medical Editors (), the code on good publication practice produced by the Committee on Publication Ethics (), and the EQUATOR network resource centre () for good research reporting.
Swine flu, better natural immunity than artificial one 22 October 2009 Juan Gérvas,
Rural General Practitioner
28730 Buitrago de Lozoya (Madrid) Spain,
Jim Wright

Send response to journal:
Re: Swine flu, better natural immunity than artificial one

SWINE FLU VACCINE (IF IT WORKS) MAY AVOID NATURAL IMMUNITY THAT LASTS FOR MORE THAN 50 YEARS

FDA approved vaccines against influenza A (H1N1) (1) which gives support for government plans to provide mass vaccination programs for H1N1 later this year. Such plans are irrational and based on fear mongering and not on a “common sense and self control” policy (as proposed by Spanish physicians and other health professionals) (2).

We strongly disagree with mass vaccination, which is based on several false assumptions.

The first assumption is that the H1N1 pandemic will mimic the Spanish flu of 1919. This is highly unlikely as the Spanish flu was a pandemic flu in a very poor world, with no public health systems, no tap-water and no antibiotics for complications. In support of this the Spanish flu killed mainly poor people; for example, in India it killed soldiers (in warehouses, bad food, bad hygiene conditions) but not officers (good food, British style houses, etc.).

The second assumption is that H1N1 flu is severe and deadly. There is substantial evidence that that is not the case and in fact the mortality rate from H1N1 flu is much less than seasonal flu (3,4).

The third assumption is that the vaccine will work. The immunologic response is not a guarantee that the vaccine will reduce severe infections and mortality. Demonstration of that benefit requires large RCTs (randomized controlled trials), which are lacking for both H1N1 vaccines as well as for seasonal flu vaccines.

The fourth assumption is that the H1N1 vaccine will provide similar immunity to the natural infection. Immunity to viral flu has a very interesting peculiarity that is known as the “original antigenic sin” (5). This concept means that the first flu virus we are exposed to generates the strongest immune response and that immunity lasts for over 50 years. It explains the fact that people over 50 years of age appear to have some immunity to the H1N1 virus because a similar influenza A virus, circulated globally from 1918 to 1957. Thus it appears that natural infection creates immunity for 50 years at no cost as compared to influenza vaccines, which require one (or two) shots annually to achieve a lesser degree of immunity.

We therefore recommend that most if not all H1N1 vaccine be used as part of placebo controlled RCTs to establish whether the benefits outweigh the harms. Without such an approach, in September 2010 we will again be in a position of not knowing who to vaccinate. Similar RCTs are also badly needed for seasonal flu vaccine as the long-term effects of annual flu vaccination are unknown, and there is a good chance that the harms of annual flu vaccination as compared to no vaccination outweigh the benefits.

1. Influenza A (H1N1) 2009 monovalent. http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm181950.htm

2. Villanueva T, Gérvas A. Spain and swine flu. CMAJ. 2009. http://www.cmaj.ca/cgi/eletters/181/6-7/E102

3. Assessment of the influenza A (H1N1) pandemic on selected countries in the southern hemisphere: Argentina, Australia, Chile, New Zealand and Uruguay. Department of Health and Human Services and other USG Departments for the White House National Security Council. 26th August 2009. http://flu.gov/professional/global/final.pdf

4. Collignon PJ. Mass vaccination against swine flu: could it cause more harm than good? http://www.bmj.com/cgi/eletters/339/sep03_2/b3471#219801

5. Couch RB, Kasel JA. Immunity to influenza in man. Ann Rev Microbiol. 1983;37:529-49.

Competing interests: None declared

http://www.bmj.com/cgi/eletters/339/oct21_2/b4335#223220