Pain relief in minoirites

Stanford study.

RESULTS. Approximately 28%

of the Hispanic and 31% of the African-American patients received analgesics of insufficient strength to manage their pain. Although the majority of patients received appropriate analgesics, 65% reported severe pain. Physicians underestimated pain severity for 64% of the Hispanic and 74% of the African-American patients. Physicians were more likely to underestimate the pain severity of female patients than male patients. Inadequate pain assessment, patient reluctance to report pain, and lack of staff time were perceived as barriers to pain management. CONCLUSIONS. Although the data suggest recent improvements in analgesic prescribing practices for African-American and Hispanic cancer patients, the majority of patients reported high levels of pain and limited pain relief from analgesic medications. Inadequate pain assessment remains a major barrier to optimal cancer pain treatment.

something to remember the next time the experts decide to make it harder for patients in pain to get pain medicines because they might be diverted.Yes diversion is a problem, as is family mamembers or friends who steal their medicine. But most of the overdose deaths are from street drugs, so why make patient suffer?

Ahd where the hell are the pastors/bishops/pope on this? It was the methodist/Baptists who worked against the cheap gin and alcohol abuse two centuries ago, but aside from AA in church basements, too often the preventive instructions in sermons is not part of their job.

The Dilbert scandal: MAID before adequate treatment

Scott Adams made it know that he was having severe (undertreated) pain from his prostate cancer and decided to kill himself legally, got his medicine, and even had the date set to do it.

But then a doctor suggested to him to use hormone blockers, which he had refused earlier because he was under the impression he would be a different person if he took them.

But according to a discussion here he tells of how one physician persuaded him to take hormone blockers, and since then he has gone into remission and is improving.

WTF?

now, these hormone blockers have a bad reputation because they are being misused to transition transexual children and stop puberty.

Wikipedia on GNRH Antagonists.

but they are used for other problems: hormone sensitive cancers, benign tumors, and (in my case) endometriosis.

I took a course of hormone blockers for benign tumors and endometriosis as an alternative to a hysterectomy so I could get pregnant (no I didn't get pregnant, but the point is that I was young and unmarried, and was grateful for them doing this since I did marry a few years later). They work by putting you into artificial menopause, so the benign tumors and the endometriosis, both of which are hormone dependent, shring. 

The hormone blockers did work: after several months of treatment and surgery to remove extensive scar tissue from the endometriosis, I remained pain free for ten years before the condition reoccured. 

But I cried every day on that treatment i.e. went into depression so I warned my male patients taking hormone blockers  for prostate cancer that if they got depressed, well it was the medicine, not reality.

So anyway, one is happy for Mr Adams that he was persuaded to take a fairly benign (next to chemotherapy) medicine for his cancer and presumably got a doctor to manage his pain relief and other cancer symptoms.

But you know: this shows that getting legal persmission to get drus to kill oneself is flawed.

and if a rich, intelligent guy like Mr Adams got poor treatment for his cancer, what about people like my patients, who tended to be poor, not sophisticated or educated, minorities, and lived far from expert care? 

what makes me especially angry? This is not an experimental drug.

GNRH Antagonists are a variation of an old and well known and widely used treatment for bone metastatses from Porstate cancer (and breast cancer too): estrogens or surgical castration.

 Hormone dependent cancers with metastates have long been treated by blocking the hormone. 

Before the GNRH Antagonists, they castrated men with prostate cancer, or gave them estrogen to turn off the male hormone that fed the growth of the cancer and relieve bone pain from metastases. (and for women, Ovarian removal was used for women with metastatic breast cancer.)

Back when I started medical school both castration and estrogen were used for prostate cancer, until a study showed that giving estrogen didn't prolong life in large studies because the patients had more heart disease. (never mind that part about pain relief).

So presumably blocking the hormone replaced estrogen.

So I asked Grok abbout using estrogen in prostate cancer:

Estrogen was first used for prostate cancer treatment in the early 1940s. Charles B. Huggins, a urologist, pioneered its use after discovering that hormonal manipulation could slow the growth of prostate tumors.

His research, published in 1941, showed that diethylstilbestrol (DES), a synthetic estrogen, reduced tumor activity in patients with metastatic prostate cancer, marking a significant milestone in hormone therapy. This work earned Huggins the Nobel Prize in 1966.

so Grok when did these hormone blockers replace estrogen for prostate cancer?

Estrogens, such as diethylstilbestrol (DES), were a primary hormone therapy for advanced prostate cancer from the 1940s until the late 1970s and early 1980s, when they were largely supplanted due to significant cardiovascular side effects like blood clots and an increased risk of heart disease.

This shift was driven by the introduction of gonadotropin-releasing hormone (GnRH) agonists (e.g., leuprolide and goserelin), which achieved medical castration more safely and effectively without the estrogen-related risks; the first patient was treated with a GnRH agonist in 1979, leading to rapid worldwide adoption by the mid-1980s.

GnRH antagonists (e.g., degarelix and relugolix), which suppress testosterone without the initial "flare" seen with agonists, did not directly replace estrogens. Instead, they emerged later as an alternative to GnRH agonists for specific clinical needs, such as avoiding flare in high-risk patients (e.g., those with spinal metastases).

The first GnRH antagonist, abarelix, was approved by the FDA in 2003 but withdrawn in 2005 due to allergic reactions.

Degarelix gained FDA approval in 2008, establishing GnRH antagonists as a viable option in clinical practice. Relugolix, an oral formulation, followed in 2020.

Today, both agonists and antagonists are standard androgen deprivation therapies, with antagonists preferred in certain cardiovascular-risk scenarios.

so one is happy that Mr Adams now is on the correct treatment for his painful cancer.

But if an intelligent and sophisticated man can't get decent treatment, what about ordinary folk, especially minorities? 

the next big drug crisis?

Science Daily:

Nitazenes, a powerful and largely hidden class of synthetic opioids, are quickly becoming a deadly factor in the overdose crisis. Over 20 times stronger than fentanyl, these drugs often go undetected on routine drug tests, making overdoses harder to diagnose and reverse. Cases from Tennessee reveal a disturbing pattern of fatalities, with nitazenes frequently mixed into counterfeit pills alongside fentanyl and methamphetamine.

actually they have been around for awhile but are just starting to be a problem in the USA:
 

this video is from Australia
 

and yes, they come from China:

More here:

The illicit opioid supply is increasingly adulterated with novel synthetic opioids such as nitazenes. Nitazenes are very potent opioids and are increasingly associated with opioid overdoses and deaths. Despite their potency, nitazenes are reversed by naloxone. Given the high risk of overdose associated with these agents, improvements in the delivery of addiction care and naloxone distribution are needed to prevent morbidity and mortality from nitazenes and other novel opioids. The Evolution of the Opioid Crisis More than 107,000 drug overdose deaths occurred in 2022 with an age-adjusted rate of 32.6 deaths per 100,000 of the standard population.1 Since 2002, the age-adjusted rate of drug overdose deaths increased for both men and women, although from 2021 to 2022 the rate decreased by one percent for women. In 2021 and 2022, drug overdose death rates were highest for adults aged 35–44 years old; people over the age of 65 had the largest percent increase from 12.0 to 13.2%. Regarding overdoses involving synthetic opioids, including fentanyl and fentanyl analogs, rates increased from 2013 to 2022 (1.0 to 22.7%), while rates from heroin overdoses decreased from 2.8 to 1.8% from 2021 to 2022.

history of TB

Ebola again

𝗖𝗼𝗻𝗴𝗼 𝗗𝗲𝗰𝗹𝗮𝗿𝗲𝘀 𝗡𝗲𝘄 𝗘𝗯𝗼𝗹𝗮 𝗢𝘂𝘁𝗯𝗿𝗲𝗮𝗸 𝗔𝗳𝘁𝗲𝗿 𝟭𝟱 𝗗𝗲𝗮𝘁𝗵𝘀, 𝗗𝗼𝘇𝗲𝗻𝘀 𝗼𝗳 𝗦𝘂𝘀𝗽𝗲𝗰𝘁𝗲𝗱 𝗖𝗮𝘀𝗲𝘀

Health authorities in the Democratic Republic of Congo (DRC) have declared a new Ebola virus outbreak, reporting 15 deaths and 28… pic.twitter.com/ZQ9crFl0kB

— The Epoch Times (@EpochTimes) September 6, 2025

,,,,

according to ABC Australia this is the 15th outbreak, three years after the last one.

Key counter measures [included] testing, contact tracing, infection prevention and control, treatment and community engagement. "Vaccination — a crucial protective measure — was launched just four days after the outbreak was declared." The WHO said Congo had a stockpile of treatments as well as 2,000 doses of the Ervebo vaccine that will be transported to Kasai to vaccinate contacts and frontline health workers.

Isolation of cases, protective equipment, and ring vaccinaion is how previous outbreaks have been stopped.

 

CDC Reform and asking the proper questions

yes you need plans for possible disasters

 I usually support Dr. Campbell, and know about the world wide overreach with the covid epidemic that was used by some politicians to increase control of civliian populations.

But in this one I think he needs to both recognize how overreach doesn't mean you throw the baby out with the bathwater:

I added this to the comments:

After 911, there were worries about a rogue smallpox attack; Our government clinic got plans on how to isoate and do ring vaccinations if this happened. 

 When I read the plans, it was simllar to the public health plans when there was a cholera epidemic when I worked in Africa. 

 And although this UK Document Dr Campbell is citing is a civilian plan, it is similar to military documents about NBC attacks (nuclear biological chemical).

 Nothing new about it.  I did some training about this when I was in the US National Guard (the NatGuard are usually the first ones called up for local disasters)

The military has plans out there for all sorts of emergencies so that you don't have to start from scratch if somehting like this occurs: 

 In civilian life, we had periodic disaster drills on tirage, evacuation, mass casualty treatment etc. and our hospital's disaster drill was about a tornado. So I am glad the UK is aware of such things.

here are some links and suggestions for later reading if you are interested:

pdf manuals:

On how to handle mass casulties.

mass casualty triage

other military manuals out there (you can google for the links): 

 STANAG 2228 - Allied Joint Doctrine for Medical Support– AJP-4.10(C) 

STANAG 2087 – Forward Aeromedical Evacuation – AAMedP-1.5 

STANAG 2122 – Requirement for Training in Casualty Care and Basic Hygiene for all Military Personnel AMedP-8.15 

STANAG 2358 – CBRN First Aid Handbook – AMedP-7.2 

STANAG 2461 – The Medical Management of CBRN Casualties – AMedP-7.1 

STANAG 2542 - Allied Joint Medical Planning Doctrine AJMedP-1 

STANAG 2544 - Requirements for Military Acute Trauma Care Training – AMedP-8.1 and lots of pdfs of manuals here.

other manuals can be downloaded from here.

this is more than triage: You have to triage then send the sickest who have a chance to live to various hospitals so you don't overload the nearest hospital. For biological, you might have to shut down and vaccinate using the ring vaccination plans that helped stop a major Ebola epidemic in central Africa but got little pulicity in the USA.

Alas after the covid debacle, people might not trust authorities and might not obey such orders. 

Sigh.

and although here in the Philippines it seems that locals are the first responders, there are plans in place about how to respond to disaster.

Usually they call up the military to help first responders. And usually the Americans come in to help. Part of the Balikatan dual Phi/Am training exercizes are to train on how to work together for disasters, of which we have many. (floods, earthquakes, typhoons).

history of medicine: Childbirth in Heian Japan

 

In Tale of Genji, his wife dies of an eclamsic seizure, or perhaps a pulmonary emboli, a few days post partum. The description of Aoi and her early labor suggests Preeclampsia but after childbirth she seemed weak but healthy so Genji went back to work, and then she died a sudden death.

other diaries mention childbirth:

 in Sarashima diary, her sister died in childbirth.

On the moon-birth of the Rice-Sprout month my sister died after giving birth to a child. From childhood, even a stranger's death had touched my heart deeply. This time I lamented, filled with speechless pity and sorrow. While mother and the others were with the dead, I lay with the memory-awakening children one on either side of me. The moonlight found its way through the cracks of the roof [perhaps of their temporary dwelling] and illumined the face of the baby. The sight gave my heart so deep a pang that I covered its face with my sleeve, and drew the other child closer to my side, mothering the unfortunate.

and other diaries mention childbirth:

and in Murasaki's diary, there is a description of the empress having a baby.

All day long she lay ill at ease. Men cried at the top of their voices to scare away evil spirits. There assembled not only the priests who had been summoned here for these months, but also itinerant monks who were brought from every mountain and temple. Their prayers would reach to the Buddhas of the three worlds. All the soothsayers in the world were summoned. Eight million gods seemed to be listening with ears erect for their Shinto prayers. Messengers ran off to order sutra-reciting at various temples; thus the night was passed. On the east side of the screen [placed around the Queen's bed] there assembled the ladies of the Court. On the west side there were lying the Queen's substitutes possessed with [or who were enticing] the evil spirits.[17] Each was lying surrounded by a pair of folding screens. The joints of the screens were curtained and priests were appointed to cry sutras there. On the south side there sat in many rows abbots and other dignitaries of the priesthood, who prayed and swore till their voices grew hoarse, as if they were bringing down the living form of Fudo.[18] The space between the north room and the dais [on which was the Queen's bed] was very narrow, yet when I thought of it afterwards I counted more than forty persons who were standing there. They could not move at all, and grew so dizzy that they could remember nothing. The people [i.e. the ladies-in-waiting and maids-of-honour] now coming from home could not enter the main apartment at all. There was no place for their flowing robes and long sleeves. Certain older women wept secretly. Eleventh day. At dawn the north sliding doors were taken away to throw the two rooms together. The Queen was moved towards the veranda. As there was no time to hang misu, she was surrounded by kichō. The Reverend Gyocho and the other priests performed incantations. The Reverend Ingen recited the prayer written by the Lord Prime Minister on the previous day adding some grave vows of his own. His words were infinitely august and hopeful. The Prime Minister joining in the prayer, we felt more assured of a fortunate delivery. Yet there was still lingering anxiety which made us very sad, and many eyes were filled with tears. We said, "Tears are not suitable to this occasion," but we could not help crying. They said that Her Majesty suffered more because the rooms were too crowded, so the people were ordered to the south and east rooms. After this there remained in the Royal Apartment only the more important personages. The Prime Minister, Lady Sanuki, and Lady Saisho were within the [Royal] screen. The honoured priest of Ninna Temple and the court priest of Mii Temple were summoned within. The Prime Minister gave various commands, and his voice overpowered those of the priests. There were also Ladies Dainagon, Koshosho, Miya-no-Naishi, Nakatsukasa-no-Kimi, Tayu-no-Myobu, Daishikibu-no-Omoto, Tono-no-Senji—these last were venerable ladies of experience, but even they were bewildered with good reason. I am yet a novice, and I felt with all my heart that the occasion was serious. Also, in the place a little behind, outside the curtain, there were the nurses of the Princesses Naishi-no-Kami and Nakatsukasa, of the Queen's sister Shōnagon, and of her younger sister Koshikibu. These nurses forced their way into the narrow passage behind the two screens and there walked back and forth, so that none could pass that way. There were many other persons bustling about, but I could not distinguish them. The Prime Minister's son, Lieutenant-General Saisho, Major-General Masamichi of the Fourth Rank, not to speak of Lieutenant-General Tsunefusa, of the Left Bodyguard, and Miya-no-Tayu, who had not known Her Majesty familiarly, all looked over her screen for some time. They showed eyes swollen up with weeping [over her sufferings], forgetting the shame of it. On their heads rice[19] was scattered white as snow. Their rumpled clothes must have been unseemly, but we could only think of those things afterward. A part of the Queen's head was shaved.[20] I was greatly astonished and very sorry to see it, but she was delivered peacefully. The after-birth was delayed, and all priests crowded to the south balcony, under the eaves of the magnificent main building, while those on the bridge recited sutras more passionately, often kneeling.,,As the after-birth came, it was fearful to hear the jealously swearing voices of the evil spirits. Shinzo-Azari took charge of Lady Ben-no-Kurodo; Sōyo took charge of Hyoé-no-Kurodo; a priest Hojuji took charge of Ukon-no-Kurodo;[22] Chiso Azari took charge of Lady Miya-no-Naishi.,

 

the problem of cytokine storm solved?

 via Instapundit:

MedicalExpress:

Novel monoclonal antibody targets deadly sepsis by preventing 'cytokine storms'

Scientists at the University of Virginia School of Medicine and the University of Michigan have developed a monoclonal antibody to stop sepsis, a deadly full-body infection. The antibody also has the potential to treat a broad array of other inflammatory conditions, including autoimmune disorders, their research indicates.

,,,,Ma and his collaborators' new antibody, they hope, could become the first treatment that directly targets the underlying immune system dysregulation responsible for sepsis. It seeks to prevent the "cytokine storms" that made headlines in the pandemic, shutting down the body's hyperactive immune response before organ damage can occur.

very early research and now will go into reality i.e. clinical trials.

smile

 

frankenbunnies

from LegalInsurrection:

BREAKING; Experts Warn of Infected ‘Frankenstein’ Rabbits with Tentacles Invading the US.

These wild rabbits have been spotted hopping around with nightmarish facial growths across Fort Collins, Colorado. pic.twitter.com/QStFIQKNJz

— PulseX (@PulseX10) August 12, 2025

translation: Wart virus causing HUGE warts on the face of the bunnies.

a similar virus causes genital warts and cervical cancer that can kill women.

partly dead or really really dead

propaganda and the covid debacle

 

the sex change hoax

Public health

Ivermectin lowers malaria rate

From Science Daily:

Malaria reduction in Kenya In Kwale County, Kenya, children who received ivermectin experienced a 26% reduction in malaria infection incidence compared to those who received albendazole, the control drug used in the study. The trial involved over 20,000 participants and more than 56,000 treatments, demonstrating that ivermectin significantly reduced malaria infection rates -- particularly among children living further from cluster borders or in areas where drug distribution was more efficient. Moreover, the safety profile of ivermectin was favorable, with no severe drug-related adverse events and only mild, transient side effects already seen with ivermectin in campaigns against neglected tropical diseases. "We are thrilled with these results," says Carlos Chaccour, co-principal investigator of the BOHEMIA project and ISGlobal researcher at the time of the study. "Ivermectin has shown great promise in reducing malaria transmission and could complement existing control measures. With continued research, ivermectin MDA could become an effective tool for malaria control and even contribute to elimination efforts," Chaccour, who is now a researcher at the Navarra Centre for International Development at the University of Navarra, adds. "These results align with the World Health Organization's (WHO) criteria for new vector control tools," states Joseph Mwangangi, from the KEMRI-Wellcome Trust Research Programme. "The findings suggest that ivermectin MDA could be a valuable complementary strategy for malaria control, particularly in areas where mosquito resistance to insecticides is a growing concern,"

organ transplant scandal gets publicity thanks to RFK Jr

 

This was supposed to be an urban legend, but I have been told of many cases by people who said they heard it from someone who heard it from someone, which often means it wasn't happening.

This video is from a Catholic network, which is not a hysterical anti science site, since Catholics recognize brain death as death. But the cardiac death criteria which has been used in receent years, is the real problem, since the brain is still alive and is a fuzzier criteria since if the heart stops too long the organs are unusable, so often there is a rush to declare death.

here is the information off of a twitter post which for some reason I am unable to post:

 Dr. Heidi Klessig

@heidiklessigmd

The US Department of Health and Human Services under RFK Jr. is announcing a major initiative to overhaul the organ transplant system after an HRSA investigation uncovered significant problems:

from the HHS:The US Department of Health and Human Services under RFK Jr. is announcing a major initiative to overhaul the organ transplant system after an HRSA investigation uncovered significant problems: HRSA examined 351 cases where organ donation was authorized, but ultimately not completed. It found: •103 cases (29.3%) showed concerning features, including 73 patients with neurological signs incompatible with organ donation. •At least 28 patients may not have been deceased at the time organ procurement was initiated—raising serious ethical and legal questions. •Evidence pointed to poor neurologic assessments, lack of coordination with medical teams, questionable consent practices, and misclassification of causes of death, particularly inoverdose cases.

30 years ago, when bioethicist Dr Caplan went for his Pennsylvania driver's license, when he asked the clerk how to add organ donor to his license, she cautioned him: Don't sign it or they will let you die. He wrote a letter about this to JAMA (sorry no date or link). But I know that I have heard too many people tell me of anecdotes they heard from someone who heard it from someone that a person was waking up when they tried to take their organs.

Trust is already being destroyed in the medical profession, and this will not help.

WHO Treaty

,,,,,P

the argument is that of course this doesn't overcome national soverieignty, but as I quoted in an earlier post, once there is a rule like this in the UN laws, if a government tries to refuse to go along with it, there are powerful lobbies to pressure you to follow the law.

---------------update: Powerlineblog quotes an article from Breitbart about how international organizations will pressure/control governments that don't go along with the Climate treaty stuff that they refused to sign:

The International Court of Justice (ICJ) in The Hague on Wednesday will reveal a host of proposed penalties the U.N. can implement against countries that defy climate diktats. Activists hope the legal opinion from the ICJ judges will have far-reaching consequences in the fight against “climate change”….

Carbon monoxide poisoning

 Carbon monoxide is a silent killer. And this case on Homicide Hunter starts out as a ritual suicide and an investigation finally revealed it was an accident in venting the furnace because the landlord did a DIY instead of paying for an expert.

smallpox and... yogurt in ancient Japan

reading the Tale of Genji has made me curious about that era.

 I am working my way through this book because it gives information on disease in Haien period Japan

before the Haien period, there was a lot of trade and immigration from Korea and even China, and this included the introduction of diseases and Buddhism. 

Buddhism and an unknown disease that caused an epidemic, probably smallpox arrived at the same time, but it wasn't until 200 years later in 735 that a verified smallpox epidemic depopulated Japan and much of the aristocracy (25 percen mortality).

and I ran into a quote describing the household of  a rich guy during the Haien period, whose servants include.... a  yogurt maker.

Yogurt? as in milk based yogurt? Yup. Apparently along with small pox and sutras, yogurt and ghee came to Japan with Buddhist monks. After all, Buddhism was originally an Indian religion, and yogurt and ghee were commonly used in India.

the use of milk products died out in Japan, but continued in some parts of China. But milk products continued to be used as medicine. 

LINK

Dairy was also known to early Chinese civilization. Huang (2002, p. 809) states that “oracle-bone and bronze inscriptions suggest that the collecting of milk from cows and mares was not an unfamiliar art during the Shang Dynasty (ca. 1520–1030 b.c.)”. We might ask the extent to which dairy was consumed not only in China in later centuries—particularly during the first millennium CE—but also whether contemporary Japan had a comparable industry. Buddhism, medicine, astronomy and the Chinese script were transmitted from the mainland to Japan, but what about cattle rearing and the production of dairy products? The role of dairy in premodern China is slowly becoming recognized today, despite some past preconceived notions that peoples in East Asia seldom enjoyed milk and cheese until the twentieth century. Miranda Brown recently published a study of a text from 1504 that includes a recipe for cheese-stuffed pasta by a certain Mr. Song. The use of cheese in Chinese culture, particularly in premodern periods, is generally not recognized today by historians of food

there are several papers out there about trade between China Korea and Japan, which introduced Buddhism and disease among other things. This one states;

Smallpox was first introduced to the islands of Japan by merchants and Buddhist missionaries from the Korean kingdom of Paekche in the sixth century CE. Once it reached the shores of Japan, smallpox did not disappear but emerged in waves that were sometimes manageable and were at other times catastrophic. In 735, a second smallpox epidemic afflicted Japan, reducing the population by 30 percent and resulting in labor shortages and declines in agricultural production and tax revenue for the court

and periodic epidemics continued: The author of Tale of Genji lost her husband to small pox. But there is not a lot of information about epidemics in either that novel or the diaries and books of other court ladies, nor is there any mention of smallpox scars....

 in Genji several deaths are described: Post partum eclampsia death of Genji's wife  (such seizures can occur up to six weeks post partum), the lingering death of the seducer of the Third princess that sounds like Beri beri, and the lingering death of Murasaki, probably from tuberculosis.

But no mention of yogurt or ghee/clarified butter.

so how was smallpox treated?

 

At the height of the epidemic, Emperor Shomu consulted his officials at the Bureau of Medicine. They recommended various remedies and guidelines, including a prohibition against drinking water, an encouragement to eat boiled rhubarb, and a recommendation to apply powdered silkworm cocoons to boils. 

When these guidelines did not help to quell the disease, Emperor Shomu ordered Buddhist monks and nuns to read sutras to the afflicted and prayers to kami, whom he interpreted to be deities that were part of the Buddhist universe.

 

....

....

So what does Grok say

about all of this?

In Heian period Japan (794–1185), yogurt and butter were rare and valued mostly for their medicinal uses, mainly among the aristocracy and in Buddhist practices. Dairy was not widely consumed due to Buddhist prohibitions on animal products, but it held a special place in elite and religious contexts.

**Medicinal Yogurt**: A yogurt-like product called *raku* (possibly fermented milk) was documented in texts like the *Ishinpō* (984 CE), a medical treatise. It was considered a health-promoting food, used to aid digestion and treat illnesses, especially among nobles. Its use was influenced by Chinese medicine, where dairy was seen as beneficial for vitality. *Raku* was likely consumed in small amounts by the elite, as dairy production was limited and tied to imperial or aristocratic estates.[](https://www.incrediblediscourse.com/post/dairy-in-japan)[](https://traditional-foods.maff.go.jp/en/bunrui/chikusankakohin)

**Medicinal Butter**: Butter, referred to as *so* or *gyuuraku*, was also a luxury item, primarily supplied to the imperial court, as noted in the *Engi Shiki* (927 CE). It was used medicinally to support health and digestion, often prescribed in Chinese-influenced medical practices. Butter was sometimes processed into forms like *hakugyūraku* (a condensed milk product) for its nutritional value. Its production was overseen by the Bureau of Medicine, showing its link to health rather than everyday diet.[]>

(https://www.incrediblediscourse.com/post/dairy-in-japan)[]

(https://www.thechinastory.org/dairy-the-deep-historical-link-between-china-and-japan/)[](https://gochisohistory.com/cheese-dairy-in-japan/)

**Buddhist Context**: Dairy, including yogurt and butter, was used in Buddhist rituals, inspired by Indian traditions via China. Texts like the *Vairocanābhisambodhi* mention dairy in offerings, such as yogurt rice or butter in magical rituals. While direct evidence of ritual use in Japan is limited, the influence of Chinese Buddhism suggests dairy was likely part of similar practices, especially in aristocratic temples.[](https://www.incrediblediscourse.com/post/dairy-in-japan)[](https://www.thechinastory.org/dairy-the-deep-historical-link-between-china-and-japan/)

**Limitations**: Dairy was scarce, expensive, and mostly inaccessible to commoners. Its use declined toward the end of the Heian period as aristocratic power waned and Buddhist vegetarianism grew stronger, reducing dairy’s presence until the modern era.[](https://www.incrediblediscourse.com/post/dairy-in-japan)

In summary, yogurt and butter were elite, medicinal products in Heian Japan, tied to Chinese medical traditions and Buddhist rituals, with limited use beyond the aristocracy.

Diptheria

This is an old article from AlJezeerah about the measles epidemic a couple years ago here in the Philippines. 

What caused it? Hysteria about complications from an experimental Dengue vaccine given to children which if given to people who had never had dengue exposure made them more prone to get severe dengue.

all the cases of so-called “severe dengue” were relatively mild. Sanofi’s definition of “severe dengue” also contained much milder symptoms than other international definitions.

So none of the more than 30,000 children in the clinical trial died of dengue:

 yes there were some deaths in children that were blamed on the vaccine, but public health authorities said their deaths were from other causes but the damage had been done, and many parents refused to let their kids get even the routine vaccines that had been around for decades.

 

......, '

Fast forward to today.

A lot of hysteria about measles vaccine in the USA, but I wondered why the autism epidemic blamed on measles vaccine waited 30 years to start causing problems. But never mind. Parents want answers. Hopefully RFKJr will figure it out.

Measles is rarely fatal in well nourished Americans, but it is highly fatal in Africa and Asia, where a lot of children have borderline malnutrition... 

But with millions of unscreened migrants let in by Biden's policies, it may be only a matter of time that we start seeing diseases not seen in the US for a century start popping up.

 

 there has been cases of Diphtheria in migrants in Europe. because many of these were not vaccinated in their own country. But ironically many who caught diphtheria caught it  in Europe, meaning that there are clusters of mild cases, carriers, i.e. patients who carry the germ and spread it to others, or cases treated with antibiotics but not diagnosed as diphtheria in certain communities of migrants.

and so cases will continue to occur. And if the anti vax hysteria stops people from getting these vaccines that have been around since the 1920s, well, it is an epidemic waiting to happen.

so far, unlike Europe, the USA seems to be safe from epidemics:

from Grok:

Diphtheria is extremely rare in the United States due to widespread vaccination. ... a few cases have been noted in recent years: - In 2012, one provisional case was reported. - In 2019, two cases were reported, the most recent data available from sources like Our World in Data (https://ourworldindata.org/grapher/diphtheria-cases-in-the-united-states) - A 2020 case report described a 33-year-old unvaccinated man in Georgia with respiratory diphtheria, likely linked to his recent incarceration and lack of childhood vaccinations.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC7753149/)[](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753149/) These cases are exceptions, often tied to unvaccinated or under-vaccinated individuals, international travel, or contact with travelers from areas where diphtheria is more common, like parts of Africa, Asia, or conflict zones. The disease remains under control in the U.S. thanks to high vaccination coverage with DTaP, Tdap, or Td vaccines.[](https://www.cdc.gov/diphtheria/about/index.html)[](https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/diphtheria)[](https://www.hhs.gov/immunization/diseases/diphtheria/index.html)

more here.

 and the bad news is that unless your doctor worked or trained overseas, they might not recognize it in time for the correct treatment. Of course, if you go to an old fashioned doctor who gives antibiotics for sore throats, you might have it cured before you develop proper symptoms.

what inspired this blog post was a book I ran across while checking Project Gutenberg: a 1919 describing the public health approach to diphtheria.

 And there was a cure: Anti toxin. 

Depending on the way it is treated, diphtheria is one of the least dangerous or one of the most dangerous diseases. It is one of the least dangerous when promptly treated with antitoxin; it is one of the most[8] dangerous when the antitoxin treatment is not given, or is delayed or insufficient.

In the days before we had antitoxin one out of every three children who had diphtheria died. Now, if antitoxin is used on the first or second day of the disease ninety-eight out of every hundred children recover. The sooner diphtheria is attended to the more certain is a cure.

The toxin is the reason for those tough membranes that cause choking. 

Breathing problems. Diphtheria-causing bacteria may produce a toxin. This toxin damages tissue in the immediate area of infection — usually, the nose and throat. At that site, the infection produces a tough, gray membrane made up of dead cells, bacteria and other substances. This membrane can obstruct breathing.

there is also a real danger of myocarditis and neurological complications from the toxin produced by the germ.

Nowadays, there is treatment: antibiotics and anti toxin.

 

Alas, diphtheria is still present here in the Philippines, and seen in various Asian and African countries:    right now there is an outbreak of diphteria in the Rohingye refugees in Bengladesh

Luckily, antibiotics will help stop the infection, but the problem is the toxin produced by the germ: For this we still use anti toxin. Here is Grok's answer to diphtheria before treatment available:

In the 19th and early 20th centuries, diphtheria was a major cause of death, especially in children, with mortality rates as high as 20-50% in some outbreaks.

....Antitoxin and antibiotics, developed later in the 1890s and 1940s respectively, drastically reduced mortality, but before these, diphtheria was a terrifying and often fatal illness.

when I first started medical school in the 1960s, we still had an infectious disease hospital in our city and outside there was a bell. We were told if a child came in choking from the membrane, they could be saved by immediate tracheostomy, so they would ring the bell and any doctor in the area would come to the ER and do it.

In Dr. Versghese's book The Covanant of water, there is a description of a child being saved from choking by one of the young protagonists who does a tracheostomy under supervision of a local doctor can't do it due to hand injury.

I am surprised that there isn't more descriptions of this in various historical dramas: Dr Quinn series had one episode, but not a lot of clinical details.

 

The history of treatment is here:

In 1890, an effective treatment for diphtheria – antitoxin – was discovered by Shibasaburo Kitasato and Emil von Behring in Germany...

more HERE. 

it was made by giving the toxin to horses, starting with a small dose then increasing the dosage until the horse provided lots of antibodies, which then were removed and purified to give to people

Horse serums have a danger of severe allergic reactions that can be fatal, so now newer technology is used to produce antibodies. 

Horses were given gradually increased doses of diphtheria toxins, and their bodies built up antitoxins (antibodies) to neutralize those toxins. The horses were only weakly affected by the toxins, yet their bodies were capable of producing large amounts of antitoxin serum. The horses were bled, and the antitoxin serum was harvested from the blood and processed. When given to a human diphtheria patient, the horse’s antibodies neutralized the toxins poisoning the patient. The Department’s laboratories had a stable of serum production horses with which they provided New York and other areas of the country with diphtheria antitoxin.

what brought the treatment to the attention of the public was the outbreak in Nome Alaska:

 

Balto, one of the dogs who carried the serum, became the poster child for publicizing that there was a treatment for sipheria, (but some purists correctly point out that Togo was actually the first dog to arrive with the serum)

Wikipedia article has a lot of details: not a one time delivery, but several deliveries of the needed vaccine.

And Balto became the poster dog for those who risked their lives to save the children of Nome.

This blog has the photo of Balto's statue in Central ParkA low-relief plaque bears the words 

“Dedicated to the indomitable spirit of the sled dogs that relayed antitoxins 660 miles over rough ice, across treacherous waters, through Arctic blizzards from Nenana to the relief of stricken Nome in the winter of 1925.”