2005. Awaiting revision 2008

MEDICINE IN THE NEXT 100 YEARS

APPLYING LEECHES TO THE SKIN TO SUCK BLOOD, now considered perverse and archaic, was once a common medical practice.

In a hundred years' time, many contemporary medical practices will be looked on in a similar light.

Two such abuses, for example, are the dangerous overuse of antibiotics; and the removal of healthy appendices 'just in case' of a later inflammation - a common contemporary practice.

We will be looked back on as rather quaint to permit doctors to foist such 'cures' on us.

Of course, practices such as these seem quite usual today. And as for leeches - I expect that having a leech doctor was the height of chic in the 18th century Western world. The poor must have looked on and thought, 'If only we could afford leeches...'.


So - open your mind - cast your prejudices to the wind... while I touch on some of the exciting medical discoveries now being made. They will revolutionise your view of healthcare over the coming decades.

Some of the questions I will answer over the next few issues of the HealthZine, are:

There are around 100,000 genes in a human being. This is repeated in every cell of the body. Each gene consists of long chains of BASE PAIRS of four kinds of nucleic acids called, for short, A, C, T and G. Think of it as a long, thin jigsaw of 4 interlocking pieces, repeated over and over in differing orders. The precise order decides the genetic make-up of a person. If we can learn the order of nucleic acids, and what the nucleic acids in a particular position relate to, we can understand the genetic code.

Are you following this?

TO SUMMARISE

A MAJOR PIECE OF THE PUZZLE - THE MAP OF THE HUMAN GENOME
With a total of 3,000 million base pairs, it would be a big help to have a map of all of the genes, showing exactly which gene on which chromosome controlled which function of a part of the body. Creating this map was the aim of the US Government-sponsored Human Genome Project.


THE HUMAN GENOME PROJECT
The American government decided to fund a project to identify and  label every gene in the human genome. (The 'genome' is the collective name for all the genes of an organism. As mentioned previously, this is the same in every cell in the body of that organism.)

Supported by some UK researchers, the US proposed to complete this huge task over fifteen years.

POLITICS REARS ITS UGLY HEAD!
Francis Collins - head of the Project once said: "There is only one Human Genome Project..."    Wrong!

'Gene hunter' Craig Venter thought he could cut the time taken to map the human genome in half. His approach used a 'shotgun' method of splattering the DNA to pieces, and mapping it as part of the re-assembly process. This was too messy for the government people. They said their method was superior. (So was the Beta max video format...)

So Venter got together with Tony White of the company Celera, who was as committed as Venter to sequencing the genome.

Automatic sequencing machines ran day and night analysing DNA. Celera's electricity bill was around $1m a year!


US GOVERNMENT EAT YOUR HEART OUT
Venter - a great self-publicist - was able to boast that the job would be finished in 3 years - and at a tenth of the cost of the government effort.

Maybe it wouldn't be so thorough an approach - but Venter would iron out the errors in his findings by repeating it several times, and cross checking.

WHOOPS!
The government suddenly had second thoughts themselves - and decided they could speed up considerably. Not enough to beat Celera though - who crossed the finishing line in April 2000. They had sequenced the entire human genome several months earlier than even their own estimates.


LINKS
Celera:
www.celera.com/celerascience/index.cfm

Human Genome News - official newsletter of the Human Genome Project
www.ornl.gov/hgmis/publicat/hgn/hgn.html


A LOT OF WORK REMAINS
A mammoth task has been completed - but that is just the beginning.

Now the hard work starts; making sense of the data, and extracting more.

Researchers can start to look more carefully at which genes are involved in diseases, which proteins those genes create, and what each of the proteins do.

And there is still the job of identifying the role of the other 97% of the DNA - the bit apart from the genes. Celera themselves say: 'Nothing will be absolutely understood anytime in this (21st) century.' But the basics are there.

Whose method was better - the US government, or Venter/Celera? Hard to say - but one thing is certain - Venter sped up the whole process by between five and ten years.


FRANKENSTEIN LIVES?
The big question is: where do you draw the line between 'sensible
manipulation' of genes, or 'unacceptable meddling'?

Some people don't like the idea of messing around with genes. But if you - or your child - had a 50% chance of developing a killer disease, and you had the opportunity of changing a gene which would avoid the disease - would you take it?

If the chances of side-effects were slim, you probably would - unless you had contrary religious or moral beliefs.

HOW SOON WILL THERE BE EASY ACCESS TO GENE THERAPY?
This type of choice will definitely be available to you in the fairly near future - in the next 10-20 years. Not for everything - but the therapy will cease to be a novelty.

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