http://groups.yahoo.com/group/aspartameNM/message/883

three texts by H.J. Roberts, 1958, 1971, 1979: Murray 11.6.2 rmforall



I finally realized a three-year ambition: to use the Countway Library

of Harvard Medical School -- but had to incur a $ 35.00 door fee on

Wed 10.30.2, so I did as much as I could in the venerable stacks from

4 to 8 PM.  They had three texts by Hyman Jacob Roberts, born 1924,

now 78.



1958 Difficult diagnosis: a guide for the interpretation of obscure

illness



1971 The causes, ecology and prevention of traffic accidents; with

emphasis on traffic medicine   [Since this was held in the Law School

library, I did not puruse it.]



1979 Is vasectomy safe?: medical, health, and legal implications



[The cover of Is Vasectomy Safe? says the text has

a bibliography of 570 references, and has a handsome photo.]

Sunshine Academic Press, Inc. [his own press...]

304 27th Street

West Palm Beach, Florida 33407



About the Author

Dr. H.J. Roberts practices internal medicine in West Palm Beach.

He has established a reputation for astute clinical observation,

creative clinical research, and innovative treatment over a span of

three decades.  He has provided original insights within many

challenging areas in more than 130 published reports.  His texts,

Difficult Diagnosis: A Guide to the Interpretation of Obscure Illness

and The Causes, Ecology and Prevention of Traffic Accidents, are

acknowledged as authoriative and encyclopedic.



Dr. Roberts is a cum laude graduate of Tufts University Medical School.

He served on the faculty at Tufts University Medical School and

Georgetown University Medical School.  He has been recertified as a

Diplomate of the American Board of Internal Medicine.

He is a member of many prestigious organizations,

and recipient of numerous professional and civic honors.



[He has been long married to Carol Antonia Roberts, once major of Palm

Beach, and they raised six children.]



[I am researching vasectomy research since then, to compose a brief

exploration of the major conclusions by many researchers since this

pioneering work in 1979.  It has about 300 pages.]



The Countway Libray had about six copies of Difficult Diagnosis, 1958,

when Roberts was 34, and the title page has a pencil notation,

"Reprinted December, 1958".

W.B. Saunders Company  Philadelphia, London



[Roberts says this 913-page tome sold over 60,000 copies.]



Title Page:

Diplomate of the American Board of Internal Medicine;

Fellow of the American College of Chest Physicians;

Associate of the American College of Physicians;

Staff, Good Samaritan Hospital and St. Mary's Hospital,

West Palm Beach, Florida;

Formerly, Research Fellow and Instructor in Medicine,

Tufts University Medical School;

Formerly, Research Fellow and Instructor in Medicine,

Georgetown Medical School.



v       Preface

"Was man weiss man sicht"

(What one knows one sees.)  Goethe



vii     Acknowledgements

[Reviewers listed are Drs. Ralph Myerson, Jacob Neber, Lewis Hurxthal,

Victor McKusick, Mark Lepper, Walter Shelley.

The modern sensibility re woman's empowerment will note

that ten females did all the "tedious secretarial services" and

"bibliography".]



The assistance and guidance of the W.B. Saunders Company were truly

indispensable.  Only one who has already gone through the process of

having his first book published can begin to

appreciate the value of the

counsel, the experience, and above all

the patience and encouragement of

the publisher in overcoming the countless editorial and typographical

problems that beset an author.

The Saunders editorial staff has offered

an extraordinarily high caliber of aid, starting from the processing of

the original manuscript.



ix-xi     Contents



1-8       Introduction

"Satus est initius maderi quam fini"

(It is better to doctor at the beginning than at the end.) Erasmus



"He will manage the cure best who has foreseen what is to happen from

the present state of matters."  Hippocrates



In an era which abounds in the mass

of medical texts and literature that

is characteristic of ours, I have been asked what the indications for

another volume on medical diagnosis might be (and particularly so in

view of its basic "organic" orientation).  Accordingly, I am taking the

author's prerogative in this introduction to set forth those

considerations which not only prompted me to attempt such a treatise,

but which also served as guides in choosing and assembling its present

content and form.



This book will pesent the system of a practising internist that has

served him well as a valuable and practical Ariadne's guiding thread

through the diagnostic labyrinth of obscure illness.  It is not set

forth as a "primer" in diagnostics, even though the author has made

every effort to make the text as readable as possible.  Rather, its

orientation is on an advanced postgraduate level for clinicians whose

experience and skepticism will critically dictate to them its place in

the analysis of difficult case material.

Conversely, for one who is not

thoroughly grounded in the disciplines of everyday diagnostics, it is

cautioned that there are many potential pitfalls

in this type of medical reading.



I am keenly and humbly cognizant of the many omissions and commissions

the very nature of this book necessitates.

A similar feeling relates to

the limitations of knowledge which arise when a single physician

attempts such a comprehensive volume in this age of multiple

authorships.  In the final analysis, the present effort stemmed largely

from an admonition similar to that expressed

by Hobbes of the importance

"for any man that aspires to true knowlege

to examine the definitions of

former authorities; and either to correct them

when they are negligently

set down, or make them for himself."



In the course of the practice of medicine, every physician and

consultant encounters problem patients who, after careful history and

examination, appear to be suffering from persistent symptoms of both a

general nature and from those referable to several specific systems of

the body.  The routine laboratory and x-ray

diagnostic procedures may be

either "negative," "borderline," or "inconclusive."  He is then faced

with the problem of: (1) biding his time, hoping that subsequent events

in the clinical course may clarify the nature of the patient's

condition; (2) diagnosings the symptom complex as psychosomatic, if

significant elements of anxiety or depression are present; or (3)

intensively pursuing further diagnostic approaches in the hope that a

specific treatment or prognosis may be more readily ascertained.

It has repeatedly impressed the author that

these difficult diagnostic problems

are definitely on the increase in this transitional age of medicine,

characterized as it is by both the

continuing effective control of acute

illness and the undeniable emphasis upon disease affecting the middle

and older age groups.



...our ever improving ability to maintain patients with many chronic

disorders in states of relative good health not only introduces the

factor of the known degenerative or malignant complications

characteristic of these disorders-- as is so well exemplified in the

instances of diabetes mellitus and pernicious anemia-- but also, the

masking effect of a second and unrelated disease once the "tag" of the

initial condition is applied...



...It is apparent that both study and experience are prerequisites for

the complete disclosure of clinical details, and especially the

employment of this form of analysis, since lacking knowledge of any

given disease, one would obviously not know how to seek out its

manifestations...



One must naturally be aware of the following shortcomings in the

approach to diagnostics used here.

The wizened and humble diagnostician

appreciates more than do most others Oscar Wilde's quip to the effect

that "experience is the name everyone gives to his mistakes."



First, as a result of his reading and training, particularly at

clinicopathologic conferences, the physician tends to attribute all the

patient's symptoms to one disease entity.  By following this pedagogic

rule too closely in practice, he may readily overlook other concomitant

and treatable organic or emotional afflictions.



Secondly, the temptation might occur to "fit the patient to the

disease."  This is an unfortunate situation if in either the "riding of

a hobby" or the "grasping at straws," one overlooks the more common and

probable conditions, and subjects his patients

to undue expense, anxiety and potential physical danger (as with

excessive diagnostic radiation or

from anaphylactoid reactions to test substances)...



Thirdly, these can be no short cuts to accurate diagnosis without the

collection and careful, systematic and logical analysis

of as many facts as can be obtained concerning a given case,

depending on both circumstances and the urgency of the problem.

It is apparent that those

clinicians who enjoy the respect of their colleagues as astute

diagnosticians usually achieve this status primarily as a result of the

time and interest they give their patients.  This does not doubt the

propriety for the clinician of experience to occasionally trust and

respect his intuitive "hunch" about the nature and management of an

obscure illness.  In fact, such perception is often necessary,

so that a seriously ill patient will not suffer further from

over-rationalized diagnosis or treatment...



Bearing all these considerations in mind, one stands to gain much from

this type of orientation and aid in diagnostics.  Most significant of

all is the possible opportunity afforded of being able to offer the

patient with an obscure symptom complex a specific therapy-- if not a

cure-- when others have not been able to do so because of an incorrect

diagnosis.  The continual improvement

of one's diagnostic skills derived

from "pearls" relating to history taking and physical diagnosis, along

with the capacity of being able to extract the greatest help from the

least amount of laboratory work, is inherent in this attitude.

Finally, as he reads the literature with greater

interest and keenness in an active attempt to add constantly to this

foundation, one succeeds in evolving a truly personal and integrated

approach to the diagnostics of medicine.



...I am in general accord with Hutchison's "Dont's for Diagnosticians,"

the first two of which read, "Don't be too clever" and "Don't diagnose

rarities."...



11-559     Part I: Groupings of related diseases frequently producing

puzzling illness  [17 groupings]



after 514, An atlas of systemic dermadromes

            [64 pages of graphic photos, color and black & white]



560-663    References for Part I  [104 pages]



667-913    Part II. A classification and analysis of useful

            diagnostic procedures [Introduction and 16 Sections]



831-850    References for Part II  [20 pages]



851-874    Index of signs, symptoms, and laboratory manifestations



875-913    General index  [39 pages]



[I have selected items that show the immense scope of this highly

successful work, and the capacity of mind, memory, originality, will,

and ethical depth of the author.  If aspartame toxicity is indeed a

real illness, then Roberts would seem to be fatefully well equipped to

see in his own practice the complex patterns of its signs and signals.



Apparently Roberts and the Palm Beach Institute for Medical Research,

Inc. are one and the same.  Perhaps, decades ago, he envisioned an

expanding organization.  However, I don't recall any collaborators in

his books and research reports.

For whatever reasons, and probably very good ones, he is a lone ranger.]

***********************************************************************



Rich Murray, MA    Room For All    rmforall@...

1943 Otowi Road, Santa Fe  NM  87505 USA   505-986-9103



http://groups.yahoo.com/group/aspartameNM/message/871

aspartame toxicity brief review: Murray 11.5.2 rmforall



http://groups.yahoo.com/group/aspartameNM/messages

for 882 posts in a public searchable archive



http://groups.yahoo.com/group/aspartameNM/message/862    long review



http://groups.yahoo.com/group/aspartameNM/message/860

RTM: FDA: objections to neotame approval 8.3.2 rmforall  38 pages



http://groups.yahoo.com/group/aspartameNM/message/868

Murray: submit complaints and papers to FDA Docket 02P-0317

by Jan 12  2003: Recall Aspartame as a Neurotoxic Drug 9.20.2 rmforall



http://www.dorway.com/tldaddic.html  5-page review

Roberts HJ Aspartame (NutraSweet) addiction.

Townsend Letter  2000 Jan;  HJRobertsMD@...

http://www.sunsentpress.com/    sunsentpress@...

Sunshine Sentinel Press  P.O.Box 17799  West Palm Beach, FL 33416

800-814-9800 561-588-7628 561-547-8008 fax



http://groups.yahoo.com/group/aspartameNM/message/669

1038-page medical text   "Aspartame Disease: An Ignored Epidemic"

published May 30  2001    $ 85.00 postpaid    data from 1200 cases

available at  http://www.amazon.com

over 600 references from standard medical research

http://www.aspartameispoison.com/contents.html    34 chapters



Roberts, Hyman J., 1924- ,

Useful insights for diagnosis, treatment and public heath: an updated

anthology of original research, 2002, 798 pages,

Palm Beach Institute for Medical Research, Inc.

P.O. Box 17799,  West Palm Beach, FL 33416

fax 561-547-8008   dr.roberts@...

aspartame disease pages 627-685, 778-780 .



http://groups.yahoo.com/group/aspartameNM/message/790

RTM: Moseley:

review Roberts "Aspartame Disease: An Ignored Epidemic" 2.7.2  rmforall

***********************************************************************



http://groups.yahoo.com/group/aspartameNM/message/859

RTM: Roberts: the life work of a brilliant clinician:

aspartame toxicity 8.2.2 rmforall



July 5 2001 I turned 59 July 3, and got a wonderful, long-anticipated

gift from H.J. Roberts, MD, FACP, FCCP.:

"Aspartame Disease: An Ignored Epidemic". I will be studying this

very helpful comprehensive review carefully, and composing summary

posts on almost all of the 34 chapters, to explore this immense

tapestry of data, observations, conclusions, and questions, making it

easier for potential readers to decide whether to pay the price,

$ 85.00 postpaid. The size of a Santa Fe phone book, the 1038

pages are 8.5X11, and appear to be composed in HTML. I will

quote various passages, and give comments. Roberts' style is

throughout lucid, dignified, high-minded, plain-spoken, direct,

calm, succinct, and often shows a dry wit.



p 7 ADDITIONAL COMMENTS:

Several added points deserve clarification for critical readers.

ITEM 1: I wrote this book myself. (The term "authentic" comes from

a Greek word meaning "one who does things with his own hands.")

There were no collaborators, "ghost writers," or editors.



p 8 Corporate Neutrality:

I take pride in my corporate neutrality. No grants or salary were

received for this effort, which originated in clinical practice.



p 27 EVOLVING DOUBTS: "GOING PUBLIC'

Like most physicians, the author had no reason to doubt the

scientific basis for its safety when aspartame was approved by

the FDA [in July, 1981]. My attitude changed, however, after

repeatedly encountering serious reactions in my patients

(Section 2) that seemed justifiably linked to use of such

products.



These doubts increased after learning by mid-1986 that over

10,000 consumers had sent complaints to the FDA, the

Centers for Disease Control (CDC), the manufacturer,

interested investigators, and consumer organizations.



p 28 More On the Author's Background:

The reader is entitled to specifics about the author's interest and

credentials.

At the time my observations on aspartame disease first evolved,

I was a primary-care internist, medical consultant, and

director of a corporate-neutral medical research organization.

Patients with a broad spectrum of diagnostic and therapeutic

difficulties were seen, generally after having consulted with a

number of physicians and clinics. The unique role stemmed from

having authored many scientific articles and books. The first,

"Difficult Diagnosis: A Guide to the Interpretation of Obscure

Illness (W.B. Saunders Company, 1958), has been used by

more than 60,000 physicians in the United States.



In the mid-1980s, I became aware of subtle changes and

challenges pertaining to both the diagnosis and management

of patients whose difficulties later could be related directly

to the use of aspartame products.



A 16-year-old girl (Case III-2) had recurrent seizures that

baffled several neurologists. Her convulsions stopped after

avoiding aspartame products. An attack was then reproduced

within three hours following rechallenge with one small serving

of an aspartame pudding."



[This paragraph epitomizes the 1200 case reports that are the

foundation of this text.]



These insights led to routinely inquiring of "problem patients"

about aspartame consumption. Their prompt improvement

following abstinence indicated an evolving public health

problem... at least within the context of my practice.

Numerous persons having "mysterious ailments" came to

realize that they were afflicted with aspartame disease when

striking improvement occurred after stopping such products.

Virtually every day became a learning experience as I

delved into the numerous facets of aspartame disease.



[This indicates that a single doctor who inquires about

aspartame use by all his own clients is likely to find many

cases a week of aspartame disease, and this in turn is

evidence for a huge degree of prevalence. Skeptical

professionals have an opportunity to confirm or refute

this in their own clinical practice. I will gladly post any

observations, and critical reviews, pro or con, sent to me,

on http://groups.yahoo.com/group/aspartameNM/messages ]



p 31 On July 30, 1986, I presented my data on 100

aspartame reactors at a press conference in West Palm Beach...

I delivered my first scientific report on 360 aspartame reactors

to the Section on Medicine of the Southern Medical Association

on November 10, 1986. The first article on 496 aspartame

reactors appeared in the January 1987 edition of "On Call",

official publication of the Palm Beach County Medical Society.



The flood of calls and letters from grateful aspartame "victims" and

their families dispelled my earlier misgivings about "going

public." A husband wrote, "Without someone publishing this

information that was so helpful to me, my wife could have died

from illness due to this cause."



p 6 I have engaged in independent patient-based clinical research

involving various realms for more than four decades. They

include pesticides (notably pentachlorophenol), products

contaminated with toxic metals, arbitrary severe caloric

restriction, megadoses of vitamin E, antistatic clothes softeners,

fluoridation of water, and even vasectomy. I repeatedly

stressed two pertinent issues. First, a long time may be

required to identify the hazards of new products and

medical interventions, particularly drugs and industial chemicals.

Second, it may take even longer for these risks to be

acknowledged by physicians and public health officials.

***********************************************************************