Candida and The Human Microbiome 251Historical background
Truss was in fact far from being the first investigator in this field.
My late British colleague Dr. Keith Eaton researched this topic extensively
and found Truss’s ideas were anticipated almost seventy years earlier by
a physician called Turner, who presented a paper on what he termed
‘intestinal germ carbohydrate fermentation’ [Proceedings of the Royal
Society of Medicine Symposium of Intestinal Toxaemia, 1911] [Eaton KK,
Gut fermentation: a reappraisal of an old clinical condition with diagnostic
tests and management: discussion paper, J Roy Soc Med 1991; 84: 669-71].
In 1931 Arthur F. Hurst was in his footsteps, writing about
‘intestinal carbohydrate dyspepsia’ [Hurst AF, Knott FA, Intestinal
carbohydrate dyspepsia, Quart J Med 1930-31; 24: 171-80]. In the 1930s
and 1940s this dyspepsia was being treated with Lactobacillus acidophilus, B
vitamin supplements and a low-starch diet (remarkably like modern anti-
candida treatment except that legumes are no longer banned, as they were
at that time).
Medical literature has tried to define the patient-type who suffers
with this syndrome. A major text on gastroenterology in 1976 described
victims as “Essentially unhappy people... any suggested panacea or therapeutic straw
is grasped... no regime is too severe and no programme [sic] too difficult... with the
tenacity of the faithful, they grope their way from one practitioner to the next in the
search for a permanently successful remedy.” This disparaging description shows
a lamentable weakness on the part of doctors for blaming any patient they
cannot help.
The ‘problem patient’ attitude was probably what sank the condition
in the 1950s. At that time, the psychosomatic theory of disease was enjoying
a great revival. The tendency was to dismiss all patients with vague, ill-
defined symptoms as psychiatric cases. Unlike today, there were no physical
findings to disprove the psychiatric label and so it stuck. It’s still with us, to
a large degree.
Intestinal fermentation
So the idea of a yeast-like gut pathogen that lives on starches and
sugars and causes bowel disturbance is far from new. It seems to enjoy a
vogue in medical circles every few decades and then lapses out of sight once
again. The reason is probably that, as in the 1980s, some doctors become
convinced they know what causes the syndrome, but then can’t seem to find