Charlotte's Digest: A Book Review on "Strong Medicine"

“We humans have always been and always will be interested in two vital things: food and reproduction. In this country food and reproduction seem to be quite similar in two respects – the quantity is too high and the quality too low.” –Dr Blake Donaldson from Strong Medicine, 1962, p201

Last year, I was privileged to attend the PaleoFX conference here in Austin. I had never heard Dr. Michael Eades speak before, who is a well-known medical doctor and author of Protein Power, so my husband and I went to one of his lectures. In his talk, he mentioned a book titled Strong Medicine by Blake F. Donaldson. He identified it as a very influential book in his life. I was intrigued and of course, added it to my Amazon cart. Now I know why Dr Eades recommended it.

Strong Medicine was published in 1962 at the latter end of the author’s life. He wrote of how interns would encourage him to write down his experiences, realizing that:

“When opportunities have been great in medicine some sort of accounting of stewardship is in order. It isn’t right to have so much of what you think you have learned die with you (p10).”

I agree, which I why I feel compelled to draw attention to his work.

Dr. Donaldson was a medical doctor in New York in the early 1900s. His calling was to find a solution to obesity, which he felt was the underlying cause of cardiovascular disease. He accomplished this through a controversial dietary intervention of a half a pound of fatty meat per meal with a half a cup of black coffee, only drinking water between meals, and a 30-minute walk upon waking.

Intriguing, yes?

Well, I think so because I happen to love eating fatty meat, and a good cup of coffee isn’t far behind. I cannot tell you how much I enjoyed reading his clinical adventures with this diet. He started out using the diet for obesity, but then shortly thereafter, others found him: cases of allergies, osteoarthritis, gall bladder disease, and my personal favorite, a desperate mother whose son had severe eczema. He was about to refer her to a “specialist” when she said something to the effect of, “I’ve already been to see everyone else in town. I want to work with you.” And yes, he gave it a try, which proved to be successful.

Wouldn’t it be revolutionary to our medical system if research actually started with clinical experience versus what is happening now where biased research ends up dictating the clinical practice?

Dr. Donaldson admits that he is not a writer (and that is obvious), but it doesn't matter. His observations are clear, astute, and very useful. Once you get past his racial slurs and misogynistic comments, which are both simply signs of times past, this book is filled with pearls of wisdom. In fact, his honesty and frankness are extremely entertaining. There was plenty of nights reading when my husband would ask me: what are you giggling about? Well, I think you will see. At any rate, here are more than a few of the pearls of wisdom that stand out to me from this book:

#1 “I had learned that many of the troubles in life can be walked off (p24).”

Being a doctor in wartime shaped Dr. Donaldson’s view. At one point he had to manage traumatized soldiers. Most of them fully recovered with a walking routine. Since summers in Texas are HOT, I was inspired to take on Dr. Donaldson’s recommended morning walk. Not only is it good for our marriage and our son, our sleep quality has noticeably improved. We are both going to sleep easier and waking up earlier, fully rested and more alert than we had been historically. After just a few days, I found myself looking forward to our walk when I was getting ready for bed. Be honest with yourself: do you go to bed looking forward to tomorrow morning? I do and here’s what I had highlighted in the book and forgotten about:

“There is nothing that is much good for sleeplessness but a thirty-minute walk before breakfast. Usually you’ll find that after you have done that morning walk five times, you will sleep deeply on the fifth night (p123).”

It is a simple intervention, but definitely not easy. It requires self-discipline.

There is more. He also relates the positive effects of a morning walk on the person with allergic physiology:

“Of all the things you are told to do the management of allergy, this thirty-minute walk is the most important (p150).

Well, I also happen to have a history and current tendency toward allergies, and as I reflect on the past months of taking this early morning walk, I have to say that I am feeling really well. Less sneezing fits, less intermittent achiness and fatigue that can accompany my allergies, and definitely a happier, more content woman, wife, mother, and daughter. All from a 30-minute morning walk!? I dunno. Maybe.

#2 “Bread isn’t the staff of life in these times. Rather it is the staff of death” (p123).

I do not feel the need to elaborate on this point. It says it all.

On second thought, I do have one comment to make. The quality of our entire food supply has declined dramatically since Dr. Donaldson was in medical practice, but particularly when it comes to bread. The gluten content has increased making wheat even harder to digest. Genetic modification of grains is common practice now. If this doesn't concern you, it should: genetically modified foods destroy our environment, food supply, and health. Last but not least, the presence of chemicals like glyphosate, which is an herbicide thought to play a role in Autism and non-celiac gluten sensitivity (NCGS), dramatically increase the toxicity of most flours. So my question is: what would Dr. Donaldson say now about bread? Is there another way to refer to bread that is more dramatic than “the staff of death?” My guess is that he would have found a way.

#3 “Much of the concern shown over nutrition has been with vitamin deficiency. In this country the real deficiency state is not due to lack of vitamins but to a lack of amino acids. We must get enough of these essential amino acids to keep our body cells in a state of good repair….From what I have observed, a half pound of meat per meal is the minimum quantity needed to maintain the work of repair of body cells." (p35).

Another dramatic statement, but what if, it’s true? I know in my clinical work, I rarely see people consuming adequate protein. Sometimes my only recommendation to a client is to add a serving of animal protein at each meal. They report back to me that they feel better and have more energy. In my own personal experience I certainly feel increased vitality eating a large portion of meat three times per day and a predictable decline in my well being when I do not abide by this. I am sure many of you are thinking that his assertions are absurd. Just remember that he is not dealing with healthy patients, right? In their states of obesity and chronic inflammation, their metabolism is deranged and requires a drastic intervention, hence the title of the book Strong Medicine. Here is what he says about the 25% of patients who fail his program:

“They give up because the prescription of simple living is medicine too strong for them to take. What they really want is to buy some miracle drug that will enable them to live in carefree fashion. But nature does not stoop to miracles.”

For many people, it is good to remember that abstinence is best, in terms of diet and beyond. Abstinence is the only effective path of many alcoholics and drug addicts. Did you know that your brain gets more of a dopamine hit from sugar than cocaine? I can see how Dr Donaldson’s approach would be extraordinary for those struggling with carbohydrate dependency and food allergies, which both contribute to binging and weight gain.

#4 My personal favorite:

“If [my dietary] theory is sound, the emphasis in medical teaching should be changed, along with the eating and shopping habits of the nation. Any book that is written about the simple aspects of medicine should concern itself with the mental processes of the little woman pushing a cart through the country’s shopping centers. What she buys, or doesn’t buy, can make manufacturers tremble and governments totter. In her hands lies the health of the nation. When she uses bad judgment in the kitchen the results are manifest in the office (p6).”

I could certainly criticize his delivery, but come on, admit it…he’s RIGHT! We vote with our dollars every day. When you buy any food, you are saying that it is ok. Fast food and sodas, for example, exist because we want them to! We would have a completely different food supply if consumers were educated and took Dr. Donaldson’s words seriously. As a mother who controls the food in our household, I walk the aisles of grocery stores and farmer’s market with my head high. I know my power as a purchaser.

Again, he states: “I just want to emphasize that the housewife, with her power of the purse and her way of preparing her purchases, controls our destiny” (p235).

#5 “Lettuce is one of the hardest foods to digest that is known” (p231).

When I ask many of my clients what a healthy meal looks like, they will often say, “You know, salad with some veggies and maybe some chicken or fish with a light dressing.” I feel a combination of excitement and dismay when I hear this. Excitement because this person’s world of food is going to open up in a magical way and dismay because people still believe this.

Lettuce is a very cold food, which for some people may not be a desirable meal. Traditional Chinese Medicine and Ayurvedic Medicine both speak to the fact that a healthy digestive tract is hot. We want to stoke our digestive fire, not put it out with ice water and cold foods. Some people may thrive on salads, but for those of us who do not, feel the freedom of listening to your body – what may be good for one person, may not be good for another. Salads included.

Many people see lettuce leaves in their stool and it’s not just about inadequately chewing; it is difficult for the body to digest! I am thrilled that Dr Donaldson acknowledges the shadow side of salad in his work. It has not gotten enough attention in the field of nutrition. Stewed leafy greens, like collard greens, kale, and dandelion leaves with bacon and chicken broth, are much more nutritious and easier to digest than a salad.

These are just a few of the valuable insights that I gained from reading this book. I do hope they are somehow useful to you.

And for your amusement:

I failed to mention that he calls his secretary in his office to write a letter of instruction to his patients. He freely shares those letters in his book – talk about a straight shooter! The wisdom and humor in these letters are nothing short of splendid. I cannot help but share one portion of a conversation he was having with a difficult patient. Her husband was sick, and she was resistant to change:

“There is an old military axiom that when you are in trouble it is better to attack. So I fired both barrels… ‘Irritating ‘new’ food and drink [defined as anything that has come up in the past eight thousand years (p175)] are cramping the blood vessels in your husband’s brain. Some American men are being slowly slaughtered by lazy and ignorant housewives…In the first place keep this in mind. If your husband has more than one inch of loose fat on his lower abdomen, measured between fingers, expect him to die fifteen years before his appointed time. You won’t enjoy life as a widow. For that reason I want you to keep flour off the table” (p190-1).

Who needs to be tactful when you are a beacon of truth and light?

I feel the need to clarify two additional pieces:

First, I do think that a HUGE part of the success of Dr Donaldson’s dietary intervention has to do with what his patients did NOT eat on this diet. Food allergies, the most common being dairy, wheat, corn and soy, play a significant role in chronic inflammatory diseases. However you go about avoiding these foods will likely increase your vitality in an amazing way. For example, the other day I was talking to my friend who just happened to have recently adopted a vegan-ketogenic diet. She is feeling great and so is her boyfriend. I am happy for her, but I do not think the diet is the cause of her well-being. It is what she is not eating that is having a positive impact. I do believe that a diet based on animal proteins, along with organs and glands, vegetables, berries, nuts, seeds, and good quality fats is a sustainable way to eat that promotes vitality long term.

Second, there is some concern over how this approach would affect our microbiota. Microbiota is the latest technical word to describe the bacteria living in our gut. With the removal of plant foods from the diet, the bacteria no longer have fiber to eat (often called prebiotics in the supplement industry), and there is a noted decline in diversity, which has been shown to be a very important factor in the health of our microbiome (as a side note, antibiotics have played a more detrimental role here than any dietary intervention ever would). The microbiome is a VERY lively field of study right now. But when I stop and think about it, there were periods of time when our ancestors didn’t have any plant foods to consume. Dr. Weston A Price documents in his book Nutrition & Physical Degeneration that some Native Americans in Canada ate nothing but deer for six months out of the year, and they thrived on their traditional diet. As is usually the case with diet, it is complex, and there is a lot we don’t know.

Dr. Donaldson also addresses the dangers vaccinations and lowering cholesterol, which apparently were also a concern fifty-three years ago. Fancy that, Dr. Donaldson was ahead of his time. He faced opposition in his field, stuck to his guns, and wrote about his life’s work in this book. He is indeed one of my nutritional heroes, and I am grateful his book crossed my Eating in Peace path.

Thanks for coming along this book review journey with me.

Eat in Peace!

Love,

Charlotte